1
|
Nelaturi P, Kademani SP, Siva Subramanian V, Ravikumar S. Noninvasive Biomarkers for Alcohol-Related Liver Disease-A Proteomic Related Preliminary Report. Indian J Clin Biochem 2024; 39:392-400. [PMID: 39005863 PMCID: PMC11239637 DOI: 10.1007/s12291-023-01120-9] [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: 08/22/2022] [Accepted: 02/20/2023] [Indexed: 03/06/2023]
Abstract
Increased alcohol intake over decades leads to progressive alcohol-related liver disease (ALD) and contributes to increased mortality. It is characterized by reduced platelet count. Platelets have a role in protecting vascular integrity and involved in liver regeneration. Alcohol affects the platelet count and its function. Platelet function is regulated by their proteins, released during pathophysiological conditions. Therefore, platelet proteome plays a vital role during ALD. This preliminary study consists of 10 patients with ALD. It includes the preparation of human platelets for the proteomic approach. We performed liquid chromatography-mass spectrometry for the samples. A total of 536 proteins were identified in patients with ALD of which 31 proteins were mentioned as a candidate based on their clinical significance. The advancement of diagnostic or therapeutic tools based on the application of platelet proteins in ALD is still far off. Platform for platelet and its proteome research may give diagnostic and prognostic insights into ALD. Platelet proteomes could possibly be concluded as therapeutic and potential diagnostic or prognostic markers in ALD. Supplementary Information The online version contains supplementary material available at 10.1007/s12291-023-01120-9.
Collapse
Affiliation(s)
- Prabhudas Nelaturi
- Multi-Disciplinary Center for Biomedical Research, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission's Research Foundation (Deemed to Be University), Kirumampakkam, Puducherry, 607402 India
| | - Sangeetha P Kademani
- Multi-Disciplinary Center for Biomedical Research, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission's Research Foundation (Deemed to Be University), Kirumampakkam, Puducherry, 607402 India
| | - Vithiavathi Siva Subramanian
- Department of General Medicine, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission's Research Foundation (Deemed to Be University), Kirumampakkam, Puducherry, 607402 India
| | - Sambandam Ravikumar
- Multi-Disciplinary Center for Biomedical Research, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission's Research Foundation (Deemed to Be University), Kirumampakkam, Puducherry, 607402 India
| |
Collapse
|
2
|
Kipchumba B, Gitonga F, Jepchirchir C, Gitau GW, Okanya PW, Amwayi PW, Isaac AO, Nyabuga NJ. Alcohol spiked with zolpidem and midazolam potentiates inflammation, oxidative stress and organ damage in a mouse model. Forensic Toxicol 2024; 42:45-59. [PMID: 37814103 DOI: 10.1007/s11419-023-00674-w] [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: 07/17/2023] [Accepted: 09/25/2023] [Indexed: 10/11/2023]
Abstract
PURPOSE Crime-related spiking of alcoholic drinks with prescription drugs is quite common and has been happening for centuries. This study, therefore, evaluated the effects of oral administration of alcohol spiked with the zolpidem and midazolam potent sedatives on inflammation, oxidative stress and various organ damage in male Swiss albino mice. METHODS Mice were randomly assigned into six treatment groups; the first group constituted the normal control, the second group received 50 mg/kg body weight of zolpidem only, the third group received 50 mg/kg body weight zolpidem dissolved in 5 g/kg alcohol, the fourth group received 50 mg/kg midazolam only, the fifth group received midazolam (50 mg/kg) dissolved in 5 g/kg alcohol and the sixth group received 5 g/kg alcohol. RESULTS Alcohol-induced significant reduction in neurological function and altered blood hematological indicators. Such neurological impairment and negative effects on blood were exacerbated in mice administered with spiked alcohol. Additionally, midazolam and zolpidem enhanced alcohol-driven elevation of liver function markers; the serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) gamma glutamyltransferase (GGT), total bilirubin and alkaline phosphatase. Exposure to alcohol and/or spiked alcohol led to significant augmentation of nitric oxide and malonaldehyde, with concomitant depletion of liver glutathione (GSH) levels. Similarly, serum levels of pro-inflammatory cytokines tumor necrosis factor alpha and interferon-gamma were increased by co-exposure with midazolam or zolpidem. Alcohol-induced hepatotoxicity and nephrotoxicity were amplified by exposure to alcohol spiked with midazolam/zolpidem. CONCLUSION Exposure to alcohol spiked with midazolam or zolpidem appears to exacerbate neurological deficits, inflammation, oxidative stress, and organ damage.
Collapse
Affiliation(s)
- Biwott Kipchumba
- Department of Biochemistry and Biotechnology, Technical University of Kenya, 52428, Nairobi, 00200, Kenya
| | - Francis Gitonga
- Department of Biochemistry and Biotechnology, Technical University of Kenya, 52428, Nairobi, 00200, Kenya
| | - Careen Jepchirchir
- Department of Biochemistry and Biotechnology, Technical University of Kenya, 52428, Nairobi, 00200, Kenya
| | - Grace Wairimu Gitau
- Department of Biochemistry and Biotechnology, Technical University of Kenya, 52428, Nairobi, 00200, Kenya
| | - Patrick W Okanya
- Department of Biochemistry and Biotechnology, Technical University of Kenya, 52428, Nairobi, 00200, Kenya
| | - Peris Wanza Amwayi
- Department of Biochemistry and Biotechnology, Technical University of Kenya, 52428, Nairobi, 00200, Kenya
| | - Alfred Orina Isaac
- Department of Pharmaceutical Technology, School of Health Sciences and Technology, Technical University of Kenya, 52428, Nairobi, 00200, Kenya
| | - Nyariki James Nyabuga
- Department of Biochemistry and Biotechnology, Technical University of Kenya, 52428, Nairobi, 00200, Kenya.
| |
Collapse
|
3
|
Abbas D, Ciricillo JA, Elom HA, Moon AM. Extrahepatic Health Effects of Alcohol Use and Alcohol-associated Liver Disease. Clin Ther 2023; 45:1201-1211. [PMID: 37806811 DOI: 10.1016/j.clinthera.2023.08.018] [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: 05/16/2023] [Revised: 08/08/2023] [Accepted: 08/24/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE Alcohol use disorder (AUD) is a growing public health concern and an important contributor to global morbidity and mortality. While the hepatotoxic effects of alcohol are well known, the adverse effects of alcohol are manifested in almost every organ system. With the growing public health impact of AUD, the aim of this narrative review is to highlight the epidemiology and burden of AUD and its association with extrahepatic diseases including malignancy and disorders of the gastrointestinal (GI), cardiovascular, immunologic, neurologic, endocrine, and hematologic systems. METHODS A narrative review of the literature was performed to identify studies addressing the epidemiology, pathophysiology, clinical manifestations, and therapy of extrahepatic health manifestations of alcohol use. FINDINGS In the United States, an estimated 14.5 million people have AUD and approximately 88,000 adults die yearly due to alcohol-related causes. The consumption of alcohol and AUD is associated with injuries, violence, cancers, nonmalignant conditions of the GI system, infections, effects on the cardiovascular system, and neurodegenerative diseases. These conditions contribute to the increased mortality associated with AUD and are burdensome to patients and caregivers. IMPLICATIONS Increased awareness of the extrahepatic manifestations of AUD, screening for AUD using validated screening tools, such as the Alcohol Use Disorders Identification Test-Concise (AUDIT-C) score, and offering evidence-based interventions to patients with AUD is imperative to reduce the public health burden of AUD. Although historically controversial, recent evidence suggests that any level of alcohol consumption can have negative health consequences. Further research is warranted to determine if any amount of alcohol is safe for consumption. Public health efforts are warranted to help curtail the growing burden of AUD.
Collapse
Affiliation(s)
- Daniyal Abbas
- Department of Internal Medicine, East Carolina University, Greenville, North Carolina
| | - Jacob A Ciricillo
- Department of Internal Medicine, University of Cincinnati Medicine Center, Cincinnati, Ohio
| | - Hilary A Elom
- Department of Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Andrew M Moon
- Department of Gastroenterology and Hepatology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
| |
Collapse
|
4
|
Sun Y, Yang M, Li S, Hu Y, Yang B, Li X, Yan R, Dai K. Alantolactone induces platelet apoptosis by activating the Akt pathway. Platelets 2023; 34:2173505. [PMID: 36813739 DOI: 10.1080/09537104.2023.2173505] [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: 02/24/2023]
Abstract
Alantolactone (ALT), a sesquiterpene lactone compound isolated from Inula helenium L., has recently attracted much attention for its anti-tumor properties. ALT reportedly functions by regulating the Akt pathway, which has been shown to be involved in programmed platelet death (apoptosis) and platelet activation. However, the precise effect of ALT on platelets remains unclear. In this study, washed platelets were treated with ALT in vitro, and apoptotic events and platelet activation were detected. In vivo, platelet transfusion experiments were employed to detect the effect of ALT on platelet clearance. Platelet counts were examined after intravenous injection of ALT. We found that ALT treatment induced Akt activation and Akt-mediated apoptosis in platelets. ALT-activated Akt elicited platelet apoptosis by activating phosphodiesterase (PDE3A) and PDE3A-mediated protein kinase A (PKA) inhibition. Pharmacological inhibition of the PI3K/Akt/PDE3A signaling pathway or PKA activation was found to protect platelets from apoptosis induced by ALT. Moreover, ALT-induced apoptotic platelets were removed faster in vivo, and ALT injection resulted in the platelet count decline. Either PI3K/Akt/PDE3A inhibitors or a PKA activator could protect platelets from clearance, ultimately ameliorating the ALT-induced decline in platelet count in the animal model. These results reveal the effects of ALT on platelets and their related mechanisms, suggesting potential therapeutic targets for the prevention and alleviation of possible side effects resulting from ALT treatments.
Collapse
Affiliation(s)
- Yueyue Sun
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital and Collaborative Innovation Center of Hematology, Suzhou Medical College, Soochow University, Suzhou, China.,State Key Laboratory of Radiation Medicine and Protection, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Cyrus Tang Medical Institute, Medical College, Soochow University, Suzhou, China
| | - Mengnan Yang
- State Key Laboratory of Radiation Medicine and Protection, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Cyrus Tang Medical Institute, Medical College, Soochow University, Suzhou, China
| | - Shujun Li
- State Key Laboratory of Radiation Medicine and Protection, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Cyrus Tang Medical Institute, Medical College, Soochow University, Suzhou, China
| | - Ying Hu
- State Key Laboratory of Radiation Medicine and Protection, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Cyrus Tang Medical Institute, Medical College, Soochow University, Suzhou, China
| | - Biao Yang
- State Key Laboratory of Radiation Medicine and Protection, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Cyrus Tang Medical Institute, Medical College, Soochow University, Suzhou, China
| | - Xu Li
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital and Collaborative Innovation Center of Hematology, Suzhou Medical College, Soochow University, Suzhou, China
| | - Rong Yan
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital and Collaborative Innovation Center of Hematology, Suzhou Medical College, Soochow University, Suzhou, China.,State Key Laboratory of Radiation Medicine and Protection, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Cyrus Tang Medical Institute, Medical College, Soochow University, Suzhou, China
| | - Kesheng Dai
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital and Collaborative Innovation Center of Hematology, Suzhou Medical College, Soochow University, Suzhou, China.,State Key Laboratory of Radiation Medicine and Protection, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Cyrus Tang Medical Institute, Medical College, Soochow University, Suzhou, China
| |
Collapse
|
5
|
Han W, Huang R, Li B, Liu L, Xu W, Zhang G. Characteristics of FXa-storing platelets in hemophilia B mice and the influence of alcohol on the platelets. Sci Rep 2023; 13:16488. [PMID: 37779119 PMCID: PMC10543635 DOI: 10.1038/s41598-023-43649-y] [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: 06/03/2023] [Accepted: 09/26/2023] [Indexed: 10/03/2023] Open
Abstract
Platelet-stored activated blood coagulation factor X (FXa) has great potential in the gene therapy of hemophilia B (HB). However, we still need to understand more about the properties of FXa-storing platelets and how dietary factors affect them. We created transgenic mice called 2bFXa-HB, which had stable expression and storage of FXa in their platelets, resulting in the alleviation of the bleeding disorder in these mice. Even after inducing anti-factor IX (FIX) inhibitors in 2bFXa-HB mice, the hemorrhage phenotype could still be rescued by the expression of FXa. The activation capacity of 2bFXa-HB platelets remained unchanged, and there were no signs of elevated thrombotic risk in these mice. In an acute alcohol exposure mouse model, a single administration of alcohol reduced both the number of platelets and their activation capacity, as well as impaired coagulation function. However, it did not increase the markers of thrombotic risk in either 2bFXa-HB or HB mice. These results suggest that FXa storage in platelets is safe and effective for treatment of HB, but alcohol could impair the therapeutic effect of FXa-containing platelets.
Collapse
Affiliation(s)
- Wenwen Han
- Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Hangzhou Normal University, No. 2318, Yuhangtang Rd, Cangqian, Yuhang District, Hangzhou, 311121, Zhejiang, China
| | - Rui Huang
- Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Hangzhou Normal University, No. 2318, Yuhangtang Rd, Cangqian, Yuhang District, Hangzhou, 311121, Zhejiang, China
| | - Binbin Li
- Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Hangzhou Normal University, No. 2318, Yuhangtang Rd, Cangqian, Yuhang District, Hangzhou, 311121, Zhejiang, China
| | - Lu Liu
- Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Hangzhou Normal University, No. 2318, Yuhangtang Rd, Cangqian, Yuhang District, Hangzhou, 311121, Zhejiang, China
| | - Wenjue Xu
- Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Hangzhou Normal University, No. 2318, Yuhangtang Rd, Cangqian, Yuhang District, Hangzhou, 311121, Zhejiang, China
| | - Guowei Zhang
- Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Hangzhou Normal University, No. 2318, Yuhangtang Rd, Cangqian, Yuhang District, Hangzhou, 311121, Zhejiang, China.
| |
Collapse
|
6
|
Airapetov MI, Eresko SO, Bychkov ER, Lebedev AA, Shabanov PD. Effect of Ethanol on Platelet Biology. BIOCHEMISTRY (MOSCOW), SUPPLEMENT SERIES B: BIOMEDICAL CHEMISTRY 2022. [DOI: 10.1134/s1990750822040023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
7
|
Airapetov MI, Eresko SO, Bychkov ER, Lebedev AA, Shabanov PD. [Effect of ethanol on platelet biology]. BIOMEDITSINSKAIA KHIMIIA 2022; 68:81-92. [PMID: 35485482 DOI: 10.18097/pbmc20226802081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In recent years, interest in the study of platelets, significantly increased due to recent discoveries providing convincing evidence that their functions by are not limited to their participation in the blood coagulation mechanism. Many works are devoted to the study of the functional state of platelets under conditions of acute and chronic alcohol exposure. The results of such studies can be useful for the development of new markers of the degree of alcohol intoxication of the body for the subsequent choice of the method drug correction of disorders caused by acute or chronic alcohol effects. The review summarizes results in vivo and in vitro of studies performed during more than 60 years on the effect of ethanol on the biogenesis, number, morphology and biochemistry of platelets.
Collapse
Affiliation(s)
- M I Airapetov
- Department of Neuropharmacology, Institute of Experimental Medicine, Saint Petersburg, Russia; Department of Pharmacology, St. Petersburg State Pediatric Medical University, Saint Petersburg, Russia
| | - S O Eresko
- Department of Neuropharmacology, Institute of Experimental Medicine, Saint Petersburg, Russia; Research and Training Center of Molecular and Cellular Technologies, Saint Petersburg, Russia
| | - E R Bychkov
- Department of Neuropharmacology, Institute of Experimental Medicine, Saint Petersburg, Russia
| | - A A Lebedev
- Department of Neuropharmacology, Institute of Experimental Medicine, Saint Petersburg, Russia
| | - P D Shabanov
- Department of Neuropharmacology, Institute of Experimental Medicine, Saint Petersburg, Russia; Department of Pharmacology, Kirov Military Medical Academy, Saint Petersburg, Russia
| |
Collapse
|
8
|
KULU M, ÖZSOY F, DEMİR B. Alkol ve madde kullanım bozukluğu tanılı hastalarda inflamasyon düzeyleri. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.975848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
9
|
Platelet count/spleen volume ratio has a good predictive value for esophageal varices in patients with hepatitis B liver cirrhosis. PLoS One 2021; 16:e0260774. [PMID: 34855845 PMCID: PMC8638864 DOI: 10.1371/journal.pone.0260774] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 11/16/2021] [Indexed: 12/17/2022] Open
Abstract
Background & aims Platelet count/spleen longest diameter ratio (PSDR) is widely used in clinical practice due to its good performance in predicting esophageal varices (EV). We obtained spleen volume (SV) by magnetic resonance examination, the purpose of this study was to evaluate the clinical value of platelet count/spleen volume ratio (PSVR) and spleen volume in predicting EV in patients with hepatitis B cirrhosis. Methods: This study was a diagnostic accuracy experiment and retrospective, 199 patients with hepatitis B cirrhosis who met the criteria were selected as the research subjects. All patients were collected blood samples in the morning on an empty stomach within 2 days, and related indicators were tested. Within 10 days, they received electronic gastroscopy and abdominal magnetic resonance examination. According to the Child-Pugh score, the patients were divided into groups with or without EV and with or without high-risk esophageal varices (HRV), then statistical analysis of the two groups was performed. Results The area under the curve (AUC) of PSVR in predicting EV or HRV in each group (85.5%-92.6%) was higher than PSDR, SV, spleen diameter, and platelet count. The AUC of PSDR in diagnosing HRV was higher than SV, and the AUC of SV in diagnosing EV was higher than PSDR, but the difference was not significant (P>0.05). In Child-Pugh A patients, Multivariate logistic regression analysis showed PSVR could be a predictor of HRV (P<0.05), SV was a reliable predictor of EV (P<0.05). Conclusion PSVR is better than PSDR, spleen diameter, platelet count in predicting EV; in the absence of serological results, SV could be used instead of PSDR. Both can predict EV or HRV of patients with hepatitis B cirrhosis.
Collapse
|
10
|
Zhang X, Chen X, Yang J, Du L, Zhou Y, Li K. Meta-analysis of alcohol consumption and venous thromboembolism. J Public Health (Oxf) 2021; 44:477-498. [PMID: 33824981 DOI: 10.1093/pubmed/fdab045] [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: 07/11/2020] [Revised: 12/20/2020] [Accepted: 02/12/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The associations of alcohol consumption and venous thromboembolism (VTE) have been investigated widely, but the conclusions were inconsistent. OBJECTIVE To summarize the relationship of alcohol consumption and VTE. METHODS This study has been registered in PROSPERO (ID: CRD42020164567). We searched the PubMed, Embase, Web of Science and the Cochrane Library databases from inception to September 2019 and reviewed the reference list of relevant articles to identify studies assessing the association between alcohol consumption and risk of VTE. RESULTS Fourteen cohorts and four case-control studies were included in the meta-analysis. Compared with non-drinkers, the risk of VTE was decreased (RR: 0.93; 95% confidence interval [CI] 0.88-0.99) for alcohol drinkers. The pooled RRs of VTE were 0.91 (95% CI 0.84-0.99) for low to moderate alcohol intake (0.1-14.0 drinks/week) and 0.91 (95% CI 0.78-1.06) for high alcohol intake (>14.0 drinks/week) compared with non-drinker. Subgroup analysis showed liquor intake might slightly increase the risk of VTE (1.01; 95% CI 0.85-1.21) although the difference was not significant. CONCLUSIONS Alcohol consumption in low to moderate was associated with a lower risk of VTE. However, precautions are needed when providing personal drinking advice considering the potential harm of alcohol. Further studies are warranted to determine whether moderate alcohol consumption has a causal role in VTE.
Collapse
Affiliation(s)
- Xingxia Zhang
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xinrong Chen
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jie Yang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Liang Du
- Chinese Evidence-based Medicine/Cochrane Center, Chengdu 610041, China
| | - Yong Zhou
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ka Li
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu 610041, China
| |
Collapse
|
11
|
Short-term standard alcohol consumption enhances platelet response to clopidogrel through inhibition of Nrf2/Ces1 pathway and induction of Cyp2c in mice. Life Sci 2021; 279:119268. [PMID: 33626394 DOI: 10.1016/j.lfs.2021.119268] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 12/22/2022]
Abstract
AIMS Drinking alcohol is prevalent worldwide; however, it is unknown whether alcohol could affect the antiplatelet effects of clopidogrel in patients when taking both concomitantly. This study was designed to investigate the influence of short-term standard alcohol consumption on the metabolic activation of and platelet response to clopidogrel in mice as well as the mechanisms involved. MAIN METHODS Male C57BL/6J mice were administered with normal saline (vehicle control) or alcohol at 2 g/kg/day for 7 days, and then gavaged with vehicle control or a single dose of clopidogrel at 10 mg/kg. Inhibition of ADP-induced platelet aggregation and activation by clopidogrel, plasma concentrations of clopidogrel and its active metabolite H4, and changes in mRNA and protein expression of genes related to clopidogrel metabolism and its regulation were measured in mice pretreated with or without alcohol. KEY FINDINGS Compared with vehicle control, alcohol pretreatment significantly reduced hydrolysis of clopidogrel as a result of significant down-regulation of Nrf2-mediated Ces1 expression (responsible for the formation of clopidogrel carboxylate), increased metabolic activation of clopidogrel due to significant up-regulation of Cyp2c (for the formation of active thiol metabolite H4), and consequently enhanced inhibition of ADP-induced platelet aggregation and activation by clopidogrel. SIGNIFICANCE Short-term standard alcohol consumption would significantly enhance suppression of ADP-induced platelet aggregation and activation by clopidogrel through significant inhibition of Nrf2/Ces1 signaling pathway and induction of Cyp2c, suggesting that alcohol may interact with drugs that are predominantly metabolized by CES1 or CYP2C in patient care, including clopidogrel.
Collapse
|
12
|
Kazarinov KD, Shchelkonogov VA, Baranova OA, Chekanov AV, Solovieva EU, Fedin AI. The Effect of Microwave Radiation on Cell Sensitivity to Monohydric Alcohols in Platelet-Rich Plasma. Biophysics (Nagoya-shi) 2020. [DOI: 10.1134/s000635092006007x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
13
|
A journey upstream: Fluctuating platelet-specific genes in cell-free plasma as proof-of-concept for using ribonucleic acid sequencing to improve understanding of postinjury platelet biology. J Trauma Acute Care Surg 2020; 88:742-751. [PMID: 32195992 DOI: 10.1097/ta.0000000000002681] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND The mechanisms of aberrant circulating platelet behavior following injury remain unclear. Platelets retain megakaryocyte immature ribonucleic acid (RNA) splicing and protein synthesis machinery to alter their functions based on physiologic signals. We sought to identify fluctuating platelet-specific RNA transcripts in cell-free plasma (CFP) from traumatic brain injury (TBI) patients as proof-of-concept for using RNA sequencing to improve our understanding of postinjury platelet behavior. We hypothesized that we could identify differential expression of activated platelet-specific spliced RNA transcripts from CFP of patients with isolated severe fatal TBI (fTBI) compared with minimally injured trauma controls (t-controls), filtered by healthy control (h-control) data sets. METHODS High-read depth RNA sequencing was applied to CFP from 10 patients with fTBI (Abbreviated Injury Scale [AIS] for head ≥3, AIS for all other categories <3, and expired) and five t-controls (Injury Severity Score ≤1, and survived). A publicly available CFP RNA sequencing data set from 23 h-controls was used to determine the relative steady state of splice-form RNA transcripts discoverable in CFP. Activated platelet-specific spliced RNA transcripts were derived from studies of ex vivo platelet activation and identified by splice junction presence greater than 1.5-fold or less than 0.67-fold ex vivo nonactivated platelet-specific RNA transcripts. RESULTS Forty-two differentially spliced activated platelet-specific RNA transcripts in 34 genes were altered in CFP from fTBI patients (both upregulated and downregulated). CONCLUSION We have discovered differentially expressed activated platelet-specific spliced RNA transcripts present in CFP from isolated severe fTBI patients that are upregulated or downregulated compared with minimally injured trauma controls. This proof-of-concept suggests that a pool of immature platelet RNAs undergo splicing events after injury for presumed modulation of platelet protein products involved in platelet function. This validates our exploration of injury-induced platelet RNA transcript modulation as an upstream "liquid biopsy" to identify novel postinjury platelet biology and treatment targets for aberrant platelet behavior. LEVEL OF EVIDENCE Diagnostic tests, level V.
Collapse
|
14
|
Silczuk A, Habrat B. Alcohol-induced thrombocytopenia: Current review. Alcohol 2020; 86:9-16. [PMID: 32330589 DOI: 10.1016/j.alcohol.2020.02.166] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/27/2019] [Accepted: 02/07/2020] [Indexed: 12/11/2022]
Abstract
Thrombocytopenia is a decrease in the platelet count below 150,000 in a microliter of blood, i.e., below the lower limit of the reference range, which is 150,000-400,000/μL. The phenomenon of thrombocytopenia related to heavy drinking began to arouse interest in the 1960s and 1970s. It was initially described in case reports and clinical studies on small groups. In the following years, the phenomenon itself and the significance of alcohol-induced thrombocytopenia was studied. Many methodological difficulties inhibiting objective conclusions from research were encountered. Model pathological mechanisms of alcohol thrombocytopenia and the effects of alcohol on the structure and function of platelets were described. Furthermore, the phenomenon of rapid normalization of the number of platelets in people who stopped drinking was described. Relationships between alcohol use, its intensity and occurrence, and intensity of thrombocytopenia have been demonstrated. Predictive platelet counts for alcohol withdrawal syndrome complications have been proven and calculated. The risk of occurrence of withdrawal seizures or delirium tremens in alcohol withdrawal syndrome increases significantly when the platelet count is less than 119,000/μL. The knowledge of the nature of the phenomenon of alcohol-induced thrombocytopenia in a clinical environment allows decisions that are more rational. The attention of clinicians should be drawn to the importance of results of blood tests routinely collected on admission.
Collapse
|
15
|
Burkhardt G, Adorjan K, Kambeitz J, Kambeitz-Ilankovic L, Falkai P, Eyer F, Koller G, Pogarell O, Koutsouleris N, Dwyer DB. A machine learning approach to risk assessment for alcohol withdrawal syndrome. Eur Neuropsychopharmacol 2020; 35:61-70. [PMID: 32418843 DOI: 10.1016/j.euroneuro.2020.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 03/04/2020] [Accepted: 03/27/2020] [Indexed: 02/01/2023]
Abstract
At present, risk assessment for alcohol withdrawal syndrome relies on clinical judgment. Our aim was to develop accurate machine learning tools to predict alcohol withdrawal outcomes at the individual subject level using information easily attainable at patients' admission. An observational machine learning analysis using nested cross-validation and out-of-sample validation was applied to alcohol-dependent patients at two major detoxification wards (LMU, n = 389; TU, n = 805). 121 retrospectively derived clinical, blood-derived, and sociodemographic measures were used to predict 1) moderate to severe withdrawal defined by the alcohol withdrawal scale, 2) delirium tremens, and 3) withdrawal seizures. Mild and more severe withdrawal cases could be separated with significant, although highly variable accuracy in both samples (LMU, balanced accuracy [BAC] = 69.4%; TU, BAC = 55.9%). Poor outcome predictions were associated with higher cumulative clomethiazole doses during the withdrawal course. Delirium tremens was predicted in the TU cohort with BAC of 75%. No significant model predicting withdrawal seizures could be found. Our models were unique to each treatment site and thus did not generalize. For both treatment sites and withdrawal outcome different variable sets informed our models' decisions. Besides previously described variables (most notably, thrombocytopenia), we identified new predictors (history of blood pressure abnormalities, urine screening for benzodiazepines and educational attainment). In conclusion, machine learning approaches may facilitate generalizable, individualized predictions for alcohol withdrawal severity. Since predictive patterns highly vary for different outcomes of withdrawal severity and across treatment sites, prediction tools should not be recommended for clinical practice unless adequately validated in specific cohorts.
Collapse
Affiliation(s)
- Gerrit Burkhardt
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich Nussbaumstr. 7, 80336 Munich, Germany.
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich Nussbaumstr. 7, 80336 Munich, Germany; Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, University of Cologne, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich Nussbaumstr. 7, 80336 Munich, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich Nussbaumstr. 7, 80336 Munich, Germany
| | - Florian Eyer
- Department of Clinical Toxicology, TUM School of Medicine, Technical University of Munich, Germany
| | - Gabi Koller
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich Nussbaumstr. 7, 80336 Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich Nussbaumstr. 7, 80336 Munich, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich Nussbaumstr. 7, 80336 Munich, Germany
| | - Dominic B Dwyer
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich Nussbaumstr. 7, 80336 Munich, Germany
| |
Collapse
|
16
|
Bhat A, Das S, Yadav G, Chaudhary S, Vyas A, Islam M, Gupta AC, Bajpai M, Maiwall R, Maras JS, Sarin SK. Hyperoxidized Albumin Modulates Platelets and Promotes Inflammation Through CD36 Receptor in Severe Alcoholic Hepatitis. Hepatol Commun 2020; 4:50-65. [PMID: 31909355 PMCID: PMC6939543 DOI: 10.1002/hep4.1440] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 09/17/2019] [Indexed: 12/14/2022] Open
Abstract
Hyperoxidized albumin promotes inflammation and modulates several immune cells in severe alcoholic hepatitis (SAH). Platelets mediate inflammation by interacting with immune cells, endothelium, and other cells. The role of hyperoxidized albumin in platelet activation and alteration of platelet phenotype/functions is not known. Quantitative platelet proteomics performed in 10 patients with SAH was compared with 10 patients with alcoholic cirrhosis and 10 healthy controls, respectively. Dysregulated pathways were identified and validated in a separate cohort (n = 40). Healthy platelets were exposed to patient plasma or purified albumin or ex vivo modified albumin (human-mercaptalbumin, humannonmercaptalbumin-1, and human nonmercaptalbumin 2) in the presence or absence of CD36 blockade, and platelet secretome was analyzed. Two hundred and two up-regulated proteins linked to platelet activation, complement regulation, lipid transportation, and 321 down-regulated proteins related to platelet hemostasis and coagulation (fold change ± 1.5, P < 0.01) were identified. Blood transcription module enrichment showed an inflammatory phenotype of SAH platelet. Increased level of platelet factor-4, P-selectin, and soluble cluster of differentiation-40 ligand correlated with severity (Model for End-Stage Liver Disease score, r > 0.3, P < 0.05) in SAH. Transcripts linked to platelet activation (increased) and granular secretions (decreased in SAH) correlated with disease severity. SNARE (soluble-N-ethylmaleimide-sensitive-factor-activating-protein-receptor) complex proteins (SNAP-23 [synaptosomal-associated protein 23] and VAMP-8 [vesicle-associated membrane protein 3]) were down-regulated in SAH platelets (P < 0.05). In vitro stimulation of healthy platelets showed enhanced activation with patient plasma, or purified albumin-treatment blocking of CD36 blunted this effect (P < 0.05). Ex vivo modified albumin (primarily nonmercaptalbumin-human nonmercaptalbumin 2 [HNA2; 1 mg/mL]) showed high activation and aggregation and intracellular reactive oxygen species production in healthy platelets (P < 0.05), which significantly reduced after CD36 neutralization. Platelet secretome showed reduced inflammatory mediators and increased repair proteins. Conclusion: Hyperoxidized albumin triggers platelet activation (possibly through the CD36 receptor), promotes inflammation and oxidative stress, and contributes to disease severity in patients with SAH.
Collapse
Affiliation(s)
- Adil Bhat
- Department of Molecular and Cellular MedicineInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Sukanta Das
- Department of Molecular and Cellular MedicineInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Gaurav Yadav
- Department of Molecular and Cellular MedicineInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Sudrishti Chaudhary
- Department of Molecular and Cellular MedicineInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Ashish Vyas
- Department of Molecular and Cellular MedicineInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Mojahidul Islam
- Department of Molecular and Cellular MedicineInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Abhishak C. Gupta
- Department of Molecular and Cellular MedicineInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Meenu Bajpai
- Department of Transfusion MedicineInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Rakhi Maiwall
- Department of HepatologyInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Jaswinder Singh Maras
- Department of Molecular and Cellular MedicineInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Shiv K. Sarin
- Department of Molecular and Cellular MedicineInstitute of Liver and Biliary SciencesNew DelhiIndia
- Department of HepatologyInstitute of Liver and Biliary SciencesNew DelhiIndia
| |
Collapse
|
17
|
Abstract
Lymphocyte-related parameters in Alcohol Use Disorder (AUD) have recently been investigated. However, knowledge of platelet to lymphocyte ratio (PLR) in AUD is limited. In this study, we compared complete blood count values of 31 AUD male patients and 31 healthy male controls. There was no significant difference between the two groups in terms of PLR (p = .123). When the age was controlled, there was a negative correlation between the duration of alcohol use and PLR (r = -0.567; p = .005). The significance of the parameters in the AUD group was found to be related to the duration of alcohol use.
Collapse
Affiliation(s)
| | - Mahmut Zabit Kara
- Child and Adolescent Psychiatry, Health Sciences University, Antalya Training and Research Hospital, Antalya, Turkey
| |
Collapse
|
18
|
Haynes A, Halpert P, Levine M. Colorimetric Detection of Aliphatic Alcohols in β-Cyclodextrin Solutions. ACS OMEGA 2019; 4:18361-18369. [PMID: 31720538 PMCID: PMC6844157 DOI: 10.1021/acsomega.9b02612] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 10/10/2019] [Indexed: 05/20/2023]
Abstract
The sensitive, selective, and practical detection of aliphatic alcohols is a continuing technical challenge with significant impact in public health research and environmental remediation efforts. Reported herein is the use of a β-cyclodextrin derivative to promote proximity-induced interactions between aliphatic alcohol analytes and a brightly colored organic dye, which resulted in highly analyte-specific color changes that enabled accurate alcohol identification. Linear discriminant analysis of the color changes enabled 100% differentiation of the colorimetric signals obtained from methanol, ethanol, and isopropanol in combination with BODIPY and Rhodamine dyes. The resulting solution-state detection system has significant broad-based applicability because it uses only easily available materials to achieve such detection with moderate limits of detection obtained. Future research with this sensor system will focus on decreasing limits of detection as well as on optimizing the system for quantitative detection applications.
Collapse
Affiliation(s)
- Anna Haynes
- Department
of Chemistry, University of Rhode Island, 140 Flagg Road, Kingston, Rhode Island 02881, United States
| | - Priva Halpert
- Stella
K. Abraham High School for Girls, 291 Meadowview Ave, Hewlett, New York 11557, United States
| | - Mindy Levine
- Department
of Chemistry, University of Rhode Island, 140 Flagg Road, Kingston, Rhode Island 02881, United States
| |
Collapse
|
19
|
Targeting Tyrosine Phosphatases by 3-Bromopyruvate Overcomes Hyperactivation of Platelets from Gastrointestinal Cancer Patients. J Clin Med 2019; 8:jcm8070936. [PMID: 31261776 PMCID: PMC6678874 DOI: 10.3390/jcm8070936] [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] [Received: 05/16/2019] [Revised: 06/17/2019] [Accepted: 06/21/2019] [Indexed: 12/24/2022] Open
Abstract
Venous thromboembolism (VTE) is one of the most common causes of cancer related mortality. It has been speculated that hypercoagulation in cancer patients is triggered by direct or indirect contact of platelets with tumor cells, however the underlying molecular mechanisms involved are currently unknown. Unraveling these mechanisms may provide potential avenues for preventing platelet-tumor cell aggregation. Here, we investigated the role of protein tyrosine phosphatases in the functionality of platelets in both healthy individuals and patients with gastrointestinal cancer, and determined their use as a target to inhibit platelet hyperactivity. This is the first study to demonstrate that platelet agonists selectively activate low molecular weight protein tyrosine phosphatase (LMWPTP) and PTP1B, resulting in activation of Src, a tyrosine kinase known to contribute to several platelet functions. Furthermore, we demonstrate that these phosphatases are a target for 3-bromopyruvate (3-BP), a lactic acid analog currently investigated for its use in the treatment of various metabolic tumors. Our data indicate that 3-BP reduces Src activity, platelet aggregation, expression of platelet activation makers and platelet-tumor cell interaction. Thus, in addition to its anti-carcinogenic effects, 3-BP may also be effective in preventing platelet-tumor cell aggregationin cancer patients and therefore may reduce cancer mortality by limiting VTE in patients.
Collapse
|
20
|
Acquired platelet function disorders. Thromb Res 2019; 196:561-568. [PMID: 31229273 DOI: 10.1016/j.thromres.2019.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 06/08/2019] [Accepted: 06/14/2019] [Indexed: 12/16/2022]
Abstract
The possibility of an acquired platelet function disorder should be considered in patients who present with recent onset muco-cutaneous bleeding. Despite the availability of newer and faster platelet function assays, light transmission aggregometry (LTA) remains the preferred diagnostic test. This review examines and discusses the causes of acquired platelet dysfunction; most commonly drugs, dietary factors, medical disorders and procedures. In addition to well-known antiplatelet therapies, clinicians should be alert for newer drugs which can affect platelets, such as ibrutinib. There is little clinical trial evidence to guide the management of acquired platelet function defects, but we summarise commonly employed strategies, which include addressing the underlying cause, antifibrinolytic agents, desmopressin infusions, and in selected patients, platelet transfusions.
Collapse
|
21
|
Li S, Huang Z, Chen W, Pan C, Huang Z. Risk factors for postoperative hemorrhage in patients with oral squamous cell carcinoma: A retrospective study. Head Neck 2019; 41:2093-2099. [PMID: 30706556 DOI: 10.1002/hed.25659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 12/22/2018] [Accepted: 01/04/2019] [Indexed: 12/26/2022] Open
Affiliation(s)
- Shihao Li
- Department of Oral and Maxillofacial SurgerySun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou Guangdong China
| | - Zixian Huang
- Department of Oral and Maxillofacial SurgerySun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou Guangdong China
| | - Weiliang Chen
- Department of Oral and Maxillofacial SurgerySun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou Guangdong China
| | - Chaobin Pan
- Department of Oral and Maxillofacial SurgerySun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou Guangdong China
| | - Zhiquan Huang
- Department of Oral and Maxillofacial SurgerySun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou Guangdong China
| |
Collapse
|
22
|
Grigorian A, Gambhir S, Al-Khouja L, Gabriel V, Schubl SD, Nastanski F, Lekawa M, Joe V, Nahmias J. Decreased incidence of venous thromboembolism found in trauma patients with positive blood alcohol concentration on admission. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2018; 45:77-83. [PMID: 30084660 DOI: 10.1080/00952990.2018.1504951] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND The reported incidence of venous thromboembolism (VTE) disease in trauma is 1-58% and is considered a preventable cause of mortality. Positive blood alcohol concentration (BAC) is found in 8-45% of trauma admissions; however, its association with VTE is controversial. OBJECTIVES We hypothesized that a positive BAC on admission would be associated with a lower rate of VTE in a large national database of trauma patients. METHODS We queried the largest United States trauma registry, National Trauma Data Bank (2007-2015), for any patient with positive BAC on admission. The primary outcome was VTE and the secondary outcome was mortality. A multivariable logistic regression model was used for analysis. RESULTS From 2,725,032 patients (70.1% male, 29.9% female), 1,800,216 (66.1%) had a negative BAC while 924,816 (33.9%) had a positive BAC. A positive BAC was associated with lower rates of VTE (OR = 0.88, CI = 0.86-0.90, p < 0.001) and mortality (OR = 0.91, CI = 0.90-0.93, p < 0.001). CONCLUSION In a large national database, trauma patients with a positive BAC were associated with a lower rate of VTE compared to those with negative BAC. Additionally, trauma patients with positive BAC had a lower association with mortality. These findings remained after adjustment of well-known risk factors for VTE and mortality, respectively.
Collapse
Affiliation(s)
- Areg Grigorian
- a Department of Surgery, Division of Trauma, Burns and Surgical Critical Care , University of California, Irvine , Orange , CA , USA
| | - Sahil Gambhir
- a Department of Surgery, Division of Trauma, Burns and Surgical Critical Care , University of California, Irvine , Orange , CA , USA
| | - Lutfi Al-Khouja
- a Department of Surgery, Division of Trauma, Burns and Surgical Critical Care , University of California, Irvine , Orange , CA , USA
| | - Viktor Gabriel
- a Department of Surgery, Division of Trauma, Burns and Surgical Critical Care , University of California, Irvine , Orange , CA , USA
| | - Sebastian D Schubl
- a Department of Surgery, Division of Trauma, Burns and Surgical Critical Care , University of California, Irvine , Orange , CA , USA
| | - Frank Nastanski
- a Department of Surgery, Division of Trauma, Burns and Surgical Critical Care , University of California, Irvine , Orange , CA , USA
| | - Michael Lekawa
- a Department of Surgery, Division of Trauma, Burns and Surgical Critical Care , University of California, Irvine , Orange , CA , USA
| | - Victor Joe
- a Department of Surgery, Division of Trauma, Burns and Surgical Critical Care , University of California, Irvine , Orange , CA , USA
| | - Jeffry Nahmias
- a Department of Surgery, Division of Trauma, Burns and Surgical Critical Care , University of California, Irvine , Orange , CA , USA
| |
Collapse
|
23
|
Avellaneda-Gómez C, Serra Martínez M, Rodríguez-Campello A, Ois Á, Cuadrado-Godia E, Giralt-Steinhauer E, Vivanco-Hidalgo R, Jiménez-Conde J, Gómez-González A, de Ceballos Cerrajería P, Zabalza de Torres A, Mola-Caminal M, Soriano-Tárraga C, Roquer J. Alcohol overuse and intracerebral hemorrhage: characteristics and long-term outcome. Eur J Neurol 2018; 25:1358-1364. [PMID: 29938871 DOI: 10.1111/ene.13734] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 06/21/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Alcohol overuse (AOu) is considered an important risk factor for spontaneous intracerebral hemorrhage (ICH). The clinical and outcome characteristics of these patients (AOu-ICH) are not well known. METHODS All patients with ICH admitted to a single university tertiary stroke center were prospectively studied from May 2005 to May 2015. Demographic profiles, radiologic characteristics and clinical outcomes of patients with acute ICH and previous AOu (>40 g/day or >300 g/week) were analyzed. RESULTS During the study period, 555 patients with spontaneous primary ICH met the inclusion criteria. A total of 81 patients (14.6%) reported AOu (24.3% of men vs. 3.1% of women; P < 0.0001; mean age, 63 years old for AOu vs. 74 years old for non-AOu; P < 0.0001). Of the classic cardiovascular risk factors, only smoking was associated with AOu (63% vs. 12.2% of non-AOu; P < 0.0001). Initial severity and hematoma volume were similar in both groups, with no observed differences in stroke care or in-hospital medical complications. Patients with AOu had worse outcome (modified Rankin Scale score, 3-6 points) than patients without AOu at 3 months [odds ratio (OR), 2.50; 95% confidence interval (CI), 1.32-4.75; P = 0.005] and 12 months (OR, 2.47; 95% CI, 1.23-5.00; P = 0.011). A similar trend was observed at 5 years (OR, 2.48; 95% CI, 0.96-6.39; P = 0.059). CONCLUSIONS Alcohol overuse was present in 14.6% of patients with ICH, who were predominantly male, smokers and a mean of 11 years younger than the non-AOu group. Despite a lack of differences in initial clinical severity, stroke care and early medical complications, patients with AOu had worse short- and long-term outcomes.
Collapse
Affiliation(s)
| | | | - A Rodríguez-Campello
- Neurology Department, Hospital del Mar, Barcelona.,IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona.,Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona
| | - Á Ois
- Neurology Department, Hospital del Mar, Barcelona.,IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona.,Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona
| | - E Cuadrado-Godia
- IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona.,DCEXS, Universitat Pompeu Fabra, Barcelona, Spain
| | - E Giralt-Steinhauer
- Neurology Department, Hospital del Mar, Barcelona.,IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona
| | - R Vivanco-Hidalgo
- IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona
| | - J Jiménez-Conde
- Neurology Department, Hospital del Mar, Barcelona.,IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona.,Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona
| | - A Gómez-González
- Neurology Department, Hospital del Mar, Barcelona.,IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona
| | | | | | - M Mola-Caminal
- IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona
| | - C Soriano-Tárraga
- IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona
| | - J Roquer
- Neurology Department, Hospital del Mar, Barcelona.,IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona.,Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona
| |
Collapse
|
24
|
Animal models of binge drinking, current challenges to improve face validity. Neurosci Biobehav Rev 2018; 106:112-121. [PMID: 29738795 DOI: 10.1016/j.neubiorev.2018.05.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 03/29/2018] [Accepted: 05/01/2018] [Indexed: 01/08/2023]
Abstract
Binge drinking (BD), i.e., consuming a large amount of alcohol in a short period of time, is an increasing public health issue. Though no clear definition has been adopted worldwide the speed of drinking seems to be a keystone of this behavior. Developing relevant animal models of BD is a priority for gaining a better characterization of the neurobiological and psychobiological mechanisms underlying this dangerous and harmful behavior. Until recently, preclinical research on BD has been conducted mostly using forced administration of alcohol, but more recent studies used scheduled access to alcohol, to model more voluntary excessive intakes, and to achieve signs of intoxications that mimic the human behavior. The main challenges for future research are discussed regarding the need of good face validity, construct validity and predictive validity of animal models of BD.
Collapse
|
25
|
Determinants of re-operation for bleeding in head and neck cancer surgery. The Journal of Laryngology & Otology 2018. [PMID: 29517474 DOI: 10.1017/s0022215118000294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Post-operative bleeding in the head and neck area is potentially fatal. This 'real world' study sought to assess factors that increase the risk of re-operation for post-operative bleeding in head and neck cancer surgery. METHODS A total of 456 patients underwent surgery for head and neck cancer (591 operations). The primary endpoint was re-operation for bleeding. RESULTS The rate of re-operation for bleeding was 5 per cent of all operations. Re-operation for bleeding was an independent risk factor for 30-day mortality (odds ratio = 5.27, p = 0.014). Risk factors for re-operation because of bleeding included excessive (more than 4000 ml) fluid administration (over 24 hours) (p < 0.001), heavy alcohol consumption (p = 0.014), pre-operative oncological treatment (p = 0.017), advanced disease stage (p = 0.020) and higher tumour (T) classification (p = 0.034). Operations with more excessive bleeding (700 ml or more) were associated with an increased risk (p = 0.001) of re-operation for post-operative bleeding. Moreover, the risk of re-operation was significantly higher in patients undergoing microvascular surgery compared to those who had no oncological treatment pre-operatively (18 vs 6 per cent, p = 0.001). CONCLUSION The 30-day mortality risk increased over 5-fold in patients undergoing re-operation for bleeding.
Collapse
|
26
|
De Silva E, Kim H. Drug-induced thrombocytopenia: Focus on platelet apoptosis. Chem Biol Interact 2018; 284:1-11. [PMID: 29410286 DOI: 10.1016/j.cbi.2018.01.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 12/23/2017] [Accepted: 01/18/2018] [Indexed: 12/16/2022]
Abstract
Thrombocytopenia is a serious and potentially fatal complication of drug therapy that results either from a decrease in bone marrow platelet production or the excessive destruction of circulating platelets. Although multiple mechanisms are responsible for deregulated platelet clearance, the role of programmed platelet death (apoptosis) in drug-induced thrombocytopenia has been relatively under-investigated until recently. Here we review apoptotic signaling pathways in platelets, with a focus on current data that provide mechanistic insights into drug-induced apoptosis and thrombocytopenia.
Collapse
Affiliation(s)
- Enoli De Silva
- Centre for Blood Research, University of British Columbia, Vancouver, Canada; Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, Canada
| | - Hugh Kim
- Centre for Blood Research, University of British Columbia, Vancouver, Canada; Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, Canada; Faculty of Dentistry, University of British Columbia, Vancouver, Canada.
| |
Collapse
|