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Barbieri F, Hall IF, Elia L, Civilini E. Vascular malformation rupture in a patient affected by Costello syndrome. BMJ Case Rep 2022; 15:e250948. [PMID: 36526283 PMCID: PMC9764614 DOI: 10.1136/bcr-2022-250948] [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] [Indexed: 12/23/2022] Open
Abstract
Costello syndrome (CS) is a rare genetic syndrome affecting multiple organs, generally caused by mutations of the HRAS gene, belonging to the RAS/MAPK genes family.A male patient with CS developed a painful pulsatile mass on the lateral side of the wrist. An initial ultrasonographic investigation confirmed the presence of a radial artery lesion, possibly an arterial aneurysm. On surgical resection, histological evaluation showed a tangle of vascular structures with variable calibre and abnormal wall histology. Immunohistochemical stainings revealed a very poor endothelial contribution to the central vascular wall structure. These histological observations led us to conclude we had managed an acute vascular malformation (VM) rupture, rather than a common arterial aneurysmal condition. Considering the molecular mechanisms regulated by RAS/MAPK genes, CS patients might have a higher risk of developing VMs and, in the presence of a pulsatile mass with acute onset, VM rupture should be considered.
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Affiliation(s)
| | | | - Leonardo Elia
- Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
- DMMT, Università degli Studi di Brescia, Brescia, Italy
| | - Efrem Civilini
- Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
- Humanitas University, Rozzano, Milan, Italy
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Pablo-Moreno JAD, Serrano LJ, Revuelta L, Sánchez MJ, Liras A. The Vascular Endothelium and Coagulation: Homeostasis, Disease, and Treatment, with a Focus on the Von Willebrand Factor and Factors VIII and V. Int J Mol Sci 2022; 23:ijms23158283. [PMID: 35955419 PMCID: PMC9425441 DOI: 10.3390/ijms23158283] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/22/2022] [Accepted: 07/23/2022] [Indexed: 11/27/2022] Open
Abstract
The vascular endothelium has several important functions, including hemostasis. The homeostasis of hemostasis is based on a fine balance between procoagulant and anticoagulant proteins and between fibrinolytic and antifibrinolytic ones. Coagulopathies are characterized by a mutation-induced alteration of the function of certain coagulation factors or by a disturbed balance between the mechanisms responsible for regulating coagulation. Homeostatic therapies consist in replacement and nonreplacement treatments or in the administration of antifibrinolytic agents. Rebalancing products reestablish hemostasis by inhibiting natural anticoagulant pathways. These agents include monoclonal antibodies, such as concizumab and marstacimab, which target the tissue factor pathway inhibitor; interfering RNA therapies, such as fitusiran, which targets antithrombin III; and protease inhibitors, such as serpinPC, which targets active protein C. In cases of thrombophilia (deficiency of protein C, protein S, or factor V Leiden), treatment may consist in direct oral anticoagulants, replacement therapy (plasma or recombinant ADAMTS13) in cases of a congenital deficiency of ADAMTS13, or immunomodulators (prednisone) if the thrombophilia is autoimmune. Monoclonal-antibody-based anti-vWF immunotherapy (caplacizumab) is used in the context of severe thrombophilia, regardless of the cause of the disorder. In cases of disseminated intravascular coagulation, the treatment of choice consists in administration of antifibrinolytics, all-trans-retinoic acid, and recombinant soluble human thrombomodulin.
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Affiliation(s)
- Juan A. De Pablo-Moreno
- Department of Genetics, Physiology and Microbiology, School of Biology, Complutense University, 28040 Madrid, Spain; (J.A.D.P.-M.); (L.J.S.)
| | - Luis Javier Serrano
- Department of Genetics, Physiology and Microbiology, School of Biology, Complutense University, 28040 Madrid, Spain; (J.A.D.P.-M.); (L.J.S.)
| | - Luis Revuelta
- Department of Physiology, School of Veterinary Medicine, Complutense University of Madrid, 28040 Madrid, Spain;
| | - María José Sánchez
- Centro Andaluz de Biología del Desarrollo (CABD), Consejo Superior de Investigaciones Científicas (CSIC), Junta de Andalucía, Pablo de Olavide University, 41013 Sevilla, Spain;
| | - Antonio Liras
- Department of Genetics, Physiology and Microbiology, School of Biology, Complutense University, 28040 Madrid, Spain; (J.A.D.P.-M.); (L.J.S.)
- Correspondence:
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Gossart A, Letourneur D, Gand A, Regnault V, Ben Mlouka MA, Cosette P, Pauthe E, Ollivier V, Santerre JP. Mitigation of monocyte driven thrombosis on cobalt chrome surfaces in contact with whole blood by thin film polar/hydrophobic/ionic polyurethane coatings. Biomaterials 2019; 217:119306. [PMID: 31271854 DOI: 10.1016/j.biomaterials.2019.119306] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/21/2019] [Accepted: 06/24/2019] [Indexed: 12/20/2022]
Abstract
Monocytes are active at the crossroads between inflammation and coagulation processes since they can secrete pro-inflammatory cytokines and express tissue factor (TF), a major initiator of coagulation. Cobalt-chrome (CoCr), a metal alloy, used as a biomaterial for vascular stents, has been shown to be potentially pro-thrombotic and pro-inflammatory. Research work with a polymer from a family of degradable-polar hydrophobic ionic polyurethanes (D-PHI), called HHHI, has been shown to exhibit anti-inflammatory responses from human monocytes. We have generated multifunctional polyurethane thin films (MPTF) based on the HHHI chemistry, as a thin coating for CoCr and have evaluated the reactivity of blood with MPTF-coated CoCr. The results showed that the coating of CoCr with MPTF derived from HHHI prevents thrombin generation, reduces coagulation activation, and suppresses fibrin formation in whole blood. Activation of monocytes was also suppressed at the surface of MPTF-coated CoCr and specifically the decrease in thrombin generation was accompanied by a significant decrease in TF and pro-inflammatory cytokine levels. Mass spectroscopy of the adsorbed proteins showed lower levels of fibrinogen, fibronectin and complement C3, C4, and C8 when compared to CoCr. We can conclude that MPTFs reduce the pro-thrombotic and pro-inflammatory phenotype of monocytes and macrophages on CoCr, and prevent clotting in whole blood.
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Affiliation(s)
- Audrey Gossart
- Laboratory for Vascular Translational Science (LVTS), Inserm U1148, Université Paris Diderot, Université Paris 13, Hôpital Bichat, Paris, France; Equipe de Recherche sur les Relations Matrice Extracellulaire-Cellules (ERRMECe), Biomaterial for Health Research Group, Institut des Matériaux, Maison International de la Recherche, Université de Cergy-Pontoise, 95000 Neuville sur Oise, France; Translational Biology and Engineering Program, Ted Rodgers Centre for Heart Research, Institute of Biomaterials and Biomedical Engineering (IBBME) and the Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Didier Letourneur
- Laboratory for Vascular Translational Science (LVTS), Inserm U1148, Université Paris Diderot, Université Paris 13, Hôpital Bichat, Paris, France
| | - Adeline Gand
- Equipe de Recherche sur les Relations Matrice Extracellulaire-Cellules (ERRMECe), Biomaterial for Health Research Group, Institut des Matériaux, Maison International de la Recherche, Université de Cergy-Pontoise, 95000 Neuville sur Oise, France
| | | | - Mohamed Amine Ben Mlouka
- Polymers, Biopolymers, Surface Laboratory, UMR 6270 CNRS, PISSARO Proteomic Facility, IRIB, 76821 Mont-Saint-Aignan, France
| | - Pascal Cosette
- Polymers, Biopolymers, Surface Laboratory, UMR 6270 CNRS, PISSARO Proteomic Facility, IRIB, 76821 Mont-Saint-Aignan, France
| | - Emmanuel Pauthe
- Equipe de Recherche sur les Relations Matrice Extracellulaire-Cellules (ERRMECe), Biomaterial for Health Research Group, Institut des Matériaux, Maison International de la Recherche, Université de Cergy-Pontoise, 95000 Neuville sur Oise, France
| | - Véronique Ollivier
- Laboratory for Vascular Translational Science (LVTS), Inserm U1148, Université Paris Diderot, Université Paris 13, Hôpital Bichat, Paris, France.
| | - J Paul Santerre
- Translational Biology and Engineering Program, Ted Rodgers Centre for Heart Research, Institute of Biomaterials and Biomedical Engineering (IBBME) and the Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
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Cornelissen A, Vogt FJ. The effects of stenting on coronary endothelium from a molecular biological view: Time for improvement? J Cell Mol Med 2018; 23:39-46. [PMID: 30353645 PMCID: PMC6307786 DOI: 10.1111/jcmm.13936] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 08/27/2018] [Indexed: 12/13/2022] Open
Abstract
Coronary artery stenting following balloon angioplasty represents the gold standard in revascularization of coronary artery stenoses. However, stent deployment as well as percutaneous transluminal coronary angioplasty (PTCA) alone causes severe injury of vascular endothelium. The damaged endothelium is intrinsically repaired by locally derived endothelial cells and by circulating endothelial progenitor cells from the blood, leading to re‐population of the denuded regions within several weeks to months. However, the process of re‐endothelialization is often incomplete or dysfunctional, promoting in‐stent thrombosis and restenosis. The molecular and biomechanical mechanisms that influence the process of re‐endothelialization in stented segments are incompletely understood. Once the endothelium is restored, endothelial function might still be impaired. Several strategies have been followed to improve endothelial function after coronary stenting. In this review, the effects of stenting on coronary endothelium are outlined and current and future strategies to improve endothelial function after stent deployment are discussed.
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Affiliation(s)
- Anne Cornelissen
- Department of Cardiology, Pneumology, Angiology, and Internal Intensive Medicine, University Hospital Aachen, Aachen, Germany
| | - Felix Jan Vogt
- Department of Cardiology, Pneumology, Angiology, and Internal Intensive Medicine, University Hospital Aachen, Aachen, Germany
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Kurane A, Vyavahare N. Endothelial cells seeded on elastin–heparin matrices express normal EC markers and resist detachment on exposure to shear stress: a histological study. J Histotechnol 2013. [DOI: 10.1179/014788811x12949268296004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Otsuka F, Finn AV, Yazdani SK, Nakano M, Kolodgie FD, Virmani R. The importance of the endothelium in atherothrombosis and coronary stenting. Nat Rev Cardiol 2012; 9:439-53. [PMID: 22614618 DOI: 10.1038/nrcardio.2012.64] [Citation(s) in RCA: 263] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Deployment of drug-eluting stents instead of bare-metal stents has dramatically reduced restenosis rates, but rates of very late stent thrombosis (>1 year postimplantation) have increased. Vascular endothelial cells normally provide an efficient barrier against thrombosis, lipid uptake, and inflammation. However, endothelium that has regenerated after percutaneous coronary intervention is incompetent in terms of its integrity and function, with poorly formed cell junctions, reduced expression of antithrombotic molecules, and decreased nitric oxide production. Delayed arterial healing, characterized by poor endothelialization, is the primary cause of late (1 month-1 year postimplantation) and very late stent thrombosis following implantation of drug-eluting stents. Impairment of vasorelaxation in nonstented proximal and distal segments of stented coronary arteries is more severe with drug-eluting stents than bare-metal stents, and stent-induced flow disturbances resulting in complex spatiotemporal shear stress can also contribute to increased thrombogenicity and inflammation. The incompetent endothelium leads to late stent thrombosis and the development of in-stent neoatherosclerosis. The process of neoatherosclerosis occurs more rapidly, and more frequently, following deployment of drug-eluting stents than bare-metal stents. Improved understanding of vascular biology is crucial for all cardiologists, and particularly interventional cardiologists, as maintenance of a competently functioning endothelium is critical for long-term vascular health.
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Affiliation(s)
- Fumiyuki Otsuka
- CVPath Institute Inc., 19 Firstfield Road, Gaithersburg, MD 20878, USA
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8
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Burk J, Burggraf D, Vosko M, Dichgans M, Hamann GF. Protection of cerebral microvasculature after moderate hypothermia following experimental focal cerebral ischemia in mice. Brain Res 2008; 1226:248-55. [PMID: 18586014 DOI: 10.1016/j.brainres.2008.06.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2008] [Revised: 06/08/2008] [Accepted: 06/10/2008] [Indexed: 11/29/2022]
Abstract
Clinical studies have shown that the treatment of ischemic stroke with hypothermia is promising. In this animal study, we investigated the fate of the microvasculature following focal cerebral ischemia in mice with and without hypothermia. Focal cerebral ischemia was induced by occlusion of the middle cerebral artery (MCAO) (3 h) with an intraluminal filament technique. Eight mice received normothermia (36.5 degrees C, NT) and eight received hypothermia (32-34 degrees C, HT) treatment during 24 h of reperfusion. Another six mice represented the sham group. Analysis of the hypothermic group in comparison to the normothermic group revealed a significantly reduced infarct volume (NT: 63.56+/-4.62 mm3 SEM, HT: 38.09+/-4.83 mm3 SEM; P<0.01) and showed considerably ameliorated neurological deficits (Garcia-score) after 24 h (P<0.01). In addition, the degradation of the microvascular basal lamina antigen collagen type IV after normothermia was strongly reduced (P<0.05) compared to sham. Hypothermia diminished this effect so that collagen type IV was not significantly reduced compared to sham. Moreover the hemoglobin extravasation was strongly reduced under hypothermic treatment compared to the normothermic group (P<0.01). In the hypothermia group the urokinase plasminogen-activator (uPA) activity (P=0.01) was significantly decreased compared to the normothermia group. Also MMP-9 was significantly reduced (P<0.05) during hypothermic treatment. In conclusion, for the first time we show in mice that hypothermia preserves the microvascular wall structures after ischemia. We have demonstrated that hypothermia protects the basal lamina, reduces the infarct volume and hemorrhage, and reduces proteolytic enzymes. These protective effects in an additional animal model of ischemia and reperfusion strongly recommend hypothermia as a potential beneficial treatment for stroke.
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Affiliation(s)
- Jan Burk
- Department of Neurology, Ludwig-Maximilians University, Klinikum Grosshadern, Marchioninistr. 15, 81377 Munich, Germany
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Kress JA, Seitz R, Dodt J, Etscheid M. Induction of intracellular signalling in human endothelial cells by the hyaluronan-binding protease involves two distinct pathways. Biol Chem 2006; 387:1275-83. [PMID: 16972797 DOI: 10.1515/bc.2006.158] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Recently a novel plasma serine protease with high affinity to hyaluronic acid and glycosaminoglycans, such as heparin and heparan sulfate, has been described and termed hyaluronan-binding protease (HABP). HABP cleaves kininogen in vitro, releasing the vasoactive peptide bradykinin, and activates plasminogen activators, suggesting a vascular cell-directed physiological function of this novel plasma protease. Here we show that HABP stimulates human umbilical vein endothelial cells (HUVECs) by activating two distinct cell-surface receptors. On the one hand, HABP releases bradykinin from cell surface-bound or soluble kininogen and triggers a bradykinin B2-receptor-dependent mobilisation of intracellular Ca2+. On the other hand, HABP activates the p44/42-dependent MAPK (ERK1/2) signalling cascade independent of the B2-receptor, but involving the fibroblast growth factor receptor-1 and basic fibroblast growth factor. This signalling pathway leads to phosphorylation of the kinases Raf, MEK1/2 and ERK1/2. The extracellular activity of HABP also affects the gene expression level through phosphorylation of two transcription factors, the cAMP-responsive element binding protein CREB and the proto-oncogene c-Myc. Our results indicate a proangiogenic potential of HABP, which, in combination with a profibrinolytic activity, directs the physiological function of this plasma protease to processes in which clot lysis, cell motility and neovascularisation are pivotal processes, e.g., in wound healing, tissue repair and tumour progression.
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Affiliation(s)
- Julia Anne Kress
- Department of Haematology and Transfusion Medicine, Paul-Ehrlich-Institute, Federal Agency for Sera and Vaccines, D-63225 Langen, Germany
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Segal MS, Bihorac A, Koç M. Circulating endothelial cells: tea leaves for renal disease. Am J Physiol Renal Physiol 2002; 283:F11-9. [PMID: 12060582 DOI: 10.1152/ajprenal.00008.2002] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Fully differentiated endothelial cells and their precursors circulate in the bloodstream. Since their initial description more than 30 years ago, circulating endothelial cells have been quantified in a number of different clinical conditions that affect the endothelium. Only recently, however, have investigators begun to examine the protein expression and functionality of these cells. Because a number of diseases prevalent in the field of nephrology affect endothelial cells, the study of circulating endothelial cells may allow the direct examination of the state of the endothelium in these conditions. This review will discuss the endothelium and renal disease, the methods to quantify these circulating endothelial cells, their origins, and their therapeutic potential.
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Affiliation(s)
- Mark S Segal
- Division of Nephrology, Hypertension, and Transplantation, Department of Medicine, University of Florida, Gainesville, Florida 32610, USA.
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11
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Jeschke MG, Hermanutz V, Wolf SE, Köveker GB. Polyurethane vascular prostheses decreases neointimal formation compared with expanded polytetrafluoroethylene. J Vasc Surg 1999; 29:168-76. [PMID: 9882801 DOI: 10.1016/s0741-5214(99)70358-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Synthetic grafts have been increasingly used for complex vascular reconstructions in patients with limited autologous vein availability. Materials currently in use induce increased stenosis and graft thrombosis compared with autologous vein, especially in smaller vessels. We examined whether grafts constructed of a porous biodegradation-resistant polycarbonate polyurethane (PU) exert better biocompatibility in terms of faster endothelialization and decreased chronic proliferation of intimal cells compared with expanded polytetrafluoroethylene (ePTFE). METHODS PU or ePTFE interposition grafts were implanted into the abdominal aortas of male Sprague-Dawley rats (PU, n = 37; ePTFE, n = 32). Grafts were removed at days 1, 7, 14, 28, and 56 and 6 months and were evaluated by immunohistochemical, electron microscopic, and morphometric techniques. Bromodeoxyuridine (BrdU) was injected at 1 and 24 hours before death to determine cellular proliferation. Endothelial cells and smooth muscle cells were identified with antibodies to von Willebrand factor and alpha-actin, respectively. RESULTS The luminal surface of PU grafts took 4 weeks to completely endothelialize, whereas ePTFE grafts took 24 weeks (P <.05). Neointimal cell proliferation was lower in PU grafts compared with ePTFE at 56 days (1.4 +/- 0.1 versus 8.6 +/- 1.5, P <.001) and at 6 months (0.15 +/- 0.002 versus 3.4 +/- 0.5, p <.001). Neointimal thickness at 6 months after implantation was 3.2 +/- 0.8 micrometer for PU compared with 10.3 +/- 3.1 micrometer for ePTFE (P <.05). CONCLUSION Polycarbonate polyurethane small vascular prostheses promoted faster luminal endothelialization, induced less chronic intimal proliferation, and produced a significantly thinner neointima than ePTFE grafts. These findings suggest that aliphatic-polycarbonate urethanes may offer advantages over standard materials such as ePTFE for vascular graft construction.
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Affiliation(s)
- M G Jeschke
- University of Texas Medical Branch, Department of Surgery, Shriners Hospital for Children, Galveston, Tex 77550, USA
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12
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Muldoon J, O'Riordan K, Rao S, Abecassis M. Ischemic colitis secondary to venous thrombosis. A rare presentation of cytomegalovirus vasculitis following renal transplantation. Transplantation 1996; 61:1651-3. [PMID: 8669113 DOI: 10.1097/00007890-199606150-00018] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Gastrointestinal complications occur after renal transplantation in up to 16% of patients. Cytomegalovirus (CMV) vasculitis can affect the gastrointestinal tract with significant manifestations, including colonic ulceration, bleeding, and perforation. We present a case of CMV vasculitis in a renal transplant patient that caused middle and left colic vein thrombosis and resultant ischemic colitis. There was no evidence of arterial involvement. To our knowledge, this is the first reported case of ischemic colitis secondary to large vein thrombosis associated with CMV infection.
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Affiliation(s)
- J Muldoon
- Department of Surgery, Northwestern University Medical School, Chicago, Illinois 60611, USA
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14
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Chang JC. Review: Postoperative thrombocytopenia: with etiologic, diagnostic, and therapeutic consideration. Am J Med Sci 1996; 311:96-105. [PMID: 8615383 DOI: 10.1097/00000441-199602000-00009] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- J C Chang
- Department of Medicine, Wright State University School of Medicine, Dayton, Ohio, USA
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15
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Hamann GF, Okada Y, Fitridge R, del Zoppo GJ. Microvascular basal lamina antigens disappear during cerebral ischemia and reperfusion. Stroke 1995; 26:2120-6. [PMID: 7482660 DOI: 10.1161/01.str.26.11.2120] [Citation(s) in RCA: 276] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND PURPOSE Changes in vascular permeability are well-known and important consequences of cerebral ischemia. The development of edema and of petechial hemorrhage is connected to altered vascular integrity. A major part in microvascular integrity is played by the basal lamina. METHODS The fates of the basal lamina components laminin, fibronectin, and type IV collagen during middle cerebral artery occlusion (2 hours, n = 3) and occlusion (3 hours) with reperfusion (1 hour, n = 3; 4 hours, n = 3; and 24 hours, n = 4) were evaluated in the nonhuman primate. Specific monoclonal antibodies against these components were used. The number and size distribution of the microvessels in each specimen were determined by video-imaging microscopy, and the relative fluorescence intensity of laminin was semiquantified by laser confocal microscopy. Basal lamina antigen presentations were compared by double-stain immunofluorescence histochemistry. RESULTS The number of microvascular structures defined by the presence of each basal lamina antigen decreased significantly up to 24 hours of reperfusion (P < .0001). The ratio of laminin-containing vessels between the ischemic and nonischemic territories decreased significantly from control (0.98 +/- 0.04) to 2 hours of ischemia (0.83 +/- 0.09) and 1 hour (0.79 +/- 0.08), 4 hours (0.77 +/- 0.06), and 24 hours of reperfusion (0.55 +/- 0.07). The ratio of fibronectin (cellular) and of collagen (IV)-containing vessels decreased from 0.98 +/- 0.04 to 0.75 +/- 0.1 and from 1.02 +/- 0.03 to 0.57 +/- 0.1, respectively. Mean laminin fluorescence intensity decreased from 76.1 +/- 6.0 U (controls) to 52.0 +/- 14.6 U (24 hours of reperfusion; P < .001). CONCLUSIONS The significant parallel losses of three basal lamina components, both in number and intensity, contribute to loss of microvascular integrity. These phenomena may be important for understanding cell extravasation and the hemorrhagic consequences of acute stroke.
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Affiliation(s)
- G F Hamann
- Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, Calif 92037, USA
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Haraldsen G, Rugtveit J, Kvale D, Scholz T, Muller WA, Hovig T, Brandtzaeg P. Isolation and longterm culture of human intestinal microvascular endothelial cells. Gut 1995; 37:225-34. [PMID: 7557573 PMCID: PMC1382723 DOI: 10.1136/gut.37.2.225] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Microvascular endothelial cells play an important part in inflammation as well as in organ specific leucocyte traffic, and may be functionally different from large vessel endothelium in this respect. This study therefore established a method for isolation and longterm culture of human intestinal microvascular endothelial cells (HIMEC). After dissociation by collagenase/dispase/DNase of mucosal and submucosal tissue obtained from normal adult jejunum, cells were plated and cultured to subconfluence in endothelial serum free medium containing 2.5% fetal calf serum, hydrocortisone, and N6, O2-dibutyryladenosine cyclic monophosphate. Primary cultures were trypsinised and endothelial cells were isolated by paramagnetic beads armed with monoclonal antibody to CD31. Optimal growth conditions for HIMEC cultures were established, allowing up to nine passages (three months in vitro). The cells contained Weibel-Palade bodies, expressed von Willebrand factor, CD31, and VE-cadherin; and bound Ulex Europaeus lectin I. A method to establish longterm cell cultures of HIMEC will facilitate further investigation of the function of intestinal endothelial cells and their participation in physiological and pathological events in the gut.
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Affiliation(s)
- G Haraldsen
- Laboratory for Immunohistochemistry, University of Oslo, Rikshospitalet, Norway
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Thompson MM, Budd JS, Eady SL, Allen KE, James M, James RF, Bell PR. Effect of seeding time and density on endothelial cell attachment to damaged vascular surfaces. Br J Surg 1993; 80:359-62. [PMID: 8472152 DOI: 10.1002/bjs.1800800332] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
An in vitro model to facilitate the study of endothelial cell seeding of damaged vascular surfaces has been developed. This may have applications in the study of endothelial seeding of angioplasty and endarterectomy sites. Using this model, the optimum endothelial seeding time for attachment to damaged vascular surfaces should not exceed 30 min and, to achieve confluent cell attachment, a seeding density > 5 x 10(5) cells/cm2 should be used.
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Affiliation(s)
- M M Thompson
- Department of Surgery, University of Leicester, UK
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Thompson MM, Budd JS, Eady SL, Allen KE, James M, James RF, Bell PR. Endothelial cell seeding of damaged native vascular surfaces: prostacyclin production. EUROPEAN JOURNAL OF VASCULAR SURGERY 1992; 6:487-93. [PMID: 1397341 DOI: 10.1016/s0950-821x(05)80621-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Endothelial cell seeding has been successful in reducing the thrombogenicity of prosthetic vascular grafts in animal and clinical studies. The reduction in thrombogenicity may be attributed to the intrinsic properties of endothelial cells themselves, and their ability to produce anti-thrombogenic mediators such as prostacyclin, and endothelium-derived relaxing factor. Endothelial seeding of damaged vascular surfaces produced during percutaneous transluminal angioplasty and endarterectomy is an attractive possibility due to the excellent attachment characteristics of the sub-endothelial tissue exposed during these procedures. The ability of endothelial seeded damaged vascular surfaces to produce prostacyclin was measured in an in vitro model of vascular injury. Endothelial-seeded damaged surfaces produced significantly higher prostacyclin release than did vessels damaged by balloon dilatation (265.5 pg cm-2 min-1 and 87.5 pg cm-2 min-1 respectively). This study provides evidence that endothelial seeding of damaged native vascular surfaces is technically feasible and that seeding may reduce the thrombogenicity of vascular surfaces following balloon dilatation.
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Affiliation(s)
- M M Thompson
- Department of Surgery, University of Leicester, U.K
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Abstract
Pulmonary endothelial cells form a continuous monolayer on the luminal surface of the lung vasculature. Until the mid-1970s, the pulmonary endothelium was felt to provide little more than a passive surface for the exchange of gases, water, macromolecules, and some cell traffic. Recent evidence indicates that the pulmonary endothelium is a metabolically active surface, which provides a regulatory interface for the continual processing of blood-borne vasoactive molecules, plays an active role in hemostasis and immunologic and inflammatory events, regulates vascular tone, and interacts with inflammatory cells and neighboring vascular cell types. These metabolic properties are both constitutive and capable of being induced in response to stimuli or injury. Virtually any agent that causes pulmonary endothelial cell injury will lead to impairments in the functional metabolic properties of these cells, resulting in alterations in hemodynamics, hemofluidity, permeability, gas exchange, and intercellular signaling. The net result in the lung is often the clinical picture of acute lung injury with respiratory distress, refractory hypoxemia, diffuse alveolar infiltrates, and respiratory failure.
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Affiliation(s)
- E R Block
- University of Florida College of Medicine, Gainesville
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21
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Abstract
Endothelium mediates thrombosis and fibrinolysis in part through cell-based production and binding of coagulation factors and anticoagulant moieties. A variety of biologically active agents (homocysteine, interleukin-1, and endotoxin) and environmental factors (mechanical injury and hypoxia) can upset the homeostasis of the coagulation system leading in vitro and in vivo to abnormal propensity for thrombin formation. None of the above agents or any similar agents have been demonstrated to inhibit clotting factors or thrombosis formation. As one would expect, injury to endothelium even on a sublethal basis promotes a procoagulant response. This procoagulant response appears to be multifactorial and multiphasic. Gross injury leads to factor release by dead or dying cells with rapid promotion of thrombosis by neighboring infact cells. A more subtle prothrombotic state promulgated by viable cells appears after sublethal perturbation and is characterized by protein synthesis-dependent production of endothelial-produced clotting factors in the early stages of injury with subsequent return to normal levels of these factors by 24 hr. A second phase of abnormal levels of fibrinolysis inhibitors and possible reduction in fibrinolysis promoters appears to follow up to 48 hr after the initial injury. Thus the cell can be viewed as producing means of promoting thrombus formation followed by preventing thrombus dissolution. The data presented in this article are primarily cell culture data and are thus limited both in physiologic applicability and in ability to define over long periods the relevance of those findings to other cells in the hemostatic system. Nonetheless, in vivo data of endothelial perturbation correlate with the in vitro findings.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J P Gertler
- Division of Vascular Surgery, State University of New York, Brooklyn 11203
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22
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Kaufman PA, Jones RB, Greenberg CS, Peters WP. Autologous bone marrow transplantation and factor XII, factor VII, and protein C deficiencies. Report of a new association and its possible relationship to endothelial cell injury. Cancer 1990; 66:515-21. [PMID: 2114212 DOI: 10.1002/1097-0142(19900801)66:3<515::aid-cncr2820660319>3.0.co;2-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Four patients who underwent treatment with high-dose chemotherapy (HDC) and autologous bone marrow transplantation (ABMT) and in whom posttreatment deficiencies of Factor XII and protein C subsequently developed are reported. Factor VII or Factor X deficiencies also developed in several of these patients. Three of these patients experienced chemotherapy-related cardiac, hepatic, or pulmonary toxicity. It is believed by many that endothelial cell injury may be the underlying lesion responsible for these various organ system toxicities seen in the setting of ABMT, although direct evidence of this is lacking. It is proposed that the factor deficiencies described in this report may be an additional consequence of endothelial cell injury or dysfunction. These coagulation factor deficiencies may therefore serve as both a marker to follow these organ system toxicities with and as a useful tool to better study and understand the mechanisms underlying these events. Additionally, deficiencies of either Factor VII or Factor X developed in several patients that were of a sufficient magnitude such that factor replacement therapy would be indicated before any invasive procedures or in the event of significant hemorrhage.
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Affiliation(s)
- P A Kaufman
- Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710
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23
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Sterpetti AV, Schultz RD, Hunter WJ, Cisternino S, Fontaine M. Comparison of two techniques to isolate microvascular endothelial cells from the omentum. J Surg Res 1990; 48:101-6. [PMID: 2304336 DOI: 10.1016/0022-4804(90)90199-c] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The purpose of the study was to compare two different techniques for isolation of omental microvascular endothelial cells (ECs). Segments of unreinforced polytetrafluorethylene (PTFE) grafts, 9 cm long and 6 mm in diameter, were implanted in 22 dogs as an aortic interposition. Fourteen grafts were seeded with a mean of 7 x 10(5) viable ECs, derived from the microvessels of the omentum: eight grafts (group A) were seeded with ECs obtained by collagenase digestion and by filtration through a pore mesh; six grafts (group B) were seeded with ECs obtained by collagenase digestion and by Percoll gradient separation. In eight grafts (group C), the ECs were not added to the preclot mixture and served as a control. Animals were sacrificed 5 weeks after surgery. The percentage of thrombus-free area was 65 +/- 22% for group A grafts and 74 +/- 15% for group B grafts (NS). The subendothelial layer was 280 +/- 60 microns thick in group A and 220 +/- 30 microns thick in group B (P less than 0.05). Seeded grafts showed a higher production of 6-keto-PGF1 alpha after addition of sodium arachidonate than control grafts. Percoll gradient separation allows isolation of a more purified suspension of ECs. Refinements in omental EC procurement are still required to minimize contamination with other types of cells.
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Affiliation(s)
- A V Sterpetti
- Department of Surgery and Pathology, Creighton University School of Medicine, Omaha, Nebraska 68131
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24
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25
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Eloy R, Belleville J, Rissoan MC, Baguet J. Heparinization of medical grade polyurethanes. J Biomater Appl 1988; 2:475-519. [PMID: 3058926 DOI: 10.1177/088532828700200401] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- R Eloy
- Unité 37 INSERM, Bron, France
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26
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27
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Abstract
The normal hemostatic system is complex yet exquisitely well regulated. Interrelationships exist between responses of the vasculature, circulating platelets, coagulation proteins, and fibrinolytic mechanism. These relationships serve to limit blood loss, preserve tissue perfusion, and stimulate local repair processes. Natural inhibitors of coagulation and fibrinolysis modulate these systems to prevent uncontrolled thrombosis or hemorrhage following pathologic stimuli. Vascular endothelial cells play an important role in the maintenance of a thromboresistant luminal interface with circulating cells and proteins. Normal hemostasis also requires the synthetic, metabolic, and repair processes of the vascular endothelium. The initial vascular response to injury produces brief vasoconstriction and exposes subendothelial substances that attract circulating platelets and activate coagulation proteins. Platelets respond by adherence and aggregation at the site of injury, with subsequent release of substances that mitigate blood loss. Platelet adherence to collagen requires von Willebrand's factor, fibrinogen, fibronectin, and specific glycoprotein receptors on platelet surfaces. Platelet-to-platelet interactions (aggregation) recruit additional platelets to the primary hemostatic plug. Aggregation requires fibrinogen, energy, and calcium. Release of ADP, serotonin, and the contents of intracellular granules as well as generation of prostaglandins prepares platelet surfaces for reactions with the coagulation proteins. Activation of the intrinsic or extrinsic coagulation pathway, or of both, causes formation of fibrin from fibrinogen by means of an elaborate and intricate system that also entraps platelets and activated coagulation proteins. The intrinsic system is activated by the contact of factor XII with a negatively charged surface, most likely collagen. Through a series of reactions with prekallikrein, HMWK, and factors XI, IX, and VIII, the common coagulation pathway is propagated. The extrinsic, or tissue factor, system stimulates both the common pathway and factor IX the intrinsic pathway. Discovery of this stimulation of the intrinsic pathway by factor VII in the extrinsic pathway has stimulated reassessment of the biologic importance of the extrinsic system. The common pathway includes factors X and V and causes thrombin to convert fibrinogen to fibrin. Calcium and platelet phospholipids are substances that have important roles in steps in the coagulation scheme. Once fibrin is formed, factor XIII interacts with the substance, providing a stabilizing effect.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- G C Troy
- Department of Small Animal Medicine and Surgery, Texas A&M University College of Veterinary Medicine
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28
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Scharf RE, Harker LA. Thrombosis and atherosclerosis: regulatory role of interactions among blood components and endothelium. BLUT 1987; 55:131-44. [PMID: 3304475 DOI: 10.1007/bf00320567] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Complex interactions among constituents of blood and components of the vessel wall are involved in the pathogenesis of atherosclerosis and its subsequent thrombotic complications. Alterations in the endothelium are central both to the slowly progressive process of atherogenesis and to the acute events leading to thrombotic occlusion. Recent data, obtained by systematic evaluation of chronologic events that occur in diet-induced atherosclerosis, have extended our understanding of interactive processes among endothelium, monocytes, platelets, vascular smooth muscle cells, and humoral hemostatic elements in atherogenesis.
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29
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Van Dam-Mieras MC, Bruggeman CA, Muller AD, Debie WH, Zwaal RF. Induction of endothelial cell procoagulant activity by cytomegalovirus infection. Thromb Res 1987; 47:69-75. [PMID: 2821649 DOI: 10.1016/0049-3848(87)90241-6] [Citation(s) in RCA: 62] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Endothelial cells isolated from rat aorta were infected in vitro with rat cytomegalovirus. Viral antigens appeared in nucleus and cytoplasma and newly made extracellular virus was detected in the supernatant. Furthermore, the viral infection caused the appearance of procoagulant activity on the endothelial cells.
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