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Fan Q, Tan Z, Su W, Li Q, Jin D, Du Y, Zhang L, Wu S. Efficacy, safety and mechanism of Simiaoyongan decoction in the treatment of carotid atherosclerotic plaque: a randomized, double-blind, placebo-controlled clinical trial protocol. BMC Complement Med Ther 2024; 24:277. [PMID: 39039498 PMCID: PMC11265120 DOI: 10.1186/s12906-024-04555-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 06/17/2024] [Indexed: 07/24/2024] Open
Abstract
INTRODUCTION Chronic inflammation is the major pathological feature of Atherosclerosis(As). Inflammation may accelerate plaque to develop, which is a key factor resulting in the thinning of the fibrous cap and the vulnerable rupture of plaque. Presently, clinical treatments are still lacking. It is necessary to find a safe and effective treatment for As inflammation. Simiaoyongan Decoction (SMYA) has potential anti-inflammatory and plaque protection effects. This protocol aims to evaluate the efficacy, safety, and mechanism of SMYA for patients with carotid atherosclerotic plaque. METHODS/DESIGN The assessment of SMYA clinical trial is designed as a randomized, double-blind, placebo-controlled study. The sample size is 86 cases in total, with 43 participants in the intervention group and the control group respectively. The intervention group takes SMYA, while the control group takes SMYA placebo. The medication lasts for 14 days every 10 weeks, with a total of 50 weeks. We will use carotid artery high resolution magnetic resonance imaging (HR-MRI) to measure plaque. The plaque minimum fiber cap thickness (PMFCT) is adopted as the primary outcome. The secondary outcomes include plaque fiber cap volume, volume percentage of fiber cap, lipid-rich necrotic core (LRNC) volume, volume percentage of LRNC, internal bleeding volume of plaque, internal bleeding volume percentage of plaque, plaque calcification volume, volume percentage of plaque calcification, lumen stenosis rate, average and a maximum of vessel wall thickness, vessel wall volume, total vessel wall load, carotid atherosclerosis score, hs-CRP, IL-1β and IL-6, the level of lipid profiles and blood glucose, blood pressure, and body weight. DISCUSSION We anticipate that patients with As plaque will be improved from SMYA by inhibiting inflammation to enhance plaque stability. This study analyzes plaque by using HR-MRI to evaluate the clinical efficacy and safety of SMYA. Moreover, we conduct transcriptome analysis, proteomic analysis, and metagenomic analysis of blood and stool of participants to study the mechanism of SMYA against As plaque. This is the first prospective TCM trial to observe and treat As plaque by inhibiting inflammatory reaction directly. If successful, the finding will be valuable in the treatment of As plaque and drug development, especially in the "statin era". TRIAL REGISTRATION NUMBER This trial is registered on Chinese Clinical Trials.gov with number ChiCTR2000039062 on October 15, 2020 ( http://www.chictr.org.cn ).
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Affiliation(s)
- QinHua Fan
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - ZhongJian Tan
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - WenQuan Su
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - QingXiao Li
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Dian Jin
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - YaWei Du
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - LiPing Zhang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
| | - ShengXian Wu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
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Yu M, Meng Y, Zhang H, Wang W, Qiu S, Wang B, Bao Y, Du B, Zhu S, Ge Y, Zhu L, Xu K. Associations between pericarotid fat density and image-based risk characteristics of carotid plaque. Eur J Radiol 2022; 153:110364. [DOI: 10.1016/j.ejrad.2022.110364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/10/2022] [Accepted: 05/14/2022] [Indexed: 11/26/2022]
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Zhao P, Xu E, Yuan R, Zhou R, Pan J. The Predictive Value of Contrast-Enhanced Ultrasound Combined with Serum miR-124 Level in Acute Cerebral Infarction and Their Correlation with the Contrast Enhancement of Carotid Atherosclerotic Plaque. Neuropsychiatr Dis Treat 2022; 18:1397-1403. [PMID: 35847565 PMCID: PMC9285864 DOI: 10.2147/ndt.s372557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/28/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate the predictive value of contrast-enhanced ultrasound (CEUS) combined with serum miR-124 level in acute cerebral infarction (ACI) and their association with the contrast enhancement of carotid atherosclerotic plaque. METHODS Totally 60 patients diagnosed with ACI and 60 controls were included in the study. All the subjects had carotid atherosclerotic plaques, and all of them were examined by CEUS and were tested for serum miR-124 levels. RESULTS Time to peak (TTP) and mean transit time (MTT) in the ACI group were significantly shorter than those in the control group (P < 0.05), but the peak intensity ratio (PIR), the area under the curve (AUC), and relative expression levels of serum miR-124 were notably greater in the ACI group (P < 0.05). There were statistically significant differences in TTP, MTT, PIR, AUC, and serum miR-124 expression in patients with different cerebral infarct areas in the ACI group (P < 0.05). Besides, the sensitivity and specificity of serum miR-124 levels for the prediction of ACI were 71.67% and 90.00%, respectively, with a cut-off value of 1.52, and the sensitivity was 86.67% and specificity was 93.33% of CEUS combined with serum miR-124 in the prediction of ACI. The ACI group showed a higher proportion of grades 2 and 3 (P < 0.001). Pearson correlation analysis showed that the intraplaque contrast enhancement was negatively related to TTP and MTT but had a positive correlation with PIR, AUC, and serum miR-124 levels. CONCLUSION Grades 2 and 3 intraplaque contrast enhancement and serum miR-124 level of 1.52 had high sensitivity and specificity to predict ACI. Moreover, the CEUS parameters combined with serum miR-124 level could improve the performance in predicting ACI and had auxiliary value in evaluating the stability of carotid atherosclerotic plaques.
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Affiliation(s)
- Ping Zhao
- Department of Ultrasound Medicine, Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, 315040, People's Republic of China
| | - Erdong Xu
- Department of Ultrasound Medicine, Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, 315040, People's Republic of China
| | - Rui Yuan
- Department of Ultrasound Medicine, Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, 315040, People's Republic of China
| | - Ruhai Zhou
- Department of Ultrasound Medicine, Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, 315040, People's Republic of China
| | - Jianlian Pan
- Clinical Application Department, Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, Guangzhou, 518057, People's Republic of China
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Cervical Carotid Plaque MRI : Review of Atherosclerosis Imaging Features and their Histologic Underpinnings. Clin Neuroradiol 2021; 31:295-306. [PMID: 33398451 DOI: 10.1007/s00062-020-00987-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
Magnetic resonance (MR) imaging is considered the gold standard for non-invasive evaluation of carotid artery plaque morphology and composition. A number of studies have demonstrated the clinical utility of MR plaque imaging in the risk stratification of carotid atherosclerotic disease, determination of stroke etiology, and identification of surgical and endovascular candidates for carotid revascularization procedures. The MR plaque imaging also provides researchers and clinicians with valuable insights into the pathogenesis, natural history and composition of carotid atherosclerotic disease. Nevertheless, the field of MR plaque imaging is complex, and requires a thorough knowledge of the histologic basis for how various plaque features appear on imaging. This article details the pathogenesis and histology of atherosclerosis, reviews the expected appearance of different plaque components, and describes how MR imaging features may be related to symptomatology or predict future ischemic events.
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5
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Affiliation(s)
- Mohamed A Zayed
- Section of Vascular Surgery, Department of Surgery, and Division of Molecular Cell Biology, Washington University School of Medicine, St. Louis, MO. Department of Biomedical Engineering, Washington University, McKelvey School of Engineering, St. Louis, MO. Veterans Affairs St. Louis Health Care System, St. Louis, MO
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6
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Janssen H, Felgner L, Kummer L, Gillmann HJ, Schrimpf C, Rustum S, Lichtinghagen R, Sahlmann B, Weigand MA, Teebken OE, Theilmeier G, Larmann J. Sequential Surgical Procedures in Vascular Surgery Patients Are Associated With Perioperative Adverse Cardiac Events. Front Cardiovasc Med 2020; 7:13. [PMID: 32133374 PMCID: PMC7040239 DOI: 10.3389/fcvm.2020.00013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/28/2020] [Indexed: 01/31/2023] Open
Abstract
Patients at elevated cardiovascular risk are prone to perioperative cardiovascular complications, like myocardial injury after non-cardiac surgery (MINS). We have demonstrated in a mouse model of atherosclerosis that perioperative stress leads to an increase in plaque volume and higher plaque vulnerability. Regulatory T cells (Tregs) play a pivotal role in development and destabilization of atherosclerotic plaques. For this exploratory post-hoc analysis we identified 40 patients recruited into a prospective perioperative biomarker study, who within the inclusion period underwent sequential open vascular surgery. On the basis of protein markers measured in the biomarker study, we evaluated the perioperative inflammatory response in patients' plasma before and after index surgery as well as before and after a second surgical procedure. We also analyzed available immunohistochemistry samples to describe plaque vulnerability in patients who underwent bilateral carotid endarterectomy (CEA) in two subsequent surgical procedures. Finally, we assessed if MINS was associated with sequential surgery. The inflammatory response of both surgeries was characterized by postoperative increases of interleukin-6,−10, Pentraxin 3 and C-reactive protein with no clear-cut difference between the two time points of surgery. Plaques from CEA extracted during the second surgery contained less Tregs, as measured by Foxp3 staining, than plaques from the first intervention. The 2nd surgical procedure was associated with MINS. In conclusion, we provide descriptive evidence that sequential surgical procedures involve repeat inflammation, and we hypothesize that elevated rates of cardiovascular complications after the second procedure could be related to reduced levels of intraplaque Tregs, a finding that deserves confirmatory testing and mechanistic exploration in future populations.
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Affiliation(s)
- Henrike Janssen
- Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany.,Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hanover, Germany
| | - Larissa Felgner
- Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Laura Kummer
- Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Hans-Jörg Gillmann
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hanover, Germany
| | - Claudia Schrimpf
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hanover, Germany
| | - Saad Rustum
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hanover, Germany
| | - Ralf Lichtinghagen
- Institute for Clinical Chemistry, Medical School Hannover, Hanover, Germany
| | - Bianca Sahlmann
- Department of Human Medicine, Perioperative Inflammation and Infection, Faculty of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany
| | - Markus A Weigand
- Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Omke E Teebken
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hanover, Germany
| | - Gregor Theilmeier
- Department of Human Medicine, Perioperative Inflammation and Infection, Faculty of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany.,Department of Anesthesiology, University Medical Center Groningen, Groningen, Netherlands
| | - Jan Larmann
- Department of Anesthesiology, University Hospital Heidelberg, Heidelberg, Germany.,Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hanover, Germany
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7
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Li J, Li D, Yang D, Hang H, Wu Y, Yao R, Chen X, Xu Y, Dai W, Zhou D, Zhao X. Irregularity of Carotid Plaque Surface Predicts Subsequent Vascular Event: A MRI Study. J Magn Reson Imaging 2020; 52:185-194. [PMID: 31944452 DOI: 10.1002/jmri.27038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/13/2019] [Accepted: 12/13/2019] [Indexed: 02/03/2023] Open
Affiliation(s)
- Jin Li
- Department of RadiologyThe Affiliated BenQ Hospital of Nanjing Medical University Nanjing China
| | - Dongye Li
- Department of Radiology, Sun Yat‐Sen Memorial HospitalSun Yat‐Sen University Guangzhou China
| | - Dandan Yang
- Beijing Institute of Brain DisordersCapital Medical University Beijing China
| | - Hailun Hang
- Department of NeurologyNanjing Brain Hospital Affiliated with Nanjing Medical University Nanjing China
| | - Yawei Wu
- Department of Radiology, Clinical Medical CollegeYangzhou University Yangzhou China
| | - Rong Yao
- Department of RadiologyThe Affiliated BenQ Hospital of Nanjing Medical University Nanjing China
| | - Xiaoyi Chen
- Department of RadiologyBeijing Geriatric Hospital Beijing China
| | - Yilan Xu
- Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical MedicineTsinghua University Beijing China
| | - Wei Dai
- Department of NeurologyFourth Medical Center of Chinese PLA General Hospital Beijing China
| | - Dan Zhou
- Department of RadiologyThe Affiliated BenQ Hospital of Nanjing Medical University Nanjing China
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical EngineeringTsinghua University School of Medicine Beijing China
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Li J, Li D, Yang D, Huo R, Chen X, Xu Y, Dai W, Zhou D, Zhao X. Co-existing cerebrovascular atherosclerosis predicts subsequent vascular event: a multi-contrast cardiovascular magnetic resonance imaging study. J Cardiovasc Magn Reson 2020; 22:4. [PMID: 31928532 PMCID: PMC6956475 DOI: 10.1186/s12968-019-0596-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 12/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is still unknown that whether co-existing intracranial stenosis and extracranial carotid vulnerable plaques have higher predictive value for subsequent vascular events. This study aimed to determine the relationship between co-existing extracranial carotid vulnerable plaques and intracranial stenosis and subsequent vascular events utilizing cardiovascular magnetic resonance (CMR) vessel wall imaging. METHODS Patients who had recent cerebrovascular symptoms in anterior circulation (< 2 weeks) were consecutively enrolled and underwent multi-contrast CMR vessel wall imaging for extracranial carotid arteries and 3D time-of flight CMR angiography for intracranial arteries at baseline. After baseline examination, all patients were followed-up for at least 1 year to determined recurrence of vascular events. The co-existing cerebrovascular atherosclerosis was defined as presence of both intracranial artery stenosis and at least one the following measures of extracranial artery atherosclerosis: plaque, calcification, lipid-rich necrotic core (LRNC), or intraplaque hemorrhage. Univariate and multivariate Cox regressions were used to calculate the hazard ratio (HR) and corresponding 95% confidence interval (CI) of co-existing plaques in predicting subsequent vascular events. RESULTS In total, 150 patients (mean age: 61.8 ± 11.9 years; 109 males) were recruited. During the median follow-up time of 12.1 months, 41 (27.3%) patients experienced vascular events. Co-existing intracranial artery stenosis and extracranial carotid plaque (HR, 3.57; 95% CI, 1.63-7.82; P = 0.001) and co-existing intracranial artery stenosis and extracranial carotid LRNC (HR, 4.47; 95% CI, 2.15-9.27; P < 0.001) were significantly associated with subsequent vascular events, respectively. After adjusted for confounding factors and carotid stenosis, these associations remained statistically significant (HR, 5.12; 95% CI, 1.36-19.24; P = 0.016 and HR, 8.12; 95% CI, 2.41-27.31; P = 0.001, respectively). CONCLUSIONS The co-existing cerebrovascular atherosclerotic diseases, particularly co-existing carotid lipid-rich necrotic core and intracranial stenosis, are independent predictors for subsequent vascular events.
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Affiliation(s)
- Jin Li
- Department of Radiology, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, China
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Haidian District, Beijing, 100084 China
| | - Dongye Li
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Haidian District, Beijing, 100084 China
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
| | - Dandan Yang
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
| | - Ran Huo
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Xiaoyi Chen
- Department of Radiology, Beijing Geriatric Hospital, Beijing, China
| | - Yilan Xu
- Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Wei Dai
- Department of Neurology, Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Dan Zhou
- Department of Radiology, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, China
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Haidian District, Beijing, 100084 China
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9
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Zhang D, Gao M, Jin Q, Ni Y, Zhang J. Updated developments on molecular imaging and therapeutic strategies directed against necrosis. Acta Pharm Sin B 2019; 9:455-468. [PMID: 31193829 PMCID: PMC6543088 DOI: 10.1016/j.apsb.2019.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/07/2018] [Accepted: 01/07/2019] [Indexed: 12/15/2022] Open
Abstract
Cell death plays important roles in living organisms and is a hallmark of numerous disorders such as cardiovascular diseases, sepsis and acute pancreatitis. Moreover, cell death also plays a pivotal role in the treatment of certain diseases, for example, cancer. Noninvasive visualization of cell death contributes to gained insight into diseases, development of individualized treatment plans, evaluation of treatment responses, and prediction of patient prognosis. On the other hand, cell death can also be targeted for the treatment of diseases. Although there are many ways for a cell to die, only apoptosis and necrosis have been extensively studied in terms of cell death related theranostics. This review mainly focuses on molecular imaging and therapeutic strategies directed against necrosis. Necrosis shares common morphological characteristics including the rupture of cell membrane integrity and release of cellular contents, which provide potential biomarkers for visualization of necrosis and necrosis targeted therapy. In the present review, we summarize the updated joint efforts to develop molecular imaging probes and therapeutic strategies targeting the biomarkers exposed by necrotic cells. Moreover, we also discuss the challenges in developing necrosis imaging probes and propose several biomarkers of necrosis that deserve to be explored in future imaging and therapy research.
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Affiliation(s)
- Dongjian Zhang
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210028, China
- Laboratories of Translational Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing 210028, China
| | - Meng Gao
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210028, China
- Laboratories of Translational Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing 210028, China
| | - Qiaomei Jin
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210028, China
- Laboratories of Translational Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing 210028, China
| | - Yicheng Ni
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210028, China
- Laboratories of Translational Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing 210028, China
- Theragnostic Laboratory, Campus Gasthuisberg, KU Leuven, Leuven 3000, Belgium
| | - Jian Zhang
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210028, China
- Laboratories of Translational Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing 210028, China
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Zhou C, Yuan C, Li R, Wang W, Li C, Zhao X. Association Between Incomplete Circle of Willis and Carotid Vulnerable Atherosclerotic Plaques. Arterioscler Thromb Vasc Biol 2018; 38:2744-2749. [PMID: 30354232 DOI: 10.1161/atvbaha.118.311797] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
Carotid high-risk plaque, characterized by intraplaque hemorrhage, fibrous cap rupture, and large lipid-rich necrotic core, is associated with cerebrovascular events. This study sought to investigate the relationship between high-risk carotid plaque and an incomplete circle of Willis (COW).
Approach and Results—
Patients were recruited from a multicenter study, Chinese Atherosclerosis Risk Evaluation (CARE-II) and underwent 3-dimensional time-of-flight magnetic resonance angiography for intracranial arteries and 2-dimensional multicontrast magnetic resonance vessel wall imaging for carotid arteries on a 3.0T magnetic resonance scanner. The integrity of the COW in anterior and posterior portions was evaluated. Characteristics of carotid plaques were assessed. Correlation between incomplete COW and carotid plaque features was determined. Of 482 eligible patients, patients with carotid intraplaque hemorrhage showed significantly higher prevalence of an incomplete anterior COW (52.7% versus 38.5%;
P
=0.022) compared with those without. An incomplete anterior COW was associated with intraplaque hemorrhage before (odds ratio, 1.781; 95% CI, 1.083–2.931;
P
=0.023) and after adjusted for clinical risk factors (odds ratio, 1.945; 95% CI, 1.139–3.321;
P
=0.015). The unilateral carotid artery stenosis showed no correlation with incomplete anterior COW and posterior COW (all
P
>0.025). No significant associations were found between other plaque features and any type of incomplete COW (all
P
>0.025).
Conclusions—
An incomplete COW is independently associated with intraplaque hemorrhage of carotid atherosclerotic plaques.
Clinical Trial Registration—
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT02017756.
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Affiliation(s)
- Changwu Zhou
- From the Department of Radiology, The Affiliated Hospital of Yangzhou University, Yangzhou University, China (C.Z., W.W.)
| | - Chun Yuan
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China (C.Y., R.L., X.Z.)
- Department of Radiology, University of Washington, Seattle (C.Y.)
| | - Rui Li
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China (C.Y., R.L., X.Z.)
| | - Wei Wang
- From the Department of Radiology, The Affiliated Hospital of Yangzhou University, Yangzhou University, China (C.Z., W.W.)
| | - Cheng Li
- Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China (C.L.)
| | - Xihai Zhao
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China (C.Y., R.L., X.Z.)
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Pathophysiology of cardiovascular disease in diabetes mellitus. Cardiovasc Endocrinol Metab 2018; 7:4-9. [PMID: 31646271 DOI: 10.1097/xce.0000000000000141] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 11/22/2017] [Indexed: 01/12/2023]
Abstract
Diabetes mellitus elicits cellular, epigenetic, and post-translational changes that directly or indirectly affect the biology of the vasculature and other metabolic systems resulting in the apparition of cardiovascular disease. In this review, we provide a current perspective on the most recent discoveries in this field, with particular focus on hyperglycemia- induced pathology in the cardiovascular system. We also provide perspective on the clinical importance of molecular targeting of cardiovascular and diabetes mellitus therapies to treat hyperglycemia, inflammation, thrombosis, dyslipidemia, atherosclerosis, and hypertension.
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Jiang ZZ, Liu XT, Ma CY, He C, Li XY, Hou CL, Cheng ZS, Xia GY. Detection of Atherosclerotic Plaques in the Rabbit Aorta Using Ultrasound Microbubbles Conjugated to Interleukin-18 Antibodies. Med Sci Monit 2017; 23:5446-5454. [PMID: 29142190 PMCID: PMC5701460 DOI: 10.12659/msm.907572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The purpose of the study was to investigate the ability of microbubbles (MBs) targeting interleukin-18 (IL-18) to detect plaques in a rabbit atherosclerotic plaque model. MATERIAL AND METHODS A rabbit atherosclerotic plaque model was established. The locations of the atherosclerotic plaques were verified by two-dimensional scanning and color Doppler flow imaging. An IL-18 antibody was conjugated to naked MBs (MBc) using the biotin-streptavidin conjugation method, resulting in the formation of MBIL-18. MBc and MBIL-18 were then used for contrast-enhanced ultrasound (CEUS) studies. The locations of CD34 and IL-18 within the plaques were determined by immunohistochemistry, and IL-18 expression levels in the plaques were determined by Western blot analysis. The relationships between IL-18 expression and the contrast intensity of the 2 MBs were analyzed. RESULTS MBc and MBIL-18 were both uniformly dispersed. Fluorescence microscopy and flow cytometry revealed that IL-18 was successfully conjugated to MBs. CEUS images showed that the intensity of the MBIL-18 signal was substantially enhanced and prolonged compared with that of the MBc signal. Immunohistochemistry showed that CD34 expression was significantly increased in the plaques and that IL-18 was mainly located in the inner parts and base of the atherosclerotic plaques. Western blot analysis revealed that IL-18 expression was higher in the plaque regions. Correlation analysis showed that IL-18 expression was correlated with the contrast intensity of MBIL-18 (r=0.903, P<0.05) but not with MBc (r=0.540, P>0.05). CONCLUSIONS MBs targeting IL-18 may be a novel, noninvasive method of diagnosing atherosclerotic plaques.
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Affiliation(s)
- Zhen-Zhen Jiang
- Department of Ultrasound, Shaoxing People's Hospital (Shaoxing Hospital of Zhejiang University), Shaoxing, Zhejiang, China (mainland)
| | - Xia-Tian Liu
- Department of Ultrasound, Shaoxing People's Hospital (Shaoxing Hospital of Zhejiang University), Shaoxing, Zhejiang, China (mainland)
| | - Cai-Ye Ma
- Department of Ultrasound, Shaoxing People's Hospital (Shaoxing Hospital of Zhejiang University), Shaoxing, Zhejiang, China (mainland)
| | - Cong He
- Department of Radiology, Shaoxing Second Hospital, Shaoxing, Zhejiang, China (mainland)
| | - Xing-Yun Li
- Department of Ultrasound, Shaoxing People's Hospital (Shaoxing Hospital of Zhejiang University), Shaoxing, Zhejiang, China (mainland)
| | - Chuan-Lin Hou
- Department of Pathology, Shaoxing People`s Hospital (Shaoxing Hospital of Zhejiang University), Shaoxing, Zhejiang, China (mainland)
| | - Zu-Sheng Cheng
- Department of Radiology, Shaoxing Seventh Hospital, Shaoxing, Zhejiang, China (mainland)
| | - Guo-Yuan Xia
- Department of Ultrasound, Shaoxing People's Hospital (Shaoxing Hospital of Zhejiang University), Shaoxing, Zhejiang, China (mainland)
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