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de Oliveira M, Duarte SB, Giacomini G, Pereira PCM, de Souza LDR, Miranda JRDA, de Pina DR. A lung image reconstruction from computed radiography images as a tool to tuberculosis treatment control. J Venom Anim Toxins Incl Trop Dis 2019; 25:e144918. [PMID: 31130999 PMCID: PMC6483412 DOI: 10.1590/1678-9199-jvatitd-1449-18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 10/08/2018] [Indexed: 11/21/2022] Open
Abstract
Background Background: Tuberculosis (TB) is an infectious lung disease with high worldwide incidence that severely compromises the quality of life in affected individuals. Clinical tests are currently employed to monitor pulmonary status and treatment progression. The present study aimed to apply a three-dimensional (3D) reconstruction method based on chest radiography to quantify lung-involvement volume of TB acute-phase patients before and after treatment. In addition, these results were compared with indices from conventional clinical exams to show the coincidence level. Methods A 3D lung reconstruction method using patient chest radiography was applied to quantify lung-involvement volume using retrospective examinations of 50 patients who were diagnosed with pulmonary TB and treated with two different drugs schemes. Twenty-five patients were treated with Scheme I (rifampicin, isoniazid, and pyrazinamide), whereas twenty-five patients were treated with Scheme II (rifampicin, isoniazid, pyrazinamide, and ethambutol). Acute-phase reaction: Serum exams included C-reactive protein levels, erythrocyte sedimentation rate, and albumin levels. Pulmonary function was tested posttreatment. Results We found strong agreement between lung involvement and serum indices pre- and posttreatment. Comparison of the functional severity degree with lung involvement based on 3D image quantification for both treatment schemes found a high correlation. Conclusions The present 3D reconstruction method produced a satisfactory agreement with the acute-phase reaction, most notably a higher significance level with the C-reactive protein. We also found a quite reasonable coincidence between the 3D reconstruction method and the degree of functional lung impairment posttreatment. The performance of the quantification method was satisfactory when comparing the two treatment schemes. Thus, the 3D reconstruction quantification method may be useful tools for monitoring TB treatment. The association with serum indices are not only inexpensive and sensitive but also may be incorporated into the assessment of patients during TB treatment.
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Affiliation(s)
- Marcela de Oliveira
- Universidade Estadual Paulista, Instituto de Biociências de Botucatu, Departamento de Física e Biofísica, Botucatu, SP, Brasil
| | - Sergio Barbosa Duarte
- Centro Brasileiro de Pesquisas Físicas, Departamento de Altas Energias, Rio de Janeiro, RJ, Brasil
| | - Guilherme Giacomini
- Universidade Estadual Paulista, Instituto de Biociências de Botucatu, Departamento de Física e Biofísica, Botucatu, SP, Brasil
| | - Paulo Câmara Marques Pereira
- Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Departamento de Doenças Tropicais e Diagnóstico por Imagem, Botucatu, SP, Brasil
| | - Lenice do Rosário de Souza
- Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Departamento de Doenças Tropicais e Diagnóstico por Imagem, Botucatu, SP, Brasil
| | - José Ricardo de Arruda Miranda
- Universidade Estadual Paulista, Instituto de Biociências de Botucatu, Departamento de Física e Biofísica, Botucatu, SP, Brasil
| | - Diana Rodrigues de Pina
- Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Departamento de Doenças Tropicais e Diagnóstico por Imagem, Botucatu, SP, Brasil
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de Vos A, Roelofs J, van der Loos C, de Boer O, van’t Veer C, Conway E, Poll TVD, Kager L. The thrombomodulin lectin-like domain does not change host responses to tuberculosis. Thromb Haemost 2017; 111:345-53. [DOI: 10.1160/th13-08-0719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 09/17/2013] [Indexed: 11/05/2022]
Abstract
SummaryTuberculosis (TB), caused by Mycobacterium (M.) tuberculosis, is a devastating infectious disease causing many deaths world-wide. Thrombomodulin (TM) is a multidomain glycoprotein expressed on all vascular endothelial cells. We here studied the role of the lectin-like domain of TM, responsible for a variety of anti-inflammatory properties of TM, during TB. We compared the extent of TM-expression in human lung tissue of TB and control patients. The, the role of the lectin-like domain of TM was investigated by comparing mice lacking this domain (TMLeD/LeD mice) with wild-type (WT) mice during experimental lung TB induced by infection with M. tuberculosis via the airways. Lungs were harvested for analyses at two, six and 29 weeks after infection. Lung TM-expression was downregulated in TB patients, which was not related to changes in the amount of endothelium in infected lungs. TMLeD/LeD mice showed unaltered mycobacterial loads in lungs, liver and spleen during experimental TB. Additionally, lung histopathology and cytokine concentrations were largely similar in TMLeD/LeD and WT mice, while total leukocyte counts were increased in lungs of TMLeD/LeD mice after 29 weeks of infection. Mortality did not occur in either group. The lectin-like domain of TM does not play an important role in the host response to M. tuberculosis infection in mice.
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Kothari H, Keshava S, Vatsyayan R, Mackman N, Rao LVM, Pendurthi UR. Role of tissue factor in Mycobacterium tuberculosis-induced inflammation and disease pathogenesis. PLoS One 2014; 9:e114141. [PMID: 25462128 PMCID: PMC4252100 DOI: 10.1371/journal.pone.0114141] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 11/03/2014] [Indexed: 12/23/2022] Open
Abstract
Tuberculosis (TB) is a chronic lung infectious disease characterized by severe inflammation and lung granulomatous lesion formation. Clinical manifestations of TB include hypercoagulable states and thrombotic complications. We previously showed that Mycobacterium tuberculosis (M.tb) infection induces tissue factor (TF) expression in macrophages in vitro. TF plays a key role in coagulation and inflammation. In the present study, we investigated the role of TF in M.tb-induced inflammatory responses, mycobacterial growth in the lung and dissemination to other organs. Wild-type C57BL/6 and transgenic mice expressing human TF, either very low levels (low TF) or near to the level of wild-type (HTF), in place of murine TF were infected with M.tb via aerosol exposure. Levels of TF expression, proinflammatory cytokines and thrombin-antithrombin complexes were measured post M.tb infection and mycobacterial burden in the tissue homogenates were evaluated. Our results showed that M.tb infection did not increase the overall TF expression in lungs. However, macrophages in the granulomatous lung lesions in all M.tb-infected mice, including low TF mice, showed increased levels of TF expression. Conspicuous fibrin deposition in the granuloma was detected in wild-type and HTF mice but not in low TF mice. M.tb infection significantly increased expression levels of cytokines IFN-γ, TNF-α, IL-6 and IL-1ß in lung tissues. However, no significant differences were found in proinflammatory cytokines among the three experimental groups. Mycobacterial burden in lungs and dissemination into spleen and liver were essentially similar in all three genotypes. Our data indicate, in contrast to that observed in acute bacterial infections, that TF-mediated coagulation and/or signaling does not appear to contribute to the host-defense in experimental tuberculosis.
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Affiliation(s)
- Hema Kothari
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX 75708, United States of America
- * E-mail: (LVMR); (HK)
| | - Shiva Keshava
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX 75708, United States of America
| | - Rit Vatsyayan
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX 75708, United States of America
| | - Nigel Mackman
- Division of Hematology and Oncology, McAllister Heart Institute, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill NC 27599, United States of America
| | - L. Vijaya Mohan Rao
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX 75708, United States of America
- * E-mail: (LVMR); (HK)
| | - Usha R. Pendurthi
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX 75708, United States of America
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Kager LM, Blok DC, Lede IO, Rahman W, Afroz R, Bresser P, van der Zee JS, Ghose A, Visser CE, de Jong MD, Tanck MW, Zahed ASM, Alam KM, Hassan M, Hossain A, Lutter R, Veer CV, Dondorp AM, Meijers JCM, van der Poll T. Pulmonary tuberculosis induces a systemic hypercoagulable state. J Infect 2014; 70:324-34. [PMID: 25455017 DOI: 10.1016/j.jinf.2014.10.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 09/22/2014] [Accepted: 10/13/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Human tuberculosis (TB) remains an important cause of death globally. Bangladesh is one of the most affected countries. We aimed to investigate the impact of pulmonary TB on pro- and anticoagulant mechanisms. METHODS This prospective study was conducted in Chittagong, Bangladesh. We performed an in-depth analysis of coagulation activation and inhibition in plasma obtained from 64 patients with primary lung TB and 11 patients with recurrent lung TB and compared these with 37 healthy controls. Additionally, in nine patients coagulation activation was studied in bronchoalveolar lavage fluid (BALF) harvested from the site of infection and compared with BALF from a contralateral unaffected lung subsegment. RESULTS Relative to uninfected controls, primary and recurrent TB were associated with a systemic net procoagulant state, as indicated by enhanced activation of coagulation (elevated plasma levels of thrombin-antithrombin complexes, D-dimer and fibrinogen) together with impaired anticoagulant mechanisms (reduced plasma levels of antithrombin, protein C activity, free protein S, and protein C inhibitor). Activation of coagulation did not correlate with plasma concentrations of established TB biomarkers. Coagulation activation could not be detected at the primary site of infection in a subset of TB patients. CONCLUSIONS Pulmonary TB is associated with a systemic hypercoagulable state.
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Affiliation(s)
- Liesbeth M Kager
- Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands; Center for Experimental and Molecular Medicine (CEMM), Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.
| | - Dana C Blok
- Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands; Center for Experimental and Molecular Medicine (CEMM), Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands
| | - Ivar O Lede
- Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Microbiology, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands
| | - Wahid Rahman
- Department of Internal Medicine, Chittagong Medical College & Hospital (CMCH), Chittagong, Bangladesh
| | - Rumana Afroz
- Department of Internal Medicine, Chittagong Medical College & Hospital (CMCH), Chittagong, Bangladesh
| | - Paul Bresser
- Department of Pulmonology, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands; Department of Pulmonology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Jaring S van der Zee
- Department of Pulmonology, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands; Department of Pulmonology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Aniruddha Ghose
- Department of Internal Medicine, Chittagong Medical College & Hospital (CMCH), Chittagong, Bangladesh
| | - Caroline E Visser
- Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Microbiology, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands
| | - Menno D de Jong
- Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Microbiology, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands
| | - Michael W Tanck
- Department Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands
| | - Abu Shahed M Zahed
- Department of Internal Medicine, Chittagong Medical College & Hospital (CMCH), Chittagong, Bangladesh
| | - Khan Mashrequl Alam
- Department of Microbiology, Chittagong Medical College & Hospital (CMCH), Chittagong, Bangladesh
| | - Mahtabuddin Hassan
- Department of Internal Medicine, Chittagong Medical College & Hospital (CMCH), Chittagong, Bangladesh
| | - Ahmed Hossain
- Chest Disease Clinic Chittagong (CDCC), Chittagong, Bangladesh
| | - Rene Lutter
- Department of Pulmonology, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands; Department of Experimental Immunology, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands
| | - Cornelis Van't Veer
- Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands; Center for Experimental and Molecular Medicine (CEMM), Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands
| | - Arjen M Dondorp
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine, Churchill Hospital, University of Oxford, Oxford, UK
| | - Joost C M Meijers
- Department of Experimental Vascular Medicine, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands; Department of Vascular Medicine, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands
| | - Tom van der Poll
- Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands; Center for Experimental and Molecular Medicine (CEMM), Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands; Division of Infectious Diseases, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands
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Bock F, Shahzad K, Vergnolle N, Isermann B. Activated protein C based therapeutic strategies in chronic diseases. Thromb Haemost 2014; 111:610-7. [PMID: 24652581 DOI: 10.1160/th13-11-0967] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 03/07/2014] [Indexed: 01/03/2023]
Abstract
Activated protein C (aPC) is a natural anticoagulant and a potent anti-inflammatory and cytoprotective agent. At the expense of increased bleeding risk aPC has been used - with some success - in sepsis. The design of cytoprotective-selective aPC variants circumvents this limitation of increased bleeding, reviving the interest in aPC as a therapeutic agent. Emerging studies suggest that aPC`s beneficial effects are not restricted to acute illness, but likewise relevant in chronic diseases, such as diabetic nephropathy, neurodegeneration or wound healing. Epigenetic regulation of gene expression, reduction of oxidative stress, and regulation of ROS-dependent transcription factors are potential mechanisms of sustained cytoprotective effects of aPC in chronic diseases. Given the available data it seems questionable whether a unifying mechanism of aPC dependent cytoprotection in acute and chronic diseases exists. In addition, the signalling pathways employed by aPC are tissue and cell specific. The mechanistic insights gained from studies exploring aPC`s effects in various diseases may hence lay ground for tissue and disease specific therapeutic approaches. This review outlines recent investigations into the mechanisms and consequences of long-term modulation of aPC-signalling in models of chronic diseases.
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Affiliation(s)
| | | | | | - Berend Isermann
- Berend Isermann, MD, Otto-von-Guericke-University Magdeburg, Institute of Clinical Pathology and Pathobiochemistry, Leipziger Str. 44, D-39120 Magdeburg, Germany, Tel.: +49 391 67 13900, Fax: +49 391 67 13902, E-mail: ;
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Kager LM, Runge JH, Nederveen AJ, Roelofs JJTH, Stoker J, Maas M, van der Poll T. A new murine model to study musculoskeletal tuberculosis (short communication). Tuberculosis (Edinb) 2014; 94:306-10. [PMID: 24572169 DOI: 10.1016/j.tube.2014.01.002] [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: 10/19/2013] [Accepted: 01/22/2014] [Indexed: 10/25/2022]
Abstract
Musculoskeletal tuberculosis (TB) is a severe extrapulmonary manifestation of chronic Mycobacterium (M.) tuberculosis infection. Considering increasing incidence, multi-drug resistance and associated treatment difficulties, more preclinical research is needed. In this study we developed a murine model for musculoskeletal TB. Mice, intranasally infected with M. tuberculosis, were sacrificed after ten months. Mycobacterial growth was detected in lung and femur homogenates. Ziehl-Neelsen staining of paraffin-embedded femurs showed acid-fast rods in the myelum and Magnetic Resonance Imaging demonstrated osteomyelitis and macronodular tuberculomas. This new murine model of musculoskeletal TB might be of value to further investigate immunologic and radiologic responses.
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Affiliation(s)
- Liesbeth M Kager
- Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center/University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Center for Experimental and Molecular Medicine (CEMM), Academic Medical Center/University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Jurgen H Runge
- Department of Radiology, Academic Medical Center/University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Aart J Nederveen
- Department of Radiology, Academic Medical Center/University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Joris J T H Roelofs
- Department of Pathology, Academic Medical Center/University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Jaap Stoker
- Department of Radiology, Academic Medical Center/University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Mario Maas
- Department of Radiology, Academic Medical Center/University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Tom van der Poll
- Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center/University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Center for Experimental and Molecular Medicine (CEMM), Academic Medical Center/University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Division of Infectious Diseases, Academic Medical Center/University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
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Schouten M, de Boer JD, Kager LM, Roelofs JJTH, Meijers JCM, Esmon CT, Levi M, van 't Veer C, van der Poll T. The endothelial protein C receptor impairs the antibacterial response in murine pneumococcal pneumonia and sepsis. Thromb Haemost 2014; 111:970-80. [PMID: 24401906 DOI: 10.1160/th13-10-0859] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Accepted: 12/10/2013] [Indexed: 11/05/2022]
Abstract
Pneumococcal pneumonia is a frequent cause of gram-positive sepsis and has a high mortality. The endothelial protein C receptor (EPCR) has been implicated in both the activation of protein C (PC) and the anti-inflammatory actions of activated (A)PC. The aim of this study was to determine the role of the EPCR in murine pneumococcal pneumonia and sepsis. Wild-type (WT), EPCR knockout (KO) and Tie2-EPCR mice, which overexpress EPCR on the endothelium, were infected intranasally (pneumonia) or intravenously (sepsis) with viable Streptococcus pneumoniae and euthanised at 24 or 48 hours after initiation of the infection for analyses. Pneumonia did not alter constitutive EPCR expression on pulmonary endothelium but was associated with an influx of EPCR positive neutrophils into lung tissue. In pneumococcal pneumonia EPCR KO mice demonstrated diminished bacterial growth in the lungs and dissemination to spleen and liver, reduced neutrophil recruitment to the lungs and a mitigated inflammatory response. Moreover, EPCR KO mice displayed enhanced activation of coagulation in the early phase of disease. Correspondingly, in pneumococcal sepsis EPCR KO mice showed reduced bacterial growth in lung and liver and attenuated cytokine release. Conversely, EPCR-overexpressing mice displayed higher bacterial outgrowth in lung, blood, spleen and liver in pneumococcal sepsis. In conclusion, EPCR impairs antibacterial defense in both pneumococcal pneumonia and sepsis, which is associated with an enhanced pro-inflammatory response.
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Affiliation(s)
- Marcel Schouten
- Marcel Schouten, MD, Center for Experimental and Molecular Medicine (CEMM), Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Meibergdreef 9, Room G2-130, 1105 AZ Amsterdam, The Netherlands, Tel.: +31 20 566 5910, Fax: +31 20 697 7192, E-mail:
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