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Ugurel E, Goksel E, Goktas P, Cilek N, Atar D, Yalcin O. A Novel Fragmentation Sensitivity Index Determines the Susceptibility of Red Blood Cells to Mechanical Trauma. Front Physiol 2021; 12:714157. [PMID: 34512387 PMCID: PMC8424113 DOI: 10.3389/fphys.2021.714157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022] Open
Abstract
Supraphysiological shear stresses (SSs) induce irreversible impairments of red blood cell (RBC) deformability, overstretching of RBC membrane, or fragmentation of RBCs that causes free hemoglobin to be released into plasma, which may lead to anemia. The magnitude and exposure tisme of the SSs are two critical parameters that determine the hemolytic threshold of a healthy RBC. However, impairments in the membrane stability of damaged cells reduce the hemolytic threshold and increase the susceptibility of the cell membrane to supraphysiological SSs, leading to cell fragmentation. The severity of the RBC fragmentation as a response to the mechanical damage and the critical SS levels causing fragmentation are not previously defined. In this study, we investigated the RBC mechanical damage in oxidative stress (OS) and metabolic depletion (MD) models by applying supraphysiological SSs up to 100 Pa by an ektacytometer (LORRCA MaxSis) and then assessed RBC deformability. Next, we examined hemolysis and measured RBC volume and count by Multisizer 3 Coulter Counter to evaluate RBC fragmentation. RBC deformability was significantly impaired in the range of 20-50 Pa in OS compared with healthy controls (p < 0.05). Hemolysis was detected at 90-100 Pa SS levels in MD and all applied SS levels in OS. Supraphysiological SSs increased RBC volume in both the damage models and the control group. The number of fragmented cells increased at 100 Pa SS in the control and MD and at all SS levels in OS, which was accompanied by hemolysis. Fragmentation sensitivity index increased at 50-100 Pa SS in the control, 100 Pa SS in MD, and at all SS levels in OS. Therefore, we propose RBC fragmentation as a novel sensitivity index for damaged RBCs experiencing a mechanical trauma before they undergo fragmentation. Our approach for the assessment of mechanical risk sensitivity by RBC fragmentation could facilitate the close monitoring of shear-mediated RBC response and provide an effective and accurate method for detecting RBC damage in mechanical circulatory assist devices used in routine clinical procedures.
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Affiliation(s)
- Elif Ugurel
- Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey.,School of Medicine, Koç University, Istanbul, Turkey
| | - Evrim Goksel
- Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey.,School of Medicine, Koç University, Istanbul, Turkey.,Graduate School of Health Sciences, Koç University, Istanbul, Turkey
| | - Polat Goktas
- School of Medicine, Koç University, Istanbul, Turkey.,Centre for Applied Data Analytics Research (CeADAR), School of Computer Science, University, College Dublin, Dublin, Ireland
| | - Neslihan Cilek
- Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey.,School of Medicine, Koç University, Istanbul, Turkey.,Graduate School of Health Sciences, Koç University, Istanbul, Turkey
| | - Dila Atar
- School of Medicine, Koç University, Istanbul, Turkey
| | - Ozlem Yalcin
- Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey.,School of Medicine, Koç University, Istanbul, Turkey
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Venkatesulu BP, Sanders KL, Hsieh C, Kim BK, Krishnan S. Biomarkers of radiation-induced vascular injury. Cancer Rep (Hoboken) 2019; 2:e1152. [PMID: 32721134 PMCID: PMC7941417 DOI: 10.1002/cnr2.1152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 10/31/2018] [Accepted: 10/31/2018] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Cancer survivorship has thrown the spotlight on the incidence of nonmalignant chronic diseases in cancer patients. Endothelial injury is increasingly recognized as a consequence of cancer treatment, particularly after radiation therapy (RT). This review is to provide a current understanding on the pathophysiological mechanisms and predictive biomarkers of radiation-induced vascular injury. RECENT FINDINGS Radiation directly impacts vasculature by causing endothelial apoptosis and senescence, and alterations in normal homeostasis. This altered milieu at the endothelial surface may contribute to a systemic chronic inflammatory state that is superimposed upon the cascade of normal senescence processes leading to acceleration of age-related disorders, atherosclerosis, and chronic fibrosis. Vasculature imaging, blood-based or cell-component biomarkers, and signatures of genomics, proteomics, metabolomics, and radiomics are potential tools for detection of vascular damage after irradiation. CONCLUSIONS Development of a valid prediction model by combining an array of imaging tools, blood-based biomarkers, coupled with novel predictors like exosomes and metabolic degradation products can serve to identify RT-induced vascular injury early for subsequent introduction of newer therapeutic approaches to counter radiation morbidity.
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Affiliation(s)
- Bhanu Prasad Venkatesulu
- Departments of Experimental Radiation OncologyUniversity of Texas MD Anderson Cancer CenterHoustonTexas
| | - Keith L. Sanders
- Departments of Experimental Radiation OncologyUniversity of Texas MD Anderson Cancer CenterHoustonTexas
| | - Cheng‐En Hsieh
- Departments of Experimental Radiation OncologyUniversity of Texas MD Anderson Cancer CenterHoustonTexas
- Radiation OncologyUniversity of Texas MD Anderson Cancer CenterHoustonTexas
- The University of Texas MD Anderson Cancer Center‐UT Health Graduate School of Biomedical SciencesHoustonTexas
- Departments of Radiation Oncology, Chang Gung Memorial HospitalLinkou and Chang Gung UniversityTaoyuanTaiwan, ROC
| | - Byung Kyu Kim
- Departments of Experimental Radiation OncologyUniversity of Texas MD Anderson Cancer CenterHoustonTexas
- The University of Texas MD Anderson Cancer Center‐UT Health Graduate School of Biomedical SciencesHoustonTexas
| | - Sunil Krishnan
- Departments of Experimental Radiation OncologyUniversity of Texas MD Anderson Cancer CenterHoustonTexas
- Radiation OncologyUniversity of Texas MD Anderson Cancer CenterHoustonTexas
- The University of Texas MD Anderson Cancer Center‐UT Health Graduate School of Biomedical SciencesHoustonTexas
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3
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Meng LB, Chen K, Zhang YM, Gong T. Common Injuries and Repair Mechanisms in the Endothelial Lining. Chin Med J (Engl) 2018; 131:2338-2345. [PMID: 30246720 PMCID: PMC6166454 DOI: 10.4103/0366-6999.241805] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective: Endothelial cells (ECs) are important metabolic and endocrinal organs which play a significant role in regulating vascular function. Vascular ECs, located between the blood and vascular tissues, can not only complete the metabolism of blood and interstitial fluid but also synthesize and secrete a variety of biologically active substances to maintain vascular tension and keep a normal flow of blood and long-term patency. Therefore, this article presents a systematic review of common injuries and healing mechanisms for the vascular endothelium. Data Sources: An extensive search in the PubMed database was undertaken, focusing on research published after 2003 with keywords including endothelium, vascular, wounds and injuries, and wound healing. Study Selection: Several types of articles, including original studies and literature reviews, were identified and reviewed to summarize common injury and repair processes of the endothelial lining. Results: Endothelial injury is closely related to the development of multiple cardiovascular and cerebrovascular diseases. However, the mechanism of vascular endothelial injury is not fully understood. Numerous studies have shown that the mechanisms of EC injury mainly involve inflammatory reactions, physical stimulation, chemical poisons, concurrency of related diseases, and molecular changes. Endothelial progenitor cells play an important role during the process of endothelial repair after such injuries. What's more, a variety of restorative cells, changes in cytokines and molecules, chemical drugs, certain RNAs, regulation of blood pressure, and physical fitness training protect the endothelial lining by reducing the inducing factors, inhibiting inflammation and oxidative stress reactions, and delaying endothelial caducity. Conclusions: ECs are always in the process of being damaged. Several therapeutic targets and drugs were seeked to protect the endothelium and promote repair.
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Affiliation(s)
- Ling-Bing Meng
- Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Kun Chen
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Yuan-Meng Zhang
- Department of Internal Medicine, Jinzhou Medical University, Jinzhou, Liaoning 121001, China
| | - Tao Gong
- Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
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4
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Bermejo-Martin JF, Martín-Fernandez M, López-Mestanza C, Duque P, Almansa R. Shared Features of Endothelial Dysfunction between Sepsis and Its Preceding Risk Factors (Aging and Chronic Disease). J Clin Med 2018; 7:E400. [PMID: 30380785 PMCID: PMC6262336 DOI: 10.3390/jcm7110400] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/19/2018] [Accepted: 10/27/2018] [Indexed: 02/06/2023] Open
Abstract
Acute vascular endothelial dysfunction is a central event in the pathogenesis of sepsis, increasing vascular permeability, promoting activation of the coagulation cascade, tissue edema and compromising perfusion of vital organs. Aging and chronic diseases (hypertension, dyslipidaemia, diabetes mellitus, chronic kidney disease, cardiovascular disease, cerebrovascular disease, chronic pulmonary disease, liver disease, or cancer) are recognized risk factors for sepsis. In this article we review the features of endothelial dysfunction shared by sepsis, aging and the chronic conditions preceding this disease. Clinical studies and review articles on endothelial dysfunction in sepsis, aging and chronic diseases available in PubMed were considered. The main features of endothelial dysfunction shared by sepsis, aging and chronic diseases were: (1) increased oxidative stress and systemic inflammation, (2) glycocalyx degradation and shedding, (3) disassembly of intercellular junctions, endothelial cell death, blood-tissue barrier disruption, (4) enhanced leukocyte adhesion and extravasation, (5) induction of a pro-coagulant and anti-fibrinolytic state. In addition, chronic diseases impair the mechanisms of endothelial reparation. In conclusion, sepsis, aging and chronic diseases induce similar features of endothelial dysfunction. The potential contribution of pre-existent endothelial dysfunction to sepsis pathogenesis deserves to be further investigated.
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Affiliation(s)
- Jesus F Bermejo-Martin
- Group for Biomedical Research in Sepsis (Bio∙Sepsis), Hospital Clínico Universitario de Valladolid/IECSCYL, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain.
- Centro de Investigación Biomedica En Red-Enfermedades Respiratorias (CibeRes, CB06/06/0028), Instituto de salud Carlos III (ISCIII), Av. de Monforte de Lemos, 5, 28029 Madrid, Spain.
| | - Marta Martín-Fernandez
- Group for Biomedical Research in Sepsis (Bio∙Sepsis), Hospital Clínico Universitario de Valladolid/IECSCYL, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain.
| | - Cristina López-Mestanza
- Group for Biomedical Research in Sepsis (Bio∙Sepsis), Hospital Clínico Universitario de Valladolid/IECSCYL, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain.
| | - Patricia Duque
- Anesthesiology and Reanimation Service, Hospital General Universitario Gregorio Marañón, Calle del Dr. Esquerdo, 46, 28007 Madrid, Spain.
| | - Raquel Almansa
- Group for Biomedical Research in Sepsis (Bio∙Sepsis), Hospital Clínico Universitario de Valladolid/IECSCYL, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain.
- Centro de Investigación Biomedica En Red-Enfermedades Respiratorias (CibeRes, CB06/06/0028), Instituto de salud Carlos III (ISCIII), Av. de Monforte de Lemos, 5, 28029 Madrid, Spain.
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Wang J, Yue D, Chen X, Wei Z, Lu W, Wu D. Common carotid artery dissection caused by radiotherapy: A case report. Mol Clin Oncol 2016; 5:475-477. [PMID: 27699045 DOI: 10.3892/mco.2016.990] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 07/15/2016] [Indexed: 11/06/2022] Open
Abstract
In the present study, a case of acute cerebral infarction with radiation-induced carotid artery dissection is reported. Carotid artery dissection is generally asymptomatic at the early stages. Due to the non-specific clinical manifestations of carotid artery dissection, a detailed inquiry of the past history of a patient has a critical role in making a diagnosis of radiation-induced common carotid artery dissection. Onset of acute ischemic stroke is the predominant manifestation, and for patients with a history of head-and-neck radiotherapy, dissection should be considered. The condition may progress rapidly, and result in a poor prognosis. Therefore, a correct early diagnosis and initiation of appropriate therapy may lead to rapid recovery, and influence the overall prognosis.
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Affiliation(s)
- Jiayan Wang
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201999, P.R. China
| | - Dandan Yue
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201999, P.R. China
| | - Xin Chen
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201999, P.R. China
| | - Zhenyu Wei
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201999, P.R. China
| | - Wenmei Lu
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201999, P.R. China
| | - Danhong Wu
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201999, P.R. China
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Casco S, Soto-Vega E. Development of Metabolic Syndrome Associated to Cancer Therapy: Review. Discov Oncol 2016; 7:289-295. [PMID: 27704369 DOI: 10.1007/s12672-016-0274-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 09/21/2016] [Indexed: 01/25/2023] Open
Abstract
Long-term childhood cancer survivors are at great risk of developing late adverse effects after treatment, such as, reduced growth, obesity, decreased fertility, high blood pressure, cardiovascular diseases, impaired glucose, another form of cancer, among others organ dysfunctions, some of them are part of the metabolic syndrome. Metabolic syndrome and cancer connection is still not entirely understood, but there are some notions about it. Metabolic alterations produced during childhood cancer are more likely determined by treatments like radiotherapy, chemotherapy, glucocorticoids therapy, and surgery. Cancer treatment is associated to vascular alterations, hormone deficiencies, changes in insulin sensitivity, lipid metabolism, and inflammatory mediators. Obesity has been considered a crucial component in metabolic syndrome; obesity risk factors during childhood cancer include cranial radiation, female gender, and exposure to glucocorticoids such as dexamethasone. In addition, local radiotherapy or surgery may cause endocrine deficiencies, depends on the directly damage of endocrine organs. Patients who received some types of cancer treatment should be evaluated periodically to early diagnostic metabolic disorders associated to antineoplastic therapy.
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Affiliation(s)
- Stephania Casco
- Decanato de Ciencias de la Salud, Universidad Popular Autónoma del Estado de Puebla, Puebla, Mexico
| | - Elena Soto-Vega
- Centro de Investigación Oncológica UNE-UPAEP, Una Nueva esperanza A.B.P., Puebla, Mexico.
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