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Collado A, Gan L, Tengbom J, Kontidou E, Pernow J, Zhou Z. Extracellular vesicles and their non-coding RNA cargos: Emerging players in cardiovascular disease. J Physiol 2023; 601:4989-5009. [PMID: 36094621 DOI: 10.1113/jp283200] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/02/2022] [Indexed: 11/08/2022] Open
Abstract
Extracellular vesicles (EVs), including exosomes, microvesicles and apoptotic bodies, have recently received attention as essential mechanisms for cell-to-cell communication in cardiovascular disease. EVs can be released from different types of cells, including endothelial cells, smooth muscle cells, cardiac cells, fibroblasts, platelets, adipocytes, immune cells and stem cells. Non-coding (nc)RNAs as EV cargos have recently been investigated in the cardiovascular system. Up- or downregulated ncRNAs in EVs have been shown to play a crucial role in various cardiovascular diseases. Communication via EV-derived ncRNAs can occur between cells of the same type and between different types of cells involved in the pathophysiology of cardiovascular disease. In the present review, we highlight the important aspects of diverse cell-derived EVs and their ncRNA cargos as disease mediators and potential therapeutic targets in atherosclerosis, coronary artery disease, ischaemic heart disease and cardiac fibrosis. In addition, we summarize the potential of EV-derived ncRNAs in the treatment of cardiovascular disease. Finally, we discuss the different methods for EV isolation and characterization. A better understanding of the specific role of EVs and their ncRNA cargos in the regulation of cardiovascular (dys)function will be of importance for the development of diagnostic and therapeutic tools for cardiovascular disease.
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Affiliation(s)
- Aida Collado
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Lu Gan
- Laboratory of Emergency Medicine, Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, PR China
| | - John Tengbom
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Eftychia Kontidou
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - John Pernow
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - Zhichao Zhou
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Yang J, Sundqvist ML, Zheng X, Jiao T, Collado A, Tratsiakovich Y, Mahdi A, Tengbom J, Mergia E, Catrina SB, Zhou Z, Carlström M, Akaike T, Cortese-Krott MM, Weitzberg E, Lundberg JO, Pernow J. Hypoxic erythrocytes mediate cardioprotection through activation of soluble guanylate cyclase and release of cyclic GMP. J Clin Invest 2023; 133:e167693. [PMID: 37655658 PMCID: PMC10471167 DOI: 10.1172/jci167693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 07/06/2023] [Indexed: 09/02/2023] Open
Abstract
Red blood cells (RBCs) mediate cardioprotection via nitric oxide-like bioactivity, but the signaling and the identity of any mediator released by the RBCs remains unknown. We investigated whether RBCs exposed to hypoxia release a cardioprotective mediator and explored the nature of this mediator. Perfusion of isolated hearts subjected to ischemia-reperfusion with extracellular supernatant from mouse RBCs exposed to hypoxia resulted in improved postischemic cardiac function and reduced infarct size. Hypoxia increased extracellular export of cyclic guanosine monophosphate (cGMP) from mouse RBCs, and exogenous cGMP mimicked the cardioprotection induced by the supernatant. The protection induced by hypoxic RBCs was dependent on RBC-soluble guanylate cyclase and cGMP transport and was sensitive to phosphodiesterase 5 and activated cardiomyocyte protein kinase G. Oral administration of nitrate to mice to increase nitric oxide bioactivity further enhanced the cardioprotective effect of hypoxic RBCs. In a placebo-controlled clinical trial, a clear cardioprotective, soluble guanylate cyclase-dependent effect was induced by RBCs collected from patients randomized to 5 weeks nitrate-rich diet. It is concluded that RBCs generate and export cGMP as a response to hypoxia, mediating cardioprotection via a paracrine effect. This effect can be further augmented by a simple dietary intervention, suggesting preventive and therapeutic opportunities in ischemic heart disease.
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Affiliation(s)
- Jiangning Yang
- Department of Medicine, Unit of Cardiology, Karolinska Institutet, Stockholm, Sweden
| | - Michaela L. Sundqvist
- Department of Physiology, Nutrition and Biomechanics, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Xiaowei Zheng
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Tong Jiao
- Department of Medicine, Unit of Cardiology, Karolinska Institutet, Stockholm, Sweden
| | - Aida Collado
- Department of Medicine, Unit of Cardiology, Karolinska Institutet, Stockholm, Sweden
| | - Yahor Tratsiakovich
- Department of Medicine, Unit of Cardiology, Karolinska Institutet, Stockholm, Sweden
| | - Ali Mahdi
- Department of Medicine, Unit of Cardiology, Karolinska Institutet, Stockholm, Sweden
| | - John Tengbom
- Department of Medicine, Unit of Cardiology, Karolinska Institutet, Stockholm, Sweden
| | - Evanthia Mergia
- Institute for Pharmacology and Toxicology, Ruhr-University Bochum, Bochum, Germany
| | - Sergiu-Bogdan Catrina
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Zhichao Zhou
- Department of Medicine, Unit of Cardiology, Karolinska Institutet, Stockholm, Sweden
| | - Mattias Carlström
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Takaaki Akaike
- Department of Environmental Medicine and Molecular Toxicology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Miriam M. Cortese-Krott
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Myocardial Infarction Laboratory, Division of Cardiology, Pneumology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Eddie Weitzberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Jon O. Lundberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - John Pernow
- Department of Medicine, Unit of Cardiology, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
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Jiao T, Collado A, Mahdi A, Tengbom J, Tratsiakovich Y, Milne GT, Alvarsson M, Lundberg JO, Zhou Z, Yang J, Pernow J. Stimulation of Erythrocyte Soluble Guanylyl Cyclase Induces cGMP Export and Cardioprotection in Type 2 Diabetes. JACC Basic Transl Sci 2023; 8:907-918. [PMID: 37719424 PMCID: PMC10504399 DOI: 10.1016/j.jacbts.2023.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 09/19/2023]
Abstract
Reduced nitric oxide (NO) bioactivity in red blood cells (RBCs) is critical for augmented myocardial ischemia-reperfusion injury in type 2 diabetes. This study identified the nature of "NO bioactivity" by stimulating the intracellular NO receptor soluble guanylyl cyclase (sGC) in RBCs. sGC stimulation in RBCs from patients with type 2 diabetes increased export of cyclic guanosine monophosphate from RBCs and activated cardiac protein kinase G, thereby attenuating ischemia-reperfusion injury. These results provide novel insight into RBC signaling by identifying cyclic guanosine monophosphate from RBC as a mediator of protection against cardiac ischemia-reperfusion injury induced by sGC stimulation in RBCs.
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Affiliation(s)
- Tong Jiao
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Aida Collado
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Ali Mahdi
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - John Tengbom
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Yahor Tratsiakovich
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | | | - Michael Alvarsson
- Division of Endocrinology and Diabetology, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Jon O Lundberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Zhichao Zhou
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Jiangning Yang
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - John Pernow
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- Department of Cardiology, Heart and Vascular Division, Karolinska University Hospital, Stockholm, Sweden
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Kontidou E, Collado A, Pernow J, Zhou Z. Erythrocyte-Derived microRNAs: Emerging Players in Cardiovascular and Metabolic Disease. Arterioscler Thromb Vasc Biol 2023; 43:628-636. [PMID: 36924230 DOI: 10.1161/atvbaha.123.319027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Recent studies have demonstrated a novel function of red blood cells (RBCs) beyond their classical role as gas transporters, that is, RBCs undergo functional alterations in cardiovascular and metabolic disease, and RBC dysfunction is associated with hypertension and the development of cardiovascular injury in type 2 diabetes, heart failure, preeclampsia, familial hypercholesterolemia/dyslipidemia, and COVID-19. The underlying mechanisms include decreased nitric oxide bioavailability, increased arginase activity, and reactive oxygen species formation. Of interest, RBCs contain diverse and abundant micro (mi)RNAs. microRNA expression pattern in RBCs reflects the expression in the whole blood, serum, and plasma. microRNA levels in RBCs have been found to be altered in various cardiovascular and metabolic diseases, which contributes to the development of cardiovascular complications. Evidence has shown that RBC-derived miRNAs interact with the cardiovascular system via extracellular vesicles and argonaute RISC catalytic component 2 as carriers. Alteration of RBC-to-vascular communication via miRNAs may serve as potential disease mechanism for vascular complications. The present review summarizes RBCs and their released miRNAs as potential mediators of cardiovascular injury. We further focus on the possible mechanisms by which RBC-derived miRNAs regulate cardiovascular function. A better understanding of the function of RBC-derived miRNAs will increase insights into the disease mechanism and potential targets for the treatment of cardiovascular complications.
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Affiliation(s)
- Eftychia Kontidou
- Division of Cardiology, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden (E.K., A.C., J.P., Z.Z.)
| | - Aida Collado
- Division of Cardiology, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden (E.K., A.C., J.P., Z.Z.)
| | - John Pernow
- Division of Cardiology, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden (E.K., A.C., J.P., Z.Z.).,Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden (J.P.)
| | - Zhichao Zhou
- Division of Cardiology, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden (E.K., A.C., J.P., Z.Z.)
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Mahdi A, Wodaje T, Kövamees O, Tengbom J, Zhao A, Jiao T, Henricsson M, Yang J, Zhou Z, Nieminen AI, Levin M, Collado A, Brinck J, Pernow J. The red blood cell as a mediator of endothelial dysfunction in patients with familial hypercholesterolemia and dyslipidemia. J Intern Med 2023; 293:228-245. [PMID: 36324273 PMCID: PMC10092865 DOI: 10.1111/joim.13580] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Patients with familial hypercholesterolemia (FH) display high levels of low-density lipoprotein cholesterol (LDL-c), endothelial dysfunction, and increased risk of premature atherosclerosis. We have previously shown that red blood cells (RBCs) from patients with type 2 diabetes induce endothelial dysfunction through increased arginase 1 and reactive oxygen species (ROS). OBJECTIVE To test the hypothesis that RBCs from patients with FH (FH-RBCs) and elevated LDL-c induce endothelial dysfunction. METHODS AND RESULTS FH-RBCs and LDL-c >5.0 mM induced endothelial dysfunction following 18-h incubation with isolated aortic rings from healthy rats compared to FH-RBCs and LDL-c <2.5 mM or RBCs from healthy subjects (H-RBCs). Inhibition of vascular but not RBC arginase attenuated the degree of endothelial dysfunction induced by FH-RBCs and LDL-c >5.0 mM. Furthermore, arginase 1 but not arginase 2 was elevated in the vasculature of aortic segments after incubation with FH-RBCs and LDL-c >5.0 mM. A superoxide scavenger, present throughout the 18-h incubation, attenuated the degree of endothelial dysfunction induced by FH-RBCs and LDL-c >5.0 mM. ROS production was elevated in these RBCs in comparison with H-RBCs. Scavenging of vascular ROS through various antioxidants also attenuated the degree of endothelial dysfunction induced by FH-RBCs and LDL-c >5.0 mM. This was corroborated by an increase in the lipid peroxidation product 4-hydroxynonenal. Lipidomic analysis of RBC lysates did not reveal any significant changes across the groups. CONCLUSION FH-RBCs induce endothelial dysfunction dependent on LDL-c levels via arginase 1 and ROS-dependent mechanisms.
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Affiliation(s)
- Ali Mahdi
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Tigist Wodaje
- Division of Cardiology, Department of Medicine Huddinge, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Oskar Kövamees
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - John Tengbom
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Allan Zhao
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Tong Jiao
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Marcus Henricsson
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jiangning Yang
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Zhichao Zhou
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Anni I Nieminen
- FIMM Metabolomics Unit, Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Malin Levin
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Aida Collado
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Jonas Brinck
- Division of Endocrinology, Department of Medicine Huddinge, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - John Pernow
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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Marques P, Villarroel-Vicente C, Collado A, García A, Vila L, Duplan I, Hennuyer N, Garibotto F, Enriz RD, Dacquet C, Staels B, Piqueras L, Cortes D, Sanz MJ, Cabedo N. Anti-inflammatory effects and improved metabolic derangements in ob/ob mice by a newly synthesized prenylated benzopyran with pan-PPAR activity. Pharmacol Res 2023; 187:106638. [PMID: 36586645 DOI: 10.1016/j.phrs.2022.106638] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE Selective peroxisome proliferator-activated receptors (PPARs) are widely used to treat metabolic complications; however, the limited effect of PPARα agonists on glucose metabolism and the adverse effects associated with selective PPARγ activators have stimulated the development of novel pan-PPAR agonists to treat metabolic disorders. Here, we synthesized a new prenylated benzopyran (BP-2) and evaluated its PPAR-activating properties, anti-inflammatory effects and impact on metabolic derangements. EXPERIMENTAL APPROACH BP-2 was used in transactivation assays to evaluate its agonism to PPARα, PPARβ/δ and PPARγ. A parallel-plate flow chamber was employed to investigate its effect on TNFα-induced leukocyte-endothelium interactions. Flow cytometry and immunofluorescence were used to determine its effects on the expression of endothelial cell adhesion molecules (CAMs) and chemokines and p38-MAPK/NF-κB activation. PPARs/RXRα interactions were determined using a gene silencing approach. Analysis of its impact on metabolic abnormalities and inflammation was performed in ob/ob mice. KEY RESULTS BP-2 displayed strong PPARα activity, with moderate and weak activity against PPARβ/δ and PPARγ, respectively. In vitro, BP-2 reduced TNFα-induced endothelial ICAM-1, VCAM-1 and fractalkine/CX3CL1 expression, suppressed mononuclear cell arrest via PPARβ/δ-RXRα interactions and decreased p38-MAPK/NF-κB activation. In vivo, BP-2 improved the circulating levels of glucose and triglycerides in ob/ob mice, suppressed T-lymphocyte/macrophage infiltration and proinflammatory markers in the liver and white adipose tissue, but increased the expression of the M2-like macrophage marker CD206. CONCLUSION AND IMPLICATIONS BP-2 emerges as a novel pan-PPAR lead candidate to normalize glycemia/triglyceridemia and minimize inflammation in metabolic disorders, likely preventing the development of further cardiovascular complications.
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Affiliation(s)
- Patrice Marques
- Department of Pharmacology, University of Valencia, Valencia, Spain; Institute of Health Research-INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Carlos Villarroel-Vicente
- Department of Pharmacology, University of Valencia, Valencia, Spain; Institute of Health Research-INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Aida Collado
- Department of Pharmacology, University of Valencia, Valencia, Spain; Institute of Health Research-INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Ainhoa García
- Department of Pharmacology, University of Valencia, Valencia, Spain; Institute of Health Research-INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Laura Vila
- Institute of Health Research-INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Isabelle Duplan
- University of Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U-1011-EGID, F-59000 Lille, France
| | - Nathalie Hennuyer
- University of Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U-1011-EGID, F-59000 Lille, France
| | - Francisco Garibotto
- Faculty of Chemistry, Biochemistry and Pharmacy, National University of San Luis-IMIBIO-SL-CONICET, Chacabuco 917-5700, San Luis, Argentina
| | - Ricardo D Enriz
- Faculty of Chemistry, Biochemistry and Pharmacy, National University of San Luis-IMIBIO-SL-CONICET, Chacabuco 917-5700, San Luis, Argentina
| | | | - Bart Staels
- University of Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U-1011-EGID, F-59000 Lille, France
| | - Laura Piqueras
- Department of Pharmacology, University of Valencia, Valencia, Spain; Institute of Health Research-INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain; CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Carlos III Health Institute, Madrid, Spain
| | - Diego Cortes
- Department of Pharmacology, University of Valencia, Valencia, Spain.
| | - María-Jesús Sanz
- Department of Pharmacology, University of Valencia, Valencia, Spain; Institute of Health Research-INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain; CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Carlos III Health Institute, Madrid, Spain.
| | - Nuria Cabedo
- Department of Pharmacology, University of Valencia, Valencia, Spain; Institute of Health Research-INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain.
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Jiao T, Mahdi A, Tengbom J, Collado A, Jurga J, Saleh N, Verouhis D, Bohm F, Zhou Z, Yang J, Pernow J. Erythrocytes from patients with ST-elevation myocardial infarction induce cardioprotection via the purinergic P2Y13 receptor and nitric oxide signalling. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Red blood cells (RBC) are suggested to act as important mediators in the regulation of cardiovascular function by exporting nitric oxide (NO) bioactivity and ATP under hypoxic/ischemic conditions. In addition, RBCs are known to protect from ischemia-reperfusion injury via the export of NO bioactivity in experimental settings. However, it remains unknown if such beneficial effects of RBCs are protective in patients with acute myocardial infarction.
Purpose
To investigate whether RBCs from patients with ST-elevation myocardial infarction (STEMI) protect against myocardial ischemia-reperfusion injury and whether such effect involves activation of purinergic and NO signalling in the RBCs.
Methods
RBCs were collected from patients with STEMI undergoing primary percutaneous coronary intervention and age- and gender-matched healthy controls. The RBCs were administered into the coronary circulation of isolated Langendorff-perfused rat hearts at the onset of global ischemia for 25 min followed by reperfusion of 60 min. Recovery of left ventricular developed pressure (LVDP) during reperfusion and infarct size were determined. All animal experiments and procedures were performed according to the guidelines by the U.S National Institutes of Health (NIH publication no 85–23, revised 1996). The present study was performed following The Code of Ethics of the World Medical Association outlined in the Declaration of Helsinki of 1975 and revised in 1983 for experiments that involve human subjects.
Results
Administration of RBCs from STEMI patients improved recovery of LVDP and reduced infarct size in hearts subjected to ischemia-reperfusion in comparison with RBCs from healthy controls (Figure 1A, B). Pre-incubation of the RBCs with the NO synthase (NOS) inhibitor L-NAME (Figure 1C, D) and the inhibitor of the NO receptor soluble guanylyl cyclase (sGC) ODQ abolished the cardioprotective effect of RBCs from STEMI patients. The cardioprotective effect was also attenuated by inhibition of cardiac cGMP-dependent protein kinase (PKG). Further, the purinergic P2Y13 receptor antagonist MRS2211 (Figure 1E, F), but not the P1 receptor antagonist 8PT applied to RBCs, attenuated the cardioprotection induced by RBCs from STEMI patients. Moreover, administration of RBCs from healthy subjects pre-incubated with a cell permeable ATP analogue improved post-ischemic recovery of LVDP and reduced infarct size. This cardioprotective effect was abolished by co-incubation of the RBCs with ODQ (Figure 2) and MRS2211.
Conclusion
Our findings demonstrate a novel function of RBCs in patients with STEMI that provides protection against myocardial ischemia-reperfusion injury via the activation of P2Y13 receptor and the NO-sGC pathway in RBCs and cardiac PKG.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Swedish Heart and Lung Foundation; Swedish Research Council
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Affiliation(s)
- T Jiao
- Karolinska Institute, Dept. of Medicine (Solna), Unit of Cardiology , Stockholm , Sweden
| | - A Mahdi
- Karolinska Institute, Dept. of Medicine (Solna), Unit of Cardiology , Stockholm , Sweden
| | - J Tengbom
- Karolinska Institute, Dept. of Medicine (Solna), Unit of Cardiology , Stockholm , Sweden
| | - A Collado
- Karolinska Institute, Dept. of Medicine (Solna), Unit of Cardiology , Stockholm , Sweden
| | - J Jurga
- Karolinska University Hospital, Department of Cardiology , Stockholm , Sweden
| | - N Saleh
- Karolinska University Hospital, Department of Cardiology , Stockholm , Sweden
| | - D Verouhis
- Karolinska University Hospital, Department of Cardiology , Stockholm , Sweden
| | - F Bohm
- Karolinska University Hospital, Department of Cardiology , Stockholm , Sweden
| | - Z Zhou
- Karolinska Institute, Dept. of Medicine (Solna), Unit of Cardiology , Stockholm , Sweden
| | - J Yang
- Karolinska Institute, Dept. of Medicine (Solna), Unit of Cardiology , Stockholm , Sweden
| | - J Pernow
- Karolinska Institute, Dept. of Medicine (Solna), Unit of Cardiology , Stockholm , Sweden
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8
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Tengbom J, Collado A, Jiao T, Yang J, Zhou Z, Mahdi A, Pernow J. Red blood cells induce endothelial dysfunction in patients with ST-elevation myocardial infarction and elevated C-reactive protein. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The important role of inflammation in atherosclerotic plaque progression and instability leading to myocardial infarction has been widely demonstrated. C-reactive protein (CRP) has been shown to be of predictive value in atherosclerotic cardiovascular disease. The red blood cell (RBC) is an important regulator of cardiovascular function through nitric oxide bioactivity and oxidative stress in ischemic heart disease. Also, arginase-1 has been shown to greatly influence nitric oxide bioactivity in RBCs and to cause endothelial dysfunction. However, the mechanisms by which RBCs regulate vascular function in patients with myocardial infarction and its relation to inflammation and arginase-1 remain unknown.
Objective
The study aimed to investigate the effect of RBCs on endothelial function in patients with ST-elevation myocardial infarction (STEMI) and its possible association with systemic inflammation and arginase-1.
Material and methods
Blood samples were collected from patients with STEMI within 36 h after admission and from age-matched healthy controls. RBCs were incubated with isolated rat aortic segments for 18 h after which the aortas were assessed for endothelium-dependent and endothelium-independent relaxations using wire myographs and application of acetylcholine and nitroprusside, respectively. The vascular response was evaluated in relation to the level of inflammation defined as CRP <2 and ≥2 mg/L at admission. The levels of 4-hydroxynonenal (4-HNE; a marker of oxidative stress formed by lipid peroxidation) and the expression of arginase-1 were visualized in rat aortas following incubation with RBCs by immunohistochemistry. All handling and procedures regarding human subjects and sampling were performed according to the Declaration of Helsinki. All animal experiments and procedures were performed according to the guidelines by the U.S National Institutes of Health (NIH publication no 85–23, revised 1996).
Results
RBCs from patients with STEMI and elevated CRP (≥2 mg/L, mean of 9.6 mg/L) induced significant impairment of endothelium-dependent relaxation compared to RBCs from patients with STEMI and low CRP (<2 mg/L, mean of 1.0 mg/L) and to the healthy controls (Fig. 1). Endothelium-independent relaxations did not differ between the groups. Immunohistochemical staining of the aorta revealed that incubation with RBCs from patients with STEMI and high CRP increased the expression of 4-HNE and arginase-1 compared to incubation of RBCs from healthy controls and patients with STEMI and low CRP (Fig. 2).
Conclusion
RBCs from patients with STEMI and elevated CRP induce endothelial dysfunction and increase the expression of 4-HNE and arginase-1, indicating that inflammation is involved in the mechanism by which RBCs induce endothelial dysfunction in STEMI.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Swedish Heart and Lung foundation
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Affiliation(s)
- J Tengbom
- Karolinska Institute, Division of Cardiology, Department of Medicine, Karolinska University Hospital , Stockholm , Sweden
| | - A Collado
- Karolinska Institute, Division of Cardiology, Department of Medicine, Karolinska University Hospital , Stockholm , Sweden
| | - T Jiao
- Karolinska Institute, Division of Cardiology, Department of Medicine, Karolinska University Hospital , Stockholm , Sweden
| | - J Yang
- Karolinska Institute, Division of Cardiology, Department of Medicine, Karolinska University Hospital , Stockholm , Sweden
| | - Z Zhou
- Karolinska Institute, Division of Cardiology, Department of Medicine, Karolinska University Hospital , Stockholm , Sweden
| | - A Mahdi
- Karolinska Institute, Division of Cardiology, Department of Medicine, Karolinska University Hospital , Stockholm , Sweden
| | - J Pernow
- Karolinska Institute, Division of Cardiology, Department of Medicine, Karolinska University Hospital , Stockholm , Sweden
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9
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Collado A, Jiao T, Zaccagnini G, Yang J, Carstrom M, Martelli F, Pernow J, Zhou Z. Overexpression of miR-210 ameliorates endothelial dysfunction in type 2 diabetic mice. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.3074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
MicroRNA (miR)-210 plays a protective role in many cardiometabolic diseases, and its levels are reduced in whole blood, erythrocytes, and plasma in type 2 diabetes mellitus (T2DM). Our recent study demonstrated that miR-210 is downregulated in carotid artery plaques from patients with T2DM compared to non-diabetic patients. However, the functional role of miR-210 in endothelial dysfunction is not fully understood.
Purpose
This study aimed to investigate the potential therapeutic value of miR-210 overexpression against T2DM-associated endothelial dysfunction.
Methods
miR-210 transgenic mice (TG) at age of 8 weeks were subjected to Western Diet (WD) for 12 weeks. During the last 10 days of the diet regime, doxycycline or vehicle dissolved in drinking water was given to switch on miR-210 (miR-210/on) expression or keep it off (miR-210/off), respectively. Age-matched wild-type (WT) control mice received normal chow through the same period. Additionally, WT and T2DM db/db mice at age of 15–20 weeks received tail vein injections of miR-210 mimic or miR-210 scramble oligonucleotides. All animals were euthanized at the end of the treatment or 72h after the i.v. injections for determination of endothelial function by acetylcholine-induced endothelium-dependent relaxation (EDR) of isolated aortic segments from all groups of mice using wire myographs. The expression of protein tyrosine phosphatase 1B (PTP1B; a miR-210 target protein) and the levels of 4-hydroxynonenal (4-HNE; an oxidative stress marker) were measured in aortic segments by immunohistochemistry. All animal experiments and procedures were performed according to the guidelines by the U.S National Institutes of Health (NIH publication no 85–23, revised 1996).
Results
EDR in aortic segments from miR-210/off TG mice fed WD and T2DM db/db mice injected with miR-210 scramble was significantly impaired compared to vessels from WT controls fed with regular chow (Fig. 1A, B). Of note, EDR was markedly improved or even restored in aortae from miR-210/on TG mice treated with WD and T2DM db/db mice injected with miR-210 mimic (Fig. 1A, B). Furthermore, the expression of PTP1B and the levels of 4-HNE, which is formed by lipid peroxidation, were significantly elevated in the aortae from miR-210/off TG mice treated with WD when compared to WT controls (Fig. 2A–D). The expression was attenuated in aortae of miR-210/on TG mice treated with WD compared to miR-210/off TG mice (Fig. 2A–D). There was a significant increase in the expression of PTP1B and a trend to increased 4-HNE levels in aortae of db/db mice injected with miR-210 scramble vs. control mice (Fig. 2E–H). A significant reduction in PTP1B but not 4-HNE was observed in db/db mice injected with miR-210 mimic (Fig. 2E–H).
Conclusion
Genetic and pharmacological overexpression of miR-210 ameliorates endothelial dysfunction in mice fed with WD and db/db mice. Increasing miR-210 levels may become a potential treatment strategy.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Swedish Heart and Lung Foundation
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Affiliation(s)
- A Collado
- Karolinska Institute , Stockholm , Sweden
| | - T Jiao
- Karolinska Institute , Stockholm , Sweden
| | - G Zaccagnini
- IRCCS San Donato Polyclinic , San Donato Milanese , Italy
| | - J Yang
- Karolinska Institute , Stockholm , Sweden
| | - M Carstrom
- Karolinska Institute , Stockholm , Sweden
| | - F Martelli
- IRCCS San Donato Polyclinic , San Donato Milanese , Italy
| | - J Pernow
- Karolinska Institute , Stockholm , Sweden
| | - Z Zhou
- Karolinska Institute , Stockholm , Sweden
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10
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Gómez-Ferrer A, Collado A, Ramírez M, Domínguez J, Casanova J, Mir C, Wong A, Marenco JL, Nagore E, Soriano V, Rubio-Briones J. A single-center comparison of our initial experiences in treating penile and urethral cancer with video-endoscopic inguinal lymphadenectomy (VEIL) and later experiences in melanoma cases. Front Surg 2022; 9:870857. [PMID: 36225221 PMCID: PMC9548630 DOI: 10.3389/fsurg.2022.870857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 09/08/2022] [Indexed: 12/01/2022] Open
Abstract
Background Video-endoscopic inguinal lymphadenectomy (VEIL) is a minimally invasive approach that is increasingly indicated in oncological settings, with mounting evidence for its long-term oncological safety. Objectives To present our single-center experience of treating penile and urethral cancer with VEIL, as well as its more recent application in melanoma patients. Methods We prospectively recorded our experiences with VEIL from September 2010 to July 2018, registering the patient primary indication, surgical details, complications, and follow-up. Results Twenty-nine patients were operated in one (24) or both (5) groins; 18 had penile cancer, 1 had urethral cancer, and 10 had melanoma. A mean 8.62 ± 4.45 lymph nodes were removed using VEIL and of these, an average of 1.00 ± 2.87 were metastatic; 16 patients developed lymphocele and 10 presented some degree of lymphedema; there were no skin or other major complications. The median follow-up was 19.35 months; there were 3 penile cancer patient recurrences in the VEIL-operated side. None of the melanoma patients presented a lymphatic inguinal recurrence. Conclusions VEIL is a minimally invasive technique which appears to be oncologically safe showing fewer complications than open surgery. However, complications such as lymphorrhea, lymphocele, or lymphedema were not diminished by using VEIL.
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Affiliation(s)
- A. Gómez-Ferrer
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
- Correspondence: Álvaro Gómez-Ferrer
| | - A. Collado
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - M. Ramírez
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - J. Domínguez
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - J. Casanova
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - C. Mir
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - A. Wong
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - J. L. Marenco
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - E. Nagore
- Dermatology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - V. Soriano
- Medical Oncology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - J. Rubio-Briones
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
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11
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Mahdi A, Collado A, Tengbom J, Jiao T, Wodaje T, Johansson N, Farnebo F, Färnert A, Yang J, Lundberg JO, Zhou Z, Pernow J. Erythrocytes Induce Vascular Dysfunction in COVID-19. JACC Basic Transl Sci 2022; 7:193-204. [PMID: 35194565 PMCID: PMC8849181 DOI: 10.1016/j.jacbts.2021.12.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/03/2021] [Accepted: 12/03/2021] [Indexed: 12/20/2022]
Abstract
Patients hospitalized for COVID-19 display marked impairment in endothelial function, which is persistent following recovery from the acute infection. RBCs from patients with COVID-19 impair vascular function through mechanisms involving increased arginase 1, ROS and IFNγ, and reduced NO bioactivity. These data advance our understanding in COVID-19–associated vascular injury with a clear involvement of RBCs. Targeting these mechanisms might provide a novel therapeutic strategy to alleviate vascular injury in patients with COVID-19.
Current knowledge regarding mechanisms underlying cardiovascular complications in patients with COVID-19 is limited and urgently needed. We shed light on a previously unrecognized mechanism and unravel a key role of red blood cells, driving vascular dysfunction in patients with COVID-19 infection. We establish the presence of profound and persistent endothelial dysfunction in vivo in patients with COVID-19. Mechanistically, we show that targeting reactive oxygen species or arginase 1 improves vascular dysfunction mediated by red blood cells. These translational observations hold promise that restoring the redox balance in red blood cells might alleviate the clinical complications of COVID-19–associated vascular dysfunction.
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Key Words
- ACh, acetylcholine
- C19-RBC, red blood cell from patients with COVID-19
- COVID-19
- EDR, endothelium-dependent relaxation
- EIR, endothelium-independent relaxation
- H-RBC, red blood cell from healthy subjects
- HNE, hydroxynonenal
- IFN, interferon
- RBC, red blood cell
- RHI, reactive hyperemia index
- ROS, reactive oxygen species
- SNP, sodium nitroprusside
- TNF, tumor necrosis factor
- arginase
- endothelial dysfunction
- nitric oxide
- reactive oxygen species
- red blood cells
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Affiliation(s)
- Ali Mahdi
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Aida Collado
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - John Tengbom
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Tong Jiao
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Tigist Wodaje
- Division of Cardiology, Department of Medicine Huddinge, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Niclas Johansson
- Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Filip Farnebo
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Stockholm Craniofacial Center, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Färnert
- Division of Infectious Diseases, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Jiangning Yang
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Jon O Lundberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Zhichao Zhou
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - John Pernow
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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12
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Zhou Z, Collado A, Sun C, Tratsiakovich Y, Mahdi A, Winter H, Chernogubova E, Seime T, Narayanan S, Jiao T, Jin H, Alvarsson M, Zheng X, Yang J, Hedin U, Catrina SB, Maegdefessel L, Pernow J. Downregulation of Erythrocyte miR-210 Induces Endothelial Dysfunction in Type 2 Diabetes. Diabetes 2022; 71:285-297. [PMID: 34753800 DOI: 10.2337/db21-0093] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022]
Abstract
Red blood cells (RBC) act as mediators of vascular injury in type 2 diabetes mellitus (T2DM). miR-210 plays a protective role in cardiovascular homeostasis and is decreased in whole blood of T2DM mice. We hypothesized that downregulation of RBC miR-210 induces endothelial dysfunction in T2DM. RBC were coincubated with arteries and endothelial cells ex vivo and transfused in vivo to identify the role of miR-210 and its target protein tyrosine phosphatase 1B (PTP1B) in endothelial dysfunction. RBC from patients with T2DM and diabetic rodents induced endothelial dysfunction ex vivo and in vivo. miR-210 levels were lower in human RBC from patients with T2DM (T2DM RBC) than in RBC from healthy subjects. Transfection of miR-210 in human T2DM RBC rescued endothelial function, whereas miR-210 inhibition in healthy subjects RBC or RBC from miR-210 knockout mice impaired endothelial function. Human T2DM RBC decreased miR-210 expression in endothelial cells. miR-210 expression in carotid artery plaques was lower in T2DM patients than in patients without diabetes. Endothelial dysfunction induced by downregulated RBC miR-210 involved PTP1B and reactive oxygen species. miR-210 mimic attenuated endothelial dysfunction induced by RBC via downregulating vascular PTP1B and oxidative stress in diabetic mice in vivo. These data reveal that the downregulation of RBC miR-210 is a novel mechanism driving the development of endothelial dysfunction in T2DM.
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MESH Headings
- Animals
- Case-Control Studies
- Cells, Cultured
- Diabetes Mellitus, Experimental/blood
- Diabetes Mellitus, Experimental/complications
- Diabetes Mellitus, Experimental/genetics
- Diabetes Mellitus, Experimental/physiopathology
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/genetics
- Diabetes Mellitus, Type 2/physiopathology
- Diabetic Angiopathies/blood
- Diabetic Angiopathies/genetics
- Diabetic Angiopathies/metabolism
- Diabetic Angiopathies/physiopathology
- Endothelium, Vascular/metabolism
- Endothelium, Vascular/physiopathology
- Erythrocytes/metabolism
- Humans
- Male
- Mice
- Mice, Knockout
- MicroRNAs/genetics
- MicroRNAs/metabolism
- Protein Tyrosine Phosphatase, Non-Receptor Type 1/physiology
- Rats
- Rats, Wistar
- Reactive Oxygen Species/metabolism
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Affiliation(s)
- Zhichao Zhou
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Aida Collado
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Changyan Sun
- Division of Molecular Vascular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Yahor Tratsiakovich
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Ali Mahdi
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Hanna Winter
- Department of Vascular and Endovascular Surgery, Technical University Munich, Munich, Germany
| | - Ekaterina Chernogubova
- Division of Molecular Vascular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Till Seime
- Division of Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Sampath Narayanan
- Division of Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Division of Endocrinology and Diabetology, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Tong Jiao
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Hong Jin
- Division of Molecular Vascular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Division of Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Michael Alvarsson
- Division of Endocrinology and Diabetology, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Xiaowei Zheng
- Division of Endocrinology and Diabetology, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Jiangning Yang
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Ulf Hedin
- Division of Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Sergiu-Bogdan Catrina
- Division of Endocrinology and Diabetology, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Centrum for Diabetes, Academic Specialist Centrum, Stockholm, Sweden
| | - Lars Maegdefessel
- Division of Molecular Vascular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Vascular and Endovascular Surgery, Technical University Munich, Munich, Germany
| | - John Pernow
- Division of Cardiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
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13
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Jiao T, Collado A, Mahdi A, Jurga J, Tengbom J, Saleh N, Verouhis D, Böhm F, Zhou Z, Yang J, Pernow J. Erythrocytes from patients with ST-elevation myocardial infarction induce cardioprotection through the purinergic P2Y 13 receptor and nitric oxide signaling. Basic Res Cardiol 2022; 117:46. [PMID: 36112326 PMCID: PMC9481504 DOI: 10.1007/s00395-022-00953-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 01/31/2023]
Abstract
Red blood cells (RBCs) are suggested to play a role in cardiovascular regulation by exporting nitric oxide (NO) bioactivity and ATP under hypoxia. It remains unknown whether such beneficial effects of RBCs are protective in patients with acute myocardial infarction. We investigated whether RBCs from patients with ST-elevation myocardial infarction (STEMI) protect against myocardial ischemia-reperfusion injury and whether such effect involves NO and purinergic signaling in the RBCs. RBCs from patients with STEMI undergoing primary coronary intervention and healthy controls were administered to isolated rat hearts subjected to global ischemia and reperfusion. Compared to RBCs from healthy controls, RBCs from STEMI patients reduced myocardial infarct size (30 ± 12% RBC healthy vs. 11 ± 5% RBC STEMI patients, P < 0.001), improved recovery of left-ventricular developed pressure and dP/dt and reduced left-ventricular end-diastolic pressure in hearts subjected to ischemia-reperfusion. Inhibition of RBC NO synthase with L-NAME or soluble guanylyl cyclase (sGC) with ODQ, and inhibition of cardiac protein kinase G (PKG) abolished the cardioprotective effect. Furthermore, the non-selective purinergic P2 receptor antagonist PPADS but not the P1 receptor antagonist 8PT attenuated the cardioprotection induced by RBCs from STEMI patients. The P2Y13 receptor was expressed in RBCs and the cardioprotection was abolished by the P2Y13 receptor antagonist MRS2211. By contrast, perfusion with PPADS, L-NAME, or ODQ prior to RBCs administration failed to block the cardioprotection induced by RBCs from STEMI patients. Administration of RBCs from healthy subjects following pre-incubation with an ATP analog reduced infarct size from 20 ± 6 to 7 ± 2% (P < 0.001), and this effect was abolished by ODQ and MRS2211. This study demonstrates a novel function of RBCs in STEMI patients providing protection against myocardial ischemia-reperfusion injury through the P2Y13 receptor and the NO-sGC-PKG pathway.
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Affiliation(s)
- Tong Jiao
- Department of Medicine, Division of Cardiology, Karolinska Institutet, Stockholm, Sweden
| | - Aida Collado
- Department of Medicine, Division of Cardiology, Karolinska Institutet, Stockholm, Sweden
| | - Ali Mahdi
- Department of Medicine, Division of Cardiology, Karolinska Institutet, Stockholm, Sweden
| | - Juliane Jurga
- Department of Medicine, Division of Cardiology, Karolinska Institutet, Stockholm, Sweden ,Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - John Tengbom
- Department of Medicine, Division of Cardiology, Karolinska Institutet, Stockholm, Sweden
| | - Nawzad Saleh
- Department of Medicine, Division of Cardiology, Karolinska Institutet, Stockholm, Sweden ,Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - Dinos Verouhis
- Department of Medicine, Division of Cardiology, Karolinska Institutet, Stockholm, Sweden ,Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - Felix Böhm
- Department of Medicine, Division of Cardiology, Karolinska Institutet, Stockholm, Sweden ,Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - Zhichao Zhou
- Department of Medicine, Division of Cardiology, Karolinska Institutet, Stockholm, Sweden
| | - Jiangning Yang
- Department of Medicine, Division of Cardiology, Karolinska Institutet, Stockholm, Sweden
| | - John Pernow
- Department of Medicine, Division of Cardiology, Karolinska Institutet, Stockholm, Sweden ,Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
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14
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Abstract
Abstract
Background
Vascular injury has been implicated as a major cause of clinical complications in patients with coronavirus disease 2019 (COVID-19). Autopsy studies have revealed destruction of the endothelial cell lining, which might explain cardiovascular alterations arising from the infection. However, data demonstrating endothelial dysfunction during ongoing infection are sparse, and the underlying mechanisms are still largely unknown. Red blood cells (RBCs) are affected by COVID-19 with alterations in their structure and function, possibly contributing to vascular injury via increased oxidative stress.
Purpose
To determine the presence of endothelial dysfunction in patients with COVID-19 and to explore the RBC as a possible mediator of such dysfunction.
Methods
The study was performed on 17 patients hospitalized for moderate COVID-19 infection and age- and sex-matched healthy subjects. Inclusion criteria of the COVID-19 patients were PCR-verified SARS-CoV2 infection, pulmonary infiltrates on x-ray, oxygen demand during hospital stay and ≤ one cardiovascular co-morbidity. Microvascular endothelial function in vivo was assessed with a pulse amplitude tonometry device on each index finger at baseline and during reactive hyperemia and expressed as reactive hyperemia index (RHI). RBCs from COVID-19 patients (C19-RBCs) and healthy subjects (H-RBCs) were incubated with isolated rat aortic segments for evaluation of endothelium-dependent and -independent relaxation.
Results
COVID-19 patients displayed profound impairment in endothelial function in vivo with RHI 1.56 (1.30–1.81, median and interquartile range) compared to healthy subjects 2.36 (1.97–2.79, p<0.001). C19-RBCs induced severe impairment in both endothelium-dependent (27% maximal relaxation) and -independent relaxations (54%) compared to H-RBCs (67% and 95% relaxation, respectively). Further, C19-RBCs induced upregulation of vascular arginase 1 (∼2 fold increase compared to H-RBCs) and markers of oxidative stress (∼6 fold). Consequently, inhibition of vascular arginase or superoxide attenuated the impairment in endothelial function induced by C19-RBCs. C19-RBCs were characterized by increased production of reactive oxygen species (∼1.4 fold) and reduced export of the nitric oxide metabolite nitrate. Following pre-incubation with interferon-γ, but not interleukin-6 or tumor necrosis factor-α, H-RBCs induced impairment in endothelial function.
Conclusions
This study demonstrates the presence of marked endothelial dysfunction in an otherwise mainly healthy patient group hospitalized for COVID-19, and clearly implicates a central role of the RBC as a mediator of endothelial injury through enhancement of reactive oxygen species and arginase. These data shed light on a new pathological mechanism underlying vascular dysfunction in COVID-19 patients and may lay the foundation for future therapeutic developments.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Swedish Heart and Lung foundationSwedish Research Council
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Affiliation(s)
- A Mahdi
- Karolinska Institute, Unit of Cardiology, Department of Medicine, Stockholm, Sweden
| | - A Collado
- Karolinska Institute, Unit of Cardiology, Department of Medicine, Stockholm, Sweden
| | - J Tengbom
- Karolinska Institute, Unit of Cardiology, Department of Medicine, Stockholm, Sweden
| | - T Jiao
- Karolinska Institute, Unit of Cardiology, Department of Medicine, Stockholm, Sweden
| | - T Wodaje
- Karolinska Institute, Department of Medicine Huddinge, Stockholm, Sweden
| | - J Yang
- Karolinska Institute, Unit of Cardiology, Department of Medicine, Stockholm, Sweden
| | - J O Lundberg
- Karolinska Institute, Department of Physiology and Pharmacology, Stockholm, Sweden
| | - Z Zhou
- Karolinska Institute, Unit of Cardiology, Department of Medicine, Stockholm, Sweden
| | - J Pernow
- Karolinska Institute, Unit of Cardiology, Department of Medicine, Stockholm, Sweden
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15
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Collado A, Jin H, Pernow J, Zhou Z. MicroRNA: A mediator of diet-induced cardiovascular protection. Curr Opin Pharmacol 2021; 60:183-192. [PMID: 34461563 DOI: 10.1016/j.coph.2021.07.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/20/2021] [Accepted: 07/30/2021] [Indexed: 11/30/2022]
Abstract
Diets containing nutrients such as polyunsaturated fatty acids, polyphenols, or vitamins have been shown to have cardiovascular benefits. Micro (mi)RNAs are fundamental regulators of gene expression and function in the cardiovascular system. Diet-induced cardiovascular benefits are associated with changes in endogenous expression of miRNAs in the cardiovascular system. In addition, emerging studies have shown that miRNAs present in the food can be transported in the circulation to tissues. These exogenous miRNAs may also affect cardiovascular function contributing to the diet-induced benefits. This review discusses the emerging role of both endogenous and exogenous miRNAs as mediators of diet-induced cardiovascular protection. Understanding the mechanisms of diet-mediated actions through modulation of miRNA may provide a potential strategy for new therapies.
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Affiliation(s)
- Aida Collado
- Division of Cardiology, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Hong Jin
- Division of Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - John Pernow
- Division of Cardiology, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden; Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - Zhichao Zhou
- Division of Cardiology, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
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16
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Polo Alonso E, Ramírez-Backhaus M, Wei G, Mascarós JM, Aragón Rodriguez F, Gómez-Ferrer Á, Collado A, Calatrava Fons A, Rubio-Briones J. Does active surveillance avoid overtreatment in prostate cancer? Lessons learned from salvage radical prostatectomies. Actas Urol Esp 2021; 45:373-382. [PMID: 34088437 DOI: 10.1016/j.acuroe.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/14/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Determine whether our institution´s active surveillance (AS) protocol is a suitable strategy to minimise prostate cancer overtreatment. MATERIAL AND METHODS Retrospective analysis of 516 patients on AS after prostate cancer diagnosis. Population divided into "per-protocol" vs "induced" AS depending on fulfilment of protocol´s inclusion criteria. Radical prostatectomies after AS were selected and stratified based on: reclassification, progression or patient anxiety. Clinicopathological features and biochemical relapse-free survival were studied. Primary endpoint was overtreatment ratio based on the presence of insignificant prostate cancer and adverse pathological features in the surgical specimen. Kaplan-Meier curves were used to estimate the biochemical relapse-free survival and compared with log-rank test. RESULTS 304 patients fulfilled inclusion criteria; 100 proceeded to radical prostatectomy (31% "induced", 69% "per-protocol" AS). Surgery indications were reclassification, progression and anxiety in 66%, 18% and 16% of patients respectively. Rate of positive lymph nodes was higher in the progression group (11%) compared to reclassification and anxiety (5% and 0% respectively, P = .002). Positive surgical margins were more frequently reported in the progression cohort compared to reclassification (28% vs 20%). Median follow-up from diagnosis until last radical prostatectomy was 48.3 months (32.4-70). 3 year biochemical relapse-free survival in the salvage radical prostatectomy was 85.4% (95 CI 78.3-93.2). Insignificant cancer was noticed in 7% of patients (Epstein´s vs 24% Wolters´ criteria). Rate of patients with adverse pathological features was 36%. CONCLUSIONS The majority of patients who underwent salvage surgery after AS were not overtreated. Radical prostatectomy should be considered a safe rescue treatment.
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Affiliation(s)
- E Polo Alonso
- Departamento de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain.
| | - M Ramírez-Backhaus
- Departamento de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - G Wei
- Department of Surgery, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia; Young Urology Researchers Organisation (YURO), Melbourne, Victoria, Australia
| | - J M Mascarós
- Departamento de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - F Aragón Rodriguez
- Departamento de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Á Gómez-Ferrer
- Departamento de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - A Collado
- Departamento de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - A Calatrava Fons
- Departamento de Patología, Fundacion Instituto Valenciano de Oncologia, Valencia, Spain
| | - J Rubio-Briones
- Departamento de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
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Collado A, Domingo E, Marques P, Perello E, Martínez-Hervás S, Piqueras L, Ascaso JF, Real JT, Sanz MJ. Oral Unsaturated Fat Load Impairs Postprandial Systemic Inflammation in Primary Hypercholesterolemia Patients. Front Pharmacol 2021; 12:656244. [PMID: 33959024 PMCID: PMC8093814 DOI: 10.3389/fphar.2021.656244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/18/2021] [Indexed: 12/12/2022] Open
Abstract
Context: Primary hypercholesterolemia (PH) is a lipid disorder characterized by elevated levels of cholesterol and low-density lipoprotein (LDL). Low-grade systemic inflammation is associated with PH, which might explain the higher incidence of cardiovascular diseases in this setting. Objective: To evaluate the effect of an oral unsaturated fat load (OUFL) on different immune parameters and functional consequences in patients with PH in postprandial state. Design: A commercial liquid preparation of long-chain triglycerides (Supracal®; ω6/ω3 ratio >20/1, OUFL) was administered to 20 patients and 10 age-matched controls. Whole blood was collected before (fasting state) and 4 h after administration (postprandial state). Flow cytometry was employed to determine platelet and leukocyte activation, and the levels of circulating platelet-leukocyte aggregates. Soluble markers were determined by ELISA, and the parallel-plate flow chamber was employed to study leukocyte adhesion to the dysfunctional arterial endothelium. Results: The PH group had a lower percentage of activated platelets and circulating type 1 monocytes, and blunted neutrophil activation after the OUFL, accompanied by a significant increase in the percentage of regulatory T lymphocytes. In this group, the OUFL led to a significant impairment of leukocyte adhesion to the dysfunctional [tumor necrosis factor α (TNFα)-stimulated] endothelium and reduced the plasma levels of soluble P-selectin, platelet factor-4 (PF-4)/CXCL4, CXCL8, CCL2, CCL5, and TNFα. Conclusion: The OUFL has a beneficial impact on the pro-thrombotic and pro-inflammatory state of PH patients and might be a promising macronutrient approach to dampen the systemic inflammation associated with PH and the development of further cardiovascular events.
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Affiliation(s)
- Aida Collado
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Elena Domingo
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain
| | - Patrice Marques
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Eva Perello
- Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders, Carlos III Health Institute, Madrid, Spain
| | - Sergio Martínez-Hervás
- Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders, Carlos III Health Institute, Madrid, Spain.,Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain
| | - Laura Piqueras
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders, Carlos III Health Institute, Madrid, Spain
| | - Juan F Ascaso
- Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders, Carlos III Health Institute, Madrid, Spain.,Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain
| | - José T Real
- Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders, Carlos III Health Institute, Madrid, Spain.,Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain
| | - Maria-Jesus Sanz
- Department of Pharmacology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders, Carlos III Health Institute, Madrid, Spain
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18
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Polo Alonso E, Ramírez-Backhaus M, Wei G, Mascarós J, Aragón Rodríguez F, Gómez-Ferrer A, Collado A, Calatrava Fons A, Rubio-Briones J. Does active surveillance avoid overtreatment in prostate cancer? Lessons learned from salvage radical prostatectomies. Actas Urol Esp 2021. [PMID: 33637376 DOI: 10.1016/j.acuro.2020.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Determine whether our institution's active surveillance (AS) protocol is a suitable strategy to minimise prostate cancer overtreatment. MATERIAL AND METHODS Retrospective analysis of 516 patients on AS after prostate cancer diagnosis. Population divided into «per-protocol» vs «induced» AS depending on fulfilment of protocol's inclusion criteria. Radical prostatectomies after AS were selected and stratified based on reclassification, progression or patient anxiety. Clinicopathological features and biochemical relapse-free survival were studied. Primary endpoint was overtreatment ratio based on the presence of insignificant prostate cancer and adverse pathological features in the surgical specimen. Kaplan-Meier curves were used to estimate the biochemical relapse-free survival and compared with log-rank test. RESULTS 304 patients fulfilled inclusion criteria; 100 proceeded to radical prostatectomy (31% «induced», 69% «per-protocol» AS). Surgery indications were reclassification, progression and anxiety in 66%, 18% and 16% of patients, respectively. Rate of positive lymph nodes was higher in the progression group (11%) compared to reclassification and anxiety (5% and 0%, respectively; P=.002). Positive surgical margins were more frequently reported in the progression cohort compared to reclassification (28% vs 20%). Median follow-up from diagnosis until last radical prostatectomy was 48.3months (32.4-70). Three year biochemical relapse-free survival in the salvage radical prostatectomy was 85.4% (95%CI: 78.3-93.2). Insignificant cancer was noticed in 7% of patients (Epstein's vs 24% Wolters' criteria). Rate of patients with adverse pathological features was 36%. CONCLUSIONS The majority of patients who underwent salvage surgery after AS were not overtreated. Radical prostatectomy should be considered a safe rescue treatment.
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Fernández Lucas M, Ruíz-Roso G, Merino JL, Sánchez R, Bouarich H, Herrero JA, Muriel A, Zamora J, Collado A. Initiating renal replacement therapy through incremental haemodialysis: Protocol for a randomized multicentre clinical trial. Trials 2020; 21:206. [PMID: 32075665 PMCID: PMC7031943 DOI: 10.1186/s13063-020-4058-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 01/08/2020] [Indexed: 01/25/2023] Open
Abstract
Background Thrice-weekly haemodialysis is the usual dose when starting renal replacement therapy; however, this schedule is no longer appropriate since it does not consider residual renal function. Several reports have suggested the potential benefit of beginning haemodialysis less frequently and incrementally increasing the dose as the residual renal function decreases. However, all the data published so far are from observational studies. Thus, this clinical trial avoids any potential selection bias and will assess the possible benefits that have been observed in observational studies. Methods/design This report describes the study protocol of a randomized prospective multi-centre open-label clinical trial to evaluate whether starting renal replacement therapy with twice-weekly haemodialysis sessions preserves residual renal function better than the standard thrice-weekly regimen. We also explore other clinical parameters, such as concentrations of uremic toxins, dialysis doses, control of anaemia, removal of medium-weight uremic toxins, nutritional status, quality of life, hospital admissions and mortality. Only incident haemodialysis patients who can maintain a urea clearance rate KrU ≥ 2.5 mL/min/1.73 m2 are eligible. Patient recruitment began on 1 January 2017 and will last for 2 years or until the required sample size has been recruited to ensure the established statistical power has been reached. The minimum follow-up period will be 1 year. Anuric patients with acute renal failure and patients who return to haemodialysis after a kidney transplant failure are excluded. It has been calculated that 44 patients should be recruited into each group to achieve a power of 80% in a two-sided comparison of means with a usual significance level of 0.05. A time-to-event analysis will estimate the probability of kidney function survival in both groups using the Kaplan–Meier method. Survival curves will be compared with log-rank tests. This survival analysis will be complemented with a proportional hazard model to estimate the hazard ratio of kidney function survival adjusted for any confounding factors. Analyses will be carried out in accordance with the intention-to-treat principle. Discussion The incremental initiation of dialysis may preserve residual renal function better than the conventional treatment, with similar or higher survival rates, as reported by observational studies. To our knowledge, this is the first clinical trial to evaluate whether initiating renal replacement therapy with twice-weekly haemodialysis sessions preserves residual renal function better than beginning with the standard thrice-weekly regimen. Trial registration ClinicalTrials.gov, NCT03302546. Registered on 5 October 2017.
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Affiliation(s)
- M Fernández Lucas
- Servicio de Nefrología, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain. .,Departamento de Medicina, Universidad de Alcala, Alcalá de Henares, Madrid, Spain.
| | - G Ruíz-Roso
- Servicio de Nefrología, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - J L Merino
- Hospital Universitario del Henares, Madrid, Spain
| | - R Sánchez
- Hospital Universitario La Paz, Madrid, Spain
| | - H Bouarich
- Hospital Universitario Principe de Asturias, Alcalá de Henares, Madrid, Spain
| | - J A Herrero
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - A Muriel
- Unidad de Bioestadística, H. U, Ramón y Cajal, IRYCIS, Madrid, Spain
| | - J Zamora
- Unidad de Bioestadística, H. U, Ramón y Cajal, IRYCIS, Madrid, Spain
| | - A Collado
- Servicio de Nefrología, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
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20
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Collado A, Marques P, Escudero P, Rius C, Domingo E, Martinez-Hervás S, Real JT, Ascaso JF, Piqueras L, Sanz MJ. Functional role of endothelial CXCL16/CXCR6-platelet-leucocyte axis in angiotensin II-associated metabolic disorders. Cardiovasc Res 2019; 114:1764-1775. [PMID: 29800106 DOI: 10.1093/cvr/cvy135] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 05/18/2018] [Indexed: 12/16/2022] Open
Abstract
Aims Angiotensin-II (Ang-II) is the main effector peptide of the renin-angiotensin system (RAS) and promotes leucocyte adhesion to the stimulated endothelium. Because RAS activation and Ang-II signalling are implicated in metabolic syndrome (MS) and abdominal aortic aneurysm (AAA), we investigated the effect of Ang-II on CXCL16 arterial expression, the underlying mechanisms, and the functional role of the CXCL16/CXCR6 axis in these cardiometabolic disorders. Methods and results Results from in vitro chamber assays revealed that CXCL16 neutralization significantly inhibited mononuclear leucocyte adhesion to arterial but not to venous endothelial cells. Flow cytometry and immunofluorescence studies confirmed that Ang-II induced enhanced endothelial CXCL16 expression, which was dependent on Nox5 up-regulation and subsequent RhoA/p38-MAPK/NFκB activation. Flow cytometry analysis further showed that MS patients had higher levels of platelet activation and a higher percentage of circulating CXCR6-expressing platelets, CXCR6-expressing-platelet-bound neutrophils, monocytes, and CD8+ lymphocytes than age-matched controls, leading to enhanced CXCR6/CXCL16-dependent adhesion to the dysfunctional (Ang-II- and TNFα-stimulated) arterial endothelium. Ang-II-challenged apolipoprotein E-deficient (apoE-/-) mice had a higher incidence of AAA, macrophage, CD3+, and CXCR6+ cell infiltration and neovascularization than unchallenged animals, which was accompanied by greater CCL2, CXCL16, and VEGF mRNA expression within the lesion together with elevated levels of circulating soluble CXCL16. Significant reductions in these parameters were found in animals co-treated with the AT1 receptor antagonist losartan or in apoE-/- mice lacking functional CXCR6 receptor (CXCR6GFP/GFP). Conclusion CXCR6 expression on platelet-bound monocytes and CD8+ lymphocytes may constitute a new membrane-associated biomarker for adverse cardiovascular events. Moreover, pharmacological modulation of this axis may positively affect cardiovascular outcome in metabolic disorders linked to Ang-II.
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Affiliation(s)
- Aida Collado
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain
| | - Patrice Marques
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain
| | - Paula Escudero
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain
| | - Cristina Rius
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain
| | - Elena Domingo
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Sergio Martinez-Hervás
- Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain.,Department of Medicine, Faculty of Medicine, Endocrinology and Nutrition Unit, University Clinic Hospital of Valencia, University of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Spain
| | - José T Real
- Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain.,Department of Medicine, Faculty of Medicine, Endocrinology and Nutrition Unit, University Clinic Hospital of Valencia, University of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Spain
| | - Juan F Ascaso
- Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain.,Department of Medicine, Faculty of Medicine, Endocrinology and Nutrition Unit, University Clinic Hospital of Valencia, University of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Spain
| | - Laura Piqueras
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain
| | - Maria-Jesus Sanz
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University of Valencia, Av. Menéndez Pelayo 4, Valencia, Spain
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21
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Bermejo A, Collado A, Barrachina I, Marqués P, El Aouad N, Franck X, Garibotto F, Dacquet C, Caignard DH, Suvire FD, Enriz RD, Piqueras L, Figadère B, Sanz MJ, Cabedo N, Cortes D. Polycerasoidol, a Natural Prenylated Benzopyran with a Dual PPARα/PPARγ Agonist Activity and Anti-inflammatory Effect. J Nat Prod 2019; 82:1802-1812. [PMID: 31268307 DOI: 10.1021/acs.jnatprod.9b00003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Dual peroxisome proliferator-activated receptor-α/γ (PPARα/γ) agonists regulate both lipid and glucose homeostasis under different metabolic conditions and can exert anti-inflammatory activity. We investigated the potential dual PPARα/γ agonism of prenylated benzopyrans polycerasoidol (1) and polycerasoidin (2) and their derivatives for novel drug development. Nine semisynthetic derivatives were prepared from the natural polycerasoidol (1) and polycerasoidin (2), which were evaluated for PPARα, -γ, -δ and retinoid X receptor-α activity in transactivation assays. Polycerasoidol (1) exhibited potent dual PPARα/γ agonism and low cytotoxicity. Structure-activity relationship studies revealed that a free phenol group at C-6 and a carboxylic acid at C-9' were key features for dual PPARα/γ agonism activity. Molecular modeling indicated the relevance of these groups for optimal ligand binding to the PPARα and PPARγ domains. In addition, polycerasoidol (1) exhibited a potent anti-inflammatory effect by inhibiting mononuclear leukocyte adhesion to the dysfunctional endothelium in a concentration-dependent manner via RXRα/PPARγ interactions. Therefore, polycerasoidol (1) can be considered a hit-to-lead molecule for the further development of novel dual PPARα/γ agonists capable of preventing cardiovascular events associated with metabolic disorders.
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Affiliation(s)
- Almudena Bermejo
- Department of Pharmacology , University of Valencia , 46113 Valencia Spain
- Center of Citriculture and Vegetal Production , IVIA , Moncada, 46100 Valencia , Spain
| | - Aida Collado
- Department of Pharmacology , University of Valencia , 46113 Valencia Spain
| | - Isabel Barrachina
- Department of Pharmacology , University of Valencia , 46113 Valencia Spain
| | - Patrice Marqués
- Department of Pharmacology , University of Valencia , 46113 Valencia Spain
- Institute of Health Research-INCLIVA , University Clinic Hospital of Valencia , 46010 Valencia , Spain
| | | | - Xavier Franck
- UMR CNRS 6014/FR 3038, COBRA, Université de Rouen , Mont-Saint-Aignan 76821 , France
| | - Francisco Garibotto
- Facultad de Química, Bioquímica y Farmacia , Universidad Nacional de San Luis-IMIBIO-SL-CONICET , Chacabuco 915 , San Luis , Argentina
| | - Catherine Dacquet
- Départament des Sciences Expérimentales , Institut de Recherches Servier , Suresnes 92150 , France
| | - Daniel H Caignard
- Départament des Sciences Expérimentales , Institut de Recherches Servier , Suresnes 92150 , France
| | - Fernando D Suvire
- Facultad de Química, Bioquímica y Farmacia , Universidad Nacional de San Luis-IMIBIO-SL-CONICET , Chacabuco 915 , San Luis , Argentina
| | - Ricardo D Enriz
- Facultad de Química, Bioquímica y Farmacia , Universidad Nacional de San Luis-IMIBIO-SL-CONICET , Chacabuco 915 , San Luis , Argentina
| | - Laura Piqueras
- Department of Pharmacology , University of Valencia , 46113 Valencia Spain
- Institute of Health Research-INCLIVA , University Clinic Hospital of Valencia , 46010 Valencia , Spain
| | - Bruno Figadère
- UMR CNRS 8076, LERMIT , Université Paris-Sud, UFR de Pharmacie , Châtenay-Malabry 92290 , France
| | - María-Jesús Sanz
- Department of Pharmacology , University of Valencia , 46113 Valencia Spain
- Institute of Health Research-INCLIVA , University Clinic Hospital of Valencia , 46010 Valencia , Spain
| | - Nuria Cabedo
- Department of Pharmacology , University of Valencia , 46113 Valencia Spain
- Institute of Health Research-INCLIVA , University Clinic Hospital of Valencia , 46010 Valencia , Spain
| | - Diego Cortes
- Department of Pharmacology , University of Valencia , 46113 Valencia Spain
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Ortega R, Collado A, Selles F, Gonzalez-Navarro H, Sanz MJ, Real JT, Piqueras L. SGLT-2 (Sodium-Glucose Cotransporter 2) Inhibition Reduces Ang II (Angiotensin II)-Induced Dissecting Abdominal Aortic Aneurysm in ApoE (Apolipoprotein E) Knockout Mice. Arterioscler Thromb Vasc Biol 2019; 39:1614-1628. [PMID: 31294626 DOI: 10.1161/atvbaha.119.312659] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Abdominal aortic aneurysm (AAA) is a pathological condition of permanent vessel dilatation that predisposes to the potentially fatal consequence of aortic rupture. SGLT-2 (sodium-glucose cotransporter 2) inhibitors have emerged as powerful pharmacological tools for type 2 diabetes mellitus treatment. Beyond their glucose-lowering effects, recent studies have shown that SGLT-2 inhibitors reduce cardiovascular events and have beneficial effects on several vascular diseases such as atherosclerosis; however, the potential effects of SGLT-2 inhibition on AAA remain unknown. This study evaluates the effect of oral chronic treatment with empagliflozin-an SGLT-2 inhibitor-on dissecting AAA induced by Ang II (angiotensin II) infusion in apoE (apolipoprotein E)-/- mice. Approach and Results: Empagliflozin treatment significantly reduced the Ang II-induced increase in maximal suprarenal aortic diameter in apoE-/- mice independently of blood pressure effects. Immunohistochemistry analysis revealed that empagliflozin diminished Ang II-induced elastin degradation, neovessel formation, and macrophage infiltration at the AAA lesion. Furthermore, Ang II infusion resulted in a marked increase in the expression of chemokines (CCL-2 [chemokine (C-C motif) ligand 2] and CCL-5 [chemokine (C-C motif) ligand 5]), VEGF (vascular endothelial growth factor), and MMP (matrix metalloproteinase)-2 and MMP-9 in suprarenal aortic walls of apoE-/- mice, and all were reduced by empagliflozin cotreatment. Western blot analysis revealed that p38 MAPK (p38 mitogen-activated protein kinase) and NF-κB (nuclear factor-κB) activation was also reduced in the suprarenal aortas of apoE-/- mice cotreated with empagliflozin. Finally, in vitro studies in human aortic endothelial cells and macrophages showed that empagliflozin inhibited leukocyte-endothelial cell interactions and release of proinflammatory chemokines. CONCLUSIONS Pharmacological inhibition of SGLT-2 by empagliflozin inhibits AAA formation. SGLT-2 inhibition might represent a novel promising therapeutic strategy to prevent AAA progression.
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Affiliation(s)
- Rebeca Ortega
- From the Institute of Health Research-INCLIVA, Valencia, Spain (R.O., A.C., F.S., H.G.-N., M.J.S., J.T.R., L.P.)
| | - Aida Collado
- From the Institute of Health Research-INCLIVA, Valencia, Spain (R.O., A.C., F.S., H.G.-N., M.J.S., J.T.R., L.P.)
| | - Francisca Selles
- From the Institute of Health Research-INCLIVA, Valencia, Spain (R.O., A.C., F.S., H.G.-N., M.J.S., J.T.R., L.P.)
| | - Herminia Gonzalez-Navarro
- From the Institute of Health Research-INCLIVA, Valencia, Spain (R.O., A.C., F.S., H.G.-N., M.J.S., J.T.R., L.P.).,CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research-ISCIII, Madrid, Spain (H.G.-N., M.J.S., J.T.R., L.P.)
| | - Maria-Jesus Sanz
- From the Institute of Health Research-INCLIVA, Valencia, Spain (R.O., A.C., F.S., H.G.-N., M.J.S., J.T.R., L.P.).,Department of Pharmacology, Faculty of Medicine, University of Valencia, Spain (M.J.S., L.P.).,CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research-ISCIII, Madrid, Spain (H.G.-N., M.J.S., J.T.R., L.P.)
| | - José T Real
- From the Institute of Health Research-INCLIVA, Valencia, Spain (R.O., A.C., F.S., H.G.-N., M.J.S., J.T.R., L.P.).,Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Spain (J.T.R.).,CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research-ISCIII, Madrid, Spain (H.G.-N., M.J.S., J.T.R., L.P.)
| | - Laura Piqueras
- From the Institute of Health Research-INCLIVA, Valencia, Spain (R.O., A.C., F.S., H.G.-N., M.J.S., J.T.R., L.P.).,Department of Pharmacology, Faculty of Medicine, University of Valencia, Spain (M.J.S., L.P.).,CIBERDEM: Diabetes and Associated Metabolic Diseases Networking Biomedical Research-ISCIII, Madrid, Spain (H.G.-N., M.J.S., J.T.R., L.P.)
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Marques P, Collado A, Martinez-Hervás S, Domingo E, Benito E, Piqueras L, Real JT, Ascaso JF, Sanz MJ. Systemic Inflammation in Metabolic Syndrome: Increased Platelet and Leukocyte Activation, and Key Role of CX 3CL1/CX 3CR1 and CCL2/CCR2 Axes in Arterial Platelet-Proinflammatory Monocyte Adhesion. J Clin Med 2019; 8:jcm8050708. [PMID: 31109070 PMCID: PMC6572270 DOI: 10.3390/jcm8050708] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/14/2019] [Accepted: 05/16/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Metabolic syndrome is associated with low-grade systemic inflammation, which is a key driver of premature atherosclerosis. We characterized immune cell behavior in metabolic syndrome, its consequences, and the potential involvement of the CX3CL1/CX3CR1 and CCL2/CCR2 chemokine axes. METHODS Whole blood from 18 patients with metabolic syndrome and 21 age-matched controls was analyzed by flow cytometry to determine the leukocyte immunophenotypes, activation, platelet-leukocyte aggregates, and CX3CR1 expression. ELISA determined the plasma marker levels. Platelet-leukocyte aggregates adhesion to tumor necrosis factor-α (TNFα)-stimulated arterial endothelium and the role of CX3CL1/CX3CR1 and CCL2/CCR2 axes was investigated with the parallel-plate flow chamber. RESULTS When compared with the controls, the metabolic syndrome patients presented greater percentages of eosinophils, CD3+ T lymphocytes, Mon2/Mon3 monocytes, platelet-eosinophil and -lymphocyte aggregates, activated platelets, neutrophils, eosinophils, monocytes, and CD8+ T cells, but lower percentages of Mon1 monocytes. Patients had increased circulating interleukin-8 (IL-8) and TNFα levels and decreased IL-4. CX3CR1 up-regulation in platelet-Mon1 monocyte aggregates in metabolic syndrome patients led to increased CX3CR1/CCR2-dependent platelet-Mon1 monocyte adhesion to dysfunctional arterial endothelium. CONCLUSION We provide evidence of generalized immune activation in metabolic syndrome. Additionally, CX3CL1/CX3CR1 or CCL2/CCR2 axes are potential candidates for therapeutic intervention in cardiovascular disorders in metabolic syndrome patients, as their blockade impairs the augmented arterial platelet-Mon1 monocyte aggregate adhesiveness, which is a key event in atherogenesis.
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Affiliation(s)
- Patrice Marques
- Department of Pharmacology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
| | - Aida Collado
- Department of Pharmacology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
| | - Sergio Martinez-Hervás
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
- Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Elena Domingo
- Department of Pharmacology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
| | - Esther Benito
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Laura Piqueras
- Department of Pharmacology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - José T Real
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
- Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Juan F Ascaso
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
- Endocrinology and Nutrition Service, University Clinic Hospital of Valencia, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Maria-Jesus Sanz
- Department of Pharmacology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
- Institute of Health Research INCLIVA, Av. Menéndez Pelayo 4, 46010 Valencia, Spain.
- CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029 Madrid, Spain.
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Rivero‐Juarez A, Tellez F, Castaño‐Carracedo M, Merino D, Espinosa N, Santos J, Macias J, Paniagua‐García M, Zapata‐Lopez A, Collado A, Gómez‐Vidal MA, Perez‐Stachowski J, Muñoz‐Medina L, Fernandez‐Fuertes E, Rivero A. Parenteral drug use as the main barrier to hepatitis C treatment uptake inHIV‐infected patients. HIV Med 2019; 20:359-367. [DOI: 10.1111/hiv.12715] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2018] [Indexed: 12/18/2022]
Affiliation(s)
- A Rivero‐Juarez
- Infectious Diseases Unit Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC) Hospital Universitario Reina Sofía de Córdoba Universidad de Córdoba Córdoba Spain
| | - F Tellez
- Infectious Diseases Unit Hospital Universitario de Puerto Real Instituto de Investigación e Innovación en Ciencias Biomédicas de la Provincia de Cádiz Universidad de Cádiz Cádiz Spain
| | - M Castaño‐Carracedo
- Infectious Diseases Unit Hospital Regional Universitario de Málaga Málaga Spain
| | - D Merino
- Infectious Diseases Unit Hospitales Juan Ramón Jiménez e Infanta Elena de Huelva Huelva Spain
| | - N Espinosa
- Infectious Diseases Unit Hospital Universitario Virgen del Rocio Instituto de Biomedicina de Sevilla (iBiS) Sevilla Spain
| | - J Santos
- Infectious Diseases Unit Hospital Universitario Virgen de la Victoria Complejo Hospitalario Provincial de Málaga Málaga Spain
| | - J Macias
- Infectious Diseases Unit Hospital Universitario de Valme Instituto de Biomedicina de Sevilla (iBiS) Sevilla Spain
| | - M Paniagua‐García
- Infectious Diseases Unit Hospital Universitario Virgen Macarena Instituto de Biomedicina de Sevilla (iBiS) Sevilla Spain
| | | | - A Collado
- Infectious Diseases Unit Complejo Hospitalario Torrecárdenas Almería Spain
| | - MA Gómez‐Vidal
- Infectious Diseases Unit Complejo Hospitalario de Jaén Jaén Spain
| | | | - L Muñoz‐Medina
- Infectious Diseases Unit Hospital Universitario San Cecilio Granada Spain
| | | | - A Rivero
- Infectious Diseases Unit Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC) Hospital Universitario Reina Sofía de Córdoba Universidad de Córdoba Córdoba Spain
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25
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Rubio-Briones J, Ramírez-Backhaus M, Gómez-Ferrer A, Mir C, Domínguez-Escrig J, Collado A, Iborra I, Casanova J, Solsona E, Mascarós J, Calatrava A. Long-term oncological results of treatment for high-risk prostate cancer using radical prostatectomy in a cancer hospital. Actas Urol Esp 2018; 42:507-515. [PMID: 29631913 DOI: 10.1016/j.acuro.2018.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 02/14/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To analyse the most relevant oncologic results of treatment using radical prostatectomy (RP) for high-risk prostate cancer (HRPC) in a specialist cancer hospital. MATERIAL AND METHODS A descriptive retrospective study of RP was conducted at our centre from 1986 to 2017 on HRPC whose primary objective was to determine overall survival (OS) and cancer-specific survival (CSS). The study's secondary objectives were to determine biochemical progression-free survival (BPFS), metastasis-free survival (MFS), rescue therapy-free survival (RTFS), hormone therapy-free survival (HTFS) and the development of castration-resistant prostate cancer. We performed a Cox regression analysis to establish predictive models and to better understand the weight of each variable that defines high risk. RESULTS A total of 2093 RPs were performed, 480 (22.9%) of which were for HRPC. The median follow-up for the overall series was 79.57 months (P25-75 37.92-135.16). Lymphadenectomy was not performed in 6.5% of the cases. The lymphadenectomy was of the obturator type in 51.2% of the cases and extended in 42.3%. Overall survival at 5, 10 and 15 years was 89.8% (95% CI 86.7-92.9%), 73.3% (95% CI 68-78.6%) and 51.4% (95% CI 43.8-59%), respectively. CSS at 5, 10 and 15 years was 94.8% (95% CI 92.4-97.2%), 84.0% (95% CI 79.3-88.7%) and 75.5% (95% CI 68.8-82.2%), respectively. MFS at 5, 10 and 15 years was 87.4% (95% CI 84.1-90.7%), 72.2% (95% CI 66.7-77.7%) and 61.7% (95% CI 54.3-69.1%), respectively. A total of 120 patients of 477 analysed (25.1%) required rescue radiation therapy, and 293/477 never required hormone therapy (61.4%). Of the 93 pN1 patients, 33 (35.5%) did not require hormone therapy. The time from RP to biochemical progression was the variable with the greatest prognostic weight for MFS, CSS and overall survival. CONCLUSIONS RP plus extended lymphadenectomy should be the first therapeutic manoeuvre when feasible within a multimodal strategy. A longer follow-up of the series is needed to validate the hypothesis of better oncologic results based on the earlier implementation of rescue radiation therapy, extended lymphadenectomy and drugs that prolong survival in the CRPC phase.
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26
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Plens-Galaska M, Szelag M, Collado A, Marques P, Vallejo S, Ramos-González M, Wesoly J, Sanz MJ, Peiró C, Bluyssen HAR. Genome-Wide Inhibition of Pro-atherogenic Gene Expression by Multi-STAT Targeting Compounds as a Novel Treatment Strategy of CVDs. Front Immunol 2018; 9:2141. [PMID: 30283459 PMCID: PMC6156247 DOI: 10.3389/fimmu.2018.02141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 08/30/2018] [Indexed: 12/21/2022] Open
Abstract
Cardiovascular diseases (CVDs), including atherosclerosis, are globally the leading cause of death. Key factors contributing to onset and progression of atherosclerosis include the pro-inflammatory cytokines Interferon (IFN)α and IFNγ and the Pattern Recognition Receptor (PRR) Toll-like receptor 4 (TLR4). Together, they trigger activation of Signal Transducer and Activator of Transcription (STAT)s. Searches for compounds targeting the pTyr-SH2 interaction area of STAT3, yielded many small molecules, including STATTIC and STX-0119. However, many of these inhibitors do not seem STAT3-specific. We hypothesized that multi-STAT-inhibitors that simultaneously block STAT1, STAT2, and STAT3 activity and pro-inflammatory target gene expression may be a promising strategy to treat CVDs. Using comparative in silico docking of multiple STAT-SH2 models on multi-million compound libraries, we identified the novel multi-STAT inhibitor, C01L_F03. This compound targets the SH2 domain of STAT1, STAT2, and STAT3 with the same affinity and simultaneously blocks their activity and expression of multiple STAT-target genes in HMECs in response to IFNα. The same in silico and in vitro multi-STAT inhibiting capacity was shown for STATTIC and STX-0119. Moreover, C01L_F03, STATTIC and STX-0119 were also able to affect genome-wide interactions between IFNγ and TLR4 by commonly inhibiting pro-inflammatory and pro-atherogenic gene expression directed by cooperative involvement of STATs with IRFs and/or NF-κB. Moreover, we observed that multi-STAT inhibitors could be used to inhibit IFNγ+LPS-induced HMECs migration, leukocyte adhesion to ECs as well as impairment of mesenteric artery contractility. Together, this implicates that application of a multi-STAT inhibitory strategy could provide great promise for the treatment of CVDs.
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Affiliation(s)
- Martyna Plens-Galaska
- Department of Human Molecular Genetics, Institute of Molecular Biology and Biotechnology, Adam Mickiewicz University, Poznan, Poland
| | - Malgorzata Szelag
- Department of Human Molecular Genetics, Institute of Molecular Biology and Biotechnology, Adam Mickiewicz University, Poznan, Poland
| | - Aida Collado
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Patrice Marques
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Susana Vallejo
- Department of Pharmacology, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Mariella Ramos-González
- Department of Pharmacology, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Joanna Wesoly
- Laboratory of High Throughput Technologies, Institute of Molecular Biology and Biotechnology, Faculty of Biology, Adam Mickiewicz University, Poznan, Poland
| | - María Jesus Sanz
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Concepción Peiró
- Department of Pharmacology, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Hans A R Bluyssen
- Department of Human Molecular Genetics, Institute of Molecular Biology and Biotechnology, Adam Mickiewicz University, Poznan, Poland
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27
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Álvarez-Ossorio MJ, Sarmento E Castro R, Granados R, Macías J, Morano-Amado LE, Ríos MJ, Merino D, Álvarez EN, Collado A, Pérez-Pérez M, Téllez F, Martín JM, Méndez J, Pineda JA, Neukam K. Impact of interferon-free regimens on the glomerular filtration rate during treatment of chronic hepatitis C in a real-life cohort. J Viral Hepat 2018; 25:699-706. [PMID: 29377515 DOI: 10.1111/jvh.12867] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 12/20/2017] [Indexed: 01/09/2023]
Abstract
Little data are available on renal toxicity exerted by direct-acting antivirals (DAAs) in real life. The aim of this study was to assess the impact of direct-acting antivirals against hepatitis C virus infection currently used in Spain and Portugal on the estimated glomerular filtration rate (eGFR) in clinical practise. From an international, prospective multicohort study, patients treated with DAAs for at least 12 weeks and with eGFR ≥30 mL/min per 1.73 m2 at baseline were selected. eGFR was determined using the CKD-EPI formula. A total of 1131 patients were included; 658 (58%) were HIV/HCV-coinfected patients. Among the 901 patients treated for 12 weeks, median (interquartile range) eGFR was 100 (87-107) at baseline vs 97 (85-105) mL/min per 1.73 m2 at week 12 of follow-up (FU12) post-treatment (P < .001). For HIV-coinfected subjects who received tenofovir plus a ritonavir-boosted HIV protease inhibitor (PI/r), baseline vs FU12 eGFR were 104 (86-109) vs 104 (91-110) mL/min per 1.73 m2 (P = .913). Among subjects receiving ombitasvir/paritaprevir with or without dasabuvir, eGFR did not show any significant change. Of 1100 subjects with eGFR >60 mL/min per 1.73 m2 at baseline, 22 (2%) had eGFR <60 mL/min per 1.73 m2 at FU12, but none presented with eGFR <30 mL/min per 1.73 m2 . In conclusion, eGFR slightly declines during therapy with all-oral DAAs and this effect persists up to 12 weeks after stopping treatment in subjects with normal to moderately impaired renal function, regardless of HIV status. Concomitant use of tenofovir plus PI/r does not seem to have an impact on eGFR.
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Affiliation(s)
- M J Álvarez-Ossorio
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Seville, Spain
| | | | - R Granados
- Unit of Infectious Diseases, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | - J Macías
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Seville, Spain
| | - L E Morano-Amado
- Unit of Infectious Pathology, Hospital Universitario Alvaro Cunqueiro, Vigo, Spain
| | - M J Ríos
- Unit of Infectious Diseases, Hospital Universitario Virgen Macarena, Seville, Spain
| | - D Merino
- Unit of Infectious Diseases, Complejo Hospitalario Universitario de Huelva, Huelva, Spain
| | - E N Álvarez
- Infectious Diseases Unit, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - A Collado
- Infectious Diseases Unit, Hospital Universitario Torrecárdenas, Almeria, Spain
| | - M Pérez-Pérez
- Unit of Infectious Diseases, Hospital La Línea, AGS Campo de Gibraltar, Cadiz, Spain
| | - F Téllez
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Puerto Real, Instituto de Investigación e Innovación en Ciencias Biomédicas de la Provincia de Cádiz (INiBICA), Puerto Real, Spain
| | - J M Martín
- Unit of Infectious Diseases, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | - J Méndez
- Unit of Infectious Diseases, Centro Hospitalar do Porto, Porto, Portugal
| | - J A Pineda
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Seville, Spain
| | - K Neukam
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Seville, Spain.,Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
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Marques P, Collado A, Escudero P, Rius C, González C, Servera E, Piqueras L, Sanz MJ. Cigarette Smoke Increases Endothelial CXCL16-Leukocyte CXCR6 Adhesion In Vitro and In Vivo. Potential Consequences in Chronic Obstructive Pulmonary Disease. Front Immunol 2017; 8:1766. [PMID: 29326688 PMCID: PMC5733535 DOI: 10.3389/fimmu.2017.01766] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 11/27/2017] [Indexed: 01/08/2023] Open
Abstract
Cardiovascular disease (CVD) is a major comorbidity in chronic obstructive pulmonary disease (COPD). Although the mechanism of its development remains largely unknown, it appears to be associated with cigarette consumption and reduced lung function. Therefore, the aim of this study was to investigate the potential link between water-soluble cigarette smoke extract (CSE)-induced endothelial dysfunction and the function of CXCL16/CXCR6 axis on the initial attachment of leukocytes, in addition to its possible impact on COPD-associated systemic inflammation. To do this, we employed several experimental approaches, including RNA silencing and flow cytometry analysis, the dynamic flow chamber technique, and intravital microscopy in the cremasteric arterioles of animals exposed to cigarette smoke (CS). CSE-induced arterial CXCL16 expression, leading to increased platelet–leukocyte and mononuclear cell adhesiveness. CSE-induced CXCL16 expression was dependent on Nox5 expression and subsequent RhoA/p38 MAPK/NF-κB activation. Flow cytometry analysis revealed that COPD patients (n = 35) presented greater numbers of activated circulating platelets (PAC-1+ and P-selectin+) expressing CXCL16 and CXCR6 as compared with age-matched controls (n = 17), with a higher number of CXCR6+-platelets in the smoking COPD group than in ex-smokers. This correlated with enhanced circulating CXCR6+-platelet–leukocyte aggregates in COPD patients. The increase in circulating numbers of CXCR6-expressing platelets and mononuclear cells resulted in enhanced platelet–leukocyte and leukocyte adhesiveness to CSE-stimulated arterial endothelium, which was greater than that found in age-matched controls and was partly dependent on endothelial CXCL16 upregulation. Furthermore, CS exposure provoked CXCL16-dependent leukocyte–arteriolar adhesion in cremasteric arterioles, which was significantly reduced in animals with a nonfunctional CXCR6 receptor. In conclusion, we provide the first evidence that increased numbers of CXCR6-expressing circulating platelets and mononuclear leukocytes from patients with COPD might be a marker of systemic inflammation with potential consequences in CVD development. Accordingly, CXCL16/CXCR6 axis blockade might constitute a new therapeutic approach for decreasing the risk of CVD in COPD patients.
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Affiliation(s)
- Patrice Marques
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Aida Collado
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Paula Escudero
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Cristina Rius
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Cruz González
- Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain.,Neumology Unit, University Clinic Hospital of Valencia, Valencia, Spain
| | - Emilio Servera
- Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain.,Neumology Unit, University Clinic Hospital of Valencia, Valencia, Spain
| | - Laura Piqueras
- Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Maria-Jesus Sanz
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
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Rubio-Briones J, Casanova J, Martínez F, Domínguez-Escrig JL, Fernández-Serra A, Dumont R, Ramírez-Backhaus M, Gómez-Ferrer A, Collado A, Rubio L, Molina A, Vanaclocha M, Sala D, Lopez-Guerrero JA. PCA3 as a second-line biomarker in a prospective controlled randomized opportunistic prostate cancer screening programme. Actas Urol Esp 2017; 41:300-308. [PMID: 28342633 DOI: 10.1016/j.acuro.2016.10.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/07/2016] [Accepted: 10/10/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVES PCA3 performance as a single second line biomarker is compared to the European Randomised Study of Screening for Prostate Cancer risk calculator model 3 (ERSPC RC-3) in an opportunistic screening in prostate cancer (PCa). MATERIAL AND METHODS 5,199 men, aged 40-75y, underwent prostate-specific antigen (PSA) screening and digital rectal examination (DRE). Men with a normal DRE and PSA ≥3ng/ml had a PCA3 test done. All men with PCA3 ≥35 underwent an initial biopsy (IBx) -12 cores-. Men with PCA3 <35 were randomized 1:1 to either IBx or observation. We compared them to those obtained with ERSPC RC-3. RESULTS PCA3 test was performed on 838 men (16.1%). In PCA3(+) and PCA3(-) groups, global PCa detection rates were 40.9% and 14.7% with a median follow-up (FU) of 21.7 months (P<.001). In the PCA3(+) arm (n=301, 35.9%), PCa was identified in 115 men at IBx (38.2%). In the randomized arm, 256 underwent IBx and PCa was found in 46 (18.0%) (P<.001). The biopsy-sparing potential would have been 64.1% as opposed to 76.6% if we had used ERSPC RC-3. However, the estimated false negative cases for HGPCa would have been reduced by 37.1% (89 to 56 patients). Moreover, if we had applied PCA3-35 to avoid IBx, 14.7% PCa and 9.1% of clinical significant PCa patients would not have been diagnosed during this FU. CONCLUSIONS When PCA3-35 is used as a second-line biomarker when PSA ≥3ng/ml and DRE is normal, IBx could be avoided in 12.5% less than if ERSPC RC-3 is used and would reduce the false negative cases by 36.2%. At a FU of 21.7 months, this dual protocol would miss 9.1% of clinically significant PCa, so strict FU is mandatory with established biopsy criteria based on PSA and DRE in cases with PCA3 <35.
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Affiliation(s)
- J Rubio-Briones
- Servicio de Urología, Fundación Instituto Valenciano de Oncología, Valencia, España.
| | - J Casanova
- Servicio de Urología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - F Martínez
- Departamento de Estadística, Universidad de Valencia, Valencia, España
| | - J L Domínguez-Escrig
- Servicio de Urología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - A Fernández-Serra
- Biología Molecular, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - R Dumont
- Servicio de Urología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - M Ramírez-Backhaus
- Servicio de Urología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - A Gómez-Ferrer
- Servicio de Urología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - A Collado
- Servicio de Urología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - L Rubio
- Biología Molecular, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - A Molina
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica en la Comunitat Valenciana (FISABIO-Salud Pública), Valencia, España
| | - M Vanaclocha
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica en la Comunitat Valenciana (FISABIO-Salud Pública), Valencia, España
| | - D Sala
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica en la Comunitat Valenciana (FISABIO-Salud Pública), Valencia, España
| | - J A Lopez-Guerrero
- Biología Molecular, Fundación Instituto Valenciano de Oncología, Valencia, España
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30
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Zizi S, Seixas A, Collado A, Boby A, Camille P, Payano L, Abid A, Gyamfi L, Zizi F, Jean-Louis G. 1020 ASTHMA AND SLEEP AMONG HISPANICS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rivero-Juarez A, Lopez-Cortes LF, Castaño M, Merino D, Marquez M, Mancebo M, Cuenca-Lopez F, Jimenez-Aguilar P, Lopez-Montesinos I, Lopez-Cardenas S, Collado A, Lopez-Ruz MA, Omar M, Tellez F, Perez-Stachowski X, Hernandez-Quero J, Girón-Gonzalez JA, Fernandez-Fuertes E, Rivero A. Impact of universal access to hepatitis C therapy on HIV-infected patients: implementation of the Spanish national hepatitis C strategy. Eur J Clin Microbiol Infect Dis 2017; 36:487-494. [PMID: 27787664 PMCID: PMC5309278 DOI: 10.1007/s10096-016-2822-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 10/16/2016] [Indexed: 02/06/2023]
Abstract
In April 2015, the Spanish National Health System (SNHS) developed a national strategic plan for the diagnosis, treatment, and management of hepatitis C virus (HCV). Our aim was to analyze the impact of this on human immunodeficiency virus (HIV)-infected patients included in the HERACLES cohort during the first 6 months of its implementation. The HERACLES cohort (NCT02511496) was set up in March 2015 to evaluate the status and follow-up of chronic HCV infection in patients co-infected with HIV in the south of Spain. In September 2015, the data were analyzed to identify clinical events (death, liver decompensation, and liver fibrosis progression) and rate of treatment implementation in this population. The study population comprised a total of 3474 HIV/HCV co-infected patients. The distribution according to liver fibrosis stage was: 1152 F0-F1 (33.2 %); 513 F2 (14.4 %); 641 F3 (18.2 %); 761 F4 (21.9 %); and 407 whose liver fibrosis was not measured (12.3 %). During follow-up, 248 patients progressed by at least one fibrosis stage [7.1 %; 95 % confidence interval (CI): 6.3-8 %]. Among cirrhotic patients, 52 (6.8 %; 95 % CI: 5.2-8.9 %) developed hepatic decompensation. In the overall population, 50 patients died (1.4 %; 95 % CI: 1.1-1.9 %). Eight hundred and nineteen patients (23.56 %) initiated interferon (IFN)-free treatment during follow-up, of which 47.8 % were cirrhotic. In our study, during 6 months of follow-up, 23.56 % of HIV/HCV co-infected patients included in our cohort received HCV treatment. However, we observed a high incidence of negative short-term outcomes in our population.
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Affiliation(s)
- A Rivero-Juarez
- Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofía de Córdoba, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Avenida Menéndez Pidal s/n, 14004, Córdoba, Spain.
| | - L F Lopez-Cortes
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - M Castaño
- Unidad Clínica de Enfermedades Infecciosas, Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - D Merino
- Unidad Clínica de Enfermedades Infecciosas, Complejo Hospitalario Universitario de Huelva, Huelva, Spain
| | - M Marquez
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Regional Universitario Virgen de la Victoria, Málaga, Spain
| | - M Mancebo
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario de Valme, Seville, Spain
| | - F Cuenca-Lopez
- Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofía de Córdoba, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Avenida Menéndez Pidal s/n, 14004, Córdoba, Spain
| | - P Jimenez-Aguilar
- Unidad Clínica de Enfermedades Infecciosas, Hospital Universitario Puerto Real, Cádiz, Spain
| | - I Lopez-Montesinos
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Seville, Spain
| | - S Lopez-Cardenas
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital de Jerez, Jerez, Spain
| | - A Collado
- Unidad Clínica de Enfermedades Infecciosas, Complejo Hospitalario Torrecárdenas, Almería, Spain
| | - M A Lopez-Ruz
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - M Omar
- Unidad Clínica de Enfermedades Infecciosas, Complejo Hospitalario de Jaén, Jaén, Spain
| | - F Tellez
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital La Línea, AGS Campo de Gibraltad, Cádiz, Spain
| | | | - J Hernandez-Quero
- Unidad Clínica de Enfermedades Infecciosas, Hospital Universitario San Cecilio, Granada, Spain
| | - J A Girón-Gonzalez
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Puerta del Mar, Cádiz, Spain
| | | | - A Rivero
- Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofía de Córdoba, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Avenida Menéndez Pidal s/n, 14004, Córdoba, Spain.
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Pineda JA, Morano-Amado LE, Granados R, Macías J, Téllez F, García-Deltoro M, Ríos MJ, Collado A, Delgado-Fernández M, Suárez-Santamaría M, Serrano M, Miralles-Álvarez C, Neukam K. Week 4 response predicts sustained virological response to all-oral direct-acting antiviral-based therapy in cirrhotic patients with hepatitis C virus genotype 3 infection. Clin Microbiol Infect 2017; 23:409.e5-409.e8. [PMID: 28137633 DOI: 10.1016/j.cmi.2016.12.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 12/29/2016] [Accepted: 12/31/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of this study was to determine the predictive capacity of response at treatment week (TW) 4 for the achievement of sustained virological response 12 weeks after the scheduled end of therapy date (SVR12) to treatment against hepatitis C virus (HCV) genotype 3 (GT3) infection with all-oral direct-acting antiviral (DAA) -based regimens. PATIENTS AND METHODS From a prospective multicohort study, HCV GT3-infected patients who completed a course of currently recommended DAA-based therapy at 33 Spanish hospitals and who had reached the SVR12 evaluation time-point were selected. TW4 HCV-RNA levels were categorized as target-not-detected (TND), below the lower limit of quantification (LLOQTD) and ≥LLOQ. RESULTS A total of 123 patients were included, 86 (70%) received sofosbuvir/ daclatasvir±ribavirin, 27 (22%) received sofosbuvir/ ledipasvir/ ribavirin and 10 (8.1%) received sofosbuvir/ ribavirin, respectively. In all, 114 (92.7%) of the 123 patients presented SVR12 in an on-treatment approach, but nine (7.3%) patients relapsed, all of them had presented cirrhosis at baseline. In those who achieved TND, LLOQTD and ≥LLOQ, SVR12 was observed in 81/83 (98%; 95% CI 91.5%-99.7%), 24/28 (85.7%; 95% CI 67.3%-96%) and 9/12 (75%; 95% CI 42.8%-94.5%), respectively; p(linear association) 0.001. Corresponding numbers for subjects with cirrhosis were: 52/54 (96.3%; 95% CI 87.3%-95.5%), 14/18 (77.8%; 95% CI 52.4%-93.6%) and 7/10 (70%; 95% CI 34.8%-93.3%); p 0.004. CONCLUSIONS TW4-response indicates the probability of achieving SVR12 to currently used DAA-based therapy in HCV genotype 3-infected individuals with cirrhosis. This finding may be useful to tailor treatment strategy in this setting.
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Affiliation(s)
- J A Pineda
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Seville, Spain
| | - L E Morano-Amado
- Unit of Infectious Pathology, Hospital Universitario Alvaro Cunqueiro, Vigo, Spain
| | - R Granados
- Unit of Infectious Diseases, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | - J Macías
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Seville, Spain; Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
| | - F Téllez
- Unit of Infectious Diseases and Microbiology, Hospital La Línea, AGS Campo de Gibraltar, La Linea de la Concepcion, Spain
| | - M García-Deltoro
- Unit of Infectious Diseases, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - M J Ríos
- Unit of Infectious Diseases, Hospital Virgen Macarena, Seville, Spain
| | - A Collado
- Unit of Infectious Diseases, Hospital Universitario Torrecárdenas, Almeria, Spain
| | | | - M Suárez-Santamaría
- Fundación Biomédica del Complejo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain
| | - M Serrano
- Unit of Infectious Diseases, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | - C Miralles-Álvarez
- Unit of Infectious Pathology, Hospital Universitario Alvaro Cunqueiro, Vigo, Spain
| | - K Neukam
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Seville, Spain; Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain.
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Martorell S, Hueso L, Gonzalez-Navarro H, Collado A, Sanz MJ, Piqueras L. Vitamin D Receptor Activation Reduces Angiotensin-II-Induced Dissecting Abdominal Aortic Aneurysm in Apolipoprotein E-Knockout Mice. Arterioscler Thromb Vasc Biol 2016; 36:1587-97. [PMID: 27283745 DOI: 10.1161/atvbaha.116.307530] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 05/27/2016] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Abdominal aortic aneurysm (AAA) is a vascular disorder characterized by chronic inflammation of the aortic wall. Low concentrations of vitamin D3 are associated with AAA development; however, the potential direct effect of vitamin D3 on AAA remains unknown. This study evaluates the effect of oral treatment with the vitamin D3 receptor (VDR) ligand, calcitriol, on dissecting AAA induced by angiotensin-II (Ang-II) infusion in apoE(-/-) mice. APPROACH AND RESULTS Oral treatment with calcitriol reduced Ang-II-induced dissecting AAA formation in apoE(-/-) mice, which was unrelated to systolic blood pressure or plasma cholesterol concentrations. Immunohistochemistry and reverse-transcription polymerase chain reaction analysis demonstrated a significant increase in macrophage infiltration, neovessel formation, matrix metalloproteinase-2 and matrix metalloproteinase-9, chemokine (CCL2 [(C-C motif) ligand 2], CCL5 [(C-C motif) ligand 5], and CXCL1 [(C-X-C motif) ligand 1]) and vascular endothelial growth factor expression in suprarenal aortic walls of apoE(-/-) mice infused with Ang-II, and all were significantly reduced by cotreatment with calcitriol. Phosphorylation of extracellular signal-regulated kinases 1/2, p38 mitogen-activated protein kinase, and nuclear factor-κB was also decreased in the suprarenal aortas of apoE(-/-) mice cotreated with calcitriol. These effects were accompanied by a marked increase in VDR-retinoid X receptor (RXR) interaction in the aortas of calcitriol-treated mice. In vitro, VDR activation by calcitriol in human endothelial cells inhibited Ang-II-induced leukocyte-endothelial cell interactions, morphogenesis, and production of endothelial proinflammatory and angiogenic chemokines through VDR-RXR interactions, and knockdown of VDR or RXR abolished the inhibitory effects of calcitriol. CONCLUSIONS VDR activation reduces dissecting AAA formation induced by Ang-II in apoE(-/-) mice and may constitute a novel therapeutic strategy to prevent AAA progression.
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Affiliation(s)
- Sara Martorell
- From the Institute of Health Research-INCLIVA, Department of Pharmacology, Valencia, Spain (S.M., L.H., H.G.-N., A.C., M.-J.S., L.P.); Faculty of Medicine, Department of Pharmacology, University of Valencia, Valencia, Spain (M.-J.S.); and Diabetes and Associated Metabolic Disorders Unit, CIBERDEM, Madrid, Spain (H.G.-N.)
| | - Luisa Hueso
- From the Institute of Health Research-INCLIVA, Department of Pharmacology, Valencia, Spain (S.M., L.H., H.G.-N., A.C., M.-J.S., L.P.); Faculty of Medicine, Department of Pharmacology, University of Valencia, Valencia, Spain (M.-J.S.); and Diabetes and Associated Metabolic Disorders Unit, CIBERDEM, Madrid, Spain (H.G.-N.)
| | - Herminia Gonzalez-Navarro
- From the Institute of Health Research-INCLIVA, Department of Pharmacology, Valencia, Spain (S.M., L.H., H.G.-N., A.C., M.-J.S., L.P.); Faculty of Medicine, Department of Pharmacology, University of Valencia, Valencia, Spain (M.-J.S.); and Diabetes and Associated Metabolic Disorders Unit, CIBERDEM, Madrid, Spain (H.G.-N.)
| | - Aida Collado
- From the Institute of Health Research-INCLIVA, Department of Pharmacology, Valencia, Spain (S.M., L.H., H.G.-N., A.C., M.-J.S., L.P.); Faculty of Medicine, Department of Pharmacology, University of Valencia, Valencia, Spain (M.-J.S.); and Diabetes and Associated Metabolic Disorders Unit, CIBERDEM, Madrid, Spain (H.G.-N.)
| | - Maria-Jesus Sanz
- From the Institute of Health Research-INCLIVA, Department of Pharmacology, Valencia, Spain (S.M., L.H., H.G.-N., A.C., M.-J.S., L.P.); Faculty of Medicine, Department of Pharmacology, University of Valencia, Valencia, Spain (M.-J.S.); and Diabetes and Associated Metabolic Disorders Unit, CIBERDEM, Madrid, Spain (H.G.-N.).
| | - Laura Piqueras
- From the Institute of Health Research-INCLIVA, Department of Pharmacology, Valencia, Spain (S.M., L.H., H.G.-N., A.C., M.-J.S., L.P.); Faculty of Medicine, Department of Pharmacology, University of Valencia, Valencia, Spain (M.-J.S.); and Diabetes and Associated Metabolic Disorders Unit, CIBERDEM, Madrid, Spain (H.G.-N.).
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Rivero-Juarez A, Gutierrez-Valencia A, Castaño M, Merino D, Neukam K, Ríos-Villegas MJ, Lopez-Ruz MA, Jiménez-Aguilar P, Marquez M, Collado A, Gomez-Vidal A, Hernandez-Quero J, Tellez F, Fernandez-Fuertes E, Rivero A, López-Cortés LF. Dimension of chronic hepatitis C virus in HIV-infected patients in the interferon-free era: an overview from south Spain. Eur J Clin Microbiol Infect Dis 2015; 34:2247-55. [PMID: 26342330 PMCID: PMC4607719 DOI: 10.1007/s10096-015-2476-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 08/20/2015] [Indexed: 02/08/2023]
Abstract
The implementation of hepatitis C (HCV) direct-acting antiviral drugs is prioritized in several populations in which its application provides the most immediate and impactful benefit. In this scenario, a precise knowledge of the situation of human immunodeficiency virus (HIV)/HCV chronic co-infection is required to adequately address this disease. This cross-sectional study was performed in 21 hospitals in Andalusia (Spain). The study population consisted of HIV-infected patients with an active HCV chronic infection who were not receiving HCV treatment at the time of inclusion. A total of 13,506 HIV-infected patients were included in the study. Of them, 2561 (18.9 %) presented chronic HCV infection. The majority of the patients included were on highly active antiretroviral therapy (HAART; 96.2 %), showed plasma levels with an undetectable HIV viral load (92.5 %), and had a good immunological status (median CD4+ cell count of 486 cells/mL). The HCV genotype distribution was as follows: 58.1 % were genotype 1, 1.1 % were genotype 2, 16.1 % were genotype 3, and 22.1 % were genotype 4 (2.6 % were missing data). In total, 24.8 % of the patients showed liver fibrosis stage F0-F1, 27.9 % showed stage F2, 16.7 % showed stage F3, and 21 % showed stage F4 (9.6 % were missing data). With regards to previous HCV treatment experiences, 68.05 % of the patients were naïve and 31.95 % had failed to respond to a previous treatment. The burden of HCV/HIV co-infected patients in our population was reported as one in five HIV-infected patients requiring HCV treatment. The implementation of extra resources to face this important health challenge is mandatory.
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Affiliation(s)
- A Rivero-Juarez
- Unidad Clínica de Enfermedades Infecciosas, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Hospital Universitario Reina Sofía, Avda. Menendez Pidal s/n, 14004, Cordoba, Spain.
| | - A Gutierrez-Valencia
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - M Castaño
- Unidad Clínica de Enfermedades Infecciosas, Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - D Merino
- Unidad Clínica de Enfermedades Infecciosas, Complejo Hospitalario Universitario de Huelva, Huelva, Spain
| | - K Neukam
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario de Valme, Seville, Spain
| | - M J Ríos-Villegas
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Seville, Spain
| | - M A Lopez-Ruz
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - P Jiménez-Aguilar
- Unidad Clínica de Enfermedades Infecciosas, Hospital Universitario Puerto Real, Cádiz, Spain
| | - M Marquez
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Regional Universitario Virgen de la Victoria, Málaga, Spain
| | - A Collado
- Unidad Clínica de Enfermedades Infecciosas, Complejo Hospitalario Torrecárdenas, Almería, Spain
| | - A Gomez-Vidal
- Unidad Clínica de Enfermedades Infecciosas, Complejo Hospitalario de Jaén, Jaén, Spain
| | - J Hernandez-Quero
- Unidad Clínica de Enfermedades Infecciosas, Hospital Universitario San Cecilio, Granada, Spain
| | - F Tellez
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital La Línea, AGS Campo de Gibraltad, Cádiz, Spain
| | - E Fernandez-Fuertes
- Unidad Clínica de Enfermedades Infecciosas, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Hospital Universitario Reina Sofía, Avda. Menendez Pidal s/n, 14004, Cordoba, Spain
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
- Unidad Clínica de Enfermedades Infecciosas, Hospital Regional Universitario Carlos Haya, Málaga, Spain
- Unidad Clínica de Enfermedades Infecciosas, Complejo Hospitalario Universitario de Huelva, Huelva, Spain
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario de Valme, Seville, Spain
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Seville, Spain
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Unidad Clínica de Enfermedades Infecciosas, Hospital Universitario Puerto Real, Cádiz, Spain
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Regional Universitario Virgen de la Victoria, Málaga, Spain
- Unidad Clínica de Enfermedades Infecciosas, Complejo Hospitalario Torrecárdenas, Almería, Spain
- Unidad Clínica de Enfermedades Infecciosas, Complejo Hospitalario de Jaén, Jaén, Spain
- Unidad Clínica de Enfermedades Infecciosas, Hospital Universitario San Cecilio, Granada, Spain
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital La Línea, AGS Campo de Gibraltad, Cádiz, Spain
- Unidad de Medicina Tropical, Hospital de Poniente, Almería, Spain
| | - A Rivero
- Unidad Clínica de Enfermedades Infecciosas, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Hospital Universitario Reina Sofía, Avda. Menendez Pidal s/n, 14004, Cordoba, Spain.
| | - L F López-Cortés
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
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Mira JA, Neukam K, López-Cortés LF, Rivero-Juárez A, Téllez F, Girón-González JA, de los Santos-Gil I, Ojeda-Burgos G, Merino D, Ríos-Villegas MJ, Collado A, Torres-Cornejo A, Macías J, Rivero A, Pérez-Pérez M, Pineda JA. Efficacy of and risk of bleeding during pegylated interferon plus ribavirin treatment in HIV/HCV-coinfected patients with pretreatment thrombocytopenia. Eur J Clin Microbiol Infect Dis 2015; 34:1879-84. [PMID: 26115631 DOI: 10.1007/s10096-015-2426-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 06/05/2015] [Indexed: 01/21/2023]
Abstract
The aim of this study was to assess the efficacy of and the risk of major bleeding during pegylated interferon (peg-IFN)/ribavirin (RBV) treatment among human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-coinfected patients according to the pretreatment platelet count. Two hundred and seventy-four HCV/HIV-coinfected, previously naïve individuals with compensated cirrhosis enrolled in one Spanish prospective cohort who received peg-IFN/RBV were included in this study. The frequency of severe bleeding and sustained virological response (SVR) rate were compared between patients with a pretreatment platelet count ≤70,000/mm(3) and >70,000/mm(3), respectively. Sixty-one (22 %) patients had a baseline platelet count ≤70,000/mm(3). The median (Q1-Q3) pretreatment platelet count was 58,000 (49,000-65,000) cells/mm(3) in the platelet ≤70,000 group and 129,000 (102,500-166,000) cells/mm(3) in the platelet >70,000 group (p < 0.0001). Seventeen (28 %) subjects of the platelet ≤70,000 group and 71 (33 %) patients of the platelet >70,000 group achieved SVR (p = 0.4). Only 2 (3.2 %) patients in the platelet ≤70,000 group developed a severe hemorrhagic event, specifically esophageal variceal bleeding. The efficacy of therapy with peg-IFN/RBV in HIV/HCV-coinfected patients with low pretreatment platelet counts is comparable to that found in the overall subset of subjects with compensated cirrhosis. The frequency of severe hemorrhagic events related with this therapy is low in this population.
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Affiliation(s)
- J A Mira
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avenida de Bellavista S/N, 41014, Sevilla, Spain
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Escudero P, Martinez de Marañón A, Collado A, Gonzalez-Navarro H, Hermenegildo C, Peiró C, Piqueras L, Sanz MJ. Combined sub-optimal doses of rosuvastatin and bexarotene impair angiotensin II-induced arterial mononuclear cell adhesion through inhibition of Nox5 signaling pathways and increased RXR/PPARα and RXR/PPARγ interactions. Antioxid Redox Signal 2015; 22:901-20. [PMID: 25602514 PMCID: PMC4376291 DOI: 10.1089/ars.2014.5969] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AIM Mononuclear cell (MC) infiltration into the arterial subendothelium is a key event in atherogenesis. Rosuvastatin (Rosu) and bexarotene (Bex) exert anti-inflammatory activity, but serious dose-related adverse effects have emerged. The need for safer and effective strategies to prevent and treat atherosclerosis led us to test the effect of combined use of both drugs on angiotensin II (Ang-II)-induced arterial MC recruitment. RESULTS Vehicle, Rosu (10-30 nM), Bex (0.3-1 μM), or a combination of both were administered to human umbilical arterial endothelial cells (HUAECs) 20 h before stimulation with 1 μM Ang-II (4 h). Surprisingly, a combination of Rosu (10 nM)+Bex (0.3 μM), which did not influence Ang-II-induced MC recruitment when either stimulus was studied alone, significantly reduced this response. This effect was accompanied by diminished Ang-II-induced ICAM-1, VCAM-1, and CX3CL1 endothelial expression and CXCL1, CXCL8, CCL2, and CCL5 production. Preincubation of HUAECs with Rosu+Bex inhibited Nox5 expression and Nox5-induced RhoA activation stimulated by Ang-II through increased RXRα, PPARα, and PPARγ expression in addition to RXRα/PPARα and RXRα/PPARγ interactions. In vivo, combined but not single administration of Rosu (1.25 mg/kg/day) and Bex (10 mg/kg/day) significantly diminished Ang-II-induced arteriolar leukocyte adhesion in the cremasteric microcirculation of C57BL/6 mice and atherosclerotic lesion formation in apoE(-/-) mice subjected to an atherogenic diet. INNOVATION AND CONCLUSION Combined administration of Bex+Rosu at suboptimal doses may constitute a new alternative and effective therapy in the control of the vascular inflammation associated to cardiometabolic disorders, since they synergize in their anti-inflammatory actions and may counteract their associated adverse effects.
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Affiliation(s)
- Paula Escudero
- 1 Department of Pharmacology, Faculty of Medicine, University of Valencia , Valencia, Spain
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Rubio-Briones J, Iborra I, Ramírez M, Calatrava A, Collado A, Casanova J, Domínguez-Escrig J, Gómez-Ferrer A, Ricós JV, Monrós JL, Dumont R, López-Guerrero JA, Salas D, Solsona E. Obligatory information that a patient diagnosed of prostate cancer and candidate for an active surveillance protocol must know. Actas Urol Esp 2014; 38:559-65. [PMID: 24636075 DOI: 10.1016/j.acuro.2014.02.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 02/06/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To know the necessary information to reproduce the results found in the literature on active surveillance (AS) in prostate cancer (PCa) in our own center so that the information would be objective and correctly given to the patients. We have aimed to study the percentage of candidates for AS chosen in our setting, and the data on infrastaging, subgrading and prediction of insignificant PCa, debugging the predictive value of clinical variables to improve our selection criteria and finally to analyze the results of our patients enrolled in AS. MATERIALS AND METHODS A retro- and prospective review of our data bases was performed. A one-year period was analyzed to know AS candidates. Analysis of our radical prostatectomy specimens for infrastaging, subgrading and prediction of insignificant PCa (Epstein's criteria) was made as well as a uni/multivariate analysis of clinical variables in patients with insignificant PCa in the specimen. A prospective validation was performed with overall survival and survival free of active treatment (SFAT) as endpoints in patients enrolled in AS. RESULTS Between October-2010/October-2011, 44.7% of our PCa were candidates for AS, but only 11.2% choose it. The percentages found for infrastaging, subgrading and prediction of insignificant PCa were 14%, 31.4% and 55.7%, respectively. However, only just 6 patients (6.97%) had≥pT3a+Gleason≥7+volume>0.5cc PCa. The multivariate analysis showed that PSA density and number of affected cores were independent predictors of insignificant PCa. With a mean follow-up of 36±39months, 63 out of 232 patients enrolled in AS went on to active treatment (27.1%), with only 13 due to anxiety without pathologic progression. Median time of SFAT was 72.7 months (CI 95% 30.9-114.4). SFAT at 24 months was 76.4% (69.7-83.1%) and at 48 months 58.1% (48.8-67.4%). Only 10 patients died (4.3%), 9 due to causes different of PCa. Estimated overall survival at 5 years was 92.8% (CI 95% 86.7-98.9%). CONCLUSIONS It should be mandatory to have the exact knowledge of the local data of each Center in order to objectively inform patients about prostate biopsy efficiency, and if percentages of infrastaging, subgrading and prediction of insignificant PCa are in accordance with the literature. At 3 years, we reproduced the results of the longest series of AS, so we have ascertained that our AS protocol can be implemented with increasingly more patients.
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Affiliation(s)
- J Rubio-Briones
- Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España.
| | - I Iborra
- Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España
| | - M Ramírez
- Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España
| | - A Calatrava
- Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, España
| | - A Collado
- Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España
| | - J Casanova
- Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España
| | - J Domínguez-Escrig
- Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España
| | - A Gómez-Ferrer
- Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España
| | - J V Ricós
- Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España
| | - J L Monrós
- Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España
| | - R Dumont
- Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España
| | - J A López-Guerrero
- Laboratorio de Biología Molecular, Instituto Valenciano de Oncología, Valencia, España
| | - D Salas
- Departamento de Salud Pública, Consellería de Sanidad, Generalitat Valenciana, Valencia, España
| | - E Solsona
- Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España
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Rodriguez-Rodriguez L, Lamas J, Jover J, Baena S, Olano E, Collado A, Rivera J, Fernandez-Gutierrez B. THU0477 Genetic Risk Factors for Fibromyalgia Associated Symptoms/Syndromes and Disease Severity. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rubio-Briones J, Casanova J, Dumont R, Rubio L, Fernandez-Serra A, Casanova-Salas I, Domínguez-Escrig J, Ramírez-Backhaus M, Collado A, Gómez-Ferrer A, Iborra I, Monrós J, Ricós J, Solsona E, Salas D, Martínez F, Lopez-Guerrero J. Optimizing prostate cancer screening; prospective randomized controlled study of the role of PSA and PCA3 testing in a sequential manner in an opportunistic screening program. Actas Urol Esp 2014; 38:217-23. [PMID: 24169211 DOI: 10.1016/j.acuro.2013.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 09/08/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To reduce unnecessary biopsies (Bx) in an opportunistic screening programme of prostate cancer. MATERIAL AND METHODS We perform a prospective evaluation of PCA3 as a second line biomarker in an opportunistic screening for prostate cancer (PCa). From September-2010 until September-2012, 2,366 men, aged 40-74 years and with >10 years life expectancy, were initially screened with PSA/digital rectal examination (DRE). Men with previous Bx or with recent urine infections were excluded. Men with abnormal DRE and/or PSA >3 ng/ml were submitted for PCA3. All men with PCA3 ≥ 35 underwent an initial biopsy (IBx) -12cores-. Men with PCA3 < 35 were randomized 1:1 to either IBx or observation. Re-biopsy(16-18 cores) criteria were PSA increase >.5 ng/ml at 4-6 months or PSAv > .75 ng/ml/year. RESULTS With median follow-up (FU) of 10.1 months, PCA3 was performed in 321/2366 men (13.57%), 289 at first visit and 32 during FU. All 110 PCA3+ men (34.3%) were biopsied and PCa was identified in 43 men in IBx (39.1%). In the randomized arm, 110 were observed and 101 underwent biopsy, finding 12 PCa (11.9%), showing a statistically significant reduction of PCa detection rate in this cohort (P<.001). Global PCa detection rates were 40.9% and 9.5% for the PCA3+ and PCA3- branches, respectively (P<.001). Area under the curve for PSA and PCA3 were .601 and .74, respectively. This is an ongoing prospective study limited by its short follow-up period and still limited enrolment. CONCLUSIONS PCA3 as a second line biomarker within an opportunistic dual screening protocol, can potentially avoid 65.7% and 50.1% biopsies at first round and at median FU of 10.1 months, respectively, just missing around 3.2% of high grade PCa.
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Ramírez-Backhaus M, Rubio-Briones J, Collado A, Casanova J, Gómez-Ferrer A, Domínguez J, Ricos J, Monros J, Iborra I, Solsona E. Radical prostatectomy is a reasonable treatment for patients over 70 years of age. Actas Urol Esp 2014; 38:21-7. [PMID: 23648265 DOI: 10.1016/j.acuro.2013.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 02/17/2013] [Accepted: 02/20/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To compare the tumor nature and oncological course of patients operated on by radical prostatectomy in three age groups. MATERIAL AND METHOD From the prospective completion of the data base of our department, we analyzed 1012 patients operated on between 1986 and December 2009. Patients with neo- or adjuvant treatment and those with pre-operative PSA over 50 were excluded. The sample was divided into three groups: younger than 60, 60 to 69 and over 70. The clinical, pathological variables, biochemical course and need for rescue treatment were analyzed. We consider biochemical relapse as when the PSA values reached values greater than 0.4 in two consecutive measurements. Rescue was defined as the need for hormone treatment or radiotherapy. We then made a comparative study, a univariate survival analysis by Kaplan and Meyer Curves and multivariate by Cox's regression. RESULTS The median follow-up was 55.1 months. Of the 1012 patients included in the study, 317 patients (31.3%) had biochemical progression and 259 (25.6%) required rescue treatment. We observed that the groups with the older age had a significantly higher PSA and higher stages than the rest. No differences were observed in the Gleason score of the surgical specimen or in the state of the surgical margins. Biochemical relapse free survival at 5 years was 72.3% (CI 66.4-78.2) in patients under 60 years, 65.3% (CI 60.6-70.0) for patients under 70 and 62.2% (CI 53.2-71.1) for patients of 70 years or older; P<.05. In the univariate study, age was a factor that was significantly associated to biochemical relapse. However, it loses interest in the multivariate study and PSA, pathological state and Gleason score regain interest. Rescue treatment free survival did not differ by age groups. CONCLUSIONS In the current study, worse biochemical evolution of patients over 70 was observed. However, this worse biochemical course was conditioned by clinically more aggressive tumors that, in our opinion, justifies the decision made in regards to the surgical approach taken with these patients.
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Ramírez-Backhaus M, Rubio-Briones J, Calatrava-Fons A, Gómez-Ferrer Á, Collado A, Iborra I, Monrós J, Ricós J, Solsona Narbón E. Margin status is a very important prognostic factor for patients with pT3b prostate cancer. Actas Urol Esp 2013; 37:538-43. [PMID: 23419742 DOI: 10.1016/j.acuro.2012.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Accepted: 11/27/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Despite early diagnosis of prostate cancer, seminal vesicle invasion is still a common clinical scenario nowadays. The objective of this study is to evaluate clinical and pathological prognostic factors in that subgroup of patients. MATERIAL AND METHODS After approval of our Ethical Committee, we selected all pT3b prostate cancer patients operated between 1987 and 2010. Neoadjuvant treatment patients were excluded. The biochemical free survival periods BFS and the period free of complementary treatment were calculated with the Kaplan Meier method. Cox regression model was used to select those variables associated with biochemical failure and the need for complementary treatment. We considered complementary treatment when radiotherapy or hormone therapy in an adjuvant or salvage scheme was required. RESULTS 101 patients were selected from 1470 procedures. Among these, 28 patients died (27,7%), 18 due to tumor, and 74 showed biochemical relapse (73,3%). The median follow up was of 4 years and 4 months. The five years BFS was 30.2% (IC 95%: 20.2-40.1), whereas the 5 year period free of complementary treatment was 16.9% (IC 95%: 8.1-25.8%). In the multivariate analysis, margin status (R) was independently and significantly associated with biochemical relapse and the need for complementary treatment. Likewise, the preoperative PSA was associated to biochemical relapse and N1 tumours were clearly associated to complementary treatment. CONCLUSION pT3b prostate cancer patients with R1 disease have a worse biochemical prognosis and higher probability of complementary treatment.
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Torres X, Collado A, Gomez E, Arias A, Cabrera-Villalba S, Messina OD, Vidal LF, Clark P, Ríos C, Salomón PA. SAT0389 Validation of the Spanish Version of the Fibromyalgia Rapid Screening Tool (First). Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rivera J, Collado A, Alegre J, Blanch J, Vidal J, Arias A, Carbonel J. THU0345 Similarities between fibromyalgia and chronic fatigue syndrome: A single disease?:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Docampo E, Escaramis G, Rabionet R, Carbonell J, Rivera J, Alegre J, Vidal J, Estivill X, Collado A. OP0067 Cluster analysis of clinical data identifies fibromyalgia subgroups. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Riera E, Collado A, Llinares E, Moragas G, Garcia J, Lomeña F. 90Yttrium PET-CT images assessing radioisotopic knee synoviorthesis. Rev Esp Med Nucl Imagen Mol 2013. [DOI: 10.1016/j.remnie.2013.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Riera E, Collado A, Llinares E, Moragas G, Garcia J, Lomeña F. 90Yttrium PET-CT images assessing radioisotopic knee synoviorthesis. Rev Esp Med Nucl Imagen Mol 2013; 32:134-5. [DOI: 10.1016/j.remn.2012.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 07/10/2012] [Accepted: 07/13/2012] [Indexed: 11/30/2022]
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Sánchez M, Jiménez-Lendínez M, Cidoncha M, Asensio MJ, Herrerot E, Collado A, Santacruz M. Comparison of fluid compartments and fluid responsiveness in septic and non-septic patients. Anaesth Intensive Care 2012; 39:1022-9. [PMID: 22165353 DOI: 10.1177/0310057x1103900607] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Our objective was to study the response to a fluid load in patients with and without septic shock, the relationship between the response and baseline fluid distributions and the ratios of the various compartments. A total of 18 patients with septic shock and 14 control patients without pathologies that increase capillary permeability were evaluated prospectively. We used transpulmonary thermodilution to measure the extravascular lung water index, intrathoracic blood volume index and pulmonary blood volume. For the measurement of the initial distribution volume of glucose, plasma volume and extracellular water we used dilutions of glucose, indocyanine green and sinistrin respectively. Transpulmonary thermodilution and dilutions of glucose were repeated 75 minutes after the beginning of the fluid load. The patients in the septic group had higher volumes of extracellular water (median 295 vs. 234 ml/kg, P < 0.001), lower intrathoracic blood volume index (median 894 vs. 1157 ml/m2, P < 0.003), higher pulmonary permeability ratios (extravascular lung water/pulmonary blood volume) (P < 0.003) and higher systemic permeability ratios (interstitial/plasma volume) (P < 0.04). The intrathoracic blood volume index increase after fluid loading was lower in the septic group (10 vs. 145 ml/m2). The pulmonary permeability ratios did not correlate with the systemic permeability ratios, and in the septic group, the percentage volume retained in the intrathoracic blood volumes after fluid loading did not correlate with the systemic permeability ratios. Septic shock can cause a redistribution of fluids. Fluid administration in these patients produced a minimal increase in intrathoracic blood volume, and the percentage of volume retained in this space was not correlated with the interstitial/plasma volume ratio.
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Affiliation(s)
- M Sánchez
- Department of Intensive Care Medicine, University Hospital of La Paz, Madrid, Spain.
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Laffita W, Rodiles E, Jiménez-Reyes W, Rodríguez-Terrero I, Collado A. Oclusión intestinal por brida congénita en una gestante de 28 semanas. Informe de un caso. Clínica e Investigación en Ginecología y Obstetricia 2011. [DOI: 10.1016/j.gine.2009.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gómez-Ferrer A, Rubio-Briones J, Collado A, Trassierra M, Casanova J, Monrós JL, Ricós JV, Bonillo MÁ, Iborra I, Solsona E. [Reconstruction of the glans with free-skin graft applying the Bracka technique]. Actas Urol Esp 2011; 35:180-3. [PMID: 21296453 DOI: 10.1016/j.acuro.2010.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 09/03/2010] [Accepted: 09/18/2010] [Indexed: 11/18/2022]
Abstract
INTRODUCTION We analyse our experience in the conservative surgical management of penile cancer and/or penile skin pathologies at our institution. MATERIAL AND METHODS We have retrospectively reviewed all the skin grafting procedures performed in penile surgery in the last eight years. We show the indications and results of these surgical procedures and the detailed surgical technique originally described by Bracka. RESULTS Ten patients had several types of partial penile removal surgery followed by free-skin graft resurfacing, creating a neoglans. There were no relevant or major complications; two patients suffered partial necrosis of the skin graft. There was no local recurrence. 6 Patients returned to normal sexual activity after complete healing. CONCLUSIONS There is a significant number of patients with penile cancer and/or other penile skin pathologies who can undergo definitive and non-mutilating surgery with excellent oncologic, cosmetic and functional results with skin grafting.
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Affiliation(s)
- A Gómez-Ferrer
- Servicio de Urología, Instituto Valenciano de Oncología, Valencia, España.
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Gómez-Ferrer Á, Rubio-Briones J, Collado A, Trassierra M, Casanova J, Monrós J, Ricós J, Bonillo M, Iborra I, Solsona E. Reconstrucción del glande con injerto cutáneo libre según técnica de Bracka. Actas Urol Esp 2011. [DOI: 10.4321/s0210-48062011000300012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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