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Brito-Robinson T, Ayinuola YA, Ploplis VA, Castellino FJ. Plasminogen missense variants and their involvement in cardiovascular and inflammatory disease. Front Cardiovasc Med 2024; 11:1406953. [PMID: 38984351 PMCID: PMC11231438 DOI: 10.3389/fcvm.2024.1406953] [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: 03/25/2024] [Accepted: 06/06/2024] [Indexed: 07/11/2024] Open
Abstract
Human plasminogen (PLG), the zymogen of the fibrinolytic protease, plasmin, is a polymorphic protein with two widely distributed codominant alleles, PLG/Asp453 and PLG/Asn453. About 15 other missense or non-synonymous single nucleotide polymorphisms (nsSNPs) of PLG show major, yet different, relative abundances in world populations. Although the existence of these relatively abundant allelic variants is generally acknowledged, they are often overlooked or assumed to be non-pathogenic. In fact, at least half of those major variants are classified as having conflicting pathogenicity, and it is unclear if they contribute to different molecular phenotypes. From those, PLG/K19E and PLG/A601T are examples of two relatively abundant PLG variants that have been associated with PLG deficiencies (PD), but their pathogenic mechanisms are unclear. On the other hand, approximately 50 rare and ultra-rare PLG missense variants have been reported to cause PD as homozygous or compound heterozygous variants, often leading to a debilitating disease known as ligneous conjunctivitis. The true abundance of PD-associated nsSNPs is unknown since they can remain undetected in heterozygous carriers. However, PD variants may also contribute to other diseases. Recently, the ultra-rare autosomal dominant PLG/K311E has been found to be causative of hereditary angioedema (HAE) with normal C1 inhibitor. Two other rare pathogenic PLG missense variants, PLG/R153G and PLG/V709E, appear to affect platelet function and lead to HAE, respectively. Herein, PLG missense variants that are abundant and/or clinically relevant due to association with disease are examined along with their world distribution. Proposed molecular mechanisms are discussed when known or can be reasonably assumed.
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Affiliation(s)
| | | | | | - Francis J. Castellino
- Department of Chemistry and Biochemistry and the W.M. Keck Center for Transgene Research, University of Notre Dame, Notre Dame, IN, United States
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2
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Landi E, Mugnaini M, Vatansever T, Fort A, Vignoli V, Giurranna E, Argento FR, Fini E, Emmi G, Fiorillo C, Becatti M. Advancing Thrombosis Research: A Novel Device for Measuring Clot Permeability. SENSORS (BASEL, SWITZERLAND) 2024; 24:3764. [PMID: 38931548 PMCID: PMC11207702 DOI: 10.3390/s24123764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/28/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024]
Abstract
Thromboembolism, a global leading cause of mortality, needs accurate risk assessment for effective prophylaxis and treatment. Current stratification methods fall short in predicting thrombotic events, emphasizing the need for a deeper understanding of clot properties. Fibrin clot permeability, a crucial parameter in hypercoagulable states, impacts clot structure and resistance to lysis. Current clot permeability measurement limitations propel the need for standardized methods. Prior findings underscore the importance of clot permeability in various thrombotic conditions but call for improvements and more precise, repeatable, and standardized methods. Addressing these challenges, our study presents an upgraded, portable, and cost-effective system for measuring blood clot permeability, which utilizes a pressure-based approach that adheres to Darcy's law. By enhancing precision and sensitivity in discerning clot characteristics, this innovation provides a valuable tool for assessing thrombotic risk and associated pathological conditions. In this paper, the authors present a device that is able to automatically perform the permeability measurements on plasma or fibrinogen in vitro-induced clots on specific holders (filters). The proposed device has been tailored to distinguish clot permeability, with high precision and sensitivity, between healthy subjects and high cardiovascular-risk patients. The precise measure of clot permeability represents an excellent indicator of thrombotic risk, thus allowing the clinician, also on the basis of other anamnestic and laboratory data, to attribute a risk score to the subject. The proposed instrument was characterized by performing permeability measurements in plasma and purified fibrinogen clots derived from 17 Behcet patients and 15 sex- and age-matched controls. As expected, our results clearly indicate a significant difference in plasma clot permeability in Behcet patients with respect to controls (0.0533 ± 0.0199 d vs. 0.0976 ± 0.0160 d, p < 0.001). This difference was confirmed in the patient's vs. control fibrin clots (0.0487 ± 0.0170 d vs. 0.1167 ± 0.0487 d, p < 0.001). In conclusion, our study demonstrates the feasibility, efficacy, portability, and cost-effectiveness of a novel device for measuring clot permeability, allowing healthcare providers to better stratify thrombotic risk and tailor interventions, thereby improving patient outcomes and reducing healthcare costs, which could significantly improve the management of thromboembolic diseases.
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Affiliation(s)
- Elia Landi
- Department of Information Engineering and Mathematics, University of Siena, 53100 Siena, Italy; (M.M.); (T.V.); (A.F.); (V.V.)
| | - Marco Mugnaini
- Department of Information Engineering and Mathematics, University of Siena, 53100 Siena, Italy; (M.M.); (T.V.); (A.F.); (V.V.)
| | - Tunahan Vatansever
- Department of Information Engineering and Mathematics, University of Siena, 53100 Siena, Italy; (M.M.); (T.V.); (A.F.); (V.V.)
| | - Ada Fort
- Department of Information Engineering and Mathematics, University of Siena, 53100 Siena, Italy; (M.M.); (T.V.); (A.F.); (V.V.)
| | - Valerio Vignoli
- Department of Information Engineering and Mathematics, University of Siena, 53100 Siena, Italy; (M.M.); (T.V.); (A.F.); (V.V.)
| | - Elvira Giurranna
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, 50121 Florence, Italy; (E.G.); (F.R.A.); (E.F.); (C.F.); (M.B.)
| | - Flavia Rita Argento
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, 50121 Florence, Italy; (E.G.); (F.R.A.); (E.F.); (C.F.); (M.B.)
| | - Eleonora Fini
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, 50121 Florence, Italy; (E.G.); (F.R.A.); (E.F.); (C.F.); (M.B.)
| | - Giacomo Emmi
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34100 Trieste, Italy;
| | - Claudia Fiorillo
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, 50121 Florence, Italy; (E.G.); (F.R.A.); (E.F.); (C.F.); (M.B.)
| | - Matteo Becatti
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, 50121 Florence, Italy; (E.G.); (F.R.A.); (E.F.); (C.F.); (M.B.)
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3
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Wong YL, Yu M, Chong C, Yang D, Xu D, Lee ML, Hsu W, Wong TY, Cheng C, Cheung CY. Association between deep learning measured retinal vessel calibre and incident myocardial infarction in a retrospective cohort from the UK Biobank. BMJ Open 2024; 14:e079311. [PMID: 38514140 PMCID: PMC10961540 DOI: 10.1136/bmjopen-2023-079311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/19/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Cardiovascular disease is a leading cause of global death. Prospective population-based studies have found that changes in retinal microvasculature are associated with the development of coronary artery disease. Recently, artificial intelligence deep learning (DL) algorithms have been developed for the fully automated assessment of retinal vessel calibres. METHODS In this study, we validate the association between retinal vessel calibres measured by a DL system (Singapore I Vessel Assessment) and incident myocardial infarction (MI) and assess its incremental performance in discriminating patients with and without MI when added to risk prediction models, using a large UK Biobank cohort. RESULTS Retinal arteriolar narrowing was significantly associated with incident MI in both the age, gender and fellow calibre-adjusted (HR=1.67 (95% CI: 1.19 to 2.36)) and multivariable models (HR=1.64 (95% CI: 1.16 to 2.32)) adjusted for age, gender and other cardiovascular risk factors such as blood pressure, diabetes mellitus (DM) and cholesterol status. The area under the receiver operating characteristic curve increased from 0.738 to 0.745 (p=0.018) in the age-gender-adjusted model and from 0.782 to 0.787 (p=0.010) in the multivariable model. The continuous net reclassification improvements (NRIs) were significant in the age and gender-adjusted (NRI=21.56 (95% CI: 3.33 to 33.42)) and the multivariable models (NRI=18.35 (95% CI: 6.27 to 32.61)). In the subgroup analysis, similar associations between retinal arteriolar narrowing and incident MI were observed, particularly for men (HR=1.62 (95% CI: 1.07 to 2.46)), non-smokers (HR=1.65 (95% CI: 1.13 to 2.42)), patients without DM (HR=1.73 (95% CI: 1.19 to 2.51)) and hypertensive patients (HR=1.95 (95% CI: 1.30 to 2.93)) in the multivariable models. CONCLUSION Our results support DL-based retinal vessel measurements as markers of incident MI in a predominantly Caucasian population.
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Affiliation(s)
- Yiu Lun Wong
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Marco Yu
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Crystal Chong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Dawei Yang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Dejiang Xu
- School of Computing, National University of Singapore, Singapore
| | - Mong Li Lee
- School of Computing, National University of Singapore, Singapore
| | - Wynne Hsu
- School of Computing, National University of Singapore, Singapore
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Tsinghua Medicine, Tsinghua University, Beijing, China
| | - Chingyu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
- Centre for Innovation and Precision Eye Health; and Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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4
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Guillotin F, Mercier É, Fortier M, Bouvier S, Jacquet Q, Dallo M, Chéa M, Bourguignon C, Cochery-Nouvellon É, Perez-Martin A, Gris JC. Clonal haematopoiesis of indeterminate potential in patients with venous thromboembolism. J Thromb Thrombolysis 2023:10.1007/s11239-023-02836-4. [PMID: 37300604 DOI: 10.1007/s11239-023-02836-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2023] [Indexed: 06/12/2023]
Abstract
Over the last decade, the concept of Clonal haematopoiesis of undetermined potential (CHIP) has emerged. Low frequency somatic mutations in hematopoietic cells can occur with age and might allow formation of clones in individuals with no characterized haematological pathology. These CHIP mutations are associated with an increased risk of cancer or atherothrombosis, and their prevalence are more and more studied in pathologies with an inflammatory component. In our study, we analysed, by next generation sequencing, the prevalence of CHIP mutation in 94 patients with deep venous thrombosis (DVT), distinguishing two clinical phenotypes: provoked distal and non-provoked proximal DVTs. We show that there is no difference in CHIP prevalence between these two groups, nor with a matched-aged control group. The number of mutation per patients and the affected genes remain also the same between the three groups. Consequently and despite the relative small number of patients in each cohort, it seems that CHIP is not a strong concern in venous thromboembolism.
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Affiliation(s)
| | - Éric Mercier
- Department of Haematology, University Hospital of Nîmes, Nîmes, France
- Faculty of Pharmaceutical and Biological Sciences, University of Montpellier, Montpellier, France
- Institut Desbrest d'Epidémiologie et de Santé Publique UMR INSERM, Montpellier, France
| | - Mathieu Fortier
- Department of Haematology, University Hospital of Nîmes, Nîmes, France.
| | - Sylvie Bouvier
- Department of Haematology, University Hospital of Nîmes, Nîmes, France
- Faculty of Pharmaceutical and Biological Sciences, University of Montpellier, Montpellier, France
- Institut Desbrest d'Epidémiologie et de Santé Publique UMR INSERM, Montpellier, France
| | - Quentin Jacquet
- Department of Haematology, University Hospital of Nîmes, Nîmes, France
| | - Marine Dallo
- Department of Haematology, University Hospital of Nîmes, Nîmes, France
| | - Mathias Chéa
- Department of Haematology, University Hospital of Nîmes, Nîmes, France
| | - Chloé Bourguignon
- Department of Haematology, University Hospital of Nîmes, Nîmes, France
- Institut Desbrest d'Epidémiologie et de Santé Publique UMR INSERM, Montpellier, France
| | | | - Antonia Perez-Martin
- Institut Desbrest d'Epidémiologie et de Santé Publique UMR INSERM, Montpellier, France
- Department of Vascular Medicine, University Hospital of Nîmes, Nîmes, France
| | - Jean-Christophe Gris
- Department of Haematology, University Hospital of Nîmes, Nîmes, France
- Faculty of Pharmaceutical and Biological Sciences, University of Montpellier, Montpellier, France
- Institut Desbrest d'Epidémiologie et de Santé Publique UMR INSERM, Montpellier, France
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
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5
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Quintal Martínez JP, Segura Campos MR. Bioactive compounds and functional foods as coadjuvant therapy for thrombosis. Food Funct 2023; 14:653-674. [PMID: 36601778 DOI: 10.1039/d2fo03171j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death. The most common cardiovascular pathologies are thromboembolic diseases. Antithrombotic therapy prevents thrombus formation or dissolves that previously constituted. However, it presents a high rate of accidents such as gastric bleeding and cerebrovascular embolism. Plant foods and their secondary metabolites have been reported to regulate blood hemostasis. This review article aims to propose plant foods and their metabolites as adjuvant therapy for the management of thromboembolic diseases. Various databases were consulted, using antiplatelet, anticoagulant, and fibrinolytic as key terms. In total, 35 foods and 24 secondary metabolites, via in vitro, in vivo, and clinical studies, have been reported to regulate platelet aggregation, blood coagulation, and fibrinolysis. According to the studies presented in this review, plant foods with effects at concentrations less than 50 μg mL-1 and secondary metabolites with IC50 less than 100 μM can be considered agents with high antithrombotic potential. This review suggests that plant foods and their secondary metabolites should be used to develop foods, ingredients and nutraceuticals with functional properties. The evidence presented in this review shows that plant foods and their bioactive compounds could be used as adjuvants for the treatment and prevention of thrombotic complications. However, further in vivo and clinical trials are required to establish effective and safe doses.
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6
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Polysaccharide extracted from Morchella esculenta inhibits carrageenan-induced thrombosis in mice. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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7
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Chiang YC, Wu YS, Kang YF, Wang HC, Tsai MC, Wu CC. 3,5,2′,4′-Tetramethoxystilbene, a fully methylated resveratrol analog, prevents platelet aggregation and thrombus formation by targeting the protease-activated receptor 4 pathway. Chem Biol Interact 2022; 357:109889. [DOI: 10.1016/j.cbi.2022.109889] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/01/2022] [Accepted: 03/09/2022] [Indexed: 12/30/2022]
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8
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Locatelli L, Colciago A, Castiglioni S, Maier JA. Platelets in Wound Healing: What Happens in Space? Front Bioeng Biotechnol 2021; 9:716184. [PMID: 34760877 PMCID: PMC8572965 DOI: 10.3389/fbioe.2021.716184] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/11/2021] [Indexed: 12/21/2022] Open
Abstract
Beyond their fundamental role in hemostasis, platelets importantly contribute to other processes aimed at maintaining homeostasis. Indeed, platelets are a natural source of growth factors and also release many other substances-such as fibronectin, vitronectin, sphingosine 1-phosphate-that are important in maintaining healthy tissues, and ensuring regeneration and repair. Despite rare thrombotic events have been documented in astronauts, some in vivo and in vitro studies demonstrate that microgravity affects platelet's number and function, thus increasing the risk of hemorrhages and contributing to retard wound healing. Here we provide an overview about events linking platelets to the impairment of wound healing in space, also considering, besides weightlessness, exposure to radiation and psychological stress. In the end we discuss the possibility of utilizing platelet rich plasma as a tool to treat skin injuries eventually occurring during space missions.
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Affiliation(s)
- Laura Locatelli
- Department of Biomedical and Clinical Sciences L. Sacco, Università di Milano, Milan, Italy
| | - Alessandra Colciago
- Department of Pharmacological and Biomolecular Sciences, Università di Milano, Milan, Italy
| | - Sara Castiglioni
- Department of Biomedical and Clinical Sciences L. Sacco, Università di Milano, Milan, Italy
| | - Jeanette A Maier
- Department of Biomedical and Clinical Sciences L. Sacco, Università di Milano, Milan, Italy.,Interdisciplinary Centre for Nanostructured Materials and Interfaces (CIMaINa), Università di Milano, Milan, Italy
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9
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Tamer F, Tullemans B, Kuijpers M, Claushuis D, Heemskerk JW. Nutrition phytochemicals affecting platelet signaling and responsiveness: implications for thrombosis and hemostasis. Thromb Haemost 2021; 122:879-894. [PMID: 34715717 DOI: 10.1055/a-1683-5599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Cardiovascular disease, in particular due to arterial thrombosis, is a leading cause of mortality and morbidity, with crucial roles of platelets in thrombus formation. For multiple plant-derived phytochemicals found in common dietary components, claims have been made regarding cardiovascular health and antiplatelet activities. Here we present a systematic overview of the published effects of common phytochemicals, applied in vitro or in nutritional intervention studies, on agonist-induced platelet activation properties and platelet signaling pathways. Comparing the phytochemical effects per structural class, we included general phenols: curcuminoids (e.g., curcumin), lignans (honokiol, silybin), phenolic acids (caffeic and chlorogenic acid), derivatives of these (shikimic acid) and stilbenoids (isorhapontigenin, resveratrol). Furthermore, we evaluated the flavonoid polyphenols, including anthocyanidins (delphinidin, malvidin), flavan-3-ols (catechins), flavanones (hesperidin), flavones (apigenin, nobiletin), flavonols (kaempferol, myricetin, quercetin), isoflavones (daidzein, genistein); and terpenoids including carotenes and limonene; and finally miscellaneous compounds like betalains, indoles, organosulfides (diallyl trisulfide) and phytosterols. We furthermore discuss the implications for selected phytochemicals to interfere in thrombosis and hemostasis, indicating their possible clinical relevance. Lastly, we provide guidance on which compounds are of interest for further platelet-related research.
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Affiliation(s)
- Funda Tamer
- Biochemistry, Maastricht University Cardiovascular Research Institute Maastricht, Maastricht, Netherlands.,Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Bibian Tullemans
- Biochemistry, Maastricht University Cardiovascular Research Institute Maastricht, Maastricht, Netherlands
| | - Marijke Kuijpers
- Biochemistry, University of Maastricht, Maastricht, Netherlands.,Thrombosis Expertise Centre, Heart and Vascular Centre, Maastricht Universitair Medisch Centrum+, Maastricht, Netherlands
| | | | - Johan Wm Heemskerk
- Biochemistry, Maastricht University, Maastricht, Netherlands.,Synapse Research Institute Maastricht, Maastricht, Netherlands
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10
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Pesce M, Agostoni P, Bøtker HE, Brundel B, Davidson SM, Caterina RD, Ferdinandy P, Girao H, Gyöngyösi M, Hulot JS, Lecour S, Perrino C, Schulz R, Sluijter JP, Steffens S, Tancevski I, Gollmann-Tepeköylü C, Tschöpe C, Linthout SV, Madonna R. COVID-19-related cardiac complications from clinical evidences to basic mechanisms: opinion paper of the ESC Working Group on Cellular Biology of the Heart. Cardiovasc Res 2021; 117:2148-2160. [PMID: 34117887 DOI: 10.1093/cvr/cvab201] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/09/2021] [Indexed: 12/15/2022] Open
Abstract
The pandemic of coronavirus disease (COVID)-19 is a global threat, causing high mortality, especially in the elderly. The main symptoms and the primary cause of death are related to interstitial pneumonia. Viral entry also into myocardial cells mainly via the angiotensin converting enzyme type 2 (ACE2) receptor and excessive production of pro-inflammatory cytokines, however, also make the heart susceptible to injury. In addition to the immediate damage caused by the acute inflammatory response, the heart may also suffer from long-term consequences of COVID-19, potentially causing a post-pandemic increase in cardiac complications. Although the main cause of cardiac damage in COVID-19 remains coagulopathy with micro- (and to a lesser extent macro-) vascular occlusion, open questions remain about other possible modalities of cardiac dysfunction, such as direct infection of myocardial cells, effects of cytokines storm, and mechanisms related to enhanced coagulopathy. In this opinion paper, we focus on these lesser appreciated possibilities and propose experimental approaches that could provide a more comprehensive understanding of the cellular and molecular bases of cardiac injury in COVID-19 patients. We first discuss approaches to characterize cardiac damage caused by possible direct viral infection of cardiac cells, followed by formulating hypotheses on how to reproduce and investigate the hyperinflammatory and pro-thrombotic conditions observed in the heart of COVID-19 patients using experimental in vitro systems. Finally, we elaborate on strategies to discover novel pathology biomarkers using omics platforms.
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Affiliation(s)
| | - Piergiuseppe Agostoni
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
- Dipartimento di Scienze Cliniche e di Comunità, University of Milan, Milan, Italy
| | - Hans-Erik Bøtker
- Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark
| | - Bianca Brundel
- Department of Physiology, Amsterdam University Medical Centers (UMC), Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Sean M Davidson
- The Hatter Cardiovascular Institute, University College London, London, UK
| | | | - Peter Ferdinandy
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
- Pharmahungary Group, Szeged, Hungary
| | - Henrique Girao
- Center for Innovative Biomedicine and Biotechnology (CIBB), Clinical Academic Centre of Coimbra (CACC), Faculty of Medicine, Univ Coimbra, Institute for Clinical and Biomedical Research (iCBR), Coimbra, Portugal
| | - Mariann Gyöngyösi
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Jean-Sebastien Hulot
- Université de Paris, PARCC, INSERM, Paris, France
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
| | - Sandrine Lecour
- Faculty of Health Sciences, Hatter Institute for Cardiovascular Research in Africa and Cape Heart Institute, University of Cape Town, Cape Town, South Africa
| | - Cinzia Perrino
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Rainer Schulz
- Institute of Physiology, Justus-Liebig University Giessen, Giessen, Germany
| | - Joost Pg Sluijter
- Laboratory for Experimental Cardiology, Department of Cardiology, Utrecht Regenerative Medicine Center, Circulatory Health Laboratory, University Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sabine Steffens
- Institute for Cardiovascular Prevention, German Centre for Cardiovascular Research (DZHK), Ludwig-Maximilians-University (LMU) Munich, Partner Site Munich Heart Alliance, Munich, Germany
| | - Ivan Tancevski
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Carsten Tschöpe
- Department of Cardiology, Charité, Campus Virchow Klinikum, Berlin, Germany
- BIH Center for Regenerative Therapies (BCRT), Berlin Institute of Health at Charité-Universitätmedizin Berlin, Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Sophie van Linthout
- Department of Cardiology, Charité, Campus Virchow Klinikum, Berlin, Germany
- BIH Center for Regenerative Therapies (BCRT), Berlin Institute of Health at Charité-Universitätmedizin Berlin, Berlin, Germany
| | - Rosalinda Madonna
- Cardiology Chair, University of Pisa, Pisa University Hospital, Pisa, Italy
- Department of Internal Medicine, University of Texas Medical School in Houston, Houston, TX, USA
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11
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Mechanistic and Predictive QSAR Analysis of Diverse Molecules to Capture Salient and Hidden Pharmacophores for Anti-Thrombotic Activity. Int J Mol Sci 2021; 22:ijms22158352. [PMID: 34361118 PMCID: PMC8348508 DOI: 10.3390/ijms22158352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/24/2021] [Accepted: 07/31/2021] [Indexed: 12/02/2022] Open
Abstract
Thrombosis is a life-threatening disease with a high mortality rate in many countries. Even though anti-thrombotic drugs are available, their serious side effects compel the search for safer drugs. In search of a safer anti-thrombotic drug, Quantitative Structure-Activity Relationship (QSAR) could be useful to identify crucial pharmacophoric features. The present work is based on a larger data set comprising 1121 diverse compounds to develop a QSAR model having a balance of acceptable predictive ability (Predictive QSAR) and mechanistic interpretation (Mechanistic QSAR). The developed six parametric model fulfils the recommended values for internal and external validation along with Y-randomization parameters such as R2tr = 0.831, Q2LMO = 0.828, R2ex = 0.783. The present analysis reveals that anti-thrombotic activity is found to be correlated with concealed structural traits such as positively charged ring carbon atoms, specific combination of aromatic Nitrogen and sp2-hybridized carbon atoms, etc. Thus, the model captured reported as well as novel pharmacophoric features. The results of QSAR analysis are further vindicated by reported crystal structures of compounds with factor Xa. The analysis led to the identification of useful novel pharmacophoric features, which could be used for future optimization of lead compounds.
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12
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Rezapour A, Souresrafil A, Arabloo J. Economic Evaluation of New Oral Anticoagulants in Prevention of Venous Thrombosis Following Joint Replacement Surgery: A Systematic Review. Clin Ther 2021; 43:e139-e156. [PMID: 33875243 DOI: 10.1016/j.clinthera.2021.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 03/05/2021] [Accepted: 03/17/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE The main purpose of prescribing oral anticoagulants in patients undergoing total knee and total hip replacement surgery is to prevent venous thromboembolism (VTE). The present study aimed to summarize evidence from economic evaluations regarding new oral anticoagulants (NOACs) used in VTE prophylaxis after joint replacement surgery. METHODS To obtain relevant literature on economic evaluations of NOACs used in the prevention of VTE following joint replacement surgery, we searched the Cochrane Library, PubMed, Web of Science, Embase, and Scopus, as well as specialized economic evaluation databases, for articles published from January 2008 to December 2019. Next, 2 reviewers screened the titles and abstracts of studies, extracted data from the full-text articles, and assessed the quality of the methodologies using the Quality of Health Economic Studies checklist. FINDINGS Twenty-eight studies of economic evaluations met the inclusion criteria of the research. The quality assessment showed that 20 articles had scores within the range of 75 to 100 (high quality), and 9 studies had scores within the range of 50 to 74 (moderate quality). All of the identified studies had been carried out based on modelling, and 23 studies used decision trees to model acute events after surgery. In addition, 20 studies utilized a Markov model to capture long-term complications of VTE. The results showed that rivaroxaban was more cost-effective than apixaban and dabigatran from a perspective of the health care system in the prevention of VTE after total knee and total hip replacement surgery. In addition, apixaban was associated with a lower risk for bleeding events than other NOACs, making it the most cost-effective NOAC from the perspective of the payer. IMPLICATIONS The results suggest that NOACs are cost-effective alternatives to low-molecular-weight heparins. Rivaroxaban and dabigatran were assessed as the most and least cost-effective prophylaxis options, respectively, after joint replacement surgery for the prevention of VTE. It is recommended that future research be conducted on economic evaluations of edoxaban.
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Affiliation(s)
- Aziz Rezapour
- Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Aghdas Souresrafil
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Jalal Arabloo
- Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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Sanchez EF, Alvarenga VG, Oliveira LS, Oliveira DL, Estevao-Costa MI, Flores-Ortiz R, Eble JA. A fibrinolytic snake venom metalloproteinase, mutalysin-II, with antiplatelet activity and targeting capability toward glycoprotein GPIbα and glycoprotein GPVI. Biochimie 2021; 184:1-7. [PMID: 33548391 DOI: 10.1016/j.biochi.2021.01.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/26/2021] [Accepted: 01/29/2021] [Indexed: 12/12/2022]
Abstract
Glycoprotein (GP)Ib that binds von Willebrand factor (vWF) and glycoprotein (GP)VI, that binds collagen play a significant role in platelet activation and aggregation, and are potential targets for antithrombotic treatment. They are targeted by snake venom proteinases. The effect of a such proteinase, mutalysin-II, on platelet aggregation was examined using washed human platelets and platelet-rich plasma. Its proteolytic activity on vWF, on its binding partner GPIbα, and on GPVI was analyzed by SDS-PAGE, and immunodetection with the corresponding antibodies after blotting. Dose- and time-dependently, mutalysin-II inhibits aggregation of washed platelets induced by vWF plus ristocetin and by convulxin, but with no significant effect on platelet-rich-plasma. Furthermore, mutalysin-II cleaves vWF into low molecular mass multimers of vWF and a rvWF-A1 domain to realease a ∼27-kDa fragment detectable by SDS-PAGE and blotting with mouse anti-rvWF-A1-domain IgG. Moreover, GPVI was cut by mutalysin-II into a soluble ∼55-kDa ectodomain and a fragment of ∼35-kDa. Thus, mutalysin-II inhibits vWF-induced platelet aggregation via cleavage of bound vWF-A1, and its receptor GPIbα. The additional cleavage of, GPVI, blocks collagen-induced platelets. Our data highlight mutalysin-II as an interesting platelet-directed tool targeting vWF-GPIbα binding and particularly GPVI. Thus, it might be suited for antithrombotic therapy as its combined inactivation of two receptors does not significantly compromise hemostasis, but shows high efficacy and safety. Studies are needed to further develop and demonstrate its potential benefits.
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Affiliation(s)
- Eladio F Sanchez
- Research and Development Center, Ezequiel Dias Foundation, Belo Horizonte, MG, Brazil.
| | - Valeria G Alvarenga
- Research and Development Center, Ezequiel Dias Foundation, Belo Horizonte, MG, Brazil
| | - Luciana S Oliveira
- Research and Development Center, Ezequiel Dias Foundation, Belo Horizonte, MG, Brazil
| | - Débora L Oliveira
- Research and Development Center, Ezequiel Dias Foundation, Belo Horizonte, MG, Brazil
| | - Maria I Estevao-Costa
- Institute of Physiological Chemistry and Pathobiochemistry, University of Münster, Münster, Germany
| | - Renzo Flores-Ortiz
- Center for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, BA, Brazil
| | - Johannes A Eble
- Institute of Physiological Chemistry and Pathobiochemistry, University of Münster, Münster, Germany
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14
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Ospemifene: less venous thrombosis than other selective estrogen receptor modulators in postmenopausal women with vulvo vaginal atrophy. ACTA ACUST UNITED AC 2020; 27:846-847. [PMID: 32576803 DOI: 10.1097/gme.0000000000001600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Palasubramaniam J, Wang X, Peter K. Myocardial Infarction-From Atherosclerosis to Thrombosis. Arterioscler Thromb Vasc Biol 2019; 39:e176-e185. [PMID: 31339782 DOI: 10.1161/atvbaha.119.312578] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Jathushan Palasubramaniam
- From the Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia (J.P., X.W., K.P.).,Department of Medicine, Monash University, Melbourne, Australia (J.P., X.W., K.P.).,Department of Cardiology, Alfred Hospital, Melbourne, Australia (J.P., K.P.)
| | - Xiaowei Wang
- From the Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia (J.P., X.W., K.P.).,Department of Medicine, Monash University, Melbourne, Australia (J.P., X.W., K.P.)
| | - Karlheinz Peter
- From the Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia (J.P., X.W., K.P.).,Department of Medicine, Monash University, Melbourne, Australia (J.P., X.W., K.P.).,Department of Cardiology, Alfred Hospital, Melbourne, Australia (J.P., K.P.)
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