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AGATHOS EA, LACHANAS E, AGATHOS S, TOMOS PI, KOSTOMITSOPOULOS N, KOUTSOUKOS PG. A comparison between sodium bisulfite and Therma-Fix® anticalcification treatments for implantable biological tissues. Chirurgia (Bucur) 2022. [DOI: 10.23736/s0394-9508.20.05192-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Agathos EA, Tomos PI, Kostomitsopoulos N, Koutsoukos PG. A novel anticalcification treatment strategy for bioprosthetic valves and review of the literature. J Card Surg 2019; 34:895-900. [PMID: 31269321 DOI: 10.1111/jocs.14151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIM OF THE STUDY Glutaraldehyde (Glut) fixed bioprosthetic valves fail due to progressive dystrophic calcification. Many treatments have been proposed to eliminate calcification but none have been entirely successful. Calcitonin (CT) and sodium bisulfite (BSF) have recently been introduced as independent anticalcification reagents. It is postulated that their combined effect, along with the addition of the detergent Tween 80 and alcohol at 37°C, may efficiently minimize tissue calcification due to aldehyde adduct formation and elimination of lipids. MATERIAL AND METHODS Three groups were created from porcine aortic leaflets: group I (Glut only), group II (Glut with 1% CT, 12.5% BSF, and 1.2% Tween 80 at 37°C), and group III (Glut with 1% CT, 10% BSF, 1.2% Tween 80, and 20% alcohol at 37°C). All tissues were implanted subdermally in three sets of eight (group I), six (group II), and five (group III) Wistar rats. After 4 months, the tissues were retrieved and lyophilized at -40°C at 100 mm Hg. The calcium was measured with a flat atomic absorption technique. RESULTS The preimplantation calcium (Ca) concentration in mg Ca/gram of tissue was 1.79 ± 0.14 in group I, 1.65 ± 0.28 in group II, and 0.72 ± 0.79 in group III (P = ns). After 4 months, the Ca concentration was 277.55 ± 32.52, 103.54 ± 5.39 (P < .001) and 42.02 ± 15.63 (P < .001), respectively. There was also a significant difference (P < .001) between groups II and III. CONCLUSION The combination of CT and BSF along with the detergent Tween 80 and alcohol at 37°C mitigates the calcification efficiently as compared to Glut treatment only.
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Affiliation(s)
| | - Periklis I Tomos
- Academic Department of Thoracic Surgery, Attikon University General Hospital, Athens, Greece
| | - Nikolaos Kostomitsopoulos
- Center of Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Petros G Koutsoukos
- Department of Chemical Engineering, FORTH-ICEHT, University of Patras, Patras, Greece
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Agathos EA, Tomos PI, Kostomitsopoulos N, Koutsoukos PG. Calcitonin as an anticalcification treatment for implantable biological tissues. J Cardiol 2018; 73:179-182. [PMID: 30377016 DOI: 10.1016/j.jjcc.2018.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/27/2018] [Accepted: 07/30/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM OF THE STUDY Calcification remains the major role of failure of implantable biomedical material and in particular of bioprosthetic valves. Various treatments have been proposed to mitigate calcification of glutaraldehyde-fixed bioprosthetic valves but none have succeeded in inhibiting or mitigating efficiently the calcification process of the implantable biological tissues. Since the discovery of calcitonin (CT) and its therapeutic role in treating hypercalcemic patients, CT has never been tried as an anticalcification treatment for biomaterials. It is postulated, that tissue calcification may be efficiently minimized by forming adducts with aldehyde groups thus eliminating the places of the biological tissues onto the calcium cations could be deposited. MATERIAL AND METHODS Fresh porcine aortic leaflets were cut radially in three parts. Three groups of tissue were created. Group I (glutaraldehyde only), Group II (glutaraldehyde with 1% CT) and Group III (glutaraldehyde with 10% CT). All tissues were then implanted subdermally in three sets of 8 (Group I) and 9 (Group II and Group III) male Wistar rats of 12 days old. 21 days later the rats were euthanized by inhalation of CO2. The tissues were retrieved and after rinsing with distilled water 3 times, were lyophilized at -40°C at high vacuum pressure of approximately 100mmHg for 16h. The calcium content was then measured with flat atomic absorption technique. RESULTS The preimplantation values of Ca concentration as expressed in mg Ca/g of tissue were 1.79±0.14 in Group I, 4.78±0.0079 in Group II and 2.88±0.17 in Group III (p=ns). 21 days later the values of Ca concentration were 126.95±12.97 for Group I, 24.69±2.71 for Group II (p<0.05) and 27.16±2.95 for Group III (p<0.05). There was not significance difference between Groups II and III, even if Group II showed a less accumulation of Ca concentration (×5.16) than Group III (×9.43). CONCLUSION An anticalcification treatment based on calcitonin as an additive to buffered glutaraldehyde, mitigates the calcification process of the implantable biological tissues, as compared to glutaraldehyde treatment only.
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Affiliation(s)
- E Andreas Agathos
- Department of Cardiac Surgery, Euroclinic of Athens, Athanassiadou 7-9, 115 21 Athens, Greece.
| | - Periklis I Tomos
- Academic Department of Thoracic Surgery, "Attikon" University General Hospital, Rimini 1, Chaidari Athens, Attiki, 124 64, Greece
| | - Nikolaos Kostomitsopoulos
- Center of Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 4 Soranou Ephesus St, 11527 Athens, Greece
| | - Petros G Koutsoukos
- Department of Chemical Engineering and FORTH-ICEHT, University of Patras, Patras, Greece
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Guo X, Fan Y, Cui J, Hao B, Zhu L, Sun X, He J, Yang J, Dong J, Wang Y, Liu X, Chen J. NOX4 expression and distal arteriolar remodeling correlate with pulmonary hypertension in COPD. BMC Pulm Med 2018; 18:111. [PMID: 29986678 PMCID: PMC6038356 DOI: 10.1186/s12890-018-0680-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 06/25/2018] [Indexed: 12/26/2022] Open
Abstract
Background Pulmonary hypertension (PH) in chronic obstructive pulmonary disease (COPD) is suggested as the consequence of emphysematous destruction of vascular bed and hypoxia of pulmonary microenvironment, mechanisms underpinning its pathogenesis however remain elusive. The dysregulated expression of nicotinamide adenine dinucleotide phosphate (NADPH)-oxidases and superoxide generation by pulmonary vasculatures have significant implications in the hypoxia-induced PH. Methods In this study, the involvement of NADPH oxidase subunit 4 (NOX4) in pulmonary arteriolar remodeling of PH in COPD was investigated by ascertaining the morphological alteration of pulmonary arteries and pulmonary blood flow using cardiac magnetic resonance imaging (cMRI), and the expression and correlation of NOX4 with pulmonary vascular remodeling and pulmonary functions in COPD lungs. Results Results demonstrated that an augmented expression of NOX4 was correlated with the increased volume of pulmonary vascular wall in COPD lung. While the volume of distal pulmonary arteries was inversely correlated with pulmonary functions, despite it was positively associated with the main pulmonary artery distensibility, right ventricular myocardial mass end-systolic and right ventricular myocardial mass end-diastolic in COPD. In addition, an increased malondialdehyde and a decreased superoxide dismutase were observed in sera of COPD patients. Mechanistically, the abundance of NOX4 and production of reactive oxygen species (ROS) in pulmonary artery smooth muscle cells could be dynamically induced by transforming growth factor-beta (TGF-β), which in turn led pulmonary arteriolar remodeling in COPD lungs. Conclusion These results suggest that the NOX4-derived ROS production may play a key role in the development of PH in COPD by promoting distal pulmonary vascular remodeling.
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Affiliation(s)
- Xiaotong Guo
- Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, 804 Shengli South Street, Xingqing District, Yinchuan, Ningxia, 750004, People's Republic of China
| | - Yuchun Fan
- Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, 804 Shengli South Street, Xingqing District, Yinchuan, Ningxia, 750004, People's Republic of China
| | - Jieda Cui
- Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, 804 Shengli South Street, Xingqing District, Yinchuan, Ningxia, 750004, People's Republic of China.,Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Binwei Hao
- Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, 804 Shengli South Street, Xingqing District, Yinchuan, Ningxia, 750004, People's Republic of China
| | - Li Zhu
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Xiao Sun
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Jinxi He
- Department of Thoracic Surgery, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Jiali Yang
- Institute of Human Stem Cell Research, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Jianda Dong
- Department of Pathology, Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Yanyang Wang
- Department of Radiotherapy, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Xiaoming Liu
- Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, 804 Shengli South Street, Xingqing District, Yinchuan, Ningxia, 750004, People's Republic of China. .,Institute of Human Stem Cell Research, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China.
| | - Juan Chen
- Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, 804 Shengli South Street, Xingqing District, Yinchuan, Ningxia, 750004, People's Republic of China.
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