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Machado FJDM, Marta-Enguita J, Gómez SU, Rodriguez JA, Páramo-Fernández JA, Herrera M, Zandio B, Aymerich N, Muñoz R, Bermejo R, Marta-Moreno J, López B, González A, Roncal C, Orbe J. Transcriptomic Analysis of Extracellular Vesicles in the Search for Novel Plasma and Thrombus Biomarkers of Ischemic Stroke Etiologies. Int J Mol Sci 2024; 25:4379. [PMID: 38673963 PMCID: PMC11050408 DOI: 10.3390/ijms25084379] [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: 03/18/2024] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Accurate etiologic diagnosis provides an appropriate secondary prevention and better prognosis in ischemic stroke (IS) patients; still, 45% of IS are cryptogenic, urging us to enhance diagnostic precision. We have studied the transcriptomic content of plasma extracellular vesicles (EVs) (n = 21) to identify potential biomarkers of IS etiologies. The proteins encoded by the selected genes were measured in the sera of IS patients (n = 114) and in hypertensive patients with (n = 78) and without atrial fibrillation (AF) (n = 20). IGFBP-2, the most promising candidate, was studied using immunohistochemistry in the IS thrombi (n = 23) and atrium of AF patients (n = 13). In vitro, the IGFBP-2 blockade was analyzed using thromboelastometry and endothelial cell cultures. We identified 745 differentially expressed genes among EVs of cardioembolic, atherothrombotic, and ESUS groups. From these, IGFBP-2 (cutoff > 247.6 ng/mL) emerged as a potential circulating biomarker of embolic IS [OR = 8.70 (1.84-41.13) p = 0.003], which was increased in patients with AF vs. controls (p < 0.001) and was augmented in cardioembolic vs. atherothrombotic thrombi (p < 0.01). Ex vivo, the blockage of IGFBP-2 reduced clot firmness (p < 0.01) and lysis time (p < 0.001) and in vitro, diminished endothelial permeability (p < 0.05) and transmigration (p = 0.06). IGFBP-2 could be a biomarker of embolic IS and a new therapeutic target involved in clot formation and endothelial dysfunction.
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Affiliation(s)
- Florencio J. D. M. Machado
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
| | - Juan Marta-Enguita
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
| | - Susan U. Gómez
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
| | - Jose A. Rodriguez
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - José Antonio Páramo-Fernández
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Hematology Department, Clinica Universidad de Navarra, 31008 Pamplona, Spain
| | - María Herrera
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
- Neurology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Beatriz Zandio
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
- Neurology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Nuria Aymerich
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
- Neurology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Roberto Muñoz
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
- Neurology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Rebeca Bermejo
- Neurointervencionist Radiology, Hospital Universitario de Navarra, 31008 Pamplona, Spain;
| | - Javier Marta-Moreno
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
- Neurology Department, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS-Aragon), 50009 Zaragoza, Spain
| | - Begoña López
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Cardiovascular Diseases Program, Cima Universidad de Navarra, 31008 Pamplona, Spain
| | - Arantxa González
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Cardiovascular Diseases Program, Cima Universidad de Navarra, 31008 Pamplona, Spain
- Department of Pathology, Anatomy and Physiology, Universidad de Navarra, 31008 Pamplona, Spain
| | - Carmen Roncal
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Josune Orbe
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
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Beetler DJ, Di Florio DN, Bruno KA, Ikezu T, March KL, Cooper LT, Wolfram J, Fairweather D. Extracellular vesicles as personalized medicine. Mol Aspects Med 2023; 91:101155. [PMID: 36456416 PMCID: PMC10073244 DOI: 10.1016/j.mam.2022.101155] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/14/2022] [Accepted: 10/26/2022] [Indexed: 11/29/2022]
Abstract
Extracellular vesicles (EVs) are released from all cells in the body, forming an important intercellular communication network that contributes to health and disease. The contents of EVs are cell source-specific, inducing distinct signaling responses in recipient cells. The specificity of EVs and their accumulation in fluid spaces that are accessible for liquid biopsies make them highly attractive as potential biomarkers and therapies for disease. The duality of EVs as favorable (therapeutic) or unfavorable (pathological) messengers is context dependent and remains to be fully determined in homeostasis and various disease states. This review describes the use of EVs as biomarkers, drug delivery vehicles, and regenerative therapeutics, highlighting examples involving viral infections, cancer, and neurological diseases. There is growing interest to provide personalized therapy based on individual patient and disease characteristics. Increasing evidence suggests that EV biomarkers and therapeutic approaches are ideal for personalized medicine due to the diversity and multifunctionality of EVs.
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Affiliation(s)
- Danielle J Beetler
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, 55902, USA; Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Damian N Di Florio
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, 55902, USA; Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Katelyn A Bruno
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, 32224, USA; Center for Regenerative Medicine, University of Florida, Gainesville, FL, 32611, USA; Division of Cardiology, University of Florida, Gainesville, FL, 32611, USA
| | - Tsuneya Ikezu
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Keith L March
- Center for Regenerative Medicine, University of Florida, Gainesville, FL, 32611, USA; Division of Cardiology, University of Florida, Gainesville, FL, 32611, USA
| | - Leslie T Cooper
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Joy Wolfram
- School of Chemical Engineering, The University of Queensland, Brisbane, QLD, 4072, Australia; Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - DeLisa Fairweather
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, 55902, USA; Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, 32224, USA; Department of Environmental Health Sciences and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
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He Y, Wu Q. The Effect of Extracellular Vesicles on Thrombosis. J Cardiovasc Transl Res 2022:10.1007/s12265-022-10342-w. [DOI: 10.1007/s12265-022-10342-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/17/2022] [Indexed: 11/29/2022]
Abstract
Abstract
The risk of cardiovascular events caused by acute thrombosis is high, including acute myocardial infarction, acute stroke, acute pulmonary embolism, and deep vein thrombosis. In this review, we summarize the roles of extracellular vesicles of different cellular origins in various cardiovascular events associated with acute thrombosis, as described in the current literature, to facilitate the future development of a precise therapy for thrombosis caused by such vesicles. We hope that our review will indicate a new horizon in the field of cardiovascular research with regard to the treatment of acute thrombosis, especially targeting thrombosis caused by extracellular vesicles secreted by individual cells. As more emerging technologies are being developed, new diagnostic and therapeutic strategies related to EVs are expected to be identified for related diseases in the future.
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The Role of Extracellular Vesicles in Ischemic Stroke Severity. BIOLOGY 2022; 11:biology11101489. [PMID: 36290393 PMCID: PMC9598264 DOI: 10.3390/biology11101489] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/29/2022] [Accepted: 10/06/2022] [Indexed: 11/13/2022]
Abstract
The possibility of characterizing the extracellular vesicles (EVs) based on parental cell surface markers and their content makes them a new attractive prognostic biomarker. Thus, our study aims to verify the role of EVs as relevant prognostic factors for acute and mid-term outcomes in ischemic stroke. Forty-seven patients with acute ischemic stroke were evaluated at admission (T0), immediately after recanalization treatment or after 2 h in non-treated patients (T1) and after one week (Tw) using the National Institutes of Health Stroke Scale (NIHSS), and after 3 months using the Modified Rankin Scale (mRS). Total count and characterization of EVs were assessed by Nanosight analysis and flow cytometry. The relationships between stroke outcomes and EV count were assessed through multivariable negative binomial regression models. We found that the amount of platelet-derived EVs at admission was positively associated with the severity of ischemic stroke at the onset as well as with the severity of mid-term outcome. Moreover, our study revealed that T-cell-derived EVs at admission were positively related to both early and mid-term ischemic stroke outcomes. Finally, T-cell-derived EVs at T1 were positively related to mid-term ischemic stroke outcome. The present study suggests that specific EV subtypes are associated with stroke severity and both short- and long-term outcomes. EVs could represent a valid tool to improve risk stratification in patients with ischemic stroke and post-recanalization treatment monitoring.
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Neurovascular Unit-Derived Extracellular Vesicles: From Their Physiopathological Roles to Their Clinical Applications in Acute Brain Injuries. Biomedicines 2022; 10:biomedicines10092147. [PMID: 36140248 PMCID: PMC9495841 DOI: 10.3390/biomedicines10092147] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/26/2022] [Accepted: 08/28/2022] [Indexed: 11/16/2022] Open
Abstract
Extracellular vesicles (EVs) form a heterogeneous group of membrane-enclosed structures secreted by all cell types. EVs export encapsulated materials composed of proteins, lipids, and nucleic acids, making them a key mediator in cell–cell communication. In the context of the neurovascular unit (NVU), a tightly interacting multicellular brain complex, EVs play a role in intercellular communication and in maintaining NVU functionality. In addition, NVU-derived EVs can also impact peripheral tissues by crossing the blood–brain barrier (BBB) to reach the blood stream. As such, EVs have been shown to be involved in the physiopathology of numerous neurological diseases. The presence of NVU-released EVs in the systemic circulation offers an opportunity to discover new diagnostic and prognostic markers for those diseases. This review outlines the most recent studies reporting the role of NVU-derived EVs in physiological and pathological mechanisms of the NVU, focusing on neuroinflammation and neurodegenerative diseases. Then, the clinical application of EVs-containing molecules as biomarkers in acute brain injuries, such as stroke and traumatic brain injuries (TBI), is discussed.
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Mechanisms and Biomarker Potential of Extracellular Vesicles in Stroke. BIOLOGY 2022; 11:biology11081231. [PMID: 36009857 PMCID: PMC9405035 DOI: 10.3390/biology11081231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/29/2022] [Accepted: 08/12/2022] [Indexed: 12/11/2022]
Abstract
Simple Summary A stroke occurs when there is a lack of blood flow to the brain. Stroke injures the brain and can have devastating outcomes depending on the size and location of the brain tissue affected. Currently, there are only a limited number of treatment options for stroke. Extracellular vesicles are small vesicles secreted by cells. Importantly, extracellular vesicles have specific markers indicating the cell they were released from and can pass from the brain into the blood. For these reasons, assessing extracellular vesicles in the blood may create a window into changes occurring in the brain. Assessing changes in extracellular vesicles in the blood during stroke may produce new insight into the cellular changes in the brain causing injury during stroke. This in turn may generate potential targets for the development of future treatments. We summarize what is known about changes in brain-cell-specific extracellular vesicles during stroke and stress the importance of continuing to study these changes. Abstract Stoke is a prevalent and devastating neurologic condition with limited options for therapeutic management. Since brain tissue is rarely accessible clinically, peripheral biomarkers for the central nervous system’s (CNS’s) cellular response to stroke may prove critical for increasing our understanding of stroke pathology and elucidating novel therapeutic targets. Extracellular vesicles (EVs) are cell-derived, membrane-enclosed vesicles secreted by all cell types within the CNS that can freely pass the blood-brain barrier (BBB) and contain unique markers and content linked to their cell of origin. These unique qualities make brain-derived EVs novel candidates for non-invasive blood-based biomarkers of both cell specificity and cell physiological state during the progression of stroke and recovery. While studies are continuously emerging that are assessing the therapeutic potential of EVs and profiling EV cargo, a vast minority of these studies link EV content to specific cell types. A better understanding of cell-specific EV release during the acute, subacute, and chronic stages of stroke is needed to further elucidate the cellular processes responsible for stroke pathophysiology. Herein, we outline what is known about EV release from distinct cell types of the CNS during stroke and the potential of these EVs as peripheral biomarkers for cellular function in the CNS during stroke.
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Burrello J, Burrello A, Vacchi E, Bianco G, Caporali E, Amongero M, Airale L, Bolis S, Vassalli G, Cereda CW, Mulatero P, Bussolati B, Camici GG, Melli G, Monticone S, Barile L. Supervised and unsupervised learning to define the cardiovascular risk of patients according to an extracellular vesicle molecular signature. Transl Res 2022; 244:114-125. [PMID: 35202881 DOI: 10.1016/j.trsl.2022.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 12/21/2022]
Abstract
Cardiovascular (CV) disease represents the most common cause of death in developed countries. Risk assessment is highly relevant to intervene at individual level and implement prevention strategies. Circulating extracellular vesicles (EVs) are involved in the development and progression of CV diseases and are considered promising biomarkers. We aimed at identifying an EV signature to improve the stratification of patients according to CV risk and likelihood to develop fatal CV events. EVs were characterized by nanoparticle tracking analysis and flow cytometry for a standardized panel of 37 surface antigens in a cross-sectional multicenter cohort (n = 486). CV profile was defined by presence of different indicators (age, sex, body mass index, hypertension, hyperlipidemia, diabetes, coronary artery disease, cardiac heart failure, chronic kidney disease, smoking habit, organ damage) and according to the 10-year risk of fatal CV events estimated using SCORE charts of European Society of Cardiology. By combining expression levels of EV antigens using unsupervised learning, patients were classified into 3 clusters: Cluster-I (n = 288), Cluster-II (n = 83), Cluster-III (n = 30). A separate analysis was conducted on patients displaying acute CV events (n = 82). Prevalence of hypertension, diabetes, chronic heart failure, and organ damage (defined as left ventricular hypertrophy and/or microalbuminuria) increased progressively from Cluster-I to Cluster-III. Several EV antigens, including markers for platelets (CD41b-CD42a-CD62P), leukocytes (CD1c-CD2-CD3-CD4-CD8-CD14-CD19-CD20-CD25-CD40-CD45-CD69-CD86), and endothelium (CD31-CD105) were independently associated with CV risk indicators and correlated to age, blood pressure, glucometabolic profile, renal function, and SCORE risk. EV profiling, obtained from minimally invasive blood sampling, allows accurate patient stratification according to CV risk profile.
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Affiliation(s)
- Jacopo Burrello
- Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Italy
| | - Alessio Burrello
- Department of Electrical, Electronic and Information Engineering (DEI), University of Bologna, Italy
| | - Elena Vacchi
- Laboratory for Biomedical Neurosciences, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland; Laboratories for Translational Research, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Giovanni Bianco
- Neurology Clinic, Stroke Center, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Elena Caporali
- Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Martina Amongero
- Department of Mathematical Sciences G. L. Lagrange, Polytechnic University of Torino, Italy
| | - Lorenzo Airale
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Italy
| | - Sara Bolis
- Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Giuseppe Vassalli
- Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland; Laboratories for Translational Research, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Carlo W Cereda
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland; Neurology Clinic, Stroke Center, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Paolo Mulatero
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Italy
| | - Benedetta Bussolati
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Italy
| | - Giovanni G Camici
- Center for Molecular Cardiology, University of Zürich, Schlieren, Switzerland
| | - Giorgia Melli
- Laboratory for Biomedical Neurosciences, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland; Laboratories for Translational Research, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Silvia Monticone
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Italy
| | - Lucio Barile
- Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland; Laboratories for Translational Research, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Institute of Life Science, Scuola Superiore Sant'Anna, Pisa, Italy.
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Wang Y, Chen W, Zhou J, Wang Y, Wang H, Wang Y. Nitrate Metabolism and Ischemic Cerebrovascular Disease: A Narrative Review. Front Neurol 2022; 13:735181. [PMID: 35309590 PMCID: PMC8927699 DOI: 10.3389/fneur.2022.735181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 01/04/2022] [Indexed: 11/23/2022] Open
Abstract
Inorganic and organic nitrates are present in vivo and in vitro. Inorganic nitrate is considered a pool of nitric oxide (NO), but it can be converted into nitrite and NO through various mechanisms. It plays an important role in the regulation of complex physiological and biochemical reactions, such as anti-inflammatory processes and the inhibition of platelet aggregation, which are closely related to the pathology and treatment of cerebrovascular disease. Ischemic cerebrovascular disease is characterized by high incidence, recurrence, and disability rates. Nitrate, nitrite, and NO were recently found to be involved in cerebrovascular disease. In this review, we describe the relationship between cerebrovascular disease and nitrate metabolism to provide a basis for further advances in laboratory and clinical medicine.
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Affiliation(s)
- Yicong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Laboratory for Oral and General Health Integration and Translation, Beijing, China
| | - Weiqi Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Laboratory for Oral and General Health Integration and Translation, Beijing, China
| | - Jian Zhou
- Laboratory for Oral and General Health Integration and Translation, Beijing, China
- School of Stomatology, Capital Medical University, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Hao Wang
- Laboratory for Oral and General Health Integration and Translation, Beijing, China
- Department of Stomatology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Hao Wang
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Laboratory for Oral and General Health Integration and Translation, Beijing, China
- Yilong Wang
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Khan A, Parray A, Akhtar N, Agouni A, Kamran S, Pananchikkal SV, Priyanka R, Gad H, Ponirakis G, Petropoulos IN, Chen KH, Tayyab K, Saqqur M, Shuaib A, Malik RA. Corneal nerve loss in patients with TIA and acute ischemic stroke in relation to circulating markers of inflammation and vascular integrity. Sci Rep 2022; 12:3332. [PMID: 35228650 PMCID: PMC8885663 DOI: 10.1038/s41598-022-07353-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 02/14/2022] [Indexed: 12/01/2022] Open
Abstract
Vascular and inflammatory mechanisms are implicated in the development of cerebrovascular disease and corneal nerve loss occurs in patients with transient ischemic attack (TIA) and acute ischemic stroke (AIS). We have assessed whether serum markers of inflammation and vascular integrity are associated with the severity of corneal nerve loss in patients with TIA and AIS. Corneal confocal microscopy (CCM) was performed to quantify corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD) and corneal nerve fiber length (CNFL) in 105 patients with TIA (n = 24) or AIS (n = 81) and age matched control subjects (n = 56). Circulating levels of IL-6, MMP-2, MMP-9, E-Selectin, P-Selectin and VEGF were quantified in patients within 48 h of presentation with a TIA or AIS. CNFL (P = 0.000, P = 0.000), CNFD (P = 0.122, P = 0.000) and CNBD (P = 0.002, P = 0.000) were reduced in patients with TIA and AIS compared to controls, respectively with no difference between patients with AIS and TIA. The NIHSS Score (P = 0.000), IL-6 (P = 0.011) and E-Selectin (P = 0.032) were higher in patients with AIS compared to TIA with no difference in MMP-2 (P = 0.636), MMP-9 (P = 0.098), P-Selectin (P = 0.395) and VEGF (P = 0.831). CNFL (r = 0.218, P = 0.026) and CNFD (r = 0.230, P = 0.019) correlated with IL-6 and multiple regression analysis showed a positive association of CNFL and CNFD with IL-6 (P = 0.041, P = 0.043). Patients with TIA and AIS have evidence of corneal nerve loss and elevated IL6 and E-selectin levels. Larger longitudinal studies are required to determine the association between inflammatory and vascular markers and corneal nerve fiber loss in patients with cerebrovascular disease.
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Affiliation(s)
- Adnan Khan
- Department of Medicine, Research Division, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Aijaz Parray
- Department of Neurology and Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar
| | - Naveed Akhtar
- Department of Neurology and Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar
| | - Abdelali Agouni
- Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Saadat Kamran
- Department of Neurology and Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar
| | - Sajitha V Pananchikkal
- Department of Neurology and Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar
| | - Ruth Priyanka
- Department of Neurology and Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar
| | - Hoda Gad
- Department of Medicine, Research Division, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Georgios Ponirakis
- Department of Medicine, Research Division, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Ioannis N Petropoulos
- Department of Medicine, Research Division, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Kuan-Han Chen
- Department of Medicine, Research Division, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Kausar Tayyab
- Department of Medicine, Research Division, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Maher Saqqur
- Department of Neurology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Ashfaq Shuaib
- Stroke Program, Department of Neurology, University of Alberta, Alberta, Canada
| | - Rayaz A Malik
- Department of Medicine, Research Division, Weill Cornell Medicine-Qatar, Doha, Qatar.
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10
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Yates AG, Pink RC, Erdbrügger U, Siljander PR, Dellar ER, Pantazi P, Akbar N, Cooke WR, Vatish M, Dias‐Neto E, Anthony DC, Couch Y. In sickness and in health: The functional role of extracellular vesicles in physiology and pathology in vivo: Part II: Pathology: Part II: Pathology. J Extracell Vesicles 2022; 11:e12190. [PMID: 35041301 PMCID: PMC8765328 DOI: 10.1002/jev2.12190] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/03/2021] [Accepted: 09/15/2021] [Indexed: 02/06/2023] Open
Abstract
It is clear from Part I of this series that extracellular vesicles (EVs) play a critical role in maintaining the homeostasis of most, if not all, normal physiological systems. However, the majority of our knowledge about EV signalling has come from studying them in disease. Indeed, EVs have consistently been associated with propagating disease pathophysiology. The analysis of EVs in biofluids, obtained in the clinic, has been an essential of the work to improve our understanding of their role in disease. However, to interfere with EV signalling for therapeutic gain, a more fundamental understanding of the mechanisms by which they contribute to pathogenic processes is required. Only by discovering how the EV populations in different biofluids change-size, number, and physicochemical composition-in clinical samples, may we then begin to unravel their functional roles in translational models in vitro and in vivo, which can then feedback to the clinic. In Part II of this review series, the functional role of EVs in pathology and disease will be discussed, with a focus on in vivo evidence and their potential to be used as both biomarkers and points of therapeutic intervention.
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Affiliation(s)
- Abi G. Yates
- Department of PharmacologyUniversity of OxfordOxfordUK
- School of Biomedical SciencesFaculty of MedicineUniversity of QueenslandSt LuciaAustralia
| | - Ryan C. Pink
- Department of Biological and Medical SciencesFaculty of Health and Life SciencesOxford Brookes UniversityOxfordUK
| | - Uta Erdbrügger
- Department of Medicine, Division of NephrologyUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Pia R‐M. Siljander
- Molecular and Integrative Biosciences Research ProgrammeFaculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
| | - Elizabeth R. Dellar
- Department of Biological and Medical SciencesFaculty of Health and Life SciencesOxford Brookes UniversityOxfordUK
| | - Paschalia Pantazi
- Department of Biological and Medical SciencesFaculty of Health and Life SciencesOxford Brookes UniversityOxfordUK
| | - Naveed Akbar
- Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUK
| | - William R. Cooke
- Nuffield Department of Women's and Reproductive HealthJohn Radcliffe Hospital, HeadingtonOxfordUK
| | - Manu Vatish
- Nuffield Department of Women's and Reproductive HealthJohn Radcliffe Hospital, HeadingtonOxfordUK
| | - Emmanuel Dias‐Neto
- Laboratory of Medical Genomics. A.C. Camargo Cancer CentreSão PauloBrazil
- Laboratory of Neurosciences (LIM‐27) Institute of PsychiatrySão Paulo Medical SchoolSão PauloBrazil
| | | | - Yvonne Couch
- Acute Stroke Programme ‐ Radcliffe Department of MedicineUniversity of OxfordOxfordUK
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11
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Burrello J, Bianco G, Burrello A, Manno C, Maulucci F, Pileggi M, Nannoni S, Michel P, Bolis S, Melli G, Vassalli G, Albers GW, Cianfoni A, Barile L, Cereda CW. Extracellular Vesicle Surface Markers as a Diagnostic Tool in Transient Ischemic Attacks. Stroke 2021; 52:3335-3347. [PMID: 34344167 DOI: 10.1161/strokeaha.120.033170] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND PURPOSE Extracellular vesicles (EVs) are promising biomarkers for cerebral ischemic diseases, but not systematically tested in patients with transient ischemic attacks (TIAs). We aimed at (1) investigating the profile of EV-surface antigens in patients with symptoms suspicious for TIA; (2) developing and validating a predictive model for TIA diagnosis based on a specific EV-surface antigen profile. METHODS We analyzed 40 subjects with symptoms suspicious for TIA and 20 healthy controls from a training cohort. An independent cohort of 28 subjects served as external validation. Patients were stratified according to likelihood of having a real ischemic event using the Precise Diagnostic Score, defined as: unlikely (score 0-1), possible-probable (score 2-3), or very likely (score 4-8). Serum vesicles were quantified by nanoparticle tracking analysis and EV-surface antigen profile characterized by multiplex flow cytometry. RESULTS EV concentration increased in patients with very likely or possible-probable TIA (P<0.05) compared with controls. Nanoparticle concentration was directly correlated with the Precise Diagnostic score (R=0.712; P<0.001). After EV immuno-capturing, CD8, CD2, CD62P, melanoma-associated chondroitin sulfate proteoglycan, CD42a, CD44, CD326, CD142, CD31, and CD14 were identified as discriminants between groups. Receiver operating characteristic curve analysis confirmed a reliable diagnostic performance for each of these markers taken individually and for a compound marker derived from their linear combinations (area under the curve, 0.851). Finally, a random forest model combining the expression levels of selected markers achieved an accuracy of 96% and 78.9% for discriminating patients with a very likely TIA, in the training and external validation cohort, respectively. CONCLUSIONS The EV-surface antigen profile appears to be different in patients with transient symptoms adjudicated to be very likely caused by brain ischemia compared with patients whose symptoms were less likely to due to brain ischemia. We propose an algorithm based on an EV-surface-antigen specific signature that might aid in the recognition of TIA.
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Affiliation(s)
- Jacopo Burrello
- Cellular and Molecular Cardiology Laboratory, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland (J.B., G.V.)
| | - Giovanni Bianco
- Neurology Clinic, Stroke Center, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano (G.B., C.M., F.M., G.M., C.W.C.)
| | - Alessio Burrello
- Department of Electrical, Electronic and Information Engineering (DEI), University of Bologna, Italy (A.B.)
| | - Concetta Manno
- Neurology Clinic, Stroke Center, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano (G.B., C.M., F.M., G.M., C.W.C.)
| | - Francesco Maulucci
- Neurology Clinic, Stroke Center, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano (G.B., C.M., F.M., G.M., C.W.C.)
| | - Marco Pileggi
- Department of Neuroradiology, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano (M.P., A.C.)
| | - Stefania Nannoni
- Stroke Center, Neurology Service, Lausanne University Hospital, Switzerland (S.N., P.M., C.W.C.)
| | - Patrik Michel
- Stroke Center, Neurology Service, Lausanne University Hospital, Switzerland (S.N., P.M., C.W.C.)
| | - Sara Bolis
- Laboratory for Cardiovascular Theranostics, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland (S.B., L.B.)
| | - Giorgia Melli
- Neurology Clinic, Stroke Center, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano (G.B., C.M., F.M., G.M., C.W.C.).,Faculty of Biomedical Sciences, Università Svizzera italiana, Lugano, Switzerland (G.M., G.V., L.B., C.W.C)
| | - Giuseppe Vassalli
- Cellular and Molecular Cardiology Laboratory, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland (J.B., G.V.).,Faculty of Biomedical Sciences, Università Svizzera italiana, Lugano, Switzerland (G.M., G.V., L.B., C.W.C)
| | - Gregory W Albers
- Department of Neurology & Neurologic Sciences, Stanford University, Stanford Stroke Center (G.W.A.)
| | - Alessandro Cianfoni
- Department of Neuroradiology, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano (M.P., A.C.)
| | - Lucio Barile
- Laboratory for Cardiovascular Theranostics, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland (S.B., L.B.).,Faculty of Biomedical Sciences, Università Svizzera italiana, Lugano, Switzerland (G.M., G.V., L.B., C.W.C)
| | - Carlo W Cereda
- Neurology Clinic, Stroke Center, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano (G.B., C.M., F.M., G.M., C.W.C.).,Stroke Center, Neurology Service, Lausanne University Hospital, Switzerland (S.N., P.M., C.W.C.).,Faculty of Biomedical Sciences, Università Svizzera italiana, Lugano, Switzerland (G.M., G.V., L.B., C.W.C)
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12
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Yuan F, Li YM, Wang Z. Preserving extracellular vesicles for biomedical applications: consideration of storage stability before and after isolation. Drug Deliv 2021; 28:1501-1509. [PMID: 34259095 PMCID: PMC8281093 DOI: 10.1080/10717544.2021.1951896] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Extracellular vesicles (EVs) are nanovesicles released by various cell types. EVs are known for cell-to-cell communications and have potent biological activities. Despite great progress in recent years for studies exploring the potentials of EVs for early disease detection, therapeutic application and drug delivery, determination of the favorable storage conditions of EVs has been challenging. The understanding of the impact of storage conditions on EVs before and after isolation is still limited. Storage may change the size, number, contents, functions, and behaviors of EVs. Here, we summarized current studies about the stability of EVs in different conditions, focusing on temperatures, durations, and freezing and thawing cycles. -80 °C seems to remain the most favorable condition for storage of biofluids and isolated EVs, while isolated EVs may be stored at 4 °C shortly. Lyophilization is promising for storage of EV products. Challenges remain in the understanding of storage-mediated change in EVs and in the development of advanced preservation techniques of EVs.
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Affiliation(s)
- Fumin Yuan
- Department of Clinical Medicine, Grade 2018, Xiangya School of Medicine of Central South University, Changsha, China
| | - Ya-Min Li
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhuhui Wang
- Hunan Testing Institute for Medical Devices, Changsha, China
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13
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Lugo-Gavidia LM, Burger D, Matthews VB, Nolde JM, Galindo Kiuchi M, Carnagarin R, Kannenkeril D, Chan J, Joyson A, Herat LY, Azzam O, Schlaich MP. Role of Microparticles in Cardiovascular Disease: Implications for Endothelial Dysfunction, Thrombosis, and Inflammation. HYPERTENSION (DALLAS, TEX. : 1979) 2021; 77:1825-1844. [PMID: 33979187 DOI: 10.1161/hypertensionaha.121.16975] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Leslie Marisol Lugo-Gavidia
- Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, Medical Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia (L.M.L.-G., V.B.M., J.M.N., M.G.K., R.C., D.K., J.C., A.J., L.Y.H., O.A., M.P.S.)
| | - Dylan Burger
- Kidney Research Centre, The Ottawa Hospital Research Institute, Department of Cellular and Molecular Medicine, University of Ottawa (D.B.)
| | - Vance B Matthews
- Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, Medical Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia (L.M.L.-G., V.B.M., J.M.N., M.G.K., R.C., D.K., J.C., A.J., L.Y.H., O.A., M.P.S.)
| | - Janis M Nolde
- Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, Medical Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia (L.M.L.-G., V.B.M., J.M.N., M.G.K., R.C., D.K., J.C., A.J., L.Y.H., O.A., M.P.S.)
| | - Márcio Galindo Kiuchi
- Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, Medical Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia (L.M.L.-G., V.B.M., J.M.N., M.G.K., R.C., D.K., J.C., A.J., L.Y.H., O.A., M.P.S.)
| | - Revathy Carnagarin
- Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, Medical Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia (L.M.L.-G., V.B.M., J.M.N., M.G.K., R.C., D.K., J.C., A.J., L.Y.H., O.A., M.P.S.)
| | - Dennis Kannenkeril
- Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, Medical Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia (L.M.L.-G., V.B.M., J.M.N., M.G.K., R.C., D.K., J.C., A.J., L.Y.H., O.A., M.P.S.).,Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Germany (D.K.)
| | - Justine Chan
- Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, Medical Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia (L.M.L.-G., V.B.M., J.M.N., M.G.K., R.C., D.K., J.C., A.J., L.Y.H., O.A., M.P.S.)
| | - Anu Joyson
- Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, Medical Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia (L.M.L.-G., V.B.M., J.M.N., M.G.K., R.C., D.K., J.C., A.J., L.Y.H., O.A., M.P.S.)
| | - Lakshini Y Herat
- Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, Medical Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia (L.M.L.-G., V.B.M., J.M.N., M.G.K., R.C., D.K., J.C., A.J., L.Y.H., O.A., M.P.S.)
| | - Omar Azzam
- Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, Medical Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia (L.M.L.-G., V.B.M., J.M.N., M.G.K., R.C., D.K., J.C., A.J., L.Y.H., O.A., M.P.S.).,Department of Internal Medicine (O.A.), Royal Perth Hospital, Western Australia
| | - Markus P Schlaich
- Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, Medical Research Foundation, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia (L.M.L.-G., V.B.M., J.M.N., M.G.K., R.C., D.K., J.C., A.J., L.Y.H., O.A., M.P.S.).,Departments of Cardiology and Nephrology (M.P.S.), Royal Perth Hospital, Western Australia.,Neurovascular Hypertension and Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia (M.P.S.)
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14
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Complement Activation on Endothelial Cell-Derived Microparticles-A Key Determinant for Cardiovascular Risk in Patients with Systemic Lupus Erythematosus? ACTA ACUST UNITED AC 2020; 56:medicina56100533. [PMID: 33065972 PMCID: PMC7601222 DOI: 10.3390/medicina56100533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/05/2020] [Accepted: 10/09/2020] [Indexed: 11/17/2022]
Abstract
Systemic lupus erythematosus is a classical systemic autoimmune disease that overactivates complement and can affect all organs. Early diagnosis and effective management are important in this immune-complex-mediated chronic inflammatory disease, which has a strong component of vasculitis and carries an increased risk of thrombosis, even in the absence of antiphospholipid antibodies. Development of lupus nephritis can be life limiting but is managed with dialysis and renal transplantation. Therefore, data have become available that cardiovascular risk poses a serious feature of systemic lupus erythematosus that requires monitoring and prospective treatment. Cell-derived microparticles circulate in plasma and thereby intersect the humoral and cellular component of inflammation. They are involved in disease pathophysiology, particularly thrombosis, and represent a known cardiovascular risk. This viewpoint argues that a focus on characteristics of circulating microparticles measured in patients with systemic lupus erythematosus may help to classify certain ethnic groups who are especially at additional risk of experiencing cardiovascular complications.
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15
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Stenz KT, Just J, Blauenfeldt RA, Drasbek KR. Extracellular Vesicles in Acute Stroke Diagnostics. Biomedicines 2020; 8:biomedicines8080248. [PMID: 32731351 PMCID: PMC7459954 DOI: 10.3390/biomedicines8080248] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/16/2020] [Accepted: 07/20/2020] [Indexed: 12/14/2022] Open
Abstract
There is a large unmet need for fast and reliable diagnostics in several diseases. One such disease is stroke, where the efficacy of modern reperfusion therapies is highly time-dependent. Diagnosis of stroke and treatment initiation should be performed as soon as possible, and preferably before arrival at the stroke center. In recent years, several potential blood biomarkers for stroke have been evaluated, but without success. In this review, we will go into detail on the possibility of utilizing extracellular vesicles (EVs) released into the blood as novel biomarkers for stroke diagnostics. EVs are known to reflect the immediate state of the secreting cells and to be able to cross the blood–brain barrier, thus making them attractive as diagnostic biomarkers of brain diseases. Indeed, several studies have reported EV markers that enable differentiation between stroke patients and controls and, to a lesser extent, the ability to correctly classify the different stroke types. Most of the studies rely on the use of sophisticated and time-consuming methods to quantify specific subpopulations of the nanosized EVs. As these methods cannot be easily implemented in a rapid point of care (POC) test, technical developments followed by prospective clinical studies are needed.
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Affiliation(s)
- Katrine Tang Stenz
- Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, DK-8000 Aarhus, Denmark; (K.T.S.); (J.J.)
- Sino-Danish Center for Education and Research, Beijing 101400, China
- Sino-Danish Center for Education and Research, DK-8000 Aarhus, Denmark
| | - Jesper Just
- Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, DK-8000 Aarhus, Denmark; (K.T.S.); (J.J.)
- Sino-Danish Center for Education and Research, Beijing 101400, China
- Sino-Danish Center for Education and Research, DK-8000 Aarhus, Denmark
| | - Rolf Ankerlund Blauenfeldt
- Department of Neurology, Aarhus University Hospital, DK-8200 Aarhus, Denmark;
- Department of Clinical Medicine, Aarhus University, DK-8200 Aarhus, Denmark
| | - Kim Ryun Drasbek
- Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, DK-8000 Aarhus, Denmark; (K.T.S.); (J.J.)
- Sino-Danish Center for Education and Research, Beijing 101400, China
- Sino-Danish Center for Education and Research, DK-8000 Aarhus, Denmark
- Correspondence: ; Tel.: +45-3027-4779
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16
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Multilevel omics for the discovery of biomarkers and therapeutic targets for stroke. Nat Rev Neurol 2020; 16:247-264. [PMID: 32322099 DOI: 10.1038/s41582-020-0350-6] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2020] [Indexed: 02/07/2023]
Abstract
Despite many years of research, no biomarkers for stroke are available to use in clinical practice. Progress in high-throughput technologies has provided new opportunities to understand the pathophysiology of this complex disease, and these studies have generated large amounts of data and information at different molecular levels. The integration of these multi-omics data means that thousands of proteins (proteomics), genes (genomics), RNAs (transcriptomics) and metabolites (metabolomics) can be studied simultaneously, revealing interaction networks between the molecular levels. Integrated analysis of multi-omics data will provide useful insight into stroke pathogenesis, identification of therapeutic targets and biomarker discovery. In this Review, we detail current knowledge on the pathology of stroke and the current status of biomarker research in stroke. We summarize how proteomics, metabolomics, transcriptomics and genomics are all contributing to the identification of new candidate biomarkers that could be developed and used in clinical stroke management.
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17
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Jallow E, Al Hail H, Han TS, Sharma S, Deleu D, Ali M, Al Hussein H, Abuzaid HO, Sharif K, Khan FY, Sharma P. Current status of stroke in Qatar: Including data from the BRAINS study. JRSM Cardiovasc Dis 2019; 8:2048004019869160. [PMID: 31452875 PMCID: PMC6700866 DOI: 10.1177/2048004019869160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 06/06/2019] [Accepted: 07/18/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Qatar is located on the north-eastern coast of the Arabian Peninsula. Qatari natives account for less than 15% of the population while the largest migrant group comprising 60% derives from South Asia. Despite projections that stroke burden in Qatar will increase with population ageing, epidemiological studies focusing on stroke in Qatar are relatively scarce. METHOD We reviewed the available epidemiological publications relating to Qatar. In addition, we have added to this knowledge by incorporating Qatari data from the on-going Bio-Repository of DNA in Stroke, an independent multinational database of stroke patients. RESULTS Qatar has low reported incidence and mortality rates of 58 and 9.17 per 100,000 per year, respectively, which may be explained by its middle-aged migrant worker majority population. Correspondingly, South Asian migrants in Qatar suffered younger strokes than Qatari natives (48.7 vs 63.4 years, P < 0.001). Among the most common risk factors identified in stroke patients were hypertension (77.9%), diabetes (43.8%) and hypercholesterolemia (28.5%). Ischaemic stroke was the most frequent subtype amongst migrant South Asians (71.1%). The majority of stroke cases had computed tomography and/or magnetic resonance imaging scans, but only 11.1% of ischaemic strokes were thrombolysed. Qataris on one-year follow up were more often found to have died (6.5% vs 0.3%) and had further stroke/transient ischaemic attack events (17.4% vs 6.4%, P = 0.009) compared to South Asians. CONCLUSION The burden of stroke is increasing in Qatar, and considerable disparities are observed between the native and migrant populations which likely will require different approaches to management by its healthcare system.
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Affiliation(s)
- Ebrima Jallow
- Institute of Cardiovascular Research, Royal Holloway University of London , London, UK
| | | | - Thang S Han
- Institute of Cardiovascular Research, Royal Holloway University of London , London, UK
| | - Sapna Sharma
- Institute of Cardiovascular Research, Royal Holloway University of London , London, UK
| | | | - Musab Ali
- Hamad Medical Corporation, Doha, Qatar
| | | | | | | | | | - Pankaj Sharma
- Institute of Cardiovascular Research, Royal Holloway University of London , London, UK
- Ashford & St Peters Hospital NHS Foundation Trust, Surrey, UK
- Imperial College Healthcare NHS Trust, London, UK
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