1
|
Rodríguez-Carrio J, Carrillo-López N, Ulloa C, Martín-Carro B, Rodríguez-Suárez C, Naves-Díaz M, Sánchez-Álvarez E, Rodríguez-García M, Arcidiacono MV, Fernández-Mariño B, Cannata-Andía JB, Suárez A, Dusso AS. Novel Immune Cell Subsets Exhibit Different Associations With Vascular Outcomes in Chronic Kidney Disease Patients-Identifying Potential Biomarkers. Front Med (Lausanne) 2021; 8:618286. [PMID: 34113627 PMCID: PMC8185045 DOI: 10.3389/fmed.2021.618286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 04/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background and Aims: Alterations in novel immune cell subsets, such as angiogenic T cells (Tang), senescent T cells (CD4+CD28null), and monocyte subsets are associated with impaired vascular homeostasis in several inflammatory conditions. However, mediators underlying vascular deterioration in chronic kidney disease (CKD) are poorly characterized. This study assessed their role in the vascular deterioration of CKD using a broad spectrum of surrogate markers ranging from altered functionality to overt calcification. Methods: Tang (CD3+CD31+CXCR4+), CD4+CD28null cells, and monocytes [CD14/CD16 subsets and angiotensin-converting enzyme (ACE) expression] were measured in peripheral blood by flow cytometry in 33 CKD stage 5 patients undergoing peritoneal dialysis (CKD5-PD) and 15 healthy controls (HCs). Analyses were replicated in a hemodialysis cohort. Vascular surrogate markers (including adventitial vasa vasorum, pulse wave velocity, intima-media thickness, and vascular calcification) were assessed by appropriate imaging methods. Results: In CKD5-PD, decreased Tang levels (p < 0.001) were unrelated to clinical features or traditional cardiovascular (CV) risk factors but correlated negatively with troponin T levels (r = −0.550, p = 0.003). Instead, CD4+CD28null frequency was increased (p < 0.001), especially in those with vascular calcifications. Quantitative and qualitative differences were also observed within the monocyte pool, a shift toward CD16+ subsets and ACE expression being found in CKD. Equivalent results were observed in the replication cohort. Each subset associated distinctly with adverse vascular outcomes in univariate and multivariate analyses: while Tang depletion was linked to poor vascular function and subclinical atherosclerosis, increases in CD4+CD28null were associated with overt vascular thickening and calcification. Monocytes were not independently associated with vascular outcomes in CKD patients. Conclusions: Novel T cell and monocyte subsets are altered in CKD. Altered T-cell subpopulations, but not monocytes, exhibited distinct associations with different vascular outcomes in CKD. Tang are emerging biomarkers of subclinical vascular deterioration in CKD.
Collapse
Affiliation(s)
- Javier Rodríguez-Carrio
- Area of Immunology, Department of Functional Biology, University of Oviedo, Oviedo, Spain.,Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Natalia Carrillo-López
- Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,REDinREN-ISCIII, Oviedo, Spain
| | - Catalina Ulloa
- Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.,Department of Nephrology, Hospital Universitario de Cabueñes, Gijón, Spain
| | - Beatriz Martín-Carro
- Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,REDinREN-ISCIII, Oviedo, Spain
| | | | - Manuel Naves-Díaz
- Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,REDinREN-ISCIII, Oviedo, Spain
| | - Emilio Sánchez-Álvarez
- REDinREN-ISCIII, Oviedo, Spain.,Department of Nephrology, Hospital Universitario de Cabueñes, Gijón, Spain
| | - Minerva Rodríguez-García
- REDinREN-ISCIII, Oviedo, Spain.,Division of Nephrology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | | - Jorge B Cannata-Andía
- Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,REDinREN-ISCIII, Oviedo, Spain.,Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Ana Suárez
- Area of Immunology, Department of Functional Biology, University of Oviedo, Oviedo, Spain.,Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Adriana S Dusso
- Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,REDinREN-ISCIII, Oviedo, Spain.,Department of Medicine, University of Oviedo, Oviedo, Spain
| |
Collapse
|
2
|
Influence of Morbid Obesity and Bariatric Surgery Impact on the Carotid Adventitial Vasa Vasorum Signal. Obes Surg 2019; 28:3935-3942. [PMID: 30030728 DOI: 10.1007/s11695-018-3410-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION/PURPOSE Adventitial vasa vasorum (VV) expansion to the avascular intima precedes an increase in carotid intima-media thickness. However, factors involved in the development of the atherosclerotic process and its reversibility remain unclear. We aimed to evaluate the VV signal in both morbid obesity and after bariatric surgery (BS). MATERIALS/METHODS We conducted a case-control study to examine the VV signal in the carotid of 40 morbidly obese patients and 40 non-obese controls. The effect of BS was evaluated in 33 patients. Contrast-enhanced carotid ultrasound was used to assess the VV signal. RESULTS The mean VV density was higher in obese than in non-obese subjects (0.739 ± 0.117 vs. 0.570 ± 0.111, p < 0.001). The VV signal positively correlated with BMI (p < 0.001) and waist circumference (p = 0.001) but was not related to cIMT. The stepwise multivariate regression analysis revealed that waist circumference (beta = 0.507, p < 0.001) together with fasting plasma glucose (beta = 0.229, p = 0.024) were independently associated with the VV signal (R2 = 0.382). Before BS, the median VV signal correlated with soluble intercellular adhesion molecule 1 (p = 0.022). After a 12-month follow-up, a 12.0% decrease in VV (0.731 ± 0.126 vs. 0.643 ± 0.115, p = 0.003) was observed. In the univariate analysis, the decrease in VV was associated with the baseline VV density (p < 0.001), baseline systolic blood pressure (p = 0.019) and a decrease in sICAM (p = 0.005). However, only baseline systolic pressure (beta = 0.417, p = 0.024) independently predicted the absolute change in VV signal (R2 = 0.174). CONCLUSIONS Morbidly obesity is associated with increased VV density. In addition, BS appears to reduce the earlier expansion of the adventitial vasa vasorum.
Collapse
|
3
|
Pereira T, Muguruza J, Mária V, Vilaprinyo E, Sorribas A, Fernandez E, Fernandez-Armenteros JM, Baena JA, Rius F, Betriu A, Solsona F, Alves R. Automatic Methods for Carotid Contrast-Enhanced Ultrasound Imaging Quantification of Adventitial Vasa Vasorum. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:2780-2792. [PMID: 30205994 DOI: 10.1016/j.ultrasmedbio.2018.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 07/27/2018] [Accepted: 07/29/2018] [Indexed: 06/08/2023]
Abstract
Adventitial vasa vasorum are physiologic microvessels that nourish artery walls. In the presence of cardiovascular risk factors, these microvessels proliferate abnormally. Studies have reported that they are the first stage of atheromatous disease. Contrast-enhanced ultrasound (CEUS) of the carotid allows direct, quantitative and non-invasive visualization of the adventitial vasa vasorum. Hence, the development of computer-assisted methods that speed image analysis and eliminate user subjectivity is important. We developed methods for automatic analyses and quantification of vasa vasorum neovascularization in CEUS and tested these methods in a cohort of 186 individuals, 63 of whom were healthy volunteers. We implemented alternative automatic strategies for using the images to stratify patients according to their risk group and compare the strategies with respect to diagnostic performance. An automatic single-parameter strategy performs less effectively than the corresponding Arcidiacono method based on manual interpretation of the images (68 < area under the receiver operating characteristic curve [AUROC] for the manual Arcidiacono method < 82; 60 < AUROC for the automatic single-parameter strategy < 63). However, by use of additional image parameters, an automatic multiparameter strategy has significantly improved performance with respect to the manual Arcidiacono method (78 < AUROC < 90). The automatic multiparameter strategy is a valuable alternative to the manual Arcidiacono method, improving both diagnostic speed and diagnostic accuracy.
Collapse
Affiliation(s)
- Tania Pereira
- Department of Basic Medical Science, University of Lleida, Catalonia, Spain; Institute for Biomedical Research in Lleida, Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain
| | - Jose Muguruza
- Department of Computer Science, University of Lleida, Catalonia, Spain
| | - Virtu Mária
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA), Hospital Universitari Arnau de Vilanova de Lleida (HUAVL), Catalonia, Spain; Vascular and Renal Translational Research Group, IRBLleida, Catalonia, Spain
| | - Ester Vilaprinyo
- Department of Basic Medical Science, University of Lleida, Catalonia, Spain; Institute for Biomedical Research in Lleida, Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain
| | - Albert Sorribas
- Department of Basic Medical Science, University of Lleida, Catalonia, Spain; Institute for Biomedical Research in Lleida, Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain
| | - Elvira Fernandez
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA), Hospital Universitari Arnau de Vilanova de Lleida (HUAVL), Catalonia, Spain; Vascular and Renal Translational Research Group, IRBLleida, Catalonia, Spain
| | - Jose Manuel Fernandez-Armenteros
- Institute for Biomedical Research in Lleida, Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain; Servei de Dermatologia, HUAVL and IRBLleida, Catalonia, Spain
| | - Juan Antonio Baena
- Institute for Biomedical Research in Lleida, Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain; Unitat de Cirurgia Endocrina, Bariàtrica i Metabolica, HUAVL and IRBLleida, Catalonia, Spain
| | - Ferran Rius
- Institute for Biomedical Research in Lleida, Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain; Endocrinology and Nutrition Department, HUAVL and IRBLleida, Catalonia, Spain
| | - Angels Betriu
- Unit for the Detection and Treatment of Atherothrombotic Diseases (UDETMA), Hospital Universitari Arnau de Vilanova de Lleida (HUAVL), Catalonia, Spain; Vascular and Renal Translational Research Group, IRBLleida, Catalonia, Spain
| | - Francesc Solsona
- Department of Computer Science, University of Lleida, Catalonia, Spain
| | - Rui Alves
- Department of Basic Medical Science, University of Lleida, Catalonia, Spain; Institute for Biomedical Research in Lleida, Dr. Pifarré Foundation (IRBLleida), Catalonia, Spain.
| |
Collapse
|
4
|
Arcidiacono MV, Rimondi E, Maietti E, Melloni E, Tisato V, Gallo S, Valdivielso JM, Fernández E, Betriu À, Voltan R, Zauli G, Volpato S, Secchiero P. Relationship between low levels of circulating TRAIL and atheromatosis progression in patients with chronic kidney disease. PLoS One 2018; 13:e0203716. [PMID: 30204795 PMCID: PMC6133360 DOI: 10.1371/journal.pone.0203716] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 08/24/2018] [Indexed: 12/15/2022] Open
Abstract
Background Chronic kidney disease (CKD) patients experience a high risk of cardiovascular disease (CV); however, the factors involved in CV-related morbidity and mortality in these patients have not been fully defined. Tumor necrosis factor related apoptosis-inducing ligand (TRAIL) is a cytokine, which exhibits pleiotropic activities on endothelial, vascular smooth muscle and inflammatory cells, with relevant effects on atheromatous plaque formation. On this basis, the present study aims to investigate the role of TRAIL in atheromatosis progression in CKD patients. Methods Circulating TRAIL levels were measured in 378 CKD patients belonging to the Spanish National Observatory of Atherosclerosis in Nephrology (NEFRONA) study. All patients were free of previous CV events. Carotid and femoral B-mode ultrasound was performed to detect the presence of plaque at baseline and after 24 months of follow-up. Results The lowest levels of TRAIL at baseline were significantly (p<0.05) associated with the appearance, after 24 months of follow-up, of at least two new atheromatous plaques in all territories and of one new plaque in the carotid artery, even after adjusting for CV risk factors. In addition, the patients with low levels of TRAIL at baseline were characterized by the presence of at least one hypoechoic plaque in the carotid artery. This association was significant (p<0.05) even after adjusting for CKD stage. Conclusions Overall, the results of our study suggest TRAIL as an assertable independent prognostic biomarker for atheromatosis plaque formation in CKD patients. This observation further supports the potential role of TRAIL for the prevention/treatment of CV disease.
Collapse
Affiliation(s)
- Maria Vittoria Arcidiacono
- Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Via dell'Istria, Trieste, Italy
- Department of Morphology, Surgery and Experimental Medicine and LTTA Centre, University of Ferrara, Via Fossato di Mortara 70, Ferrara, Italy
- * E-mail:
| | - Erika Rimondi
- Department of Morphology, Surgery and Experimental Medicine and LTTA Centre, University of Ferrara, Via Fossato di Mortara 70, Ferrara, Italy
| | - Elisa Maietti
- Department of Medical Sciences, University of Ferrara, Via Fossato di Mortara 64/b, Ferrara, Italy
| | - Elisabetta Melloni
- Department of Morphology, Surgery and Experimental Medicine and LTTA Centre, University of Ferrara, Via Fossato di Mortara 70, Ferrara, Italy
| | - Veronica Tisato
- Department of Morphology, Surgery and Experimental Medicine and LTTA Centre, University of Ferrara, Via Fossato di Mortara 70, Ferrara, Italy
| | - Stefania Gallo
- Department of Morphology, Surgery and Experimental Medicine and LTTA Centre, University of Ferrara, Via Fossato di Mortara 70, Ferrara, Italy
| | - Jose Manuel Valdivielso
- Grupo de Investigación Translacional Vascular y Renal, and RedinRen RETIC, ISCIII, Instituto de Investigación Biomédica de Lleida (IRBLleida), Lleida, Spain
| | - Elvira Fernández
- Grupo de Investigación Translacional Vascular y Renal, and RedinRen RETIC, ISCIII, Instituto de Investigación Biomédica de Lleida (IRBLleida), Lleida, Spain
| | - Àngels Betriu
- Grupo de Investigación Translacional Vascular y Renal, and RedinRen RETIC, ISCIII, Instituto de Investigación Biomédica de Lleida (IRBLleida), Lleida, Spain
| | - Rebecca Voltan
- Department of Morphology, Surgery and Experimental Medicine and LTTA Centre, University of Ferrara, Via Fossato di Mortara 70, Ferrara, Italy
| | - Giorgio Zauli
- Department of Morphology, Surgery and Experimental Medicine and LTTA Centre, University of Ferrara, Via Fossato di Mortara 70, Ferrara, Italy
| | - Stefano Volpato
- Department of Medical Sciences, University of Ferrara, Via Fossato di Mortara 64/b, Ferrara, Italy
| | - Paola Secchiero
- Department of Morphology, Surgery and Experimental Medicine and LTTA Centre, University of Ferrara, Via Fossato di Mortara 70, Ferrara, Italy
| |
Collapse
|
5
|
Pereira T, Betriu A, Alves R. Non-invasive imaging techniques and assessment of carotid vasa vasorum neovascularization: Promises and pitfalls. Trends Cardiovasc Med 2018; 29:71-80. [PMID: 29970286 DOI: 10.1016/j.tcm.2018.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/12/2018] [Accepted: 06/14/2018] [Indexed: 12/17/2022]
Abstract
Carotid adventitia vasa vasorum neovascularization (VVn) is associated with the initial stages of arteriosclerosis and with the formation of unstable plaque. However, techniques to accurately quantify that neovascularization in a standard, fast, non-invasive, and efficient way are still lacking. The development of such techniques holds the promise of enabling wide, inexpensive, and safe screening programs that could stratify patients and help in personalized preventive cardiovascular medicine. In this paper, we review the recent scientific literature pertaining to imaging techniques that could set the stage for the development of standard methods for quantitative assessment of atherosclerotic plaque and carotid VVn. We present and discuss the alternative imaging techniques being used in clinical practice and we review the computational developments that are contributing to speed up image analysis and interpretation. We conclude that one of the greatest upcoming challenges will be the use of machine learning techniques to develop automated methods that assist in the interpretation of images to stratify patients according to their risk.
Collapse
Affiliation(s)
- T Pereira
- Institute for Biomedical Research in Lleida Dr. Pifarré Foundation, Catalonia, Spain; Departament de Ciències Mèdiques Bàsiques, University of Lleida, Catalonia, Spain.
| | - A Betriu
- Unit for the Detection and Treatment of Atherothrombotic Diseases, Hospital Universitari Arnau de Vilanova de Lleida, Catalonia, Spain; Vascular and Renal Translational Research Group - IRBLleida, Catalonia, Spain
| | - R Alves
- Institute for Biomedical Research in Lleida Dr. Pifarré Foundation, Catalonia, Spain; Departament de Ciències Mèdiques Bàsiques, University of Lleida, Catalonia, Spain
| |
Collapse
|