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Ren B, Tan L, Song Y, Li D, Xue B, Lai X, Gao Y. Cerebral Small Vessel Disease: Neuroimaging Features, Biochemical Markers, Influencing Factors, Pathological Mechanism and Treatment. Front Neurol 2022; 13:843953. [PMID: 35775047 PMCID: PMC9237477 DOI: 10.3389/fneur.2022.843953] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/12/2022] [Indexed: 01/15/2023] Open
Abstract
Cerebral small vessel disease (CSVD) is the most common chronic vascular disease involving the whole brain. Great progress has been made in clinical imaging, pathological mechanism, and treatment of CSVD, but many problems remain. Clarifying the current research dilemmas and future development direction of CSVD can provide new ideas for both basic and clinical research. In this review, the risk factors, biological markers, pathological mechanisms, and the treatment of CSVD will be systematically illustrated to provide the current research status of CSVD. The future development direction of CSVD will be elucidated by summarizing the research difficulties.
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Affiliation(s)
- Beida Ren
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
- Chinese Medicine Key Research Room of Brain Disorders Syndrome and Treatment of the National Administration of Traditonal Chinese Medicine, Beijing, China
| | - Ling Tan
- Department of Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuebo Song
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Danxi Li
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
- Chinese Medicine Key Research Room of Brain Disorders Syndrome and Treatment of the National Administration of Traditonal Chinese Medicine, Beijing, China
| | - Bingjie Xue
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
- Chinese Medicine Key Research Room of Brain Disorders Syndrome and Treatment of the National Administration of Traditonal Chinese Medicine, Beijing, China
| | - Xinxing Lai
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Gao
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
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Wang C, Han S, Tong F, Li Y, Li Z, Sun Z. Predictive Value of the Serum Cystatin C/Prealbumin Ratio in Combination With NT-proBNP Levels for Long-Term Prognosis in Chronic Heart Failure Patients: A Retrospective Cohort Study. Front Cardiovasc Med 2021; 8:684919. [PMID: 34336949 PMCID: PMC8316687 DOI: 10.3389/fcvm.2021.684919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/24/2021] [Indexed: 12/28/2022] Open
Abstract
Aim: The present study was established to investigate the use of the serum cystatin C/prealbumin (Cys-C/PAB) ratio as a predictive factor for long-term prognosis in patients with chronic heart failure. Methods: We divided our retrospective cohort of 6,311 patients admitted to hospital due to an episode of heart failure (HF) into three groups according to the Cys-C/PAB ratio. The endpoints were cardiovascular and all-cause mortality. Median follow-up time were 3.3 years (2–8 years), during which 2,945 (46.7%) patients died. Results: The Cys-C/PAB ratio was revealed to be an independent predictor of cardiovascular mortality (HR: 1.12, 95% CI: 1.15–1.23, P < 0.01) and all-cause mortality (HR: 1.19, 95% CI: 1.13–1.24, P < 0.01) by multivariable Cox analysis. Integrated discrimination improvement (IDI) showed that the Cys-C/PAB ratio in conjunction with the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) conferred a significant improvement in predicting individual risks of cardiovascular (P = 0.023) and all-cause (P = 0.028) mortality. For those with a high Cys-C/PAB ratio in combination with a high NT-proBNP level, the long-term cardiovascular mortality risk ratio was 8.6-times higher than for those with low values, and 7.51-times for all-cause mortality. Our study also showed that Cys-C/PAB and NT-proBNP in combination displayed higher value for the prediction of cardiovascular and all-cause in-hospital mortality in patients with HF. Conclusions: The Cys-C/PAB ratio is valuable for predicting cardiovascular and all-cause mortality in patients with HF and offers additional information to that provided by NT-proBNP.
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Affiliation(s)
- Chuanhe Wang
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Su Han
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fei Tong
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ying Li
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhichao Li
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhijun Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
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Tan Z, Li L, Ma Y, Geng X. Clinical Significance of Cys-C and hs-CRP in Coronary Heart Disease Patients Undergoing Percutaneous Coronary Intervention. Braz J Cardiovasc Surg 2019; 34:17-21. [PMID: 30810669 PMCID: PMC6385828 DOI: 10.21470/1678-9741-2018-0171] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 07/31/2018] [Indexed: 11/16/2022] Open
Abstract
Objective To investigate the clinical significance of serum cystatin C (Cys-C) and
high-sensitivity C-reactive protein (hs-CRP) in coronary heart disease (CHD)
patients undergoing percutaneous coronary intervention (PCI). Methods One hundred and twenty-eight CHD patients were divided into drug treatment
(56 cases) and PCI treatment (72 cases) groups, receiving conventional drug
treatment and PCI plus conventional drug treatment, respectively. At
admission time and 4 weeks after treatment, the left ventricular ejection
fraction (LVEF), left ventricular end diastolic diameter, and left
ventricular end systolic diameter were measured. At admission time and 24h,
72h, 1 week, and 4 weeks after treatment, the serum levels of Cys-C and
hs-CRP were determined. Results After 4 weeks of treatment, LVEF in the PCI treatment group was significantly
higher than that before treatment (P<0.01) and it was
significantly higher than in the drug treatment group at the same time
(P<0.01). Cys-C and hs-CRP level in the PCI
treatment group were significantly higher than in the drug treatment group
72h and 1 week after treatment (P<0.05 or
P<0.01), respectively, but they were significantly
lower than in the drug treatment group 4 weeks after treatment
(P<0.01). There were obvious interaction effects
between grouping factor and time factor in Cys-C (F=3.62,
P<0.05) and hs-CRP (F=17.85,
P<0.01). Conclusion Serum levels of Cys-C and hs-CRP are closely related to the heart function in
CHD patients undergoing PCI, and they may be used for predicting the outcome
of PCI.
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Affiliation(s)
- Zheng Tan
- Second Department of Cardiovasology, Tangshan Gongren Hospital, Hebei, China
| | - Li Li
- Second Department of Cardiovasology, Tangshan Gongren Hospital, Hebei, China
| | - Yi Ma
- Second Department of Cardiovasology, Tangshan Gongren Hospital, Hebei, China
| | - Xuebin Geng
- Second Department of Cardiovasology, Tangshan Gongren Hospital, Hebei, China
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Michalska-Kasiczak M, Bielecka-Dabrowa A, von Haehling S, Anker SD, Rysz J, Banach M. Biomarkers, myocardial fibrosis and co-morbidities in heart failure with preserved ejection fraction: an overview. Arch Med Sci 2018; 14:890-909. [PMID: 30002709 PMCID: PMC6040115 DOI: 10.5114/aoms.2018.76279] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 04/24/2018] [Indexed: 02/06/2023] Open
Abstract
The prevalence of heart failure with preserved ejection fraction (HFpEF) is steadily increasing. Its diagnosis remains difficult and controversial and relies mostly on non-invasive echocardiographic detection of left ventricular diastolic dysfunction and elevated filling pressures. The large phenotypic heterogeneity of HFpEF from pathophysiologic al underpinnings to clinical manifestations presents a major obstacle to the development of new therapies targeted towards specific HF phenotypes. Recent studies suggest that natriuretic peptides have the potential to improve the diagnosis of early HFpEF, but they still have significant limitations, and the cut-off points for diagnosis and prognosis in HFpEF remain open to debate. The purpose of this review is to present potential targets of intervention in patients with HFpEF, starting with myocardial fibrosis and methods of its detection. In addition, co-morbidities are discussed as a means to treat HFpEF according to cut-points of biomarkers that are different from usual. Biomarkers and approaches to co-morbidities may be able to tailor therapies according to patients' pathophysiological needs. Recently, soluble source of tumorigenicity 2 (sST2), growth differentiation factor 15 (GDF-15), galectin-3, and other cardiac markers have emerged, but evidence from large cohorts is still lacking. Furthermore, the field of miRNA is a very promising area of research, and further exploration of miRNA may offer diagnostic and prognostic applications and insight into the pathology, pointing to new phenotype-specific therapeutic targets.
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Affiliation(s)
- Marta Michalska-Kasiczak
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland
- Department of Endocrine Disorders and Bone Metabolism, 1 Chair of Endocrinology, Medical University of Lodz, Lodz, Poland
| | - Agata Bielecka-Dabrowa
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland
- Department of Cardiology and Congenital Diseases of Adults, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany
| | - Stefan D. Anker
- Division of Cardiology and Metabolism – Heart Failure, Cachexia and Sarcopenia, Department of Cardiology, Campus Virchow-Klinikum, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland
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The profile of selected single nucleotide polymorphisms in patients with hypertension and heart failure with preserved and mid-range ejection fraction. Sci Rep 2017; 7:8974. [PMID: 28827564 PMCID: PMC5566797 DOI: 10.1038/s41598-017-09564-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 07/25/2017] [Indexed: 12/23/2022] Open
Abstract
The study aimed to assess the clinical significance of selected single nucleotide polymorphisms (SNPs) in patients with diastolic heart failure (HF): inflammation [-174 G/C Interleukin -6 (IL-6) rs1800795, tumor necrosis factor (TNF)-608 G/A rs1800629], fibrosis [Arg25Pro transforming growth factor β (TGF β) rs1800471], endothelial function [-786 T/C nitric oxide synthase (NOS) rs2070744], glucose and lipid metabolism [Pro12Ala peroxisome proliferator activated receptor (PPAR)γ rs1801282], and vitamin D metabolism [cytochrome P450 27B1 (CYP27B1) C-1260A].110 patients with HF with preserved and mid-range ejection fraction (HFpEF and HFmrEF) were recruited. GG homozygotes in 174 G/C of IL6 polymorphism are characterized by higher values of estimated glomerular filtration rate based on the study Modification of Diet in Renal Disease (eGFR MDRD) and C allele in the NOS polymorphism and AA profile in C-1260A of CYP27B1 polymorphism correlated with a lower eGFR (MDRD). In multivariate analysis the CG genotype for 174 G/C of IL-6 and allele A in C-1260A of CYP27B1 are the only SNPs independently associated with worse course of HFpEF and HFmrEF. These data confirm the importance of the selected SNPs in aggravation and complications of hypertension.
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Pretreatment Serum Cystatin C Levels Predict Renal Function, but Not Tumor Characteristics, in Patients with Prostate Neoplasia. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7450459. [PMID: 28812020 PMCID: PMC5546082 DOI: 10.1155/2017/7450459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 03/10/2017] [Accepted: 06/20/2017] [Indexed: 01/08/2023]
Abstract
To evaluate the role of Cystatin C (Cys-C) in tumorigenesis and progression of prostate cancer (PCa), we retrospectively collected the clinical information from the records of 492 benign prostatic hyperplasia (BPH), 48 prostatic intraepithelial neoplasia (PIN), and 173 PCa patients, whose disease was newly diagnosed and histologically confirmed. Pretreatment serum Cys-C levels were compared across the various groups and then analyzed to identify relationships, if any, with clinical and pathological characteristics of the PCa patient group. There were no significant differences in serum Cys-C levels among the three groups (P > 0.05). In PCa patients with normal SCr levels, patient age was correlated with serum Cys-C level (P ≤ 0.001) but did not correlate with alkaline phosphatase (AKP), lactate dehydrogenase (LDH), prostate specific antigen (PSA), Gleason score, or bone metastasis status (P > 0.05). Age and SCr contributed in part to the variations in serum Cys-C levels of PCa patients (r = 0.356, P ≤ 0.001; r = 0.520, P ≤ 0.001). In conclusion, serum Cys-C levels predict renal function in patients with prostate neoplasia, but were not a biomarker for the development of prostate neoplasia, and were not correlated with the clinicopathological characteristics of PCa.
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Damm T, Spiegel H, Barth S, Fischer R, Naehring J. Development of a Competitive Cystatin C-Specific Bioassay Suitable for Repetitive Measurements. PLoS One 2016; 11:e0147177. [PMID: 26799562 PMCID: PMC4723070 DOI: 10.1371/journal.pone.0147177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 12/30/2015] [Indexed: 11/19/2022] Open
Abstract
Human cystatin C (hCC), a cysteine protease inhibitor, has been proposed as a diagnostic marker because its serum levels correlate with certain cardiovascular and kidney diseases. All current hCC assays are based on ex vivo detection. Here we describe the generation and evaluation of antibodies that allow the repetitive binding and release of hCC and hCC-fusion proteins, a prerequisite for long-term measurement, which is required for compatibility with implantable biochip devices and for the development of innovative antibody-based assays suitable for continuous in vivo and in vitro monitoring. Recombinant hCC and hCC-fusion proteins were produced in Escherichia coli and HEK293T cells and were used to generate antibodies by hybridoma technology. After screening by indirect and sandwich ELISAs, 12 monoclonal hybridoma cell lines producing hCC-specific monoclonal antibodies were identified. To determine their hCC association and dissociation properties, the antibodies were analysed by surface plasmon resonance spectroscopy, revealing three with the desired fast binding and moderate-to-fast release characteristics. The analysis of binding and dissociation in the presence of hCC and hCC-fusion proteins using fluorescence-based replacement assays showed that mAb CyDI-4 was the most suitable for further analysis. The results showed that repetitive replacement on mAb CyDI-4 was possible and that most of the change in signal intensity occurred after 20-30 min. Furthermore, the suitability of mAb CyDI-4 for serum hCC measurement was confirmed by a fluorescence-based replacement assay using serially-diluted reference serum from the Institute for Reference Materials and Measurements (ERM-DA471/IFCC). Our results suggest that the assay covers the physiological and pathological ranges of hCC.
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Affiliation(s)
- Tatjana Damm
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Aachen, Germany
| | - Holger Spiegel
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Aachen, Germany
| | - Stefan Barth
- Institute for Molecular Biology, RWTH Aachen University, Aachen, Germany
- Institute of Applied Medical Engineering, RWTH Aachen University, Aachen, Germany
| | - Rainer Fischer
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Aachen, Germany
- Institute for Molecular Biology, RWTH Aachen University, Aachen, Germany
| | - Joerg Naehring
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Aachen, Germany
- * E-mail:
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Bielecka-Dabrowa A, Gluba-Brzózka A, Michalska-Kasiczak M, Misztal M, Rysz J, Banach M. The multi-biomarker approach for heart failure in patients with hypertension. Int J Mol Sci 2015; 16:10715-33. [PMID: 25984599 PMCID: PMC4463672 DOI: 10.3390/ijms160510715] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 04/21/2015] [Accepted: 04/23/2015] [Indexed: 01/06/2023] Open
Abstract
We assessed the predictive ability of selected biomarkers using N-terminal pro-brain natriuretic peptide (NT-proBNP) as the benchmark and tried to establish a multi-biomarker approach to heart failure (HF) in hypertensive patients. In 120 hypertensive patients with or without overt heart failure, the incremental predictive value of the following biomarkers was investigated: Collagen III N-terminal propeptide (PIIINP), cystatin C (CysC), lipocalin-2/NGAL, syndecan-4, tumor necrosis factor-α (TNF-α), interleukin 1 receptor type I (IL1R1), galectin-3, cardiotrophin-1 (CT-1), transforming growth factor β (TGF-β) and N-terminal pro-brain natriuretic peptide (NT-proBNP). The highest discriminative value for HF was observed for NT-proBNP (area under the receiver operating characteristic curve (AUC) = 0.873) and TGF-β (AUC = 0.878). On the basis of ROC curve analysis we found that CT-1 > 152 pg/mL, TGF-β < 7.7 ng/mL, syndecan > 2.3 ng/mL, NT-proBNP > 332.5 pg/mL, CysC > 1 mg/L and NGAL > 39.9 ng/mL were significant predictors of overt HF. There was only a small improvement in predictive ability of the multi-biomarker panel including the four biomarkers with the best performance in the detection of HF—NT-proBNP, TGF-β, CT-1, CysC—compared to the panel with NT-proBNP, TGF-β and CT-1 only. Biomarkers with different pathophysiological backgrounds (NT-proBNP, TGF-β, CT-1, CysC) give additive prognostic value for incident HF in hypertensive patients compared to NT-proBNP alone.
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Affiliation(s)
| | - Anna Gluba-Brzózka
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Zeromskiego 113, 90-549 Lodz, Poland.
| | | | - Małgorzata Misztal
- Department of Nephrology, Hypertension and Family Medicine, Chair of Nephrology and Hypertension, Medical University of Lodz, Zeromskiego 113, 90-549 Lodz, Poland.
| | - Jacek Rysz
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Zeromskiego 113, 90-549 Lodz, Poland.
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Gu GL, Yang QY, Zeng RL, Xu XL. The association between BMP4 gene polymorphism and its serum level with the incidence of LVH in hypertensive patients. J Transl Med 2015; 13:14. [PMID: 25591903 PMCID: PMC4324029 DOI: 10.1186/s12967-014-0368-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 12/17/2014] [Indexed: 12/13/2022] Open
Abstract
Background Bone morphogenic proteins 4 (BMP4) is associated with cardiac remodeling under different conditions. However, the role of BMP4 and its gene polymorphism in the incidence of left ventricular hypertrophy (LVH) in hypertensive patients remains unknown. Methods A total of 1265 patients diagnosed with essential hypertension (EH) were recruited. Patients were assigned to LVH+ (n = 420) and LVH- (n = 845) groups. serum BMP4 level was measured and two single nucleotide polymorphism (SNPs) polymorphisms, 6007C > T and -5826G > A of BMP4 gene were genotyped. We also inhibited the BMP4 by small interfering RNA (siRNA). The effect of BMP4 on the hypertrophic response in Human Cardiomyocytes AC16 cells was studied. Results We found that the 6007C > T polymorphism of the BMP4 gene and the serum BMP4 level were significantly associated with the risk to develop LVH. With TT as reference, multivariate logistic regression analysis showed the 6007CC genotype carriers had a higher susceptibility to LVH incidence (adjusted OR = 2.65, 95% CI: 1.63-4.31, adjusted P < 0.001). Our in vitro study shows that the BMP4 inhibition in cardiomyocyte by si-RNA technique significantly decreased the Ang II induced cardiomyocyte size and protein content per cell, indicating the importance of BMP4 in the cardiomyocyte hypertrophy. Conclusion Collectively, our data suggest that both the 6007C > T of the BMP4 gene and the serum BMP4 level may be used as potential marker for LVH incidence among the EH patients. Electronic supplementary material The online version of this article (doi:10.1186/s12967-014-0368-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- G L Gu
- Department of cardiovascular diseases, Jiangyin Hospital of traditional Chinese medicine affiliated Nanjing University of Chinese Medicine, Jiangyin, 214400, Jiangsu, China.
| | - Q Y Yang
- Department of cardiovascular diseases, Wuxi Hospital of traditional Chinese medicine, Jiangyin, 214400, Jiangsu, China.
| | - R L Zeng
- Department of cardiovascular diseases, The People's Hospital of Jiangyin, Jiangyin, 214400, Jiangsu, China.
| | - X L Xu
- Department of Cardiothoracic Surgery, Huashan Hospital, Fudan University, Shanghai, 214400, PR China.
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