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Yokouchi H, Nagasato D, Mitamura Y, Egawa M, Tabuchi H, Misawa S, Kuwabara S, Baba T. Alterations in choroidal vascular structures due to serum levels of vascular endothelial growth factor in patients with POEMS syndrome. Sci Rep 2023; 13:10650. [PMID: 37391497 PMCID: PMC10313687 DOI: 10.1038/s41598-023-37727-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/27/2023] [Indexed: 07/02/2023] Open
Abstract
A higher serum vascular endothelial growth factor (VEGF) level can cause choroidal thickening in the choroid of patients with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome. We aimed to determine whether fluctuations in serum VEGF levels affect choroidal vascular structures in patients with POEMS syndrome. This retrospective observational case series examined 17 left eyes of 17 patients with POEMS syndrome. Enhanced depth imaging optical coherence tomography (EDI-OCT) images were obtained, and serum VEGF levels were measured at baseline and 6 months after transplantation with dexamethasone (n = 6), thalidomide (n = 8), or lenalidomide (n = 3). EDI-OCT images were binarized using ImageJ software, and we calculated the areas of the whole choroid and the luminal and stromal areas. Subsequently, we determined whether the choroidal vascular structure had changed significantly between baseline and 6 months after treatment. Six months after treatment, serum VEGF levels and the whole choroid, luminal, and stromal areas had decreased significantly compared to the baseline values (all, P < 0.001). The mean luminal area to the whole choroidal area ratio at 6 months after treatment was 0.70 ± 0.03, which was significantly smaller than the ratio at baseline (0.72 ± 0.03; P < 0.001). Whole choroid and luminal area fluctuations were significantly positively correlated with fluctuations in serum VEGF levels (r = 0.626, P = 0.007 and r = 0.585, P = 0.014, respectively). Choroidal thickening induced by VEGF might be caused by increases in the choroidal vessel lumen area. These results may offer insights into the pathogenesis of POEMS syndrome and the role of serum VEGF in choroidal vascular structure, which may apply to other ocular diseases.
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Affiliation(s)
- Hirotaka Yokouchi
- Department of Ophthalmology and Visual Science, Graduate School of Medicine, Chiba University, 1-7-1, Inohana, Chiba, 260-0856, Japan.
| | - Daisuke Nagasato
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Yoshinori Mitamura
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Mariko Egawa
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Sonoko Misawa
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Satoshi Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takayuki Baba
- Department of Ophthalmology and Visual Science, Graduate School of Medicine, Chiba University, 1-7-1, Inohana, Chiba, 260-0856, Japan
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Systemic and Ocular Determinants of Choroidal Structures on Optical Coherence Tomography of Eyes with Diabetes and Diabetic Retinopathy. Sci Rep 2019; 9:16228. [PMID: 31700083 PMCID: PMC6838057 DOI: 10.1038/s41598-019-52750-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/22/2019] [Indexed: 01/14/2023] Open
Abstract
Knowledgeof the choroidal structures in eyes with diabetes and diabetic retinopathy (DR) should provide information on the pathogenesis of DR. A prospective study was performed to determine the systemic and ocular factors that affect the choroidal structures in eyes with diabetes. Two-hundred consecutive diabetic subjects consisted of 160 treatment-naïve patients with different stages of DR and 40 patients with proliferative DR with prior panretinal photocoagulation (PRP). All underwent blood and urine tests and enhanced depth imaging optical coherence tomography (EDI-OCT). The cross-sectional EDI-OCT images of the subfoveal choroid were binarized to measure the total choroidal area (TCA), luminal area, and stromal area. Multivariate regression analyses were performed to determine the systemic and ocular factors that were significantly correlated with the choroidal structures. The subfoveal choroidal thickness, TCA, luminal area, and stromal area were larger at more advanced stage of DR, and smaller in eyes with PRP than those without (P < 0.001). The TCA and stromal area were significantly and positively correlated with the degree of albuminuria (P = 0.034, P = 0.025, respectively). The choroidal lumen and stroma may increase as the stages of DR progress and decrease after PRP. Albuminuria may be associated with the choroidal stromal edema.
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Gánti B, Molnár E, Fazekas R, Mikecs B, Lohinai Z, Mikó S, Vág J. Evidence of spreading vasodilation in the human gingiva evoked by nitric oxide. J Periodontal Res 2019; 54:499-505. [PMID: 30865289 DOI: 10.1111/jre.12650] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/18/2018] [Accepted: 02/01/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVE Spreading vasodilation is an important means of increasing local blood flow effectively during increased metabolic demands or in case of vascular injury. Our aim was to develop a technique proving the presence of spreading vasodilation in the human keratinized gingiva. METHODS Local vasodilation was evoked by the application of nitric oxide (NO) donor nitroglycerin into a well, fixed 2 mm above the marginal gingiva, in 20 subjects with healthy periodontal tissue. Either 1 or 8 mg/mL nitroglycerin solutions were dropped into the test well at the upper right second incisor, and saline was applied into the control well at the upper left first incisor. The gingival blood flow (GBF) was recorded for 15 minutes by a laser speckle contrast imager below the well and in the surrounding area in the mesial, distal, apical and coronal directions. Gingival thickness was measured by an ultrasonic biometer. RESULTS Peak GBF increase was similar after 1 mg/mL and after 8 mg/mL nitroglycerin application in the well (51% ± 12% vs 42% ± 8%) and in the apical region (33 ± 9% vs 55% ± 13%). While the lower dose of nitroglycerin increased GBF only in the apical region around the well, the higher dose induced significant elevations in all surrounding regions, with apical prominence. Hyperaemia lasted 10-14 minutes in the low-dose group whereas it extended beyond the observation period in the high-dose group. Neither the baseline nor the NO-induced peak GBF were correlated with gingival thickness. CONCLUSION The role of the direct effect of NO in the regulation of perfusion was demonstrated in the human gingiva as well as the propagation of local vasodilation to distant, especially apical areas, probably by the mechanism of flow-mediated dilation. This mechanism may have a clinical importance for flap survival or wound healing.
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Affiliation(s)
- Bernadett Gánti
- Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary
| | - Eszter Molnár
- Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary
| | - Réka Fazekas
- Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary
| | - Barbara Mikecs
- Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary
| | - Zsolt Lohinai
- Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary
| | - Sándor Mikó
- Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary
| | - János Vág
- Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary
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Townsend D, D’Aiuto F, Deanfield J. Vascular Fragility and the Endothelial Glycocalyx in the Tissues Lining the Healthy Gingival Crevice. J Periodontol 2016; 87:672-9. [DOI: 10.1902/jop.2016.150568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Gyurkovics M, Nagy I, Bodor C, Székely AD, Dinya E, Rosivall L, Lohinai Z. Expression of Vascular Endothelial Growth Factor Has a Regulatory Role in Gingival Venules in Experimental Diabetes. J Periodontol 2015; 87:e27-34. [PMID: 26561995 DOI: 10.1902/jop.2015.150410] [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] [Indexed: 11/13/2022]
Abstract
BACKGROUND In the present study, the possible localization and role of vascular endothelial growth factor receptor type 2 (VEGFR2) in the regulation of gingival venules in a rat model of experimental diabetes are examined. METHODS Six weeks after streptozotocin premedication, Wistar male rats presenting blood sugar levels >20 mmol/L were selected for investigation. The VEGFR2 antagonist ZM323881 [5-((7-benzyloxyquinazolin-4-yl)amino)-4-fluoro-2-methylphenol-hydrochloride] (20 μg/mL) was dripped onto the gingiva between the mandibular incisors. Changes in diameter of the selected gingival venule were measured by vital microscopy combined with digital photography at specified times. Immunohistochemical staining was used to localize VEGFR2. For controls, the same protocol was used on animals with normal blood sugar levels and healthy gingiva. RESULTS There was a significant difference between the baseline venule diameter of the diabetic and the control groups (47 ± 1 and 28 ± 2 μm, respectively). After 15, 30, and 60 minutes of local application of ZM323881, significant vasoconstriction was observed in the venules of diabetic rats compared with the baseline (81.4% ± 4.6%, 81.8% ± 4.4%, and 80.6% ± 5.1%, respectively). The control group showed no change in the venule diameter. The immunohistochemical analysis showed significantly increased VEGFR2 expression in the mast cells along the venules in the diabetic group, whereas mast cells were rarely found in the control group. CONCLUSIONS The findings suggest that VEGF expression is increased in gingiva in experimentally induced diabetes. After VEGFR2 activation, the mast cell-derived vasodilatory and inflammatory mediators may contribute markedly to the concomitant changes in the microcirculation.
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Affiliation(s)
- Milán Gyurkovics
- Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University, Budapest, Hungary.,Department of Preventive, Restorative, and Pediatric Dentistry; School of Dental Medicine; University of Bern; Bern, Switzerland
| | - Izabella Nagy
- Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Csaba Bodor
- Paediatrics and Nephrology Research Group of the Hungarian Academy of Sciences and Semmelweis University, Institute of Pathophysiology, Faculty of Medicine, Semmelweis University
| | - Andrea D Székely
- Department of Anatomy, Histology, and Embryology; Faculty of Medicine; Semmelweis University
| | - Elek Dinya
- Institute of Health Informatics Development and Further Training, Faculty of Medicine, Semmelweis University
| | - László Rosivall
- Paediatrics and Nephrology Research Group of the Hungarian Academy of Sciences and Semmelweis University, Institute of Pathophysiology, Faculty of Medicine, Semmelweis University
| | - Zsolt Lohinai
- Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
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Szabó E, Csáki Á, Boldogkői Z, Tóth Z, Köves K. Identification of autonomic neuronal chains innervating gingiva and lip. Auton Neurosci 2015; 190:10-9. [PMID: 25854799 DOI: 10.1016/j.autneu.2015.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 03/20/2015] [Accepted: 03/23/2015] [Indexed: 11/26/2022]
Abstract
The major goals of this present study were 1) to further clarify which parasympathetic ganglion sends postganglionic fibers to the lower gingiva and lip that may be involved in the inflammatory processes besides the local factors; 2) to separately examine the central pathways regulating sympathetic and parasympathetic innervation; and 3) to examine the distribution of central premotor neurons on both sides. A retrogradely transported green fluorescent protein conjugated pseudorabies virus was injected into the lower gingiva and lip of intact and sympathectomized adult female rats. Some animals received virus in the adrenal medulla which receive only preganglionic sympathetic fibers to separately clarify the sympathetic nature of premotor neurons. After 72-120h of survival and perfusion, the corresponding thoracic part of the spinal cord, brainstem, hypothalamus, cervical, otic, submandibular and trigeminal ganglia were harvested. Frozen sections were investigated under a confocal microscope. Green fluorescence indicated the presence of the virus. The postganglionic sympathetic neurons related to both organs are located in the three cervical ganglia, the preganglionic neurons in the lateral horn of the spinal cord on ipsilateral side; premotor neurons were found in the ventrolateral medulla, locus ceruleus, gigantocellular and paraventricular nucleus and perifornical region in nearly the same number on both sides. The parasympathetic postganglionic neurons related to the gingiva are present in the otic and related to the lip are present in the otic and submandibular ganglia and the preganglionic neurons are in the salivatory nuclei. Third order neurons were found in the gigantocellular reticular and hypothalamic paraventricular nuclei and perifornical area.
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Affiliation(s)
- E Szabó
- Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University, Hungary
| | - Á Csáki
- Department of Human Morphology and Developmental Biology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Zs Boldogkői
- Department of Medical Biology, Faculty of Medicine, University of Szeged, Hungary
| | - Zs Tóth
- Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University, Hungary
| | - K Köves
- Department of Human Morphology and Developmental Biology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
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Dahrouj M, Alsarraf O, McMillin JC, Liu Y, Crosson CE, Ablonczy Z. Vascular endothelial growth factor modulates the function of the retinal pigment epithelium in vivo. Invest Ophthalmol Vis Sci 2014; 55:2269-75. [PMID: 24550368 DOI: 10.1167/iovs.13-13334] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Retinal edema, the accumulation of extracellular fluid in the retina is usually attributed to inner blood retina barrier (BRB) leakage. Vascular endothelial growth factor plays an important role in this process. The effects of VEGF on the outer BRB, the RPE, however, have received limited attention. Here, we present a methodology to assess how VEGF modulates the integrity of the RPE barrier in vivo. METHODS Control subretinal blebs (1-5 μL) and blebs containing VEGF (1-100 μg/mL), placental growth factor (PlGF; 100 μg/mL), or albumin (100-1000 μg/mL) were injected into New Zealand White or Dutch Belted rabbits with IOP maintained at 10, 15, or 20 mm Hg. One-hour intravitreal pretreatment with ZM323881 (10 μM/L) was used to inhibit the VEGF response. Fluid resorption was followed by optical coherence tomography for 1 hour. Retinal pigment epithelium leakage was assessed by fluorescein angiography. RESULTS Increasing IOP resulted in an elevated rate of bleb resorption, while increasing albumin concentration in the bleb decreased the rate of resorption. Vascular endothelial growth factor, but not PlGF, caused a significant, concentration-dependent decrease in the rate of fluid resorption, which was reversed by ZM323881. Compared with albumin-filled blebs, VEGF-filled blebs showed accelerated early-phase leakage from the choroid. CONCLUSIONS Consistent with a localized modulation of RPE function, VEGF induced a significant reduction in fluid resorption and an increase in hydraulic conductivity. Our results establish VEGF as a major cytokine regulating RPE barrier properties in vivo and indicate that the RPE is a principal factor in the pathogenesis of retinal edema.
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Affiliation(s)
- Mohammad Dahrouj
- Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, United States
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Gyurkovics M, Lohinai Z, Győrfi A, Bodor C, Székely AD, Dinya E, Rosivall L. Microvascular regulatory role and increased expression of vascular endothelial growth factor receptor type 2 in experimental gingivitis. J Periodontal Res 2012; 48:194-202. [DOI: 10.1111/j.1600-0765.2012.01520.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2012] [Indexed: 11/29/2022]
Affiliation(s)
- M. Gyurkovics
- Department of Conservative Dentistry, Faculty of Dentistry; Semmelweis University; Budapest; Hungary
| | - Z. Lohinai
- Department of Conservative Dentistry, Faculty of Dentistry; Semmelweis University; Budapest; Hungary
| | - A. Győrfi
- Department of Conservative Dentistry, Faculty of Dentistry; Semmelweis University; Budapest; Hungary
| | - C. Bodor
- Institute of Pathophysiology, Faculty of Medicine; Hungarian Academy of Sciences and Semmelweis University Research Group for Pediatrics and Nephrology, Semmelweis University; Budapest; Hungary
| | - A. D. Székely
- Department of Anatomy, Faculty of Medicine, Histology and Embryology; Semmelweis University; Budapest; Hungary
| | - E. Dinya
- Institute of Health Informatics, Faculty of Medicine; Semmelweis University; Budapest; Hungary
| | - L. Rosivall
- Institute of Pathophysiology, Faculty of Medicine; Hungarian Academy of Sciences and Semmelweis University Research Group for Pediatrics and Nephrology, Semmelweis University; Budapest; Hungary
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Neurogenic and Endothelial Nitric Oxide Regulates Blood Circulation in Lingual and Other Oral Tissues. J Cardiovasc Pharmacol 2012; 60:100-8. [DOI: 10.1097/fjc.0b013e318252452a] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Hamedian AA, Esteghamati A, Noshad S, Mozafari M, Moin-Tavakkoli H, Nakhjavani M, Mahmoudi T, Nikzamir M, Safary R, Nikzamir A. Vascular endothelial growth factor (VEGF) +405 C/G polymorphism is associated with essential hypertension in a population from Tehran of Iran. Mol Biol Rep 2011; 39:6213-8. [PMID: 22209952 DOI: 10.1007/s11033-011-1440-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Accepted: 12/26/2011] [Indexed: 01/25/2023]
Abstract
Vascular endothelial growth factor (VEGF) has long been recognized as a hypotensive mediator. Little is known regarding the contribution of polymorphisms in VEGF gene to essential hypertension (EH), however. We aimed to investigate the association between +405 VEGF C/G single nucleotide polymorphism (SNP) and occurrence of EH in a sample of patients with diabetes. A study population of 474 subjects with diabetes of which 45.6% (216) had EH was enrolled in this study. Interviews and physical examinations were performed in a clinical setting. Subjects were matched in baseline anthropometric and biochemical characteristics except for total cholesterol. Genotyping of +405 VEGF C/G (rs2010963) SNP was carried out using polymerase chain reaction-restriction fragment length polymorphism. The allelic distribution of the sample did not violate Hardy-Weinberg equilibrium. Subjects with EH had a higher frequency of G allele (P = 0.005). Additionally, those with EH had a significantly higher frequency of GG genotype (P = 0.015). In multivariate logistic regression models controlling for possible confounders, having GG against CC genotype was associated with an odds ratio of 2.51 (95% CI: 1.44-4.38; P = 0.001). Moreover, presence of each G allele was linked to a 1.58-fold increase in risk of having EH (95% CI: 1.200-2.086; P = 0.001). In conclusion, +405 VEGF C/G SNP is associated with EH in patients with diabetes, suggesting presence of G allele and GG or CG genotype confer susceptibility towards EH.
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Affiliation(s)
- Amir Abbas Hamedian
- Health Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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