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Jenkins WS, Vesey AT, Vickers A, Neale A, Moles C, Connell M, Joshi NV, Lucatelli C, Fletcher AM, Spratt JC, Mirsadraee S, van Beek EJ, Rudd JH, Newby DE, Dweck MR. In vivo alpha-V beta-3 integrin expression in human aortic atherosclerosis. Heart 2019; 105:1868-1875. [PMID: 31422361 PMCID: PMC6929706 DOI: 10.1136/heartjnl-2019-315103] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 07/15/2019] [Accepted: 07/17/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Intraplaque angiogenesis and inflammation are key promoters of atherosclerosis and are mediated by the alpha-V beta-3 (αvβ3) integrin pathway. We investigated the applicability of the αvβ3-integrin receptor-selective positron emission tomography (PET) radiotracer 18F-fluciclatide in assessing human aortic atherosclerosis. METHODS Vascular 18F-fluciclatide binding was evaluated using ex vivo analysis of carotid endarterectomy samples with autoradiography and immunohistochemistry, and in vivo kinetic modelling following radiotracer administration. Forty-six subjects with a spectrum of atherosclerotic disease categorised as stable (n=27) or unstable (n=19; recent myocardial infarction) underwent PET and CT imaging of the thorax after administration of 229 (IQR 217-237) MBq 18F-fluciclatide. Thoracic aortic 18F-fluciclatide uptake was quantified on fused PET-CT images and corrected for blood-pool activity using the maximum tissue-to-background ratio (TBRmax). Aortic atherosclerotic burden was quantified by CT wall thickness, plaque volume and calcium scoring. RESULTS 18F-Fluciclatide uptake co-localised with regions of increased αvβ3 integrin expression, and markers of inflammation and angiogenesis. 18F-Fluciclatide vascular uptake was confirmed in vivo using kinetic modelling, and on static imaging correlated with measures of aortic atherosclerotic burden: wall thickness (r=0.57, p=0.001), total plaque volume (r=0.56, p=0.001) and aortic CT calcium score (r=0.37, p=0.01). Patients with recent myocardial infarction had greater aortic 18F-fluciclatide uptake than those with stable disease (TBRmax 1.29 vs 1.21, p=0.02). CONCLUSIONS In vivo expression of αvβ3 integrin in human aortic atheroma is associated with plaque burden and is increased in patients with recent myocardial infarction. Quantification of αvβ3 integrin expression with 18F-fluciclatide PET has potential to assess plaque vulnerability and disease activity in atherosclerosis.
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Affiliation(s)
- William S Jenkins
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Alex T Vesey
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Anna Vickers
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Anoushka Neale
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Catriona Moles
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Martin Connell
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
| | - Nikhil Vilas Joshi
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | | | - Alison M Fletcher
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
| | - James C Spratt
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Saeed Mirsadraee
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
| | - Edwin Jr van Beek
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
| | - James Hf Rudd
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK
| | - David E Newby
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
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Li W, Dorans KS, Wilker EH, Rice MB, Ljungman PL, Schwartz JD, Coull BA, Koutrakis P, Gold DR, Keaney JF, Vasan RS, Benjamin EJ, Mittleman MA. Short-term exposure to ambient air pollution and circulating biomarkers of endothelial cell activation: The Framingham Heart Study. ENVIRONMENTAL RESEARCH 2019; 171:36-43. [PMID: 30654247 PMCID: PMC6478022 DOI: 10.1016/j.envres.2018.10.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/16/2018] [Accepted: 10/25/2018] [Indexed: 05/23/2023]
Abstract
BACKGROUND Short-term exposure to air pollution has been associated with cardiovascular events, potentially by promoting endothelial cell activation and inflammation. A few large-scale studies have examined the associations and have had mixed results. METHODS We included 3820 non-current smoking participants (mean age 56 years, 54% women) from the Framingham Offspring cohort examinations 7 (1998-2001) and 8 (2005-2008), and Third Generation cohort examination 1 (2002-2005), who lived within 50 km of a central monitoring station. We calculated the 1- to 7-day moving averages of fine particulate matter (PM2.5), black carbon (BC), sulfate (SO42-), nitrogen oxides (NOx), and ozone before examination visits. We used linear mixed effect models for P-selectin, monocyte chemoattractant protein 1 (MCP-1), intercellular adhesion molecule 1, lipoprotein-associated phospholipase A2 activity and mass, and osteoprotegerin that were measured up to twice, and linear regression models for CD40 ligand and interleukin-18 that were measured once, adjusting for demographics, life style and clinical factors, socioeconomic position, time, and meteorology. RESULTS We found negative associations of PM2.5 and BC with P-selectin, of ozone with MCP-1, and of SO42- and NOx with osteoprotegerin. At the 5-day moving average, a 5 µg/m3 higher PM2.5 was associated with 1.6% (95% CI: - 2.8, - 0.3) lower levels of P-selectin; a 10 ppb higher ozone was associated with 1.7% (95% CI: - 3.2, - 0.1) lower levels of MCP-1; and a 20 ppb higher NOx was associated with 2.0% (95% CI: - 3.6, - 0.4) lower levels of osteoprotegerin. CONCLUSIONS We did not find evidence of positive associations between short-term air pollution exposure and endothelial cell activation. On the contrary, short-term exposure to higher levels of ambient pollutants were associated with lower levels of P-selectin, MCP-1, and osteoprotegerin in the Framingham Heart Study.
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Affiliation(s)
- Wenyuan Li
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States; Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Kirsten S Dorans
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States; Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States; Tulane School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Elissa H Wilker
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States; Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Mary B Rice
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Petter L Ljungman
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Joel D Schwartz
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States
| | - Brent A Coull
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States
| | - Petros Koutrakis
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States
| | - Diane R Gold
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States; Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - John F Keaney
- University of Massachusetts Medical School, Worcester, MA, United States
| | - Ramachandran S Vasan
- Boston University Schools of Medicine and Public Health, Boston, MA, United States; National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA, United States
| | - Emelia J Benjamin
- Boston University Schools of Medicine and Public Health, Boston, MA, United States; National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA, United States
| | - Murray A Mittleman
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States; Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
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Htun NM, Magliano DJ, Zhang ZY, Lyons J, Petit T, Nkuipou-Kenfack E, Ramirez-Torres A, von zur Muhlen C, Maahs D, Schanstra JP, Pontillo C, Pejchinovski M, Snell-Bergeon JK, Delles C, Mischak H, Staessen JA, Shaw JE, Koeck T, Peter K. Prediction of acute coronary syndromes by urinary proteome analysis. PLoS One 2017; 12:e0172036. [PMID: 28273075 PMCID: PMC5342174 DOI: 10.1371/journal.pone.0172036] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 01/30/2017] [Indexed: 01/20/2023] Open
Abstract
Identification of individuals who are at risk of suffering from acute coronary syndromes (ACS) may allow to introduce preventative measures. We aimed to identify ACS-related urinary peptides, that combined as a pattern can be used as prognostic biomarker. Proteomic data of 252 individuals enrolled in four prospective studies from Australia, Europe and North America were analyzed. 126 of these had suffered from ACS within a period of up to 5 years post urine sampling (cases). Proteomic analysis of 84 cases and 84 matched controls resulted in the discovery of 75 ACS-related urinary peptides. Combining these to a peptide pattern, we established a prognostic biomarker named Acute Coronary Syndrome Predictor 75 (ACSP75). ACSP75 demonstrated reasonable prognostic discrimination (c-statistic = 0.664), which was similar to Framingham risk scoring (c-statistics = 0.644) in a validation cohort of 42 cases and 42 controls. However, generating by a composite algorithm named Acute Coronary Syndrome Composite Predictor (ACSCP), combining the biomarker pattern ACSP75 with the previously established urinary proteomic biomarker CAD238 characterizing coronary artery disease as the underlying aetiology, and age as a risk factor, further improved discrimination (c-statistic = 0.751) resulting in an added prognostic value over Framingham risk scoring expressed by an integrated discrimination improvement of 0.273 ± 0.048 (P < 0.0001) and net reclassification improvement of 0.405 ± 0.113 (P = 0.0007). In conclusion, we demonstrate that urinary peptide biomarkers have the potential to predict future ACS events in asymptomatic patients. Further large scale studies are warranted to determine the role of urinary biomarkers in clinical practice.
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Affiliation(s)
- Nay M. Htun
- Atherothrombosis and Vascular Biology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- Department of Medicine, Monash University, Melbourne, Australia
| | - Dianna J. Magliano
- Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Jasmine Lyons
- Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Thibault Petit
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | | | - Adela Ramirez-Torres
- Mosaiques Diagnostics GmbH, Hanover, Germany
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, California, United States of America
| | | | - David Maahs
- Department of Paediatrics, Stanford School of Medicine, Stanford, California, United States of America
- Barbara Davis Centre for Diabetes, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Joost P. Schanstra
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institut of Cardiovascular and Metabolic Disease, Toulouse, France
- Université Toulouse III Paul-Sabatier, Toulouse, France
| | | | | | - Janet K. Snell-Bergeon
- Barbara Davis Centre for Diabetes, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Harald Mischak
- Mosaiques Diagnostics GmbH, Hanover, Germany
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Jan A. Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- R&D VitaK Group, Maastricht University, Maastricht, Netherlands
| | - Jonathan E. Shaw
- Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | | | - Karlheinz Peter
- Atherothrombosis and Vascular Biology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- Department of Medicine, Monash University, Melbourne, Australia
- * E-mail:
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Serin Hİ, Yilmaz YK, Turan Y, Arslan E, Erkoç MF, Doğan A, Celikbilek M. The association between gallstone disease and plaque in the abdominopelvic arteries. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2017; 22:11. [PMID: 28458703 PMCID: PMC5367247 DOI: 10.4103/1735-1995.199087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 08/03/2016] [Accepted: 10/01/2016] [Indexed: 01/05/2023]
Abstract
Background: The aim of this study was to assess the atheromatous plaque, in the abdominopelvic arteries as a marker of cardiac risk in patients with or without gallstone disease (GD). Materials and Methods: A total of 136 patients were enrolled in this cross-sectional study. Forty-eight patients had GD and the remaining 88 patients did not. The presence or absence of gallstones was noted during abdominal ultrasonography while vascular risk factors such as plaque formation, intima-media thickness, plaque calcification, mural thrombus, stenosis, aneurysm, and inflammation were recorded during an abdominopelvic computed tomography scan. In addition, percentage of the abdominopelvic aorta surface covered by atheromatous plaque was calculated. Results: The mean age of patients with GD and without GD was 50.81 ± 16.20 and 50.40 ± 12.43, respectively. Patients with GD were more likely to have diabetes mellitus, a higher body mass index (BMI) (P < 0.001), and higher cholesterol (P < 0.01), and low-density lipoprotein-cholesterol (P < 0.02) levels. No significant differences were found between the groups regarding other atherosclerotic risk factors. Patients with GD had significantly higher rates of the vascular risk factors as intima-media thickness, plaque formation, calcification, aneurysm, mural thrombosis, stenosis, and inflammation in all abdominal arterial segments other than aneurysm in the femoral arteries. In addition, patients with GD had severe atheromatous plaques in the abdominal aorta, common iliac, external iliac, and common femoral artery (CFA). In patients with GD, parameters of age, BMI, and systolic and diastolic blood pressure were all correlated with the severity of the atheromatous plaque in abdominal aorta, common iliac, external iliac, and CFA. Conclusion: We demonstrated a direct relationship between GD and abdominopelvic atheromatous plaque, which is a marker for increased cardiovascular risk, for the first time in the literature. Patients with GD exhibit greater abdominopelvic atherosclerosis and therefore, have a higher risk of cardiovascular disease.
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Affiliation(s)
- Halil İbrahim Serin
- Department of Radiology, Faculty of Medicine, Bozok University, Yozgat, Turkey
| | - Yunus Keser Yilmaz
- Department of Cardiovascular Surgery, Faculty of Medicine, Bozok University, Yozgat, Turkey
| | - Yaşar Turan
- Department of Cardiology, Faculty of Medicine, Bozok University, Yozgat, Turkey
| | - Ergin Arslan
- Department of General Surgery, Faculty of Medicine, Bozok University, Yozgat, Turkey
| | - Mustafa Fatih Erkoç
- Department of Radiology, Faculty of Medicine, Bozok University, Yozgat, Turkey
| | - Aytaç Doğan
- Department of Radiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Celikbilek
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Faculty of Medicine, Bozok University, Yozgat, Turkey
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Reddy RKYV, Mahendra J, Gurumurthy P, Jayamathi, Babu S. Identification of Predictable Biomarkers in Conjunction to Framingham Risk Score to Predict the Risk for Cardiovascular disease (CVD) in Non Cardiac Subjects. J Clin Diagn Res 2015; 9:BC23-7. [PMID: 25859447 DOI: 10.7860/jcdr/2015/9089.5589] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 12/19/2014] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Although the cardiovascular disease (CVD) burden is rising in different countries, the morbidity and mortality rate is not reduced to much extent because of lack of application of the biomarkers for diagnosing CVD. Hence, we aimed to establish the predictable biomarkers in conjunction to framingham risk score in order to predict the risk for CVD in non cardiac patients. MATERIALS AND METHODS Three hundred subjects were screened for the study who came for the master health checkup. Out of them 50 patients were excluded as they were under medication. 23 patients were excluded due to various systemic diseases like fever and infection etc. The remaining of 227 patients with age range of 30-80 y was randomly selected for investigation. These subjects were divided into four different groups: Group I - controls with age range: 30-60 y (n=50) these subjects were free from all the systemic ailments and risk factors. Study groups comprised of Group II - (n=44) with age range: 30-40 y, Group III - (n=50) with age range: 41-50 y and Group IV - (n=83) with age range: 51-80 y. Patients with different risk factors without medication participated as study groups. Routine biochemical parameters were analysed using fully automated analyser and atherosclerotic biomarkers was analysed using ELISA kit. In addition to this, framingham risk scores was calculated in all the groups, for 30 y risk prognosis for CVD. RESULTS The atherosclerotic biomarkers such as E-selectin, Leptin, osteoprotegerin (OPG) and Ox-LDL were elevated among the study groups as compared to control group. Pearson correlation showed a significant association between the individual risk score (30 y framingham risk for CVD) of individuals, and the above biomarkers. The Receiver operating curve (ROC) analysis also showed a greater area under curve with higher sensitivity and specificity. CONCLUSION We conclude the application E-Selectin, leptin, OPG and Ox-LDL as biomarkers along with the framingham risk scores in prediction risk for CVD in the individuals with subclinical atherosclerosis. It is more reliable and predictable as compared to the individual biomarkers alone.
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Affiliation(s)
- Rama Krishna Y V Reddy
- Research Scholar, Department of Biochemistry, Frontier Lifeline Hospital , Mogappair, Chennai, India
| | - Jaideep Mahendra
- Professor, Department of Periodontics, Meenakshi Ammal Dental College , Madhuravoyal, Chennai. India
| | - Prema Gurumurthy
- Director - Research, Meenakshi Academy of Higher Education and Research , West K.K. Nagar, Chennai, India
| | - Jayamathi
- Professor, Department of Biochemistry, Meenakshi Ammal Dental College , Madhuravoyal, Chennai, India
| | - Sai Babu
- Head, Department of Biochemistry, Frontier Lifeline Hospital , Mogappair, Chennai, India
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Verdoia M, Cassetti E, Schaffer A, Barbieri L, Giovine GD, Nardin M, Marino P, Sinigaglia F, Luca GD. Relationship Between Glycoprotein IIIa Platelet Receptor Gene Polymorphism and Coronary Artery Disease. Angiology 2015; 66:79-85. [DOI: 10.1177/0003319714524296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Glycoprotein IIb/IIIa (GP IIb/IIIa) is a key receptor for platelet aggregation and adhesion. We investigated whether a single-nucleotide polymorphism of GP IIIa subunit (Leu33Pro-PlA1/PlA2 allele) is associated with the extent of coronary artery disease (CAD) in a consecutive cohort of 1518 patients undergoing coronary angiography. Significant CAD was defined as at least a stenosis >50% and severe CAD as left main disease and/or trivessel disease. Additionally, carotid intima–media thickness (cIMT) was evaluated in 339 patients. The PlA2 allele was observed in 458 (30.2%) patients and associated with hypercholesterolemia ( P = .03). No difference was observed in the prevalence of CAD (72.6% vs 70.1%, P = .29; adjusted odds ratio, OR [95% confidence interval, CI] = 0.85 [0.67-1.08], P = .19) and severe CAD (27.5% vs 26.5%, adjusted OR [95% CI] = 0.93 [0.72-1.19], P = .55). Furthermore, Leu33Pro polymorphism did not affect cIMT and the prevalence of carotid plaques. Therefore, this polymorphism cannot be regarded as a risk factor for coronary or carotid atherosclerosis.
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Affiliation(s)
- Monica Verdoia
- Division of Cardiology, Azienda Ospedaliera-Universitaria “Maggiore della Carità”, Eastern Piedmont University, Novara, Italy
| | - Ettore Cassetti
- Division of Cardiology, Azienda Ospedaliera-Universitaria “Maggiore della Carità”, Eastern Piedmont University, Novara, Italy
| | - Alon Schaffer
- Division of Cardiology, Azienda Ospedaliera-Universitaria “Maggiore della Carità”, Eastern Piedmont University, Novara, Italy
| | - Lucia Barbieri
- Division of Cardiology, Azienda Ospedaliera-Universitaria “Maggiore della Carità”, Eastern Piedmont University, Novara, Italy
| | - Gabriella Di Giovine
- Division of Cardiology, Azienda Ospedaliera-Universitaria “Maggiore della Carità”, Eastern Piedmont University, Novara, Italy
| | - Matteo Nardin
- Division of Cardiology, Azienda Ospedaliera-Universitaria “Maggiore della Carità”, Eastern Piedmont University, Novara, Italy
| | - Paolo Marino
- Division of Cardiology, Azienda Ospedaliera-Universitaria “Maggiore della Carità”, Eastern Piedmont University, Novara, Italy
| | - Fabiola Sinigaglia
- Department of Translational Medicine and Centro di Biotecnologie per la Ricerca Medica Applicata (BRMA), Eastern Piedmont University, Novara, Italy
| | - Giuseppe De Luca
- Division of Cardiology, Azienda Ospedaliera-Universitaria “Maggiore della Carità”, Eastern Piedmont University, Novara, Italy
- Department of Translational Medicine and Centro di Biotecnologie per la Ricerca Medica Applicata (BRMA), Eastern Piedmont University, Novara, Italy
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Bridge KI, Philippou H, Ariëns RAS. Clot properties and cardiovascular disease. Thromb Haemost 2014; 112:901-8. [PMID: 24899357 DOI: 10.1160/th14-02-0184] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 03/29/2014] [Indexed: 12/19/2022]
Abstract
Fibrinogen is cleaved by thrombin to fibrin, which provides the blood clot with its essential structural backbone. As an acute phase protein, the plasma levels of fibrinogen are increased in response to inflammatory conditions. In addition to fibrinogen levels, fibrin clot structure is altered by a number of factors. These include thrombin levels, treatment with common cardiovascular medications, such as aspirin, anticoagulants, statins and fibrates, as well as metabolic disease states such as diabetes mellitus and hyperhomocysteinaemia. In vitro studies of fibrin clot structure can provide information regarding fibre density, clot porosity, the mechanical strength of fibres and fibrinolysis. A change in fibrin clot structure, to a denser clot with smaller pores which is more resistant to lysis, is strongly associated with cardiovascular disease. This pathological change is present in patients with arterial as well as venous diseases, and is also found in a moderate form in relatives of patients with cardiovascular disease. Pharmacological therapies, aimed at both the treatment and prophylaxis of cardiovascular disease, appear to result in positive changes to the fibrin clot structure. As such, therapies aimed at 'normalising' fibrin clot structure may be of benefit in the prevention and treatment of cardiovascular disease.
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Affiliation(s)
| | | | - Robert A S Ariëns
- Prof. R. A. S. Ariëns, LIGHT Laboratories, University of Leeds, Clarendon Way, Leeds LS2 9JT, UK, Tel.: +44 113 343 7734, E-mail:
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9
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O'Brien LC, Mezzaroma E, Van Tassell BW, Marchetti C, Carbone S, Abbate A, Toldo S. Interleukin-18 as a therapeutic target in acute myocardial infarction and heart failure. Mol Med 2014; 20:221-9. [PMID: 24804827 DOI: 10.2119/molmed.2014.00034] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 04/28/2014] [Indexed: 12/13/2022] Open
Abstract
Interleukin 18 (IL-18) is a proinflammatory cytokine in the IL-1 family that has been implicated in a number of disease states. In animal models of acute myocardial infarction (AMI), pressure overload, and LPS-induced dysfunction, IL-18 regulates cardiomyocyte hypertrophy and induces cardiac contractile dysfunction and extracellular matrix remodeling. In patients, high IL-18 levels correlate with increased risk of developing cardiovascular disease (CVD) and with a worse prognosis in patients with established CVD. Two strategies have been used to counter the effects of IL-18:IL-18 binding protein (IL-18BP), a naturally occurring protein, and a neutralizing IL-18 antibody. Recombinant human IL-18BP (r-hIL-18BP) has been investigated in animal studies and in phase I/II clinical trials for psoriasis and rheumatoid arthritis. A phase II clinical trial using a humanized monoclonal IL-18 antibody for type 2 diabetes is ongoing. Here we review the literature regarding the role of IL-18 in AMI and heart failure and the evidence and challenges of using IL-18BP and blocking IL-18 antibodies as a therapeutic strategy in patients with heart disease.
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Affiliation(s)
- Laura C O'Brien
- Department of Physiology and Biophysics, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Eleonora Mezzaroma
- Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, Virginia, United States of America Virginia Commonwealth University Pauley Heart Center, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America Pharmacotherapy and Outcome Sciences, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Benjamin W Van Tassell
- Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, Virginia, United States of America Virginia Commonwealth University Pauley Heart Center, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America Pharmacotherapy and Outcome Sciences, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Carlo Marchetti
- Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, Virginia, United States of America Virginia Commonwealth University Pauley Heart Center, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Salvatore Carbone
- Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, Virginia, United States of America Virginia Commonwealth University Pauley Heart Center, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Antonio Abbate
- Department of Physiology and Biophysics, Virginia Commonwealth University, Richmond, Virginia, United States of America Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, Virginia, United States of America Virginia Commonwealth University Pauley Heart Center, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Stefano Toldo
- Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, Virginia, United States of America Virginia Commonwealth University Pauley Heart Center, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America
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