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Badoiu SC, Enescu DM, Tatar R, Stanescu-Spinu II, Miricescu D, Greabu M, Ionel IP, Jinga V. Serum Plasminogen Activator Inhibitor-1, α 1-Acid Glycoprotein, C-Reactive Protein, and Platelet Factor 4 Levels-Promising Molecules That Can Complete the "Puzzle" of the Biochemical Milieu in Severe Burns: Preliminary Results of a Cohort Prospective Study. J Clin Med 2024; 13:2794. [PMID: 38792336 PMCID: PMC11121965 DOI: 10.3390/jcm13102794] [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: 03/17/2024] [Revised: 04/23/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Burns represent a serious health problem, associated with multiple-organ failure, prolonged hospitalization, septic complications, and increased rate of mortality. The main aim of our study was to evaluate the levels of various circulating molecules in children with severe burns (more than 25% TBSA), in three different moments: 48 h, day 10, and day 21 post-burn. Materials and Methods: This study included 32 children with burns produced by flame, hot liquid, and electric arc and 21 controls. Serum plasminogen activator inhibitor-1 (PAI-1), α 1-acid glycoprotein (AGP), C-reactive protein (CRP), and platelet factor 4 (PF4) were detected using the Multiplex technique. Several parameters, such as fibrinogen, leucocyte count, thrombocyte count, triiodothyronine, thyroxine, and thyroid-stimulating hormone were also determined for each patient during hospitalization. Results: Significant statistical differences were obtained for CRP, AGP, and PF4 compared to the control group, in different moments of measurements. Negative correlations between CRP, AGP, and PF4 serum levels and burned body surface, and also the hospitalization period, were observed. Discussions: CRP levels increased in the first 10 days after burn trauma and then decreased after day 21. Serum PAI-1 levels were higher immediately after the burn and started decreasing only after day 10 post-burn. AGP had elevated levels 48 h after the burn, then decreased at 7-10 days afterwards, and once again increased levels after 21 days. PF4 serum levels increased after day 10 since the burning event. Conclusions: Serum CRP, AGP, PAI-1, and PF4 seem to be promising molecules in monitoring patients with a burn within the first 21 days.
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Affiliation(s)
- Silviu Constantin Badoiu
- Department of Anatomy and Embriology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania;
- Department of Plastic and Reconstructive Surgery, Life Memorial Hospital, 365 Grivitei Street, 010719 Bucharest, Romania
| | - Dan Mircea Enescu
- Department of Plastic Reconstructive Surgery and Burns, Grigore Alexandrescu Clinical Emergency Hospital for Children, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania; (D.M.E.); (R.T.)
| | - Raluca Tatar
- Department of Plastic Reconstructive Surgery and Burns, Grigore Alexandrescu Clinical Emergency Hospital for Children, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania; (D.M.E.); (R.T.)
| | - Iulia-Ioana Stanescu-Spinu
- Discipline of Physiology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania
| | - Daniela Miricescu
- Discipline of Biochemistry, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania;
| | - Maria Greabu
- Discipline of Biochemistry, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania;
| | - Ileana Paula Ionel
- Discipline of General Nursing, Faculty of Midwifery and Nursing, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Viorel Jinga
- Department of Urology, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania;
- Academy of Romanian Scientists, 3 Ilfov, 050085 Bucharest, Romania
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Mitsis A, Avraamides P, Lakoumentas J, Kyriakou M, Sokratous S, Karmioti G, Drakomathioulakis M, Theodoropoulos KC, Nasoufidou A, Evangeliou A, Vassilikos V, Fragakis N, Ziakas A, Tzikas S, Kassimis G. Role of inflammation following an acute myocardial infarction: design of INFINITY. Biomark Med 2023; 17:971-981. [PMID: 38235565 DOI: 10.2217/bmm-2023-0491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
Abstract
After a myocardial infarction, the inflammatory response is connected to major adverse outcomes such as ischemia-reperfusion injury, adverse cardiac remodeling, infarct size and poor prognosis. INFlammatIoN amI sTudY (INFINITY) is a multicenter, prospective, observational, cohort study designed to investigate the prognostic role of the cytokines IL-6, IL-10, IL-18 and IL-17 and the adipokines leptin, apelin and chemerin in patients with acute coronary syndrome. The study will test if these inflammatory biomarkers reflect different clinical manifestations of coronary artery disease and have a prognostic role in a 6-month follow-up period. This study represents an opportunity to investigate further the prognostic role of a selected combination of proinflammatory and anti-inflammatory biomarkers in the prognosis and risk stratification of acute coronary syndrome patients.
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Affiliation(s)
- Andreas Mitsis
- Cardiology Department, Nicosia General Hospital, Nicosia, 2029, Cyprus
| | | | - John Lakoumentas
- Department of Medical Physics, School of Medicine, University of Patras, Patras, 26504, Greece
| | - Michaela Kyriakou
- Cardiology Department, Nicosia General Hospital, Nicosia, 2029, Cyprus
| | | | - Georgia Karmioti
- Cardiology Department, Nicosia General Hospital, Nicosia, 2029, Cyprus
| | | | - Konstantinos C Theodoropoulos
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, 54636, Greece
| | - Athina Nasoufidou
- Second Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, 54642, Greece
| | - Alexandros Evangeliou
- Third Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, 54642, Greece
| | - Vassilios Vassilikos
- Third Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, 54642, Greece
| | - Nikolaos Fragakis
- Second Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, 54642, Greece
| | - Antonios Ziakas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, 54636, Greece
| | - Stergios Tzikas
- Third Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, 54642, Greece
| | - George Kassimis
- Second Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, 54642, Greece
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Zhao J, Xu X, Gao Y, Yu Y, Li C. Crosstalk between Platelets and SARS-CoV-2: Implications in Thrombo-Inflammatory Complications in COVID-19. Int J Mol Sci 2023; 24:14133. [PMID: 37762435 PMCID: PMC10531760 DOI: 10.3390/ijms241814133] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/14/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
The SARS-CoV-2 virus, causing the devastating COVID-19 pandemic, has been reported to affect platelets and cause increased thrombotic events, hinting at the possible bidirectional interactions between platelets and the virus. In this review, we discuss the potential mechanisms underlying the increased thrombotic events as well as altered platelet count and activity in COVID-19. Inspired by existing knowledge on platelet-pathogen interactions, we propose several potential antiviral strategies that platelets might undertake to combat SARS-CoV-2, including their abilities to internalize the virus, release bioactive molecules to interfere with viral infection, and modulate the functions of immune cells. Moreover, we discuss current and potential platelet-targeted therapeutic strategies in controlling COVID-19, including antiplatelet drugs, anticoagulants, and inflammation-targeting treatments. These strategies have shown promise in clinical settings to alleviate the severity of thrombo-inflammatory complications and reduce the mortality rate among COVID-19 patients. In conclusion, an in-depth understanding of platelet-SARS-CoV-2 interactions may uncover novel mechanisms underlying severe COVID-19 complications and could provide new therapeutic avenues for managing this disease.
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Affiliation(s)
| | | | | | - Yijing Yu
- School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China; (J.Z.); (X.X.); (Y.G.)
| | - Conglei Li
- School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China; (J.Z.); (X.X.); (Y.G.)
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4
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Ren XY, Li YF, Liu HQ, Lin H, Lin Q, Wu Y, Wan J, Lu JJ, Liu J, Cui XY. Anti-inflammatory Therapy Progress in Major Adverse Cardiac Events after PCI: Chinese and Western Medicine. Chin J Integr Med 2023:10.1007/s11655-023-3638-8. [PMID: 37198377 DOI: 10.1007/s11655-023-3638-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2023] [Indexed: 05/19/2023]
Abstract
Acute coronary syndrome (ACS) is one of the leading causes of death in cardiovascular disease. Percutaneous coronary intervention (PCI) is an important method for the treatment of coronary heart disease (CHD), and it has greatly reduced the mortality of ACS patients since its application. However, a series of new problems may occur after PCI, such as in-stent restenosis, no-reflow phenomenon, in-stent neoatherosclerosis, late stent thrombosis, myocardial ischemia-reperfusion injury, and malignant ventricular arrhythmias, which result in the occurrence of major adverse cardiac events (MACE) that seriously reduce the postoperative benefit for patients. The inflammatory response is a key mechanism of MACE after PCI. Therefore, examining effective anti-inflammatory therapies after PCI in patients with ACS is a current research focus to reduce the incidence of MACE. The pharmacological mechanism and clinical efficacy of routine Western medicine treatment for the anti-inflammatory treatment of CHD have been verified. Many Chinese medicine (CM) preparations have been widely used in the treatment of CHD. Basic and clinical studies showed that effectiveness of the combination of CM and Western medicine treatments in reducing incidence of MACE after PCI was better than Western medicine treatment alone. The current paper reviewed the potential mechanism of the inflammatory response and occurrence of MACE after PCI in patients with ACS and the research progress of combined Chinese and Western medicine treatments in reducing incidence of MACE. The results provide a theoretical basis for further research and clinical treatment.
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Affiliation(s)
- Xue-Yu Ren
- Graduate School of Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Ying-Fei Li
- Graduate School of Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Hui-Qing Liu
- Graduate School of Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Hui Lin
- Graduate School of Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Qian Lin
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Yang Wu
- Department of Cardiology, Dong Fang Hospital, Beijing University of Chinese Medicine, Beijing, 100078, China
| | - Jie Wan
- Department of Cardiology, Dong Fang Hospital, Beijing University of Chinese Medicine, Beijing, 100078, China
| | - Jin-Jin Lu
- Department of Cardiology, Dong Fang Hospital, Beijing University of Chinese Medicine, Beijing, 100078, China
| | - Jing Liu
- Department of Cardiology, Dong Fang Hospital, Beijing University of Chinese Medicine, Beijing, 100078, China
| | - Xiao-Yun Cui
- Department of Cardiology, Dong Fang Hospital, Beijing University of Chinese Medicine, Beijing, 100078, China.
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Schories C, Martus P, Guan T, Henes JK, Witte A, Müller K, Geisler T, Chatterjee M, Gawaz M, Rath D. Platelet versus plasma CXCL14, coronary artery disease, and clinical outcomes. Res Pract Thromb Haemost 2023; 7:100165. [PMID: 37255851 PMCID: PMC10225916 DOI: 10.1016/j.rpth.2023.100165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 03/28/2023] [Accepted: 04/07/2023] [Indexed: 06/01/2023] Open
Abstract
Background Platelets express CXCL14, while platelet-derived CXCL14 induces monocyte chemotaxis and exerts an angiostatic effect on endothelial cells. Objectives This study investigated both platelet surface-associated and circulating levels of CXCL14 in patients with heart disease and associations of this chemokine with myocardial function and outcomes in patients with coronary artery disease (CAD). Methods This prospective study enrolled 450 patients with symptomatic heart disease. Platelet surface-associated and plasma CXCL14 levels were analyzed. All patients were followed up for 360 days for a primary composite outcome consisting of all-cause mortality, myocardial infarction, and/or ischemic stroke. Secondary outcomes consisted of the single events of all-cause mortality or myocardial infarction. Results Baseline platelet-associated but not circulating CXCL14 levels were significantly lower in patients with chronic coronary syndrome (mean fluorescence intensity logarithmized, 1.35 ± 0.35) when compared to those with acute coronary syndrome (1.47 ± 0.38) and without CAD (1.51 ± 0.40). Platelet CXCL14 levels were significantly lower (1.37 ± 0.37 vs 1.48 ± 0.39) and circulating CXCL14 levels were significantly higher (lg, 2.88 ± 0.20 pg/mL vs 2.82 ± 0.26 pg/mL) in patients with normal baseline left ventricular ejection fraction (LVEF) when compared to those with impaired LVEF. Low baseline circulating CXCL14 (hazard ratio, 2.33; 1.00-5.46) but not platelet CXCL14 was associated with worse outcome in patients with CAD. Conclusion Platelet-associated and circulating CXCL14 levels show differential regulation in patients with and without CAD. Although platelet-associated CXCL14 increased and circulating CXCL14 decreased with impairment of LVEF, only lower circulating CXCL14 upon admission was associated with worse prognosis in patients with CAD.
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Affiliation(s)
- Christoph Schories
- Department of Cardiology and Angiology, University Hospital Tübingen, Tübingen, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biostatistics, University Hospital Tübingen, Tübingen, Germany
| | - Tianyun Guan
- Department of Cardiology and Angiology, University Hospital Tübingen, Tübingen, Germany
- Department of Cardiology, the Second Hospital of Jilin University, Jilin, People’s Republic of China
| | - Jessica Kristin Henes
- Department of Cardiology and Angiology, University Hospital Tübingen, Tübingen, Germany
| | - Alexander Witte
- Department of Cardiology and Angiology, University Hospital Tübingen, Tübingen, Germany
| | - Karin Müller
- Department of Cardiology and Angiology, University Hospital Tübingen, Tübingen, Germany
| | - Tobias Geisler
- Department of Cardiology and Angiology, University Hospital Tübingen, Tübingen, Germany
| | - Madhumita Chatterjee
- Department of Cardiology and Angiology, University Hospital Tübingen, Tübingen, Germany
- Department of Pharmacology, Experimental Therapy and Toxicology, University Hospital Tübingen, Tübingen, Germany
| | - Meinrad Gawaz
- Department of Cardiology and Angiology, University Hospital Tübingen, Tübingen, Germany
| | - Dominik Rath
- Department of Cardiology and Angiology, University Hospital Tübingen, Tübingen, Germany
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Langnau C, Janing H, Kocaman H, Gekeler S, Günter M, Petersen-Uribe Á, Jaeger P, Koch B, Kreisselmeier KP, Castor T, Rath D, Gawaz MP, Autenrieth SE, Mueller KAL. Recovery of systemic hyperinflammation in patients with severe SARS-CoV-2 infection. Biomarkers 2023; 28:97-110. [PMID: 36377411 DOI: 10.1080/1354750x.2022.2148745] [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: 11/16/2022]
Abstract
INTRODUCTION Patients with cardiovascular disease (CVD) and acute SARS-CoV-2 infection might show an altered immune response during COVID-19. MATERIAL AND METHODS Twenty-three patients with CVD and SARS-CoV-2 infection were prospectively enrolled and received a cardiological assessment at study entry and during follow-up visit. Inclusion criteria of our study were age older than 18 years, presence of CVD, and acute SARS-CoV-2 infection. The median age of the patient cohort was 69 (IQR 55-79) years. 12 (52.2%) patients were men. Peripheral monocytes and chemokine/cytokine profiles were analysed. RESULTS Numbers of classical and non-classical monocytes were significantly decreased during acute SARS-CoV-2 infection compared to 3-month recovery. While classical monocytes reached the expected level in peripheral blood after 3 months, the number of non-classical monocytes remained significantly reduced. DISCUSSION All three monocyte subsets exhibited changes of established adhesion and activation markers. Interestingly, they also expressed higher levels of pro-inflammatory cytokines like macrophage migration inhibitory factor (MIF) at the time of recovery, although MIF was only slightly increased during the acute phase. CONCLUSION Changes of monocyte phenotypes and increased MIF expression after 3-month recovery from acute SARS-CoV-2 infection may indicate persistent, possibly long-lasting, pro-inflammatory monocyte function in CVD patients.
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Affiliation(s)
- Carolin Langnau
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Henrik Janing
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Hüseyin Kocaman
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Sarah Gekeler
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Manina Günter
- Department of Hematology, Oncology, Clinical Immunology and Rheumatology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany.,Department of Dendritic Cells in Infection and Cancer, German Cancer Research Centre, Heidelberg, Germany
| | - Álvaro Petersen-Uribe
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Philippa Jaeger
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Barbara Koch
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Klaus-Peter Kreisselmeier
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Tatsiana Castor
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Dominik Rath
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Meinrad Paul Gawaz
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
| | - Stella E Autenrieth
- Department of Hematology, Oncology, Clinical Immunology and Rheumatology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany.,Department of Dendritic Cells in Infection and Cancer, German Cancer Research Centre, Heidelberg, Germany
| | - Karin Anne Lydia Mueller
- Department of Cardiology and Angiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany
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Li T, Yu Q, Wang Y, Cai X, Kong Y, Zhao H, Diao S, Qin Y, Fang Q. High-sensitivity C-reactive protein as a better predictor of post-thrombolytic functional outcome in patients with previous antiplatelet therapy. Eur J Med Res 2022; 27:83. [PMID: 35659067 PMCID: PMC9164376 DOI: 10.1186/s40001-022-00705-z] [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: 10/23/2021] [Accepted: 05/14/2022] [Indexed: 01/08/2023] Open
Abstract
Background C-reactive protein (CRP) is an important biomarker of inflammation and plays a pivotal role in predicting the clinical prognosis of cardiovascular and cerebrovascular diseases. However, the mechanism of inflammation influencing the outcome of patients with ischemic stroke are unknown. Aims We aim to investigate the association between hsCRP and mRS in 194 eligible patients by therapy-stratified analyses. Methods The modification effects of antiplatelet therapy on the association between mRS and different exposure variables were analyzed. The retained variables were analyzed in the receiver operating characteristic (ROC) curve to discriminate patients with poor outcome. Results hsCRP was positively correlated with mRS in therapy-stratified analyses. There was a statistical modification effect of antiplatelet therapy on the association of hsCRP and mRS (P for interaction = 0.0101). The discriminative effect of poor outcome was further verified by ROC curve analyses (AUCwith from 0.758 to 0.872, AUCwithout from 0.709 to 0.713). Conclusions hsCRP is correlated with the clinical outcome of patients treated with IVrt-PA, and may be a better predictor of post-thrombolytic functional outcome in patients with previous antiplatelet therapy than in non-used patients.
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Affiliation(s)
- Tan Li
- Stroke Center, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Qiannan Yu
- Stroke Center, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Yiqing Wang
- Stroke Center, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Xiuying Cai
- Stroke Center, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Yan Kong
- Stroke Center, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Hongru Zhao
- Stroke Center, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Shanshan Diao
- Stroke Center, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
| | - Yiren Qin
- Stroke Center, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
| | - Qi Fang
- Stroke Center, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
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Wang C, Wu Y, Su Y, Mao B, Luo Y, Yan Y, Hu K, Lu Y, Che W, Wan M. Elevated levels of sIL-2R, TNF-α and hs-CRP are independent risk factors for post percutaneous coronary intervention coronary slow flow in patients with non-ST segment elevation acute coronary syndrome. Int J Cardiovasc Imaging 2022; 38:1191-1202. [PMID: 35182256 PMCID: PMC11143008 DOI: 10.1007/s10554-022-02529-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/12/2022] [Indexed: 11/27/2022]
Abstract
To evaluate the association between circulating levels of inflammatory cytokines and the occurrence of post-percutaneous coronary intervention (PCI) coronary slow flow (CSF) in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS). CSF after PCI commonly occurs and implies poor outcomes, while the determinants of post-PCI CSF in patients with NSTE-ACS remain controversial. In this multicenter case control study, 176 patients diagnosed with NSTE-ACS and with post-PCI CSF occurred composed of CSF group, while 352 matched NSTE-ACS patients composed control group. Corrected thrombolysis in myocardial infarction frame count (cTFC), circulating levels of inflammatory cytokines and PCI related parameters were analyzed using Logistic regression models. Among 528 patients with median age of 67 (59-76) and male proportion of 65.5%, 176 (35.0%) patients had occurrence of post-PCI CSF defined as cTFC ≥ 24. Patients with CSF presented more intense inflammatory activity revealed by higher levels of white blood cell, high-sensitivity C-reactive protein (hs-CRP), interleukin-1ß (IL-1ß), soluble IL-2 receptor (sIL-2R), IL-6, IL-8, IL-10 and tumor necrosis factor-α (TNF-α), while PCI related parameters were comparable. Correlation analysis showed cTFC was positively correlated with those inflammatory cytokines. Logistic regression model indicates that hs-CRP (odds ratio (OR) = 3.038, 95% confidence interval (CI) 1.545-5.975), sIL-2R (OR = 2.103, 95% CI 1.959-4.026) and TNF-α (OR = 3.708, 95% CI 1.426-9.641) were valuable predictors for CSF occurrence. Elevated circulating levels of inflammatory cytokine including hs-CRP, sIL-2R and TNF-α rather than PCI related parameters could predict post-PCI CSF in patients with NSTE-ACS.
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Affiliation(s)
- Cheng Wang
- Department of Cardiology, Chongming Branch, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 66 East Xiangyang Road, Chongming, Shanghai, China
| | - Yan Wu
- Department of Cardiology, Shanghai Putuo District Liqun Hospital, Shanghai, 200333, China
| | - Yang Su
- Department of Cardiology, Chongming Branch, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 66 East Xiangyang Road, Chongming, Shanghai, China
- Department of Cardiology, Shanghai Tenth People's Hospital, Shanghai, 200072, China
| | - Bin Mao
- Department of Cardiology, Chongming Branch, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 66 East Xiangyang Road, Chongming, Shanghai, China
| | - Yihong Luo
- Department of Cardiology, Chongming Branch, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 66 East Xiangyang Road, Chongming, Shanghai, China
| | - Yexiang Yan
- Department of Cardiology, Chongming Branch, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 66 East Xiangyang Road, Chongming, Shanghai, China
| | - Kun Hu
- Department of Cardiology, Chongming Branch, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 66 East Xiangyang Road, Chongming, Shanghai, China
| | - Yi Lu
- Department of Cardiology, Chongming Branch, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 66 East Xiangyang Road, Chongming, Shanghai, China
| | - Wenliang Che
- Department of Cardiology, Chongming Branch, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 66 East Xiangyang Road, Chongming, Shanghai, China.
- Department of Cardiology, Shanghai Tenth People's Hospital, Shanghai, 200072, China.
| | - Minying Wan
- Department of Cardiology, Chongming Branch, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 66 East Xiangyang Road, Chongming, Shanghai, China.
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Ghasemzadeh M, Ahmadi J, Hosseini E. Platelet-leukocyte crosstalk in COVID-19: How might the reciprocal links between thrombotic events and inflammatory state affect treatment strategies and disease prognosis? Thromb Res 2022; 213:179-194. [PMID: 35397313 PMCID: PMC8969450 DOI: 10.1016/j.thromres.2022.03.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 03/11/2022] [Accepted: 03/28/2022] [Indexed: 01/09/2023]
Abstract
Platelet-leukocyte crosstalk is commonly manifested by reciprocal links between thrombosis and inflammation. Platelet thrombus acts as a reactive matrix that recruits leukocytes to the injury site where their massive accumulation, activation and migration promote thrombotic events while triggering inflammatory responses. As a life-threatening condition with the associations between inflammation and thrombosis, COVID-19 presents diffuse alveolar damage due to exaggerated macrophage activity and cytokine storms. These events, together with direct intracellular virus invasion lead to pulmonary vascular endothelialitis, cell membranes disruption, severe endothelial injury, and thrombosis. The developing pre-alveolar thrombus provides a hyper-reactive milieu that recruits circulating leukocytes to the injury site where their activation contributes to thrombus stabilization and thrombosis propagation, primarily through the formation of Neutrophil extracellular trap (NET). NET fragments can also circulate and deposit in further distance where they may disseminate intravascular thrombosis in severe cases of disease. Thrombi may also facilitate leukocytes migration into alveoli where their accumulation and activation exacerbate cytokine storms and tissue damage, further complicating the disease. Based on these mechanisms, whether an effective anti-inflammatory protocol can prevent thrombotic events, or on the other hand; efficient antiplatelet or anticoagulant regimens may be associated with reduced cytokine storms and tissue damage, is now of interests for several ongoing researches. Thus shedding more light on platelet-leukocyte crosstalk, the review presented here discusses the detailed mechanisms by which platelets may contribute to the pathogenesis of COVID-19, especially in severe cases where their interaction with leukocytes can intensify both inflammatory state and thrombosis in a reciprocal manner.
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Affiliation(s)
- Mehran Ghasemzadeh
- Corresponding authors at: Blood Transfusion Research Centre, High Institute for Research and Education in Transfusion Medicine, Iranian Blood Transfusion Organization Building, Hemmat Exp. Way, Next to the Milad Tower, Tehran, Iran
| | | | - Ehteramolsadat Hosseini
- Corresponding authors at: Blood Transfusion Research Centre, High Institute for Research and Education in Transfusion Medicine, Iranian Blood Transfusion Organization Building, Hemmat Exp. Way, Next to the Milad Tower, Tehran, Iran
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10
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ACKR3 regulates platelet activation and ischemia-reperfusion tissue injury. Nat Commun 2022; 13:1823. [PMID: 35383158 PMCID: PMC8983782 DOI: 10.1038/s41467-022-29341-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/25/2022] [Indexed: 12/15/2022] Open
Abstract
Platelet activation plays a critical role in thrombosis. Inhibition of platelet activation is a cornerstone in treatment of acute organ ischemia. Platelet ACKR3 surface expression is independently associated with all-cause mortality in CAD patients. In a novel genetic mouse strain, we show that megakaryocyte/platelet-specific deletion of ACKR3 results in enhanced platelet activation and thrombosis in vitro and in vivo. Further, we performed ischemia/reperfusion experiments (transient LAD-ligation and tMCAO) in mice to assess the impact of genetic ACKR3 deficiency in platelets on tissue injury in ischemic myocardium and brain. Loss of platelet ACKR3 enhances tissue injury in ischemic myocardium and brain and aggravates tissue inflammation. Activation of platelet-ACKR3 via specific ACKR3 agonists inhibits platelet activation and thrombus formation and attenuates tissue injury in ischemic myocardium and brain. Here we demonstrate that ACKR3 is a critical regulator of platelet activation, thrombus formation and organ injury following ischemia/reperfusion. ACKR3 is a critical regulator of platelet-mediated thrombosis and organ injury following ischemia/reperfusion. Platelet ACKR3 surface expression is independently associated with all-cause mortality in patients with cardiovascular diseases.
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11
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Affiliation(s)
- Bart Spaetgens
- Department of Internal Medicine, Division of General Internal Medicine, Section Geriatric Medicine, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands
| | - Magdolna Nagy
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Hugo Ten Cate
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
- Thrombosis Expertise Center, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- Center for Thrombosis and Hemostasis, Gutenberg University Medical Center, Mainz, Germany
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12
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Kazem N, Hofer F, Koller L, Hammer A, Hofbauer TM, Hengstenberg C, Niessner A, Sulzgruber P. The age-specific prognostic impact of the platelet-to-lymphocyte ratio on long-term outcome after acute coronary syndrome. EUROPEAN HEART JOURNAL OPEN 2022; 2:oeab031. [PMID: 35919656 PMCID: PMC9242036 DOI: 10.1093/ehjopen/oeab031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/19/2021] [Accepted: 10/23/2021] [Indexed: 12/12/2022]
Abstract
Aims Personalized risk stratification within the ageing society after acute coronary syndrome (ACS) remains scarce but in urgent need. Increased platelet activity together with inflammatory activation play a key role during ACS. We aimed to evaluate the age-specific prognostic potential of the platelet to lymphocyte ratio (PLR) on long-term cardiovascular mortality after ACS. Methods and results Patients presenting with ACS admitted to the Vienna General Hospital between December 1996 and January 2010 were enrolled within a clinical registry including assessment of peripheral blood samples. The impact of the PLR on survival was assessed by Cox-regression hazard analysis. We included a total of 681 patients with a median age of 64 years (interquartile range: 45–84). Two hundred (29.4%) individuals died during the median follow-up time of 8.5 years. A strong and independent association of the PLR with cardiovascular mortality was found in the total study population [adjusted (adj.) hazard ratio (HR) per 1 standard deviation (1 SD) of 1.07 (95% confidence interval, CI: 1.03–1.10); P < 0.001]. After stratification in individuals <65 years (n = 339) and ≥65 years (n = 342), a prognostic effect of the PLR on cardiovascular mortality was solely observed in elderly patients ≥65 years [adj. HR per 1 SD of 1.04 (95% CI: 1.00–1.08); P = 0.039], but not in their younger counterparts <65 years [adj. HR per 1 SD of 0.97 (95% CI: 0.83–1.14); P = 0.901]. Conclusion The present investigation highlights a strong and independent age-specific association of the PLR with cardiovascular mortality in patients with ACS. The PLR only allows to identify patients ≥65 years at high risk for fatal events after ACS—even from a long-term perspective.
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Affiliation(s)
- Niema Kazem
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna , Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Felix Hofer
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna , Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Lorenz Koller
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna , Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Andreas Hammer
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna , Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Thomas M Hofbauer
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna , Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Christian Hengstenberg
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna , Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Alexander Niessner
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna , Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Patrick Sulzgruber
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna , Waehringer Guertel 18-20, 1090 Vienna, Austria
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13
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Atypical Roles of the Chemokine Receptor ACKR3/CXCR7 in Platelet Pathophysiology. Cells 2022; 11:cells11020213. [PMID: 35053329 PMCID: PMC8773869 DOI: 10.3390/cells11020213] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 12/23/2022] Open
Abstract
The manifold actions of the pro-inflammatory and regenerative chemokine CXCL12/SDF-1α are executed through the canonical GProteinCoupledReceptor CXCR4, and the non-canonical ACKR3/CXCR7. Platelets express CXCR4, ACKR3/CXCR7, and are a vital source of CXCL12/SDF-1α themselves. In recent years, a regulatory impact of the CXCL12-CXCR4-CXCR7 axis on platelet biogenesis, i.e., megakaryopoiesis, thrombotic and thrombo-inflammatory actions have been revealed through experimental and clinical studies. Platelet surface expression of ACKR3/CXCR7 is significantly enhanced following myocardial infarction (MI) in acute coronary syndrome (ACS) patients, and is also associated with improved functional recovery and prognosis. The therapeutic implications of ACKR3/CXCR7 in myocardial regeneration and improved recovery following an ischemic episode, are well documented. Cardiomyocytes, cardiac-fibroblasts, endothelial lining of the blood vessels perfusing the heart, besides infiltrating platelets and monocytes, all express ACKR3/CXCR7. This review recapitulates ligand induced differential trafficking of platelet CXCR4-ACKR3/CXCR7 affecting their surface availability, and in regulating thrombo-inflammatory platelet functions and survival through CXCR4 or ACKR3/CXCR7. It emphasizes the pro-thrombotic influence of CXCL12/SDF-1α exerted through CXCR4, as opposed to the anti-thrombotic impact of ACKR3/CXCR7. Offering an innovative translational perspective, this review also discusses the advantages and challenges of utilizing ACKR3/CXCR7 as a potential anti-thrombotic strategy in platelet-associated cardiovascular disorders, particularly in coronary artery disease (CAD) patients post-MI.
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14
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Heinzmann ACA, Coenen DM, Vajen T, Cosemans JMEM, Koenen RR. Combined Antiplatelet Therapy Reduces the Proinflammatory Properties of Activated Platelets. TH OPEN 2021; 5:e533-e542. [PMID: 34901735 PMCID: PMC8651446 DOI: 10.1055/a-1682-3415] [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: 06/18/2021] [Accepted: 10/22/2020] [Indexed: 11/17/2022] Open
Abstract
The cause of atherothrombosis is rupture or erosion of atherosclerotic lesions, leading to an increased risk of myocardial infarction or stroke. Here, platelet activation plays a major role, leading to the release of bioactive molecules, for example, chemokines and coagulation factors, and to platelet clot formation. Several antiplatelet therapies have been developed for secondary prevention of cardiovascular events, in which anticoagulant drugs are often combined. Besides playing a role in hemostasis, platelets are also involved in inflammation. However, it is unclear whether current antiplatelet therapies also affect platelet immune functions. In this study, the possible anti-inflammatory effects of antiplatelet medications on chemokine release were investigated using enzyme-linked immunosorbent assay and on the chemotaxis of THP-1 cells toward platelet releasates. We found that antiplatelet medication acetylsalicylic acid (ASA) led to reduced chemokine (CC motif) ligand 5 (CCL5) and chemokine (CXC motif) ligand 4 (CXCL4) release from platelets, while leukocyte chemotaxis was not affected. Depending on the agonist, α
IIb
β
3
and P2Y
12
inhibitors also affected CCL5 or CXCL4 release. The combination of ASA with a P2Y
12
inhibitor or a phosphodiesterase (PDE) inhibitor did not lead to an additive reduction in CCL5 or CXCL4 release. Interestingly, these combinations did reduce leukocyte chemotaxis. This study provides evidence that combined therapy of ASA and a P2Y
12
or PDE3 inhibitor can decrease the inflammatory leukocyte recruiting potential of the releasate of activated platelets.
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Affiliation(s)
- Alexandra C A Heinzmann
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Daniëlle M Coenen
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands.,Department of Molecular and Cellular Biochemistry, University of Kentucky College of Medicine, Lexington, Kentucky, United States
| | - Tanja Vajen
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands.,Cardiovascular Research Laboratory, Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Judith M E M Cosemans
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Rory R Koenen
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
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15
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Al-Mufti F, Ogulnick J, Feldstein E, Damodara N, Bravo M, Alshammari H, Dominguez J, Cooper J, Huang KT, Marikunte S, Ali S, Patel V, Khandelwal P, Mayer SA, Amuluru K, Gandhi CD. Impact of pre-ictal antiplatelet therapy use in aneurysmal subarachnoid hemorrhage. Clin Neurol Neurosurg 2021; 211:107022. [PMID: 34781219 DOI: 10.1016/j.clineuro.2021.107022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE There is limited evidence on the use of antiplatelet therapy (APT) to reduce the risk and morbidity of cerebral aneurysmal rupture. This analysis retrospectively assessed APT use in patients presenting to our institution with aneurysmal subarachnoid hemorrhage (aSAH). METHODS We evaluated the records of 186 patients over 7 years of retrospective data from our tertiary care center and an existing database of patients with aSAH. A total of 18 cases with patients on APT and 168 patients not on APT (controls) were identified. Primary outcomes measured were clinical grade (Hunt and Hess score), radiographic grade (Fisher score), and presence of delayed cerebral ischemia (DCI). Secondary outcomes were modified Rankin score at discharge and at 3 months. DCI from cerebral vasospasm was defined as the occurrence of focal neurological impairment or a decrease in at least 2 points on the Glasgow Coma Scale. Logistic regression models were generated. RESULTS We found that APT use did not appear to lead to statistically significant differences in initial presentation, including Hunt-Hess score and Fisher grade (2.91 vs 3.06, p = 0.66, and 3.23 vs 3.22, p = 0.96 respectively). In addition, APT use was not associated with increased rates of delayed cerebral ischemia (DCI) (OR 0.27 p = 0.12). Our analysis showed that increased Hunt Hess score and the presence of DCI are both associated with increased mRS at 90 days (OR 2.32 p < 0.001; OR 2.91 p = 0.002). CONCLUSION The patients in this retrospective observational study did not demonstrate worse outcomes from their aSAH despite APT therapy. Larger prospective studies should be performed to see if this relationship holds and if decreased rates of DCI can be observed.
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Affiliation(s)
- Fawaz Al-Mufti
- Department of Neurology, Westchester Medical Center at New York Medical College, Valhalla, NY, United States; Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, United States.
| | - Jonathan Ogulnick
- School of Medicine, New York Medical College, Valhalla, NY, United States
| | - Eric Feldstein
- Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, United States
| | - Nitesh Damodara
- Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, United States
| | - Michelle Bravo
- Department of Neurology, Westchester Medical Center at New York Medical College, Valhalla, NY, United States
| | - Hussein Alshammari
- Department of Neurology, Westchester Medical Center at New York Medical College, Valhalla, NY, United States
| | - Jose Dominguez
- Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, United States
| | - Jared Cooper
- Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, United States
| | - Kristen T Huang
- School of Medicine, New York Medical College, Valhalla, NY, United States
| | - Sanjana Marikunte
- School of Medicine, New York Medical College, Valhalla, NY, United States
| | - Syed Ali
- Department of Neurology, Westchester Medical Center at New York Medical College, Valhalla, NY, United States
| | - Vikas Patel
- Mohawk Valley Health System, Utica, NY, United States
| | - Priyank Khandelwal
- Department of Neurosurgery and Neurology, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Stephan A Mayer
- Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, United States
| | - Krishna Amuluru
- Goodman Campbell Brain and Spine, Indianapolis, IN, United States
| | - Chirag D Gandhi
- Department of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, United States
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16
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Houck P. Pathophysiology of Spontaneous Coronary Artery Dissection Determines Anticoagulation Strategy. Cureus 2021; 13:e17437. [PMID: 34589344 PMCID: PMC8462393 DOI: 10.7759/cureus.17437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 11/29/2022] Open
Abstract
Spontaneous coronary dissection is an uncommon disorder, lacking convincing pathophysiologic evidence. Scientific statements and state-of-the-art articles suggest intramural hematoma from bleeding vasa vasorum is the cause. Evidence is based on limited invasive evaluation with optical coherence tomography. This assumption, therefore, suggests anti-coagulation be discontinued. Mechanical shear forces, intraluminal pressures do not support bleeding vasa vasorum closing a higher luminal pressure vessel. The endothelium’s role in inflammation, thrombosis, and repair suggests the pathophysiology is failure to repair endothelium with the lack of repair as the nidus of disruption. A tear ensues and can spontaneously reseal. The lack of inflammatory cells in pathological specimens and association with another poorly understood disease fibromuscular dysplasia supports the etiology of both entities as failure to replace endothelium. The endothelium is the fulcrum of both inflammation and thrombosis. The ability to heal the rift supports conservative therapy. Anticoagulants and antiplatelet reduce thrombosis and inflammation which will ensue when the endothelium is disrupted. These agents will substitute for the failed endothelium allowing thrombosis to be kept in check, reduce inflammation, and promote healing. This thesis and the state-of-the-art articles do not present clinical outcome data. Both support conservative interventions. Anticoagulation recommendations are however in opposite realms. Failure to repair endothelium suggest additional therapies of statins, exercise, smoking cessation will increase circulating stem cells may reduce future events and slow the progression of fibromuscular dysplasia. Future directions in understanding this disease and new therapies requires measurement of repair mechanisms such as the quantity of circulating endothelial progenitor cells.
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Affiliation(s)
- Philip Houck
- Medicine/Cardiology, Texas A&M Health Sciences Center, Temple, USA.,Medicine/Cardiology, Baylor Scott & White Health, Temple, USA
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17
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Amison RT, Page CP. Novel pharmacological therapies for the treatment of bronchial asthma. Minerva Med 2021; 113:31-50. [PMID: 34236157 DOI: 10.23736/s0026-4806.21.07559-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Asthma has long been recognised as a chronic inflammatory disease of the airways, often in response to inhaled allergens prompting inappropriate activation of the immune response. involving a range of cells including mast cells, Th2 lymphocytes and eosinophils and a wide range of inflammatory mediators. First-line therapy for treatment of persistent asthma involves the use of inhaled corticosteroids (ICS) in combination with inhaled β2-agonists enabling both the control of the underlying airways inflammation and a reduction of airway hyperresponsiveness. However, many patients remain symptomatic despite high-dose therapy. There is therefore a continued unmet clinical need to develop specifically new anti-inflammatory therapies for patients with asthma, either as an add-on therapy to ICS or as replacement monotherapies. The success of fixed dose combination inhalers containing both a bronchodilator and an anti-inflammatory drug has also led to the development of "bifunctional" drugs which are molecules specifically designed to have two distinct pharmacological actions based on distinct pharmacophores. In this review we will discuss these different pharmacological approaches under development for the treatment of bronchial asthma and the available pre-clinical and clinical data.
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Affiliation(s)
- Richard T Amison
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK -
| | - Clive P Page
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
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18
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Zaid Y, Doré É, Dubuc I, Archambault AS, Flamand O, Laviolette M, Flamand N, Boilard É, Flamand L. Chemokines and eicosanoids fuel the hyperinflammation within the lungs of patients with severe COVID-19. J Allergy Clin Immunol 2021; 148:368-380.e3. [PMID: 34111453 PMCID: PMC8180473 DOI: 10.1016/j.jaci.2021.05.032] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/10/2021] [Accepted: 05/19/2021] [Indexed: 02/06/2023]
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to a variety of clinical outcomes, ranging from the absence of symptoms to severe acute respiratory disease and ultimately death. A feature of patients with severe coronavirus disease 2019 (COVID-19) is the abundance of inflammatory cytokines in the blood. Elevated levels of cytokines are predictive of infection severity and clinical outcome. In contrast, studies aimed at defining the driving forces behind the inflammation in lungs of subjects with severe COVID-19 remain scarce. Objective Our aim was to analyze and compare the plasma and bronchoalveolar lavage (BAL) fluids of patients with severe COVID-19 (n = 45) for the presence of cytokines and lipid mediators of inflammation (LMIs). Methods Cytokines were measured by using Luminex multiplex assay, and LMIs were measured by using liquid chromatography–tandem mass spectrometry. Results We revealed high concentrations of numerous cytokines, chemokines, and LMIs in the BAL fluid of patients with severe COVID-19. Of the 13 most abundant mediators in BAL fluid, 11 were chemokines, with CXCL1 and CXCL8 being 200 times more abundant than IL-6 and TNF-α. Eicosanoid levels were also elevated in the lungs of subjects with severe COVID-19. Consistent with the presence chemotactic molecules, BAL fluid samples were enriched for neutrophils, lymphocytes, and eosinophils. Inflammatory cytokines and LMIs in plasma showed limited correlations with those present in BAL fluid, arguing that circulating inflammatory molecules may not be a reliable proxy of the inflammation occurring in the lungs of patients with severe COVID-19. Conclusions Our findings indicate that hyperinflammation of the lungs of patients with severe COVID-19 is fueled by excessive production of chemokines and eicosanoids. Therapeutic strategies to dampen inflammation in patients with COVID-19 should be tailored accordingly.
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Affiliation(s)
- Younes Zaid
- Biology Department, Faculty of Sciences, Mohammed V University in Rabat, Morocco; Cheikh Zaïd Hospital, Abulcasis University of Health Sciences, Rabat, Morocco
| | - Étienne Doré
- Axe Maladies Infectieuses et Immunitaires, Centre de Recherche du Centre Hospitalier Universitaire de Québec-Université Laval, Canada; Centre de Recherche Arthrite, Université Laval, Québec, Canada
| | - Isabelle Dubuc
- Axe Maladies Infectieuses et Immunitaires, Centre de Recherche du Centre Hospitalier Universitaire de Québec-Université Laval, Canada
| | - Anne-Sophie Archambault
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Faculté de Médecine, Département de Médecine, Université Laval, Québec City, Québec, Canada; Canada Research Excellence Chair in the Microbiome-Endocannabinoidome Axis in Metabolic Health, Université Laval, Québec, Canada
| | - Olivier Flamand
- Axe Maladies Infectieuses et Immunitaires, Centre de Recherche du Centre Hospitalier Universitaire de Québec-Université Laval, Canada
| | - Michel Laviolette
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Faculté de Médecine, Département de Médecine, Université Laval, Québec City, Québec, Canada
| | - Nicolas Flamand
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Faculté de Médecine, Département de Médecine, Université Laval, Québec City, Québec, Canada; Canada Research Excellence Chair in the Microbiome-Endocannabinoidome Axis in Metabolic Health, Université Laval, Québec, Canada
| | - Éric Boilard
- Axe Maladies Infectieuses et Immunitaires, Centre de Recherche du Centre Hospitalier Universitaire de Québec-Université Laval, Canada; Centre de Recherche Arthrite, Université Laval, Québec, Canada; Département de Microbiologie-Infectiologie et d'Immunologie, Université Laval, Québec City, Canada
| | - Louis Flamand
- Axe Maladies Infectieuses et Immunitaires, Centre de Recherche du Centre Hospitalier Universitaire de Québec-Université Laval, Canada; Département de Microbiologie-Infectiologie et d'Immunologie, Université Laval, Québec City, Canada.
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19
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Amadio P, Cosentino N, Eligini S, Barbieri S, Tedesco CC, Sandrini L, Zarà M, Fabiocchi F, Niccoli G, Magnani G, Fracassi F, Crea F, Veglia F, Marenzi G, Barbieri SS. Potential Relation between Plasma BDNF Levels and Human Coronary Plaque Morphology. Diagnostics (Basel) 2021; 11:diagnostics11061010. [PMID: 34205863 PMCID: PMC8226920 DOI: 10.3390/diagnostics11061010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/17/2021] [Accepted: 05/30/2021] [Indexed: 01/13/2023] Open
Abstract
Coronary artery disease (CAD) patients are at high ischemic risk, and new biomarkers reflecting atherosclerotic disease severity and coronary plaque vulnerability are required. The Brain-Derived Neurotrophic Factor (BDNF) affects endothelial and macrophage activation suggesting its involvement in atherosclerotic plaque behavior. To investigate whether plasma BDNF is associated with in vivo coronary plaque features, assessed by optical coherence tomography (OCT), in both acute myocardial infarction (AMI) and stable angina (SA) patients, we enrolled 55 CAD patients (31 SA and 24 AMI), and 21 healthy subjects (HS). BDNF was lower in CAD patients than in HS (p < 0.0001), and it decreased with the presence, clinical acuity and severity of CAD. The greater BDNF levels were associated with OCT features of plaque vulnerability in overall CAD as well as in SA and AMI patients (p < 0.03). Specifically, in SA patients, BDNF correlated positively with macrophages’ infiltration within atherosclerotic plaque (p = 0.01) and inversely with minimal lumen area (p = 0.02). In AMI patients a negative correlation between BDNF and cap thickness was found (p = 0.02). Despite a small study population, our data suggest a relationship between BDNF and coronary plaque vulnerability, showing that vulnerable plaque is positively associated with plasma BDNF levels, regardless of the clinical CAD manifestation.
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Affiliation(s)
- Patrizia Amadio
- Unit of Brain-Heart Axis: Cellular and Molecular Mechanisms, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (P.A.); (L.S.); (M.Z.)
| | - Nicola Cosentino
- Intensive Cardiac Care Unit, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (N.C.); (G.M.)
| | - Sonia Eligini
- Unit of Metabolomics and Cellular Biochemistry of Atherothrombosis, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy;
| | - Simone Barbieri
- Unit of Biostatistics, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (S.B.); (C.C.T.); (F.V.)
| | - Calogero Claudio Tedesco
- Unit of Biostatistics, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (S.B.); (C.C.T.); (F.V.)
| | - Leonardo Sandrini
- Unit of Brain-Heart Axis: Cellular and Molecular Mechanisms, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (P.A.); (L.S.); (M.Z.)
| | - Marta Zarà
- Unit of Brain-Heart Axis: Cellular and Molecular Mechanisms, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (P.A.); (L.S.); (M.Z.)
| | - Franco Fabiocchi
- Interventional Cardiology Unit, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy;
| | - Giampaolo Niccoli
- Cardiology Unit, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy; (G.N.); (G.M.)
| | - Giulia Magnani
- Cardiology Unit, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy; (G.N.); (G.M.)
| | - Francesco Fracassi
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168 Rome, Italy; (F.F.); (F.C.)
| | - Filippo Crea
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168 Rome, Italy; (F.F.); (F.C.)
| | - Fabrizio Veglia
- Unit of Biostatistics, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (S.B.); (C.C.T.); (F.V.)
| | - Giancarlo Marenzi
- Intensive Cardiac Care Unit, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (N.C.); (G.M.)
| | - Silvia Stella Barbieri
- Unit of Brain-Heart Axis: Cellular and Molecular Mechanisms, Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (P.A.); (L.S.); (M.Z.)
- Correspondence: ; Tel.: +39-02-58002021
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20
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Romandini M, Lima C, Pedrinaci I, Araoz A, Soldini MC, Sanz M. Prevalence and risk/protective indicators of peri-implant diseases: A university-representative cross-sectional study. Clin Oral Implants Res 2020; 32:112-122. [PMID: 33210772 DOI: 10.1111/clr.13684] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/21/2020] [Accepted: 11/10/2020] [Indexed: 12/15/2022]
Abstract
AIM To evaluate the prevalence of peri-implant diseases and to identify risk/protective indicators of peri-implantitis. MATERIALS AND METHODS Two hundred and forty randomly selected patients from a university clinic database were invited to participate. Those who accepted, once data from their medical and dental history were collected, were examined clinically and radiographically to assess the prevalence of peri-implant health and diseases. Peri-implantitis was defined as the presence of BoP/SoP together with radiographic bone levels (BL) ≧2 mm. An intermediate peri-implant health category between peri-implant mucositis and peri-implantitis was also identified, defined by the presence of BoP/SoP together with 1 mm ≦BL < 2 mm. A multilevel multivariate logistic regression analysis was carried out to identify those factors associated either positively (risk) or negatively (protective) with peri-implantitis. RESULTS Ninety-nine patients with a total of 458 dental implants were analyzed. The prevalences of pre-periimplantitis and of peri-implantitis were, respectively, 31.3% and 56.6% at patient-level, while 31.7% and 27.9% at implant level. The following factors were identified as risk indicators for peri-implantitis: smoking (OR = 3.59; 95% CI: 1.52-8.45), moderate/severe periodontitis (OR = 2.77; 95% CI: 1.20-6.36), <16 remaining teeth (OR = 2.23; 95% CI: 1.05-4.73), plaque (OR = 3.49; 95% CI: 1.13-10.75), implant malposition (too vestibular: OR = 2.85; 95% CI: 1.17-6.93), implant brand (Nobel vs. Straumann: OR = 4.41;95% CI: 1.76-11.09), restoration type (bridge vs. single crown: OR = 2.47; 95% CI: 1.19-5.12), and trauma as reason of tooth loss (vs. caries: OR = 6.51; 95% CI: 1.45-29.26). Conversely, the following factors were identified as protective indicators: interproximal flossing/brushing (OR = 0.27; 95% CI: 0.11-0.68), proton pump inhibitors (OR = 0.08; 95% CI: 0.01-0.90), and anticoagulants (OR = 0.08; 95% CI: 0.01-0.56). CONCLUSIONS Peri-implant diseases are highly prevalent among patients with dental implants in this university-based population. Several factors were identified as risk- and protective- indicators of peri-implantitis.
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Affiliation(s)
- Mario Romandini
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Cristina Lima
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Ignacio Pedrinaci
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Ana Araoz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | | | - Mariano Sanz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
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Molecular Drivers of Platelet Activation: Unraveling Novel Targets for Anti-Thrombotic and Anti-Thrombo-Inflammatory Therapy. Int J Mol Sci 2020; 21:ijms21217906. [PMID: 33114406 PMCID: PMC7662962 DOI: 10.3390/ijms21217906] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 02/06/2023] Open
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death globally-partly a consequence of increased population size and ageing-and are major contributors to reduced quality of life. Platelets play a major role in hemostasis and thrombosis. While platelet activation and aggregation are essential for hemostasis at sites of vascular injury, uncontrolled platelet activation leads to pathological thrombus formation and provokes thrombosis leading to myocardial infarction or stroke. Platelet activation and thrombus formation is a multistage process with different signaling pathways involved to trigger platelet shape change, integrin activation, stable platelet adhesion, aggregation, and degranulation. Apart from thrombotic events, thrombo-inflammation contributes to organ damage and dysfunction in CVDs and is mediated by platelets and inflammatory cells. Therefore, in the past, many efforts have been made to investigate specific signaling pathways in platelets to identify innovative and promising approaches for novel antithrombotic and anti-thrombo-inflammatory strategies that do not interfere with hemostasis. In this review, we focus on some of the most recent data reported on different platelet receptors, including GPIb-vWF interactions, GPVI activation, platelet chemokine receptors, regulation of integrin signaling, and channel homeostasis of NMDAR and PANX1.
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Nording H, Baron L, Langer HF. Platelets as therapeutic targets to prevent atherosclerosis. Atherosclerosis 2020; 307:97-108. [DOI: 10.1016/j.atherosclerosis.2020.05.018] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/30/2020] [Accepted: 05/27/2020] [Indexed: 12/11/2022]
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Petrovic SS, Vasiljevska MM, Obradovic SD, Tarabar DK, Doder RB, Majstorovic IJ, Petrovic MD, Magic ZM, Cikota BM, Perisic NJ, Brcerevic IA, Manojlovic NS, Rancic NK. Antiplatelet agents'-ticagrelol and eptifibatide-safety in experimental colitis in mice. TURKISH JOURNAL OF GASTROENTEROLOGY 2020; 31:451-458. [PMID: 32721916 DOI: 10.5152/tjg.2020.19454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS To evaluate the side effects of two antiplatelet agents - ticagrelor and eptifibatide - in mice with experimentally-induced inflammatory bowel disease. METHODS AND MATERIAL This study was designed as a controlled, animal, drug safety investigation. C57Bl/6 mice were used to establish the ulcerative colitis model by exposure to dextran sulfate sodium (DSS), and divided into three experimental groups: eptifibatide-treated (150 µg/day intraperitoneally; n = 10), ticagrelol-treated (1 mg/day via gastric tube; n = 10), and DSS-control (plain drinking water; n = 10). An unmodeled non-DSS group served as the experimental control. Complete blood count was taken for all mice at baseline (day 0, treatment initiation) and after four days of treatment. On day 4, all animals were sacrificed for autopsy. The primary outcome measure was bleeding, and the secondary outcomes were change in platelet count, hemoglobin level, and hematocrit level. RESULTS Neither ticagrelor nor eptifibatide treatment produced a significant effect on DSS colitis mice for the safety parameters measured. Platelet count and hemoglobin and hematocrit levels were statistically similar between the three DSS groups and the non-DSS control group (P > 0.05). Autopsy found no evidence of recent bleeding in liver, spleen, central nervous system or serous cavities. CONCLUSION The antiplatelet agents ticagrelor and eptifibatide were safe in DSS colitis mice, suggesting their potential in humans suffering from ulcerative colitis, and supporting future safety studies.
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Affiliation(s)
- Stanko S Petrovic
- Clinic for Gastroenterology and Hepatology, Military Medical Academy, School of Medicine of the Military Medical Academy, University of Defence Belgrade, Serbia
| | | | - Slobodan D Obradovic
- Clinic for Cardiology, Military Medical Academy, School of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
| | - Dino K Tarabar
- Clinic for Gastroenterology and Hepatology, Military Medical Academy, School of Medicine of the Military Medical Academy, University of Defence Belgrade, Serbia
| | - Radoje B Doder
- Clinic for Gastroenterology and Hepatology, Military Medical Academy, School of Medicine of the Military Medical Academy, University of Defence Belgrade, Serbia
| | | | - Marijana D Petrovic
- Clinic for Nephrology, Military Medical Academy, School of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
| | - Zvonko M Magic
- Institute for Medical Research, Military Medical Academy, Belgrade, Serbia
| | - Bojana M Cikota
- Institute for Medical Research, Military Medical Academy, Belgrade, Serbia
| | - Nenad J Perisic
- Clinic for Gastroenterology and Hepatology, Military Medical Academy, School of Medicine of the Military Medical Academy, University of Defence Belgrade, Serbia
| | - Irina A Brcerevic
- Clinic for Gastroenterology and Hepatology, Military Medical Academy, School of Medicine of the Military Medical Academy, University of Defence Belgrade, Serbia
| | - Nebojsa S Manojlovic
- Clinic for Gastroenterology and Hepatology, Military Medical Academy, School of Medicine of the Military Medical Academy, University of Defence Belgrade, Serbia
| | - Nemanja K Rancic
- Centre for Clinical Pharmacology, School of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
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24
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Baud JM, Stanciu D, Yeung J, Maurizot A, Chabay S, de Malherbe M, Chadenat ML, Bachelet D, Pico F. Contrast enhanced ultrasound of carotid plaque in acute ischemic stroke (CUSCAS study). Rev Neurol (Paris) 2020; 177:115-123. [PMID: 32653212 DOI: 10.1016/j.neurol.2020.03.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 03/17/2020] [Accepted: 03/18/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Carotid atherosclerosis represents 8 to 15% of ischemic strokes in relation to the concept of "vulnerable" plaque. Contrast enhanced ultrasound (CEUS) can detect moving microbubbles within the plaque corresponding to neovessels that constitute "precursors" of vulnerable plaque and intraplaque hemorrhage. CEUS was not studied specifically in acute ischemic strokes. The aim of this study is to analyse the prevalence of CEUS carotid plaque ipsilateral at the ischemic stroke as well as the main characteristics of contrast-plaques. METHOD A single-centre prospective pilot study involving 33 consecutive patients with a stroke ≤10 days, diagnosed by an MRI with positive diffusion sequence and having a carotid plaque thickness ≥2.5mm with low or heterogeneous echogenicity, located in the ipsilateral carotid territory at the stroke. Plaque echogenicity was done by visual analysis and by measurement of the gray scale median (GSM). A transcranial Doppler monitoring was carried out in search of HITS. The contrast ultrasound was performed after 2.5 cc IV injection of SonoVue®. A video clip was recorded after injection which was used for interpretation by visual analysis in 3 grades, provided by two independent expert readers. RESULTS The population consisted of 10 women and 23 men aged 73 on average. The topography of strokes in the carotid territory was located on the right in 11 (33%) cases and on the left in 22 (67%) cases. Seventeen patients had carotid stenosis between 0 and 49% according to the Nascet method and 16 patients had stenosis of 50 to 99%. The visual characterisation of the plaques had echolucent dominance (Type 1-2) in 18 cases and echogenic dominance (Type 3-4a) in 15 cases. Cardiovascular risk factors were common with no difference by sex. The inter-observer agreement of plaque enhancement was moderate in first reading (k=0.48) and excellent at consensus (k=0.91). Only one disagreement was found. Contrast agent enhancement of carotid plaque was observed in 11/32 patients, representing a prevalence of 34.4% - CI95% [17.9-50.9]. Variables associated with contrast plaque included the absence of antiplatelet drug (63.6% vs. 23.8%, P=0.05) and the presence of a regular edge on the plaque (91% vs. 48%, P=0.04). There was no difference in contrast enhancement for stenosis>or<50% in diameter and neither for the type of plaque. CONCLUSION In a consecutive cohort of 33 patients, the prevalence of CEUS from an ipsilateral carotid plaque to a recent acute ischemic stroke was 34.4%. There was a statistically significant association between the contrast enhancement of the plaque and the absence of antiplatelet drug (P=0.05) and also the presence of a regular edge on the plaque (P=0.04). There was no correlation between plaque contrast and clinical and biological characteristics of patients or the presence of HITS.
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Affiliation(s)
- J M Baud
- Vascular Medicine Unit, centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France.
| | - D Stanciu
- Department of Neurology and stroke centre, centre hospitalier de Versailles, 78150 Le Chesnay, France
| | - J Yeung
- Department of Neurology and stroke centre, centre hospitalier de Versailles, 78150 Le Chesnay, France
| | - A Maurizot
- Vascular Medicine Unit, centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France
| | - S Chabay
- Vascular Medicine Unit, centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France
| | - M de Malherbe
- Department of Radiology, centre hospitalier de Versailles, 78150 Le Chesnay, France
| | - M-L Chadenat
- Department of Neurology and stroke centre, centre hospitalier de Versailles, 78150 Le Chesnay, France
| | - D Bachelet
- Direction of clinical research and innovation, centre hospitalier de Versailles, 78150 Le Chesnay, France
| | - F Pico
- Department of Neurology and stroke centre, centre hospitalier de Versailles, 78150 Le Chesnay, France; Versailles Saint-Quentin-en Yvelines university, 78000 Versailles, France
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25
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Abstract
Platelets - blood cells continuously produced from megakaryocytes mainly in the bone marrow - are implicated not only in haemostasis and arterial thrombosis, but also in other physiological and pathophysiological processes. This Review describes current evidence for the heterogeneity in platelet structure, age, and activation properties, with consequences for a diversity of platelet functions. Signalling processes of platelet populations involved in thrombus formation with ongoing coagulation are well understood. Genetic approaches have provided information on multiple genes related to normal haemostasis, such as those encoding receptors and signalling or secretory proteins, that determine platelet count and/or responsiveness. As highly responsive and secretory cells, platelets can alter the environment through the release of growth factors, chemokines, coagulant factors, RNA species, and extracellular vesicles. Conversely, platelets will also adapt to their environment. In disease states, platelets can be positively primed to reach a pre-activated condition. At the inflamed vessel wall, platelets interact with leukocytes and the coagulation system, interactions mediating thromboinflammation. With current antiplatelet therapies invariably causing bleeding as an undesired adverse effect, novel therapies can be more beneficial if directed against specific platelet responses, populations, interactions, or priming conditions. On the basis of these novel concepts and processes, we discuss several initiatives to target platelets therapeutically.
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26
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Zhou WL, Mo ZZ, Xiao FY, Dai W, Wang G, Zhou G, Zhang W, Chen BL. microRNA-605 rs2043556 polymorphisms affect clopidogrel therapy through modulation of CYP2B6 and P2RY12 in acute coronary syndrome patients. Platelets 2019; 31:897-905. [PMID: 31766967 DOI: 10.1080/09537104.2019.1696455] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Wan-Lu Zhou
- Department of Geriatrics, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Zhen-Zhen Mo
- Department of Geriatrics, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Fei-Yan Xiao
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
| | - Wei Dai
- Department of Geriatrics, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Guo Wang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
| | - Gan Zhou
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
| | - Wei Zhang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
| | - Bi-Lian Chen
- Department of Geriatrics, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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27
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Lee HR, Park KY, Jeong YJ, Heo TH. Comparative effectiveness of different antiplatelet agents at reducing TNF-driven inflammatory responses in a mouse model. Clin Exp Pharmacol Physiol 2019; 47:432-438. [PMID: 31713877 DOI: 10.1111/1440-1681.13211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 10/13/2019] [Accepted: 11/04/2019] [Indexed: 11/30/2022]
Abstract
Antiplatelet drugs are conventionally used as treatments because of their anti-coagulation functions. However, their pleiotropic effects are of great significance to the treatment of ischaemic cardiovascular diseases. Many studies have reported that an excessive amount of inflammation driven by tumour necrosis factor (TNF) is closely related to the prevalence of atherosclerosis. As the drug selection criteria and evaluation methods related to the anti-TNF activity of antiplatelet drugs remain limited, our investigation of these drugs should prove beneficial. In this study, we compared the anti-TNF activity of three antiplatelet agents, namely clopidogrel, sarpogrelate, and cilostazol, using the TNF-induced inflammatory mouse model. After the oral administration of these drugs, acute inflammation was induced via injection of lipopolysaccharide (LPS) or D-galactosamine (D-gal) and TNF. Serum TNF levels, and the mRNA and protein expression levels of TNF in mouse heart tissue, macrophage accumulation in aortic lesions, and mouse survival were analysed to compare the anti-TNF effects of the three antiplatelet agents. Of the three antiplatelet agents, cilostazol significantly reduced the different levels under the most effective observation. In addition, cilostazol was found to attenuate the TNF-stimulated phosphorylation of mitogen-activated protein kinase (MAPK) and nuclear factor kappa-light-chain-enhancer of activated B cell (NF-κB) p65 in the aortic vascular smooth muscle cell line, MOVAS-1 and the D-gal plus TNF-challenged heart tissue of mouse. Therefore, cilostazol is the most ideal of the three antiplatelet drugs for the treatment of TNF-mediated inflammatory disorders.
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Affiliation(s)
- Hae-Ri Lee
- Laboratory of Pharmaco-Immunology, Integrated Research Institute of Pharmaceutical Sciences, BK21 PLUS Team for Creative Leader Program for Pharmacomics-based Future Pharmacy, College of Pharmacy, The Catholic University of Korea, Bucheon-si, Republic of Korea
| | - Kyung-Yeon Park
- Laboratory of Pharmaco-Immunology, Integrated Research Institute of Pharmaceutical Sciences, BK21 PLUS Team for Creative Leader Program for Pharmacomics-based Future Pharmacy, College of Pharmacy, The Catholic University of Korea, Bucheon-si, Republic of Korea
| | - Young-Jin Jeong
- Laboratory of Pharmaco-Immunology, Integrated Research Institute of Pharmaceutical Sciences, BK21 PLUS Team for Creative Leader Program for Pharmacomics-based Future Pharmacy, College of Pharmacy, The Catholic University of Korea, Bucheon-si, Republic of Korea
| | - Tae-Hwe Heo
- Laboratory of Pharmaco-Immunology, Integrated Research Institute of Pharmaceutical Sciences, BK21 PLUS Team for Creative Leader Program for Pharmacomics-based Future Pharmacy, College of Pharmacy, The Catholic University of Korea, Bucheon-si, Republic of Korea
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Association between preoperative aspirin and acute kidney injury following coronary artery bypass grafting. J Thorac Cardiovasc Surg 2019; 160:712-719. [PMID: 31653428 DOI: 10.1016/j.jtcvs.2019.08.119] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 08/28/2019] [Accepted: 08/30/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To test the hypothesis that preoperative aspirin administered within 24 hours before coronary artery bypass grafting (CABG) could reduce the incidence of postoperative acute kidney injury (AKI) following CABG. METHODS In this retrospective study, 696 patients were assigned to groups according to the time interval between their last aspirin dose administration and the time of surgery. A total of 322 patients received aspirin ≤24 hours before CABG, and 374 patients received aspirin between 24 and 48 hours before CABG. The primary outcome was postoperative AKI of any stage as defined by the Kidney Disease Improving Global Outcomes criteria. Propensity score matching selected 274 pairs for the final comparison. RESULTS Multivariable analysis showed that administration of aspirin within 24 hours of CABG was independently associated with reduction of AKI incidence by 36% (odds ratio, 0.64; 95% confidence interval, 0.45-0.91; P = .014). It was also noted that patients receiving their last aspirin dose ≤24 hours before CABG had a significantly higher glomerular filtration rate at discharge compared with patients who received aspirin between 24 and 48 hours before CABG. Propensity score matching analysis showed that patients receiving aspirin within 24 hours before CABG had a lower incidence of AKI compared with patients who discontinued aspirin between 24 and 48 hours before CABG (25.1% vs 36.8%; P = .004). CONCLUSIONS Continuation of aspirin until the day of surgery, with the last aspirin dose administered ≤24 hours before CABG, is associated with a significant reduction of postoperative AKI.
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Han L, Dai L, Zhao YF, Li HY, Liu O, Lan F, Jiang WJ, Zhang HJ. CD40L promotes development of acute aortic dissection via induction of inflammation and impairment of endothelial cell function. Aging (Albany NY) 2019. [PMID: 29514135 PMCID: PMC5892687 DOI: 10.18632/aging.101394] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Acute aortic dissection is one of the most lethal cardiovascular disease. The major histopathological feature of AAD is medial degradation, especially breakdown of elastin and collagen. However, the underlying mechanism remains a mystery. Platelets expressed CD40 Ligand (CD40L) is recently recognised as a key effector of cardiovascular disease development through its pro-inflammatory effect. To clarify the role of CD40L in AAD, we examined level of CD40L in human blood serum samples and found that it is significantly higher in AAD patients compared with healthy subjects (26.8±5.52 ng/mL versus 13.4±4.00 ng/mL). To further investigate if CD40L is involve in the development of AAD, we applied β-aminopropionitrile (BAPN) induced mouse model of AAD. Consistent with the human data, circulating CD40L in AAD mice much higher than normal mice (148.40±75.96 pg/mL versus 44.09±19.65 pg/mL). Meanwhile, multiple pro-inflammatory chemokines significantly increased in AAD mice. Importantly, the CD40L-/- mice treated with BAPN did not develop these phenotypes. Lastly, we confirmed that endothelial cells migration was significantly inhibited by CD40L, suggesting impaired recovery from intimal injury. In summary, we found that CD40L promoted AAD development through its pro-inflammatory effects and inhibition of endothelial cell function.
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Affiliation(s)
- Lu Han
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.,Beijing Lab for Cardiovascular Precision Medicine, Beijing, China.,Beijing Aortic Disease Center, Cardiovascular Surgery Center, Beijing, China.,Beijing Engineering Research Center for Vascular Prostheses, Beijing, China
| | - Lu Dai
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.,Beijing Lab for Cardiovascular Precision Medicine, Beijing, China.,Beijing Aortic Disease Center, Cardiovascular Surgery Center, Beijing, China.,Beijing Engineering Research Center for Vascular Prostheses, Beijing, China
| | - Yuan-Fei Zhao
- Centre for Transplant and Renal Research, The Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - Hai-Yang Li
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.,Beijing Lab for Cardiovascular Precision Medicine, Beijing, China.,Beijing Aortic Disease Center, Cardiovascular Surgery Center, Beijing, China.,Beijing Engineering Research Center for Vascular Prostheses, Beijing, China
| | - Ou Liu
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.,Beijing Lab for Cardiovascular Precision Medicine, Beijing, China.,Beijing Aortic Disease Center, Cardiovascular Surgery Center, Beijing, China.,Beijing Engineering Research Center for Vascular Prostheses, Beijing, China
| | - Feng Lan
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.,Beijing Lab for Cardiovascular Precision Medicine, Beijing, China.,Beijing Aortic Disease Center, Cardiovascular Surgery Center, Beijing, China.,Beijing Engineering Research Center for Vascular Prostheses, Beijing, China
| | - Wen-Jian Jiang
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.,Beijing Lab for Cardiovascular Precision Medicine, Beijing, China.,Beijing Aortic Disease Center, Cardiovascular Surgery Center, Beijing, China.,Beijing Engineering Research Center for Vascular Prostheses, Beijing, China
| | - Hong-Jia Zhang
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.,Beijing Lab for Cardiovascular Precision Medicine, Beijing, China.,Beijing Aortic Disease Center, Cardiovascular Surgery Center, Beijing, China.,Beijing Engineering Research Center for Vascular Prostheses, Beijing, China
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30
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Pinho-Gomes AC, Azevedo L, Ahn JM, Park SJ, Hamza TH, Farkouh ME, Serruys PW, Milojevic M, Kappetein AP, Stone GW, Lamy A, Fuster V, Taggart DP. Compliance With Guideline-Directed Medical Therapy in Contemporary Coronary Revascularization Trials. J Am Coll Cardiol 2019; 71:591-602. [PMID: 29420954 DOI: 10.1016/j.jacc.2017.11.068] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/26/2017] [Accepted: 11/28/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Despite the well-established benefits of secondary cardiovascular prevention, the importance of concurrent medical therapy in clinical trials of coronary revascularization is often overlooked. OBJECTIVES The goal of this study was to assess compliance with guideline-directed medical therapy (GDMT) in clinical trials and its potential impact on the comparison between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). METHODS The Cochrane Central Register of Controlled Trials and MEDLINE were searched from 2005 to August 2017. Clinical trial registries and reference lists of relevant studies were also searched. Randomized controlled trials comparing PCI with drug-eluting stents versus CABG and reporting medical therapy after revascularization were included. The study outcome was compliance with GDMT, defined as the following: 1) any antiplatelet agent plus beta-blocker plus statin (GDMT1); and 2) any antiplatelet agent plus beta-blocker plus statin plus angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (GDMT2). Data collection and analysis were performed according to the methodological recommendations of The Cochrane Collaboration. RESULTS From a total of 439 references, 5 trials were included based on our inclusion and exclusion criteria. Overall, compliance with GDMT1 was low and decreased over time from 67% at 1 year to 53% at 5 years. Compliance with GDMT2 was even lower and decreased from 40% at 1 year to 38% at 5 years. Compliance with both GDMT1 and GDMT2 was higher in PCI than in CABG at all time points. Meta-regression suggested an association between lower use of GDMT1 and adverse clinical outcomes in PCI versus CABG at 5 years. CONCLUSIONS Compliance with GDMT in contemporary clinical trials remains suboptimal and is significantly lower after CABG than after PCI, which may influence the comparison of clinical trial endpoints between those study groups.
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Affiliation(s)
| | - Luis Azevedo
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS) & Centre for Health Technology and Services Research (CINTESIS), Faculty of Medicine, Porto University, Porto, Portugal
| | - Jung-Min Ahn
- Asan Medical Center, University of Ulsan College of Medicine, Ulsan, Republic of South Korea
| | - Seung-Jung Park
- Asan Medical Center, University of Ulsan College of Medicine, Ulsan, Republic of South Korea
| | - Taye H Hamza
- New England Research Institutes, Watertown, Massachusetts
| | - Michael E Farkouh
- Peter Munk Cardiac Centre and Heart & Stroke/Richard Lewar Centre, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | - Gregg W Stone
- The New York Presbyterian Hospital, Columbia University Medical Center, Cardiovascular Research Foundation, New York, New York
| | - Andre Lamy
- Department of Surgery, Division of Cardiac Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Valentin Fuster
- Mount Sinai Cardiovascular Institute, New York, New York; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - David P Taggart
- Department of Cardiac Surgery, Oxford University Hospitals NHS Trust, Oxford, United Kingdom
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Fei M, Xiang L, Chai X, Jin J, You T, Zhao Y, Ruan C, Hao Y, Zhu L. Plasma soluble C-type lectin-like receptor-2 is associated with the risk of coronary artery disease. Front Med 2019; 14:81-90. [PMID: 31280468 DOI: 10.1007/s11684-019-0692-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 02/03/2019] [Indexed: 01/10/2023]
Abstract
Accumulating evidence suggests that C-type lectin-like receptor-2 (CLEC-2) plays an important role in atherothrombosis. In this case-control study, we investigated the association between CLEC-2 and incidence of coronary artery disease (CAD). A total of 216 patients, including 14 cases of stable angina pectoris (SAP, non-ACS) and 202 cases of acute coronary syndrome (ACS), and 89 non-CAD control subjects were enrolled. Plasma levels of soluble CLEC-2 (sCLEC-2) were measured using the enzyme-linked immunosorbent assay (ELISA). Compared with the control group (65.69 (55.36-143.22) pg/mL), the plasma levels of sCLEC-2 were significantly increased in patients with CAD (133.67 (88.76-220.09) pg/mL) and ACS (134.16 (88.88-225.81) pg/mL). The multivariate adjusted odds ratios (95% confidence interval) of CAD reached 2.01 (1.52-2.66) (Ptrend < 0.001) for each 1-quartile increase in sCLEC-2. Restricted cubic splines showed a positive dose-response association between sCLEC2 and CAD incidence (Plinearity < 0.001). The addition of sCLEC-2 to conventional risk factors improved the C statistic (0.821 vs. 0.761, P = 0.004) and reclassification ability (net reclassification improvement: 57.45%, P < 0.001; integrated discrimination improvement: 8.27%, P < 0.001) for CAD. In conclusion, high plasma sCLEC-2 is independently associated with CAD risk, and the prognostic value of sCLEC-2 may be evaluated in future prospective studies.
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Affiliation(s)
- Min Fei
- Cyrus Tang Medical Institute, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, 215123, China.,Jiangsu Institute of Hematology, The First Affiliated Hospital, Soochow University, Suzhou, 215006, China
| | - Li Xiang
- Department of Cardiology, The Second Affiliated Hospital, Soochow University, Suzhou, 215004, China
| | - Xichen Chai
- Department of Cardiology, The First Affiliated Hospital, Soochow University, Suzhou, 215006, China
| | - Jingchun Jin
- Department of Blood Transfusion, The First Affiliated Hospital, China Medical University, Shenyang, 110001, China
| | - Tao You
- Cyrus Tang Medical Institute, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, 215123, China.,Jiangsu Institute of Hematology, The First Affiliated Hospital, Soochow University, Suzhou, 215006, China
| | - Yiming Zhao
- Jiangsu Institute of Hematology, The First Affiliated Hospital, Soochow University, Suzhou, 215006, China
| | - Changgeng Ruan
- Cyrus Tang Medical Institute, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, 215123, China.,Jiangsu Institute of Hematology, The First Affiliated Hospital, Soochow University, Suzhou, 215006, China
| | - Yiwen Hao
- Department of Blood Transfusion, The First Affiliated Hospital, China Medical University, Shenyang, 110001, China.
| | - Li Zhu
- Cyrus Tang Medical Institute, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, 215123, China. .,Jiangsu Institute of Hematology, The First Affiliated Hospital, Soochow University, Suzhou, 215006, China.
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Zaidi H, Byrkjeland R, Njerve IU, Åkra S, Solheim S, Arnesen H, Seljeflot I, Opstad TB. Effects of exercise training on inflammasome-related mediators and their associations to glucometabolic variables in patients with combined coronary artery disease and type 2 diabetes mellitus: Sub-study of a randomized control trial. Diab Vasc Dis Res 2019; 16:360-368. [PMID: 30939905 DOI: 10.1177/1479164119836922] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Adipose tissue produces pro-inflammatory mediators involved in the atherosclerotic process. We investigated whether 12-month exercise training in patients with type 2 diabetes mellitus and coronary artery disease would reduce circulating levels and genetic expression of mediators in the interleukin-18, Caspase-1 and NLR pyrin domain containing 3 pathways. Correlations to glucometabolic variables; fasting glucose, HbA1c, duration of diabetes, insulin, C-peptide, insulin resistance (measured by homeostatic model assessment indexes - insulin resistance) and body mass index at baseline were further assessed. METHODS 137 patients (aged 41-81 years, 17.2% female participants) were included and randomized to a 12-month exercise programme or to a control group. Fasting blood and adipose tissue samples were taken at inclusion and after 12 months. RESULTS No statistically significant difference in changes of any variable between the intervention and the control group was found. At baseline, a positive correlation between insulin and homeostatic model assessment indexes - insulin resistance, interleukin-18 expression in adipose tissue and an inverse correlation between some glucometabolic variables and leukocyte expression of NLR pyrin domain containing 3 and Caspase-1 were observed. CONCLUSION No significant effects of long-term exercise training were observed on the inflammasome-related mediators in our patients with combined coronary artery disease and type 2 diabetes mellitus. The observed correlations may indicate a pro-inflammatory state in adipose tissue by overweight and a compensatory downregulation of these mediators in circulating leucocytes.
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Affiliation(s)
- Hani Zaidi
- 1 Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Oslo, Norway
- 2 Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway
- 3 Faculty of Medicine, University of Oslo, Oslo, Norway
- 4 Department of Cardiology, Akershus University Hospital, Lørenskog, Norway
| | - Rune Byrkjeland
- 1 Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Oslo, Norway
- 2 Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway
- 3 Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ida U Njerve
- 1 Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Oslo, Norway
- 2 Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway
| | - Sissel Åkra
- 1 Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Oslo, Norway
- 2 Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway
| | - Svein Solheim
- 1 Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Oslo, Norway
- 2 Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway
| | - Harald Arnesen
- 1 Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Oslo, Norway
- 2 Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway
- 3 Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingebjørg Seljeflot
- 1 Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Oslo, Norway
- 2 Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway
- 3 Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Trine B Opstad
- 1 Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Oslo, Norway
- 2 Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway
- 3 Faculty of Medicine, University of Oslo, Oslo, Norway
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Vlachopoulos C, Georgakopoulos C, Pietri P, Ioakeimidis N, Koutouzis M, Vaina S, Aznaouridis K, Toutouzas K, Latsios G, Terentes-Printzios D, Rigatou A, Tousoulis D. Effect of Ticagrelor Versus Clopidogrel on Aortic Stiffness in Patients With Coronary Artery Disease. J Am Heart Assoc 2019; 8:e012521. [PMID: 31165663 PMCID: PMC6645640 DOI: 10.1161/jaha.119.012521] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background We compared the acute and midterm effect of ticagrelor versus clopidogrel on aortic stiffness. Methods and Results We studied 117 patients in a randomized, assessor‐blinded, parallel‐group trial. The acute effect of ticagrelor was studied in 58 patients randomized (1:1) to receive a loading dose of clopidogrel (600 mg) or ticagrelor (180 mg). Carotid‐femoral pulse wave velocity (cfPWV) was measured before, 3, and 24 hours after the loading dose. The midterm effect (30‐day treatment period) was studied in 59 subjects who underwent percutaneous coronary intervention and were randomized to either clopidogrel (75 mg, OD) or ticagrelor (90 mg BID). cfPWV was measured before and at 30 days of treatment. Circulating markers of inflammation and endothelial function were measured at all study points. Repeated‐measures analysis showed a significant main effect for treatment (P=0.03), with the ticagrelor showing a reduction in cfPWV after treatment. cfPWV at 24 hours was significantly lower in the ticagrelor group compared with the clopidogrel group (P=0.017) (maximal response reduction by 0.42±0.26 m/s). At 30 days, cfPWV decreased in the ticagrelor group, whereas there was no change with clopidogrel (−0.43±0.57 versus 0.12±0.14 m/s, P=0.004). There were no significant changes in both the acute and midterm study period in the pro‐inflammatory and endothelial function parameters. Conclusions URL: https://www.clinicaltrials.gov. Unique identifier: NCT02071212. Ticagrelor decreases cfPWV for 24 hours after the loading dose and at 1 month post–percutaneous coronary intervention compared with clopidogrel. Considering that aortic stiffness is an independent predictor of cardiovascular events, this finding may have clinical implications regarding the beneficial effect of ticagrelor. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02071212.
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Affiliation(s)
| | | | | | - Nikolaos Ioakeimidis
- 1 First Department of Cardiology Hippokration Hospital Athens Medical School Athens Greece
| | - Michael Koutouzis
- 3 Second Department of Cardiology Red Cross General Hospital Athens Greece
| | - Sophia Vaina
- 1 First Department of Cardiology Hippokration Hospital Athens Medical School Athens Greece
| | | | - Konstantinos Toutouzas
- 1 First Department of Cardiology Hippokration Hospital Athens Medical School Athens Greece
| | - George Latsios
- 1 First Department of Cardiology Hippokration Hospital Athens Medical School Athens Greece
| | | | - Aggeliki Rigatou
- 3 Second Department of Cardiology Red Cross General Hospital Athens Greece
| | - Dimitris Tousoulis
- 1 First Department of Cardiology Hippokration Hospital Athens Medical School Athens Greece
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Pitchford S, Cleary S, Arkless K, Amison R. Pharmacological strategies for targeting platelet activation in asthma. Curr Opin Pharmacol 2019; 46:55-64. [PMID: 31026626 DOI: 10.1016/j.coph.2019.03.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/18/2019] [Accepted: 03/22/2019] [Indexed: 12/22/2022]
Abstract
The activation of platelets during host defence and inflammatory disorders has become increasingly documented. Clinical studies of patients with asthma reveal heightened platelet activation and accumulation into lung tissue. Accompanying studies in animal models of allergic lung inflammation, using protocols of experimentally induced thrombocytopenia proclaim an important role for platelets during the leukocyte recruitment cascade, tissue integrity, and lung function. The functions of platelets during these inflammatory events are clearly distinct to platelet functions during haemostasis and clot formation, and have led to the concept that a dichotomy (or polytomy, depending on what else platelets do) in platelet activation exists. The platelet, therefore, presents us with novel opportunities for modulating these inflammatory responses. This review discusses the rationale and effectiveness of current anti-platelet drugs in their use to supress inflammation with regard to asthma, and the need to consider novel possibilities for pharmacological modulation of platelet function associated with inflammation that are pharmacologically distinct to current anti-platelet therapies.
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Affiliation(s)
- Simon Pitchford
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, UK.
| | - Simon Cleary
- University of California San Francisco (UCSF), Department of Medicine, San Francisco, USA
| | - Kate Arkless
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, UK
| | - Richard Amison
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, UK
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Cho O, Jang YJ, Park KY, Heo TH. Beneficial anti-inflammatory effects of combined rosuvastatin and cilostazol in a TNF-driven inflammatory model. Pharmacol Rep 2019; 71:266-271. [DOI: 10.1016/j.pharep.2018.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/07/2018] [Accepted: 12/14/2018] [Indexed: 02/07/2023]
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Schwarzkopf K, Bojunga J, Rüschenbaum S, Martinez Y, Mücke MM, Seeger F, Schoelzel F, Zeuzem S, Friedrich-Rust M, Lange CM. Use of Antiplatelet Agents Is Inversely Associated With Liver Fibrosis in Patients With Cardiovascular Disease. Hepatol Commun 2018; 2:1601-1609. [PMID: 30556044 PMCID: PMC6287477 DOI: 10.1002/hep4.1254] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 08/08/2018] [Indexed: 01/13/2023] Open
Abstract
Platelets participate in the development of liver fibrosis in animal models, but little is known about the benefit of antiplatelet agents in preventing liver fibrosis in humans. We therefore explored the relationship between the use of antiplatelet agents and liver fibrosis in a prospective cohort study of patients at high risk of liver fibrosis and cardiovascular events. Consecutive patients undergoing elective coronary angiography at the University Hospital Frankfurt were prospectively included in the present study. Associations between use of antiplatelet agents (acetyl salicylic acid, P2Y12 receptor antagonists) and liver fibrosis were assessed in regression models, and the relationship between platelet-derived growth factor beta (PDGF-β) serum concentration, platelets, liver fibrosis, and use of antiplatelet agents was characterized. Out of 505 included patients, 337 (67%) received antiplatelet agents and 134 (27%) had liver fibrosis defined as a FibroScan transient elastography (TE) value ≥7.9 kPa. Use of antiplatelet agents was inversely associated with the presence of liver fibrosis in univariate and multivariate analyses (multivariate odds ratio [OR], 0.67; 95% confidence interval [CI], 0.51-0.89; P = 0.006). Use of antiplatelet agents was also inversely associated with FibroTest values (beta, -0.38; SD beta, 0.15; P = 0.02). Furthermore, there was a significant correlation between platelet counts and PDGF-β serum concentration (rho, 0.33; P < 0.0001), but PDGF-β serum levels were not affected by antiplatelet agents. Conclusion: There is a protective association between the use of antiplatelet agents and occurrence of liver fibrosis. A randomized controlled trial is needed to explore causality and the potential of antiplatelet agents as antifibrotic therapy in patients at risk for liver fibrosis progression.
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Affiliation(s)
| | - Joerg Bojunga
- Department of Internal Medicine 1 J.W. Goethe-University Hospital Frankfurt Germany
| | - Sabrina Rüschenbaum
- Department of Internal Medicine 1 J.W. Goethe-University Hospital Frankfurt Germany
| | - Yolanda Martinez
- Department of Internal Medicine 1 J.W. Goethe-University Hospital Frankfurt Germany
| | - Marcus M Mücke
- Department of Internal Medicine 1 J.W. Goethe-University Hospital Frankfurt Germany
| | - Florian Seeger
- Department of Cardiology St. Elisabeth Hospital Ravensburg Ravensburg Germany
| | - Fabian Schoelzel
- Department of Internal Medicine 1 J.W. Goethe-University Hospital Frankfurt Germany
| | - Stefan Zeuzem
- Department of Internal Medicine 1 J.W. Goethe-University Hospital Frankfurt Germany
| | | | - Christian M Lange
- Department of Internal Medicine 1 J.W. Goethe-University Hospital Frankfurt Germany
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Kubisa MJ, Jezewski MP, Gasecka A, Siller-Matula JM, Postuła M. Ticagrelor - toward more efficient platelet inhibition and beyond. Ther Clin Risk Manag 2018; 14:129-140. [PMID: 29398917 PMCID: PMC5775739 DOI: 10.2147/tcrm.s152369] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Novel antiplatelet drugs, including ticagrelor, are being successively introduced into the therapy of atherothrombotic conditions due to their superiority over a standard combination of clopidogrel with acetylsalicylic acid in patients with acute coronary syndromes (ACS). A P2Y12 receptor antagonist, ticagrelor, is unique among antiplatelet drugs, because ticagrelor inhibits the platelet P2Y12 receptor in a reversible manner, and because it demonstrates a wide palette of advantageous pleiotropic effects associated with the increased concentration of adenosine. The pleiotropic effects of ticagrelor comprise cardioprotection, restoration of the myocardium after an ischemic event, promotion of the release of anticoagulative factors and, eventually, anti-inflammatory effects. Beyond the advantageous effects, the increased concentration of adenosine is responsible for some of ticagrelor's adverse effects, including dyspnea and bradycardia. Large-scale clinical trials demonstrated that both standard 12-month therapy and long-term use of ticagrelor reduce the risk of cardiovascular events in patients with ACS, but at the expense of a higher risk of major bleeding. Further trials focused on the use of ticagrelor in conditions other than ACS, including ischemic stroke, peripheral artery disease and status after coronary artery bypass grafting. The results of these trials suggest comparable efficacy and safety of ticagrelor and clopidogrel in extra-coronary indications, but firm conclusions are anticipated from currently ongoing studies. Here, we summarize current evidence on the superiority of ticagrelor over other P2Y12 antagonists in ACS, discuss the mechanism underlying the drug-drug interactions and pleiotropic effects of ticagrelor, and present future perspectives of non-coronary indications for ticagrelor.
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Affiliation(s)
- Michał J Kubisa
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CEPT)
| | - Mateusz P Jezewski
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CEPT)
| | - Aleksandra Gasecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
- Vesicle Observation Centre, Laboratory of Experimental Clinical Chemistry, Academic Medical Centre, University of Amsterdam, the Netherlands
| | | | - Marek Postuła
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CEPT)
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Cherng YG, Lin CS, Shih CC, Hsu YH, Yeh CC, Hu CJ, Chen TL, Liao CC. Stroke risk and outcomes in patients with chronic kidney disease or end-stage renal disease: Two nationwide studies. PLoS One 2018; 13:e0191155. [PMID: 29329323 PMCID: PMC5766135 DOI: 10.1371/journal.pone.0191155] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 11/29/2017] [Indexed: 12/11/2022] Open
Abstract
Background and aims Because the risk and outcomes of stroke in patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD) were unclear, we evaluated these risks using a retrospective cohort study and a nested cohort study. Methods We used Taiwan’s National Health Insurance Research Database to identify 1378 patients aged ≥20 years who had ESRD in 2000–2004. An age- and sex-matched CKD cohort (n = 5512) and a control cohort (n = 11,024) were selected for comparison. Events of incident stroke were considered as outcome during the follow-up period in 2000–2013, and we calculated adjusted hazard ratios (HR) and 95% CIs of stroke associated with CKD or ESRD. We further used matching procedure with propensity score to estimate the risk of stroke for control group, CKD patients, and EDRD patients. A nested cohort study of 318,638 hospitalized stroke patients between 2000 and 2010 also was conducted to analyze the impact of CKD and ESRD on post-stroke mortality. Results Before propensity-score matching, the incidences of stroke for controls, CKD patients and ESRD patients were 6.57, 13.3, and 21.7 per 1000 person-years, respectively. Compared with control group, the adjusted HRs of stroke were 1.49 (95% CI, 1.32–1.68) and 2.39 (95% CI, 1.39–2.87) for people with CKD or ESRD respectively, and were significantly higher in both sexes and every age group. After propensity-score matching, the HRs of stroke for patients with CKD and ESRD were 1.51 (95% CI 1.24–1.85) and 2.08 (95% CI 1.32–3.26), respectively, during the follow-up period. Among hospitalized stroke patients, adjusted rate ratio (RR) of post-stroke mortality in CKD and ESRD cohorts were 1.44 (95% CI, 1.33–1.56) and 2.62 (95% CI, 2.43–2.82) respectively compared with control. Conclusions CKD and ESRD patient groups thus faced significantly higher risk of stroke and post-stroke mortality. Risk factor identification and preventive strategies are needed to minimize stroke risk and post-stroke mortality in these vulnerable patient groups.
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Affiliation(s)
- Yih-Giun Cherng
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chao-Shun Lin
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chun-Chuan Shih
- School of Chinese Medicine for Post-Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Program for the Clinical Drug Discovery from Botanical Herbs, Taipei Medical University, Taipei, Taiwan
| | - Yung-Ho Hsu
- Department of Nephrology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Nephrology, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chun-Chieh Yeh
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan
- Department of Surgery, University of Illinois, Chicago, United States of America
| | - Chaur-Jong Hu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Ta-Liang Chen
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chien-Chang Liao
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- * E-mail: ,
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40
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Schrör K, Huber K. Platelets, inflammation and anti-inflammatory drugs in ACS and CAD. Thromb Haemost 2017; 114:446-8. [DOI: 10.1160/th15-08-0632] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 08/07/2015] [Indexed: 12/20/2022]
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41
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Jamasbi J, Ayabe K, Goto S, Nieswandt B, Peter K, Siess W. Platelet receptors as therapeutic targets: Past, present and future. Thromb Haemost 2017; 117:1249-1257. [DOI: 10.1160/th16-12-0911] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 04/08/2017] [Indexed: 01/08/2023]
Abstract
SummaryAnti-platelet drugs reduce arterial thrombosis after plaque rupture and erosion, prevent stent thrombosis and are used to prevent and treat myocardial infarction and ischaemic stroke. Some of them may also be helpful in treating less frequent diseases such as thrombotic thrombocytopenic purpura. The present concise review aims to cover current and future developments of anti-platelet drugs interfering with the interaction of von Willebrand factor (VWF) with glycoprotein (GP) Ibα, and directed against GPVI, GPIIb/IIIa (integrin αIIbβ3), the thrombin receptor PAR-1, and the ADP receptor P2Y12. The high expectations of having novel antiplatelet drugs which selectively inhibit arterial thrombosis without interfering with normal haemostasis could possibly be met in the near future.
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42
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Yao Y, Chen Y, Adili R, McKeown T, Chen P, Zhu G, Li D, Ling W, Ni H, Yang Y. Plant-based Food Cyanidin-3-Glucoside Modulates Human Platelet Glycoprotein VI Signaling and Inhibits Platelet Activation and Thrombus Formation. J Nutr 2017; 147:1917-1925. [PMID: 28855423 DOI: 10.3945/jn.116.245944] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 01/19/2017] [Accepted: 07/19/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Platelets play an important role in hemostasis, thrombosis, and atherosclerosis. Glycoprotein VI (GPVI) is a major platelet receptor that interacts with exposed collagen on injured vessel walls. Our previous studies have shown that anthocyanins (a type of natural plant pigment) attenuate platelet function; however, whether anthocyanins affect collagen-induced GPVI signaling remains unknown.Objective: The objective of this study was to explore the effects of cyanidin-3-glucoside (Cy-3-g, one of the major bioactive compounds in anthocyanins) on platelet activation and thrombosis and the GPVI signaling pathway.Methods: Platelets from healthy men and women were isolated and incubated with different concentrations (0, 0.5, 5, and 50 μM) of Cy-3-g. The expression of activated integrin αIIbβ3, P-selectin, CD63, and CD40L, fibrinogen binding to platelets, and platelet aggregation were evaluated in vitro. Platelet adhesion and aggregation in whole blood under flow conditions were assessed in collagen-coated perfusion chambers. Thrombosis and hemostasis were assessed in 3-4-wk-old male C57BL/6J mice through FeCl3-induced intravital microscopy and tail bleeding time. The effect of Cy-3-g on collagen-induced human platelet GPVI signaling was explored with Western blot.Results: Cy-3-g attenuated platelet function in a dose-dependent manner. The 0.5-μM dose of Cy-3-g inhibited (P < 0.05) human platelet adhesion and aggregation to collagen at both venous (-54.02%) and arterial (-22.90%) shear stresses. The 5-μM dose inhibited (P < 0.05) collagen-induced human platelet activation (PAC-1: -48.21%, P-selectin: -50.63%), secretion (CD63: -73.89%, CD40L: -43.70%), fibrinogen binding (-56.79%), and aggregation (-17.81%). The 5-μM dose attenuated (P < 0.01) thrombus growth (-66.67%) without prolonging bleeding time in mice. The 50-μM dose downregulated (P < 0.05) collagen-induced GPVI signaling in human platelets and significantly decreased phosphorylation of Syk-linker for activation of T cells (LAT)-SLP76 (Syk: -39.08%, LAT: -32.25%, SLP76: -40.00%) and the expression of Lyn (-31.89%), Fyn (-36.27%), and phospholipase C-γ2 (-39.08%).Conclusions: Cy-3-g inhibits human platelet activation, aggregation, secretion, and thrombus formation, and downregulates the collagen-GPVI signaling pathway. Supplementation of Cy-3-g may have protective effects against atherothrombosis.
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Affiliation(s)
- Yanling Yao
- Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, People's Republic of China
| | - Yanqiu Chen
- Guangzhou Women and Children's Medical Centre, Guangzhou, People's Republic of China
| | - Reheman Adili
- Toronto Platelet Immunobiology Group, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Ontario, Canada; Departments of
| | - Thomas McKeown
- Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Ontario, Canada; Departments of
| | - Pingguo Chen
- Toronto Platelet Immunobiology Group, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Ontario, Canada; Departments of
| | - Guangheng Zhu
- Toronto Platelet Immunobiology Group, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Ontario, Canada; Departments of
| | - Dan Li
- Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, People's Republic of China
| | - Wenhua Ling
- Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, People's Republic of China
| | - Heyu Ni
- Toronto Platelet Immunobiology Group, University of Toronto, Toronto, Ontario, Canada; .,Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Ontario, Canada; Departments of.,Laboratory Medicine and Pathobiology.,Physiology, and.,Medicine, University of Toronto, Toronto, Ontario, Canada; and.,Canadian Blood Services, Toronto, Ontario, Canada
| | - Yan Yang
- Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China; .,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, People's Republic of China
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Platelet mass index is increased in psoriasis. A possible link between psoriasis and atherosclerosis. ARCHIVES OF MEDICAL SCIENCES. ATHEROSCLEROTIC DISEASES 2017; 1:e145-e149. [PMID: 28905037 PMCID: PMC5421536 DOI: 10.5114/amsad.2016.64444] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 11/28/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Psoriasis, whose relation with atherosclerosis etc. has long been known, is a chronic inflammatory disease. Besides providing hemostasis, platelets play important roles in inflammatory reactions and immune responses and contribute to endothelial damage, thus leading to atherosclerotic plaque formation. Mean platelet volume (MPV) has been previously reported as a platelet activation marker. Platelet mass index (PMI) is also related to platelet functionality and is thought to be a useful parameter for plaque formation capacity of platelets. MATERIAL AND METHODS Sex, age, age of onset, disease duration, family history, psoriasis area severity index, nail and joint involvement, platelet count, mean platelet volume, platelet mass index, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) of 320 patients with psoriasis and 200 healthy persons were evaluated. RESULTS Mean platelet counts were 277.7 ±73.374 and 265.06 ±59.682 (p = 0.032); MPV values were 8.248 ±1.150 and 7.442 ±1.626 (p < 0.001); and PMI values were 2259 ±545.617 and 1964 ±622.762 (p < 0.001) respectively in the psoriasis and control group. The MPV showed a significant but inverse correlation with hs-CRP (p = 0.047, r = -0.149), and no correlation with ESR (p > 0.05). Platelet count and PMI had a significant and positive correlation with ESR (p < 0.001, r = 0.404 and p < 0.001, r = 0.371), but had no correlation with hs-CRP (p > 0.05). CONCLUSIONS Higher PMI and MPV values, which mean higher plaque formation capacity and more active platelets, in psoriasis may make psoriasis patients more sensitive to atherosclerotic plaque formation and complications. On the other hand, because of the positive PMI correlation with ESR (MPV had no correlation with ESR and had a negative correlation with CRP), PMI may be a better predictor of inflammation than MPV in psoriasis.
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梁 琦, 雷 新, 李 红, 殷 艳, 任 洁, 范 力, 黄 欣, 袁 祖. [Regression analysis of red cell distribution width and mean platelet volume in patients with acute myocardial infarction]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2017; 37:1022-1027. [PMID: 28801280 PMCID: PMC6765727 DOI: 10.3969/j.issn.1673-4254.2017.08.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate clinical implications of changes in red cell distribution width (RDW) and mean platelet volume (MPV) in patients with acute myocardial infarction. METHODS A total of 127 patients (90 men and 37 women) were enrolled in this analysis, including 66 with acute myocardial infarction (AMI) and 61 with unstable angina (UA). The patients' baseline demographic and clinical data were compared between the two groups including age, hypertension, diabetes, smoking, BMI, blood biochemical profiles, cardiac functions and platelet and red blood cell parameters. The patients were further divided into subgroups according to the RDW 50% cumulative frequency, and the MPV, P-LCR, hsCRP, NT-proBNP, RBC, Dimer and MCV were compared. The correlations between platelet and erythrocyte test results were evaluated in both the AMI and UA patients. Regression analysis was performed to identify the factors affecting the RDW in the AMI group and a regression model was established. RESULTS The platelet and red blood cell test results, P-LCR, MPV, and RDW differed significantly between AMI and UA groups (P<0.01 or 0.05). Correlation analysis showed a significant positive correlation between RDW and MPV in AMI group (r=0.34, P<0.01). Between the subgroups with different RDW 50% cumulative frequencies, MPV, P-LCR, hsCRP, D-Dimer, and NT-proBNP all differed significantly (P<0.05 or 0.01). In AMI group, with RDW as the dependent variable, we established a multivariate regression model of RDW=0.19MPV+10.83. CONCLUSION RDW and MPV are closely correlated in patients with AMI. In multiple regression analysis, MPV can explain the changes in RDW in patients with AMI.
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Affiliation(s)
- 琦 梁
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 新军 雷
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 红兵 李
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 艳蓉 殷
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 洁 任
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 力宏 范
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 欣 黄
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 祖贻 袁
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
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Bekő K, Koványi B, Gölöncsér F, Horváth G, Dénes Á, Környei Z, Botz B, Helyes Z, Müller CE, Sperlágh B. Contribution of platelet P2Y 12 receptors to chronic Complete Freund's adjuvant-induced inflammatory pain. J Thromb Haemost 2017; 15:1223-1235. [PMID: 28345287 DOI: 10.1111/jth.13684] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Indexed: 11/30/2022]
Abstract
Essentials The role of platelet P2Y12 receptors in the regulation of chronic inflammatory pain is unknown. Complete Freund's Adjuvant (CFA)-induced chronic inflammatory pain model was used in mice. Gene deficiency and antagonists of P2Y12 receptors attenuate hyperalgesia and local inflammation. Platelet P2Y12 receptors contribute to these effects in the chronic phase of inflammation. SUMMARY Background P2Y12 receptor antagonists are widely used in clinical practice to inhibit platelet aggregation. P2Y12 receptors are also known to regulate different forms of pain as well as local and systemic inflammation. However, it is not known whether platelet P2Y12 receptors contribute to these effects. Objectives To explore the contribution of platelet P2Y12 receptors to chronic inflammatory pain in mice. Methods Complete Freund's adjuvant (CFA)-induced chronic inflammatory pain was induced in wild-type and P2ry12 gene-deficient (P2ry12-/- ) mice, and the potent, direct-acting and reversible P2Y12 receptor antagonists PSB-0739 and cangrelor were used. Results CFA-induced mechanical hyperalgesia was significantly decreased in P2ry12-/- mice for up to 14 days, and increased neutrophil myeloperoxidase activity and tumor necrosis factor (TNF)-α and CXCL1 (KC) levels in the hind paws were also attenuated in the acute inflammation phase. At day 14, increased interleukin (IL)-1β, IL-6, TNF-α and KC levels were attenuated in P2ry12-/- mice. PSB-0739 and cangrelor reversed hyperalgesia in wild-type mice but had no effect in P2ry12-/- mice, and PSB-0739 was also effective when applied locally. The effects of both local and systemic PSB-0739 were prevented by A-803467, a selective NaV1.8 channel antagonist, suggesting the involvement of NaV1.8 channels in the antihyperalgesic effect. Platelet depletion by anti-mouse CD41 antibody decreased hyperalgesia and attenuated the proinflammatory cytokine response in wild-type but not in P2ry12-/- mice on day 14. Conclusions In conclusion, P2Y12 receptors regulate CFA-induced hyperalgesia and the local inflammatory response, and platelet P2Y12 receptors contribute to these effects in the chronic inflammation phase.
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Affiliation(s)
- K Bekő
- Laboratory of Molecular Pharmacology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
- János Szentágothai School of Neurosciences, Semmelweis University School of PhD Studies, Budapest, Hungary
| | - B Koványi
- Laboratory of Molecular Pharmacology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
- János Szentágothai School of Neurosciences, Semmelweis University School of PhD Studies, Budapest, Hungary
| | - F Gölöncsér
- Laboratory of Molecular Pharmacology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
- János Szentágothai School of Neurosciences, Semmelweis University School of PhD Studies, Budapest, Hungary
| | - G Horváth
- Laboratory of Molecular Pharmacology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
- János Szentágothai School of Neurosciences, Semmelweis University School of PhD Studies, Budapest, Hungary
| | - Á Dénes
- Laboratory of Neuroimmunology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
| | - Z Környei
- Laboratory of Neuroimmunology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
| | - B Botz
- Department of Pharmacology and Pharmacotherapy, Center for Neuroscience, and Molecular Pharmacology, Research Team, János Szentágothai Research Center, University of Pécs, University of Pécs Medical School, Pécs, Hungary
| | - Z Helyes
- Department of Pharmacology and Pharmacotherapy, Center for Neuroscience, and Molecular Pharmacology, Research Team, János Szentágothai Research Center, University of Pécs, University of Pécs Medical School, Pécs, Hungary
- MTA-PTE NAP B Chronic Pain Research Group, University of Pécs, Pécs, Hungary
| | - C E Müller
- Pharmaceutical Institute, PharmaCenter Bonn, University of Bonn, Bonn, Germany
| | - B Sperlágh
- Laboratory of Molecular Pharmacology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
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A Double-Blinded Randomized Study Investigating a Possible Anti-Inflammatory Effect of Saxagliptin versus Placebo as Add-On Therapy in Patients with Both Type 2 Diabetes And Stable Coronary Artery Disease. Mediators Inflamm 2017; 2017:5380638. [PMID: 28596642 PMCID: PMC5449736 DOI: 10.1155/2017/5380638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 03/31/2017] [Accepted: 04/06/2017] [Indexed: 02/06/2023] Open
Abstract
Background Promising results regarding potential anti-inflammatory and antiatherosclerotic effects of gliptins have been reported. Our aim was to investigate whether saxagliptin treatment modifies expression of inflammatory markers, primarily in peripheral blood mononuclear cells (PBMCs) and in circulating leukocytes in patients with stable coronary artery disease (CAD) and T2DM. Methods Patients (n = 12) were randomized to saxagliptin 5 mg daily or placebo for 3 months. Samples were taken at baseline and end of study in fasting state prior to intake of medications. PBMCs were isolated and cryopreserved at −150°C until ex vivo exposed to 1 ng/mL of lipopolysaccharide (LPS) for 4 hours. Gene expression was performed with custom-designed TaqMan® Arrays and relative quantification by real-time PCR (RT-qPCR). Results HbA1c was reduced in the saxagliptin-treated group compared to that in the change with placebo (p = 0.042). In unstimulated PBMCs and in circulating leukocytes, we observed a significant increase in IL-10 expression in the saxagliptin group (p = 0.043, both), significantly different from that in the placebo (p = 0.009 and p = 0.032, resp.). No between group differences in changes were observed in any of the selected proinflammatory markers. Conclusion In our small cohort of patients with combined T2DM and CAD, a possible anti-inflammatory effect of saxagliptin, observed in the present study by upregulation of IL-10 in leukocytes, needs to be confirmed in larger studies.
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Xiao FY, Liu M, Chen BL, Cao S, Fan L, Liu ZQ, Zhou HH, Zhang W, Zhou G. Effects of four novel genetic polymorphisms on clopidogrel efficacy in Chinese acute coronary syndromes patients. Gene 2017; 623:63-71. [PMID: 28438693 DOI: 10.1016/j.gene.2017.04.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 03/31/2017] [Accepted: 04/12/2017] [Indexed: 11/30/2022]
Abstract
Dual antiplatelet therapy is the gold standard for the clinical treatment of coronary artery disease, especially for acute coronary syndromes patients. However, a substantial number of patients do not respond to clopidogrel despite a standardized dosage regimen, and this is directly associated with poor prognosis. Genetic polymorphisms may be one of the most important factors that contribute to this phenomenon. In this study, we aimed to detect new single nucleotide polymorphisms that can influence the efficacy of clopidogrel in 851 acute coronary syndromes (ACS) patients. Four outcomes (cerebrovascular event, Acute Myocardium Infarction, unstable angina and death) were used as endpoints among three cohorts (northern, central and southern China) of acute coronary syndromes patients. Three SNPs (rs2244923, rs2773341 and rs34428341) were significantly associated with at least one outcome in all subjects. One SNP rs16863352, may play a role in predicting unstable angina in acute coronary syndrome patients ≥75years of age.
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Affiliation(s)
- Fei-Yan Xiao
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008; Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China
| | - Min Liu
- Department of Cardiovascular, Zhengzhou Central Hospital, Zhengzhou University, Zhengzhou 450007, PR China
| | - Bi-Lian Chen
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, PR China
| | - Shan Cao
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008; Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China
| | - Lan Fan
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008; Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China
| | - Zhao-Qian Liu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008; Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China
| | - Hong-Hao Zhou
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008; Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China
| | - Wei Zhang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008; Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China
| | - Gan Zhou
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008; Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, PR China; National Institution of Drug Clinical Trial, Xiangya Hospital, Central South University, Changsha 410008, PR China.
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Abstract
PURPOSE OF REVIEW Endothelial dysfunction is intimately related to the development of various cardiovascular diseases, including hypertension, and is often used as a target for pharmacological treatment. The scope of this review is to assess effects of aspirin on endothelial function and their clinical implication in arterial hypertension. RECENT FINDINGS Emerging data indicate the role of platelets in the development of vascular inflammation due to the release of proinflammatory mediators, for example, triggered largely by thromboxane. Vascular inflammation further promotes oxidative stress, diminished synthesis of vasodilators, proaggregatory and procoagulant state. These changes translate into vasoconstriction, impaired circulation and thrombotic complications. Aspirin inhibits thromboxane synthesis, abolishes platelets activation and acetylates enzymes switching them to the synthesis of anti-inflammatory substances. Aspirin pleiotropic effects have not been fully elucidated yet. In secondary prevention studies, the decrease in cardiovascular events with aspirin outweighs bleeding risks, but this is not the case in primary prevention settings. Ongoing trials will provide more evidence on whether to expand the use of aspirin or stay within current recommendations.
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Affiliation(s)
- Mikhail S Dzeshka
- University of Birmingham Institute of Cardiovascular Sciences, City Hospital, Dudley Road, Birmingham, B18 7QH, UK
- Grodno State Medical University, Grodno, Belarus
| | - Alena Shantsila
- University of Birmingham Institute of Cardiovascular Sciences, City Hospital, Dudley Road, Birmingham, B18 7QH, UK
| | - Gregory Y H Lip
- University of Birmingham Institute of Cardiovascular Sciences, City Hospital, Dudley Road, Birmingham, B18 7QH, UK.
- Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
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Soma P, Swanepoel AC, du Plooy JN, Mqoco T, Pretorius E. Flow cytometric analysis of platelets type 2 diabetes mellitus reveals 'angry' platelets. Cardiovasc Diabetol 2016; 15:52. [PMID: 27036108 PMCID: PMC4818425 DOI: 10.1186/s12933-016-0373-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 03/23/2016] [Indexed: 12/26/2022] Open
Abstract
Background The function of platelets have extended way beyond the horizon of haemostasis and thrombosis, and are recognised as active participants in vascular inflammation, as well as in prothrombotic complications of cardiovascular diseases. We describe and compare platelet function in type II diabetes (with and without cardiovascular manifestation) and healthy individuals using scanning electron microscopy and flow cytometry. Methods Thirty subjects were recruited per group and informed consent was obtained from all participants. Diabetic patients were recruited from the diabetic clinic of the Steve Biko Academic Hospital (South Africa). Blood samples were drawn from all participants so that platelet specific antigens were analyzed in citrated whole blood. The platelet parameters used in the study were platelet identifiers (CD41 and CD42) and markers of platelet activation (CD62 and CD63). Results Results show that, compared to healthy individuals, both diabetic groups showed a significant difference in both platelet identifiers (CD41-PE, CD42b-PE) as well as markers indicating platelet activation (CD62P-PE and CD63-PE). Interpretation The flow cytometric data shows that the platelet surface receptors and platelet activation are statistically elevated. This is suggestive of enhanced platelet activation and it appears as if platelets are displaying ‘angry’ behaviour. The lysosomal granules may play a significant role in diabetes with cardiovascular complications. These results were confirmed by ultrastructural analysis.
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Affiliation(s)
- Prashilla Soma
- Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag x323, Arcadia, Pretoria, 0007, South Africa
| | - Albe Carina Swanepoel
- Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag x323, Arcadia, Pretoria, 0007, South Africa
| | - Jeanette Noel du Plooy
- Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag x323, Arcadia, Pretoria, 0007, South Africa
| | - Thandi Mqoco
- Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag x323, Arcadia, Pretoria, 0007, South Africa
| | - Etheresia Pretorius
- Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag x323, Arcadia, Pretoria, 0007, South Africa.
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50
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Jones LD, Jackson JW, Maggirwar SB. Modeling HIV-1 Induced Neuroinflammation in Mice: Role of Platelets in Mediating Blood-Brain Barrier Dysfunction. PLoS One 2016; 11:e0151702. [PMID: 26986758 PMCID: PMC4795798 DOI: 10.1371/journal.pone.0151702] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 03/02/2016] [Indexed: 01/31/2023] Open
Abstract
The number of HIV-1 positive individuals developing some form of HIV-associated neurocognitive disorder (HAND) is increasing. In these individuals, the integrity of the blood-brain barrier (BBB) is compromised due to an increase in exposure to pro-inflammatory mediators, viral proteins, and virus released from infected cells. It has been shown that soluble CD40L (sCD40L) is released upon platelet activation and is an important mediator of the pathogenesis of HAND but the underlying mechanisms are unclear, emphasizing the need of an effective animal model. Here, we have utilized a novel animal model in which wild-type (WT) mice were infected with EcoHIV; a derivative of HIV-1 that contains a substitution of envelope protein gp120 with that of gp80 derived from murine leukemia virus-1 (MuLV-1). As early as two-weeks post-infection, EcoHIV led to increased permeability of the BBB associated with decreased expression of tight junction protein claudin-5, in CD40L and platelet activation-dependent manner. Treatment with an antiplatelet drug, eptifibatide, in EcoHIV-infected mice normalized BBB function, sCD40L release and platelet activity, thus implicating platelet activation and platelet-derived CD40L in virally induced BBB dysfunction. Our results also validate and underscore the importance of EcoHIV infection mouse model as a tool to explore therapeutic targets for HAND.
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Affiliation(s)
- Letitia D Jones
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
| | - Joseph W Jackson
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
| | - Sanjay B Maggirwar
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
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