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Villar P, Carreño S, Moro S, Díez Galindo I, Bernardo Á, Gutiérrez L. Platelet function testing: Update on determinant variables and permissive windows using a platelet-count-based device. Transfus Apher Sci 2024:103930. [PMID: 38644062 DOI: 10.1016/j.transci.2024.103930] [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: 04/23/2024]
Abstract
While there are various aspects of platelet biology that can be studied in the lab (i.e. adhesion, degranulation, integrin activation), the master test for platelet function is that which gives a measure of the platelet aggregation capacity upon stimulation with an agonist. Platelet function testing is necessary for the diagnosis of platelet disorders and the monitoring of patients receiving anti-platelet treatments. Furthermore, it becomes relevant in the quality control of platelet concentrates for transfusion purposes, especially considering the global concern about long term storage, other forms of storage (i.e. cryopreservation, lyophilization), and the impact of Pathogen Reduction Treatments (PRTs) on platelet performance upon transfusion. However, it has been acknowledged as technically difficult and demanding, since a fine platelet function test must be carried out under specific conditions. Still, there might be occasions that preclude the platelet function testing abiding to the gold standard requirements, thus, leaving us with the necessity to redefine which variables may condition or limit the analysis of platelet function testing. In the present manuscript, we test different variables (such as the anticoagulant used or the time elapsed since extraction) and the possibility to reconstitute blood prior to platelet function analysis. This study aims to provide windows of action at the diagnostics lab, especially when not all of the recommended procedures and conditions can be followed: for example, when a sample is sent from a long distance, when there is a limitation on blood extraction volume or when certain parameters (platelet count) preclude reliable test results.
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Affiliation(s)
- Patricia Villar
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Sofía Carreño
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Sara Moro
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Inés Díez Galindo
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Ángel Bernardo
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Hematology Department and AGC Laboratory of Medicine, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Medicine, University of Oviedo, Oviedo, Spain.
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Martínez-Carballeira D, Bernardo Á, Caro A, Soto I, Gutiérrez L. Pathophysiology, Clinical Manifestations and Diagnosis of Immune Thrombocytopenia: Contextualization from a Historical Perspective. Hematol Rep 2024; 16:204-219. [PMID: 38651450 PMCID: PMC11036214 DOI: 10.3390/hematolrep16020021] [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: 01/09/2024] [Revised: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 04/25/2024] Open
Abstract
Immune thrombocytopenia (ITP) is an autoimmune disease characterized by an isolated decrease in the platelet count and an increased risk of bleeding. The pathogenesis is complex, affecting multiple components of the immune system and causing both peripheral destruction of platelets and impaired central megakaryopoiesis and platelet production in the bone marrow. Here, we intend to contextualize the current knowledge on the pathophysiology, terminology, epidemiology, clinical manifestations, diagnosis, and prognosis of ITP from a historical perspective and the first references to the never-stopping garnering of knowledge about this entity. We highlight the necessity to better understand ITP in order to be able to provide ITP patients with personalized treatment options, improving disease prognosis and reducing the incidence or frequency of refractoriness.
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Affiliation(s)
- Daniel Martínez-Carballeira
- Department of Hematology, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (Á.B.); (A.C.); (I.S.)
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
| | - Ángel Bernardo
- Department of Hematology, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (Á.B.); (A.C.); (I.S.)
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
| | - Alberto Caro
- Department of Hematology, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (Á.B.); (A.C.); (I.S.)
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
| | - Inmaculada Soto
- Department of Hematology, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; (Á.B.); (A.C.); (I.S.)
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
- Department of Medicine, University of Oviedo, 33006 Oviedo, Spain
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Acebes-Huerta A, Martínez-Botía P, Carbajo-Argüelles G, Fernández-Fuertes J, Muñoz-Turrillas MC, Ojea-Pérez AM, López-Vázquez A, Eble JA, Gutiérrez L. Characterization of the molecular composition and in vitro regenerative capacity of platelet-based bioproducts and related subfractions. Acta Biomater 2024; 177:132-147. [PMID: 38311196 DOI: 10.1016/j.actbio.2024.01.029] [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: 03/13/2023] [Revised: 12/29/2023] [Accepted: 01/19/2024] [Indexed: 02/10/2024]
Abstract
The use and demand of platelet-based bioproducts in regenerative medicine is steadily increasing. However, it is very difficult to establish the real clinical benefits of these therapies, as the lack of characterization and detailed production methods of platelet-based bioproducts persists in the literature and precludes cross-study comparisons. We characterized the molecular composition and in vitro regenerative capacity of platelet-rich plasma (PRP) produced in a closed-system. Furthermore, we performed a parallel characterization on different PRP subfractions (plasma and plasma-free platelet lysate), identifying that the fractions containing platelet-derived cargo exert the most potent regenerative capacity. This observation led us to develop a method to obtain a platelet secretome highly enriched in growth factors, free of plasma and cellular components (PCT/IB2022/057936), with the aim of establishing a superior bioproduct. The molecular characterization of secretomes revealed agonist-dependent differences, which correlates with beneficial grades of regenerative capacity. Importantly, secretomes showed general superiority to PRP in vitro. We discuss the variables influencing the bioproduct quality (inter-donor variation, platelet source and processing methods). Finally, we propose that the characteristics of secretomes circumvents certain limitations of PRP (autologous vs allogeneic), and envision that optimizing post-processing protocols (nanoencapsulation, lyophilization), would allow their clinical application even beyond regenerative medicine. STATEMENT OF SIGNIFICANCE: The use and demand of platelet-based bioproducts in regenerative medicine is steadily increasing. However, it is very difficult to establish the real clinical benefits of these therapies, or to improve/personalize them, as the lack of characterization of the bioproducts and their production methods is a constant in the literature, reason that precludes cross-study comparisons. In the present manuscript, we provide a comprehensive molecular and functional characterization of platelet-based bioproducts and subfractions, including platelet rich plasma, plasma fractions and platelet secretomes produced with a methodology developed by our group. Our results show that the molecular composition of each fraction correlates with its regenerative capacity in vitro. Thus, a rigorous characterization of platelet-derived bioproducts will potentially allow universal use, customizing and new applications.
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Affiliation(s)
- Andrea Acebes-Huerta
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Medicine, University of Oviedo, Spain
| | - Patricia Martínez-Botía
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Graciela Carbajo-Argüelles
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Judit Fernández-Fuertes
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Orthopedics and Trauma Surgery, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain; Department of Surgery and Medical Surgical Specialties, University of Oviedo, Spain
| | - María Carmen Muñoz-Turrillas
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Centro Regional de Transfusión de Toledo-Guadalajara, Spain
| | | | - Antonio López-Vázquez
- Department of Immunology, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - Johannes A Eble
- Institute of Physiological Chemistry and Pathobiochemistry, University of Münster, Germany
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Medicine, University of Oviedo, Spain.
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Martínez-Carballeira D, Caro A, Bernardo Á, Corte JR, Iglesias JC, Hernández de Castro IA, Gutiérrez L, Soto I. Rare bleeding disorders: Real-world data from a Spanish tertiary hospital. Blood Cells Mol Dis 2024; 106:102837. [PMID: 38387429 DOI: 10.1016/j.bcmd.2024.102837] [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: 11/12/2023] [Revised: 02/14/2024] [Accepted: 02/14/2024] [Indexed: 02/24/2024]
Abstract
INTRODUCTION Due to their low prevalence, rare bleeding disorders (RBDs) remain poorly characterized. AIM To gain insight of RBDs through our clinical practice. METHODS Retrospective study of the medical records of RBD patients followed up at the Central University Hospital of Asturias between January 2019 and December 2022. RESULTS A total of 149 patients were included. Factor (F) VII (44 %) and FXI (40 %) deficiencies were the most common diagnosed coagulopathies. Most of the patients were asymptomatic (60.4 %) and the most frequent type of bleeding were mucocutaneous and after surgery. All replacement treatments were administered on demand and no patient was on a prophylaxis regimen. Currently available products were safe; allergic reactions after administration of plasma were the most frequent complication. Genetic analysis, carried out on 55 patients (37 %), showed that the most frequent mutations in RBDs are of missense type (71.9 %). We identified 11 different novel genetic alterations in affected genes. The c.802C > T (p.Arg268Cys) variant, previously described, was identified in 71 % (15 of 21) of the patients with FXI deficiency genotyped and none were related (probable founder effect). CONCLUSION Our study on an unusual large single center cohort of RBD patients portrays location-dependent distinct genetic drives and clinical practice particularities.
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Affiliation(s)
- Daniel Martínez-Carballeira
- Department of Hematology, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain.
| | - Alberto Caro
- Department of Hematology, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - Ángel Bernardo
- Department of Hematology, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - José Ramón Corte
- Department of Hematology, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain
| | - José Carlos Iglesias
- Department of Hematology, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain
| | | | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; Department of Medicine, University of Oviedo, 33006 Oviedo, Spain
| | - Inmaculada Soto
- Department of Hematology, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain; Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
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Ruiz-Muñoz A, Guala A, Dux-Santoy L, Teixidó-Turà G, Valente F, Garrido-Oliver J, Galian-Gay L, Gutiérrez L, Fernandez-Galera R, Casas-Masnou G, González-Alujas T, Cuéllar-Calabria H, Carrasco-Poves A, Morales-Galán A, Johnson KM, Wieben O, Ferreira-González I, Evangelista A, Rodriguez-Palomares J. False lumen hemodynamics and partial thrombosis in chronic aortic dissection of the descending aorta. Eur Radiol 2024:10.1007/s00330-023-10513-6. [PMID: 38183450 DOI: 10.1007/s00330-023-10513-6] [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: 07/24/2023] [Revised: 10/17/2023] [Accepted: 11/08/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVES Partial thrombosis of the false lumen (FL) in patients with chronic aortic dissection (AD) of the descending aorta has been associated with poor outcomes. Meanwhile, the fluid dynamic and biomechanical characteristics associated with partial thrombosis remain to be elucidated. This retrospective, single-center study tested the association between FL fluid dynamics and biomechanics and the presence and extent of FL thrombus. METHODS Patients with chronic non-thrombosed or partially thrombosed FLs in the descending aorta after an aortic dissection underwent computed tomography angiography, cardiovascular magnetic resonance (CMR) angiography, and a 4D flow CMR study. A comprehensive quantitative analysis was performed to test the association between FL thrombus presence and extent (percentage of FL with thrombus) and FL anatomy (diameter, entry tear location and size), fluid dynamics (inflow, rotational flow, wall shear stress, kinetic energy, and flow acceleration and stasis), and biomechanics (pulse wave velocity). RESULTS Sixty-eight patients were included. In multivariate logistic regression FL kinetic energy (p = 0.038) discriminated the 33 patients with partial FL thrombosis from the 35 patients with no thrombosis. Similarly, in separated multivariate linear correlations kinetic energy (p = 0.006) and FL inflow (p = 0.002) were independently related to the extent of the thrombus. FL vortexes, flow acceleration and stasis, wall shear stress, and pulse wave velocity showed limited associations with thrombus presence and extent. CONCLUSION In patients with chronic descending aorta dissection, false lumen kinetic energy is related to the presence and extent of false lumen thrombus. CLINICAL RELEVANCE STATEMENT In patients with chronic aortic dissection of the descending aorta, false lumen hemodynamic parameters are closely linked with the presence and extent of false lumen thrombosis, and these non-invasive measures might be important in patient management. KEY POINTS • Partial false lumen thrombosis has been associated with aortic growth in patients with chronic descending aortic dissection; therefore, the identification of prothrombotic flow conditions is desirable. • The presence of partial false lumen thrombosis as well as its extent was related with false lumen kinetic energy. • The assessment of false lumen hemodynamics may be important in the management of patients with chronic aortic dissection of the descending aorta.
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Affiliation(s)
- Aroa Ruiz-Muñoz
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Andrea Guala
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain.
| | | | - Gisela Teixidó-Turà
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Filipa Valente
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | | | - Laura Galian-Gay
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Laura Gutiérrez
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Rubén Fernandez-Galera
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Guillem Casas-Masnou
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Teresa González-Alujas
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Hug Cuéllar-Calabria
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | | | - Kevin M Johnson
- Departments of Medical Physics & Radiology, University of Wisconsin, Madison, WI, USA
| | - Oliver Wieben
- Departments of Medical Physics & Radiology, University of Wisconsin, Madison, WI, USA
| | - Ignacio Ferreira-González
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
| | - Arturo Evangelista
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Instituto del Corazón, Quirónsalud-Teknon, Barcelona, Spain
| | - Jose Rodriguez-Palomares
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain.
- Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.
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Martínez-Botía P, Villar P, Carbajo-Argüelles G, Jaiteh Z, Acebes-Huerta A, Gutiérrez L. Proteomics-wise, how similar are mouse and human platelets? Platelets 2023; 34:2220415. [PMID: 37283127 DOI: 10.1080/09537104.2023.2220415] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The field of proteomics and its application to platelet biology, is rapidly and promisingly developing. Platelets (and megakaryocytes) are postulated as biosensors of health and disease, and their proteome poses as a tool to identify the specific health-disease hallmarks. Furthermore, the clinical management of certain pathologies where platelets are active players demands the development of alternative treatments, such is the case in patients where the balance thrombosis-bleeding is compromised, and a proteomics approach might aid at the identification of novel targets. Hereby, the mouse and human platelet proteomes and secretomes from public databases are compared, which shows that human and mouse platelets share a highly conserved proteome, considering identified proteins, and most importantly, their relative abundance. These supports, also interspecies wise, the use of the proteomics tool in the field, substantiated by a growing number of clinically relevant studies in humans or preclinical models. While the study of platelets through proteomics seems accessible and direct (i.e. noninvasive blood sampling, enucleated), there are some points of concern regarding the quality control of samples for such proteomics studies. Importantly, the quality of the generated data is improving over the years, which will allow cross-study comparisons. In parallel, the application of proteomics to the megakaryocyte compartment has a promising but long journey ahead. We foresee and encourage the application of platelet proteomics for diagnostic/prognostic purposes even beyond hematopoiesis and transfusion medicine, and as a tool that will procure the improvement of current therapies and the development of alternative treatment options.
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Affiliation(s)
- Patricia Martínez-Botía
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Patricia Villar
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Graciela Carbajo-Argüelles
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Zacaria Jaiteh
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Andrea Acebes-Huerta
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Department of Medicine, University of Oviedo, Oviedo, Spain
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Paniagua G, González-Blanco L, Sáiz PA, Moya-Lacasa C, Gutiérrez L, Martínez-Botía P, Dal Santo F, Jiménez-Treviño L, García-Portilla MP, Bobes J. Platelet and white blood-cell-based ratios: Differential inflammatory markers of severe mental disorders? Span J Psychiatry Ment Health 2023:S2950-2853(23)00008-X. [PMID: 38591835 DOI: 10.1016/j.sjpmh.2023.03.002] [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] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/21/2023] [Accepted: 03/29/2023] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Neutrophil/lymphocyte (NLR), monocyte/lymphocyte (MLR), and platelet/lymphocyte (PLR) ratios, and systemic inflammatory index (SII) represent peripheral markers of inflammation associated with different severe mental disorders. MATERIAL AND METHODS In this study, these parameters were analyzed in a sample of 622 participants [197 patients with major depressive disorder (MDD), 154 with bipolar disorder (BD), 176 with schizophrenia (SCH), and 95 healthy controls (HC)]. Sociodemographic and clinical data of patients were recorded. RESULTS Differences in age and sex were detected among groups (p<0.001), with SCH patients being younger and MDD patients being older. After stratifying by sex, these ratios were compared using the nonparametric ANCOVA (Quade's test) using age as a covariate. In males, no significant statistical differences were found between groups. However, differences were observed in MLR in the subgroup of females [MDD: 0.23 (SD=0.09); BD: 0.23 (SD=0.11); SCH: 0.24 (SD=0.11); HC: 0.29 (SD=0.13); F=5.376, p=0.001]. Post hoc testing revealed that there are MLR differences between HC versus MDD and between HC versus BD, with higher values in HC versus the other two groups. On the other hand, no differences were found in either males or females for any of the studied ratios, among the three diagnostic groups. CONCLUSIONS MLR is reduced in MDD and BD patients versus HC, but exclusively in the female group. However, based on the analyzed indices, it is not possible to differentiate among the three diagnostic groups of patients. As a limitation of this study, note that the effects of psychopharmacological treatments and smoking have not been controlled for.
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Affiliation(s)
- Gonzalo Paniagua
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Leticia González-Blanco
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Pilar A Sáiz
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
| | - Carlota Moya-Lacasa
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Medicine, Universidad de Oviedo, Oviedo, Spain
| | - Patricia Martínez-Botía
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Francesco Dal Santo
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Luis Jiménez-Treviño
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - María Paz García-Portilla
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Julio Bobes
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
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8
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Galian-Gay L, Teixidó-Turà G, Casas G, Ferrer-Sistach E, Mitroi C, Mingo S, Monivas V, Saura D, Vidal B, Moral S, Calvo F, Sánchez V, Gonzalez A, Guzman-Martínez G, Noris Mora M, Arnau Vives MÁ, Peteiro J, Bouzas A, González-Alujas T, Gutiérrez L, Fernandez-Galera R, Valente F, Guala A, Ruiz-Muñoz A, Dux-Santoy L, Oliveró Soldevila R, Avilés AS, Rodríguez Palomares JF, Ferreira-González I, Evangelista A. Changes in echocardiographic parameters over time in paradoxical low-flow low-gradient aortic stenosis. Eur Heart J Cardiovasc Imaging 2023:7148598. [PMID: 37131301 DOI: 10.1093/ehjci/jead067] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/08/2023] [Accepted: 03/26/2023] [Indexed: 05/04/2023] Open
Abstract
AIMS To assess the progression of the disease and evolution of the main echocardiographic variables for quantifying AS in patients with severe low-flow low-gradient (LFLG) AS compared to other severe AS subtypes. METHODS AND RESULTS Longitudinal, observational, multicenter study including consecutive asymptomatic patients with severe AS (aortic valve area, AVA < 1.0 cm²) and normal left ventricle ejection fraction (LVEF ≥ 50%). Patients were classified according to baseline echocardiography into: HG (high gradient; mean gradient ≥ 40 mmHg), NFLG (normal-flow low-gradient; mean gradient < 40 mmHg, indexed systolic volume (SVi) > 35mL/m2), or LFLG (mean gradient < 40 mmHg, SVi ≤ 35 mL/m²). AS progression was analyzed by comparing patients' baseline measurements and their last follow-up measurements or those taken prior to aortic valve replacement (AVR). Of the 903 included patients, 401 (44.4%) were HG, 405 (44.9%) NFLG, and 97 (10.7%) LFLG. Progression of the mean gradient in a linear mixed regression model was greater in low-gradient groups: LFLG vs. HG (regression coefficient 0.124, P = 0.005) and NFLG vs. HG (regression coefficient 0.068, P = 0.018). No differences were observed between the LFLG and NFLG groups (regression coefficient 0.056, P = 0.195). However, AVA reduction was slower in the LFLG group compared to the NFLG (P < 0.001). During follow-up, in conservatively-managed patients, 19.1% (n = 9) of LFLG patients evolved to having NFLG AS and 44.7% (n = 21) to having HG AS. In patients undergoing AVR, 58.0% (n = 29) of LFLG baseline patients received AVR with a HG AS. CONCLUSION LFLG AS shows an intermediate AVA and gradient progression compared to NFLG and HG AS. The majority of patients initially classified as having LFLG AS changed over time to having other severe forms of AS, and most of them received AVR with a HG AS.
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Affiliation(s)
- Laura Galian-Gay
- Department of Cardiology, Hospital Universitari Vall d´Hebron-VIHR, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER cardiovascular (CIBERCV), Spain
| | - Gisela Teixidó-Turà
- Department of Cardiology, Hospital Universitari Vall d´Hebron-VIHR, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER cardiovascular (CIBERCV), Spain
| | - Guillem Casas
- Department of Cardiology, Hospital Universitari Vall d´Hebron-VIHR, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER cardiovascular (CIBERCV), Spain
| | - Elena Ferrer-Sistach
- Department of Cardiology, Hospital Universitari Germans Tries i Pujol, Badalona, Spain
| | - Cristina Mitroi
- Department of Cardiology, Hospital Puerta de Hierro - Majadahonda, Madrid, Spain
| | - Susana Mingo
- Department of Cardiology, Hospital Puerta de Hierro - Majadahonda, Madrid, Spain
| | - Vanessa Monivas
- Department of Cardiology, Hospital Puerta de Hierro - Majadahonda, Madrid, Spain
| | - Daniel Saura
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, CIBER-Cardiovascular, Spain
| | - Bàrbara Vidal
- Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sergio Moral
- Department of Cardiology, Hospital Josep Trueta, Girona, Spain
| | - Francisco Calvo
- Department of Cardiology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Violeta Sánchez
- Department of Cardiology, Hospital Universitario 12 de Octubre, Madrid, CIBERCV, Spain
| | - Ariana Gonzalez
- Department of Cardiology, Hospital Ramón y Cajal, Madrid, Spain
| | - Gabriela Guzman-Martínez
- Department of Cardiology, Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Marta Noris Mora
- Department of Cardiology, Hospital Universitario Son Espases, Mallorca, Spain
| | | | - Jesús Peteiro
- Department of Cardiology, Complexo Hospitalario Universitario A Coruña, Coruña, Spain
| | - Alberto Bouzas
- Department of Cardiology, Complexo Hospitalario Universitario A Coruña, Coruña, Spain
| | - Teresa González-Alujas
- Department of Cardiology, Hospital Universitari Vall d´Hebron-VIHR, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER cardiovascular (CIBERCV), Spain
| | - Laura Gutiérrez
- Department of Cardiology, Hospital Universitari Vall d´Hebron-VIHR, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER cardiovascular (CIBERCV), Spain
| | - Rubén Fernandez-Galera
- Department of Cardiology, Hospital Universitari Vall d´Hebron-VIHR, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER cardiovascular (CIBERCV), Spain
| | - Filipa Valente
- Department of Cardiology, Hospital Universitari Vall d´Hebron-VIHR, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER cardiovascular (CIBERCV), Spain
| | - Andrea Guala
- Department of Cardiology, Hospital Universitari Vall d´Hebron-VIHR, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER cardiovascular (CIBERCV), Spain
| | - Aroa Ruiz-Muñoz
- Department of Cardiology, Hospital Universitari Vall d´Hebron-VIHR, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER cardiovascular (CIBERCV), Spain
| | - Lydia Dux-Santoy
- Department of Cardiology, Hospital Universitari Vall d´Hebron-VIHR, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER cardiovascular (CIBERCV), Spain
| | - Ruper Oliveró Soldevila
- Department of Cardiology, Hospital Universitari Vall d´Hebron-VIHR, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER cardiovascular (CIBERCV), Spain
| | - Augusto Sao Avilés
- Department of Cardiology, Hospital Universitari Vall d´Hebron-VIHR, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER cardiovascular (CIBERCV), Spain
| | - José F Rodríguez Palomares
- Department of Cardiology, Hospital Universitari Vall d´Hebron-VIHR, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER cardiovascular (CIBERCV), Spain
| | - Ignacio Ferreira-González
- Department of Cardiology, Hospital Universitari Vall d´Hebron-VIHR, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Artur Evangelista
- Department of Cardiology, Hospital Universitari Vall d´Hebron-VIHR, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER cardiovascular (CIBERCV), Spain
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9
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Rosselli Del Turco E, Pasquini Z, Scolz K, Amedeo A, Beci G, Giglia M, Bussini L, Carvalho-Brugger S, Gutiérrez L, Tedeschi S, Garcia M, Ambretti S, Pericàs JM, Giannella M, Viale P, Bartoletti M. Treatment duration for central line-associated infection caused by Enterococcus spp.: a retrospective evaluation of a multicenter cohort. Eur J Clin Microbiol Infect Dis 2022; 41:1203-1206. [PMID: 35915273 DOI: 10.1007/s10096-022-04481-w] [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: 09/07/2021] [Accepted: 07/27/2022] [Indexed: 11/25/2022]
Abstract
Objective of this study was to assess the appropriate treatment duration for enterococcal central line-associated bloodstream infections (CLABSIs). This observational, retrospective, multicenter study conducted between 2011 and 2019 enrolled all hospitalized patients with monomicrobial enterococcal CLABSI. Those with infective endocarditis and non-survivors at least 7 days from index blood culture (BC) were excluded. Primary endpoint was 30-day mortality. We enrolled 113 patients, of whom 59% were male, median age was 64 (SD ± 15) and median Charlson's index score 5 (IQR 3-8). Enterococcus faecalis and Enterococcus faecium were found in 51% and 44% of cases, respectively. Median treatment duration was 11 days (IQR 6-17), and 32% of patients (n = 36) received ≤ 7 days. Characteristics of patients receiving more or less than 7 days of treatment were similar. Central line was removed in 82% (n = 93) of cases within a median of 3 days (1-8). At both uni- and multivariate analysis, duration of antibiotic treatment > 7 days was not associated with 30-day mortality [HR 0.41 (95% CI, 0.13-1.24), p = 0.12] even after adjustment with propensity score [HR 0.47 (95% CI 0.17-1.26), p = 0.13]. A 7-day treatment course appears to be safe in non-complicated enterococcal CLABSIs.
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Affiliation(s)
- Elena Rosselli Del Turco
- Infectious Disease Unit, Policlinico Sant'Orsola-Malpighi, IRCCS Sant'Orsola, Via Massarenti, 11 - 40138, Bologna, Italy.
| | - Zeno Pasquini
- Infectious Disease Unit, Policlinico Sant'Orsola-Malpighi, IRCCS Sant'Orsola, Via Massarenti, 11 - 40138, Bologna, Italy
| | - Kristian Scolz
- Department of Medical and Surgical Science, Alma Mater Studiorum-Università Di Bologna, Bologna, Italy
| | - Alberto Amedeo
- Department of Medical and Surgical Science, Alma Mater Studiorum-Università Di Bologna, Bologna, Italy
| | - Giacomo Beci
- Department of Medical and Surgical Science, Alma Mater Studiorum-Università Di Bologna, Bologna, Italy
| | - Maddalena Giglia
- Department of Medical and Surgical Science, Alma Mater Studiorum-Università Di Bologna, Bologna, Italy
| | - Linda Bussini
- Infectious Disease Unit, Policlinico Sant'Orsola-Malpighi, IRCCS Sant'Orsola, Via Massarenti, 11 - 40138, Bologna, Italy
| | | | - Laura Gutiérrez
- Infectious Diseases Service, University Hospital Arnau de Vilanova-University Hospital Santa Maria, Lleida, Spain
| | - Sara Tedeschi
- Infectious Disease Unit, Policlinico Sant'Orsola-Malpighi, IRCCS Sant'Orsola, Via Massarenti, 11 - 40138, Bologna, Italy.,Department of Medical and Surgical Science, Alma Mater Studiorum-Università Di Bologna, Bologna, Italy
| | - Mercè Garcia
- Microbiology Service, University Hospital Arnau de Vilanova, Lleida, Spain
| | - Simone Ambretti
- Operative Unit of Microbiology, IRCCS Sant'Orsola, Bologna, Italy
| | - Juan M Pericàs
- Liver Unit, Internal Medicine Department, Vall d'Hebron Institute for Research, Vall d'Hebron University Hospital, Barcelona, Spain.,Infectious Diseases Service, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Maddalena Giannella
- Infectious Disease Unit, Policlinico Sant'Orsola-Malpighi, IRCCS Sant'Orsola, Via Massarenti, 11 - 40138, Bologna, Italy.,Department of Medical and Surgical Science, Alma Mater Studiorum-Università Di Bologna, Bologna, Italy
| | - Pierluigi Viale
- Infectious Disease Unit, Policlinico Sant'Orsola-Malpighi, IRCCS Sant'Orsola, Via Massarenti, 11 - 40138, Bologna, Italy.,Department of Medical and Surgical Science, Alma Mater Studiorum-Università Di Bologna, Bologna, Italy
| | - Michele Bartoletti
- Infectious Disease Unit, Policlinico Sant'Orsola-Malpighi, IRCCS Sant'Orsola, Via Massarenti, 11 - 40138, Bologna, Italy.,Department of Medical and Surgical Science, Alma Mater Studiorum-Università Di Bologna, Bologna, Italy
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10
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Bernardo Á, Caro A, Martínez-Carballeira D, Corte JR, Vázquez S, Palomo-Antequera C, Andreu A, Fernández-Pardo Á, Oto J, Gutiérrez L, Soto I, Medina P. Applicability of the Thrombin Generation Test to Evaluate the Hemostatic Status of Hemophilia A Patients in Daily Clinical Practice. J Clin Med 2022; 11:jcm11123345. [PMID: 35743412 PMCID: PMC9224793 DOI: 10.3390/jcm11123345] [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] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 05/25/2022] [Accepted: 06/07/2022] [Indexed: 02/01/2023] Open
Abstract
Hemophilia A (HA) is a rare bleeding disorder caused by factor VIII (FVIII) deficiency due to various genetic mutations in the F8 gene. The disease severity inversely correlates with the plasma levels of functional FVIII. The treatment of HA patients is based on FVIII replacement therapy, either following a prophylactic or on-demand regime, depending on the severity of the disease at diagnosis and the patient’s clinical manifestations. The hemorrhagic manifestations are widely variable amongst HA patients, who may require monitoring and treatment re-adjustment to minimize bleeding symptoms. Notably, laboratory monitoring of the FVIII activity is difficult due to a lack of sensitivity to various FVIII-related molecules, including non-factor replacement therapies. Hence, patient management is determined mainly based on clinical manifestations and patient–clinician history. Our goal was to validate the ST Genesia® automated thrombin generation analyzer to quantify the relative hemostatic status in HA patients. We recruited a cohort of HA patients from the Principality of Asturias (Spain), following treatment and at a stable non-bleeding phase. The entire cohort (57 patients) had been comprehensively studied at diagnosis, including FVIII and VWF activity assays and F8 genetic screening, and then clinically monitored until the Thrombin Generation Test (TGT) was performed. All patients were recruited prior to treatment administration, at the maximum time-window following the previous dose. Interestingly, the severe/moderate patients had a similar TGT compared to the mild patients, reflecting the non-bleeding phase of our patient cohort, regardless of the initial diagnosis (i.e., the severity of the disease), treatment regime, and FVIII activity measured at the time of the TGT. Thus, TGT parameters, especially the peak height (Peak), may reflect the actual hemostatic status of a patient more accurately compared to FVIII activity assays, which may be compromised by non-factor replacement therapies. Furthermore, our data supports the utilization of combined TGT variables, together with the severity of patient symptoms, along with the F8 mutation type to augment the prognostic capacity of TGT. The results from this observational study suggest that TGT parameters measured with ST Genesia® may represent a suitable tool to monitor the hemostatic status of patients requiring a closer follow-up and a tailored therapeutic adjustment, including other hemophilia subtypes or bleeding disorders.
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Affiliation(s)
- Ángel Bernardo
- Department of Hematology, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain; (A.C.); (D.M.-C.); (J.R.C.); (S.V.); (I.S.)
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
- Correspondence:
| | - Alberto Caro
- Department of Hematology, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain; (A.C.); (D.M.-C.); (J.R.C.); (S.V.); (I.S.)
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
| | - Daniel Martínez-Carballeira
- Department of Hematology, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain; (A.C.); (D.M.-C.); (J.R.C.); (S.V.); (I.S.)
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
| | - José Ramón Corte
- Department of Hematology, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain; (A.C.); (D.M.-C.); (J.R.C.); (S.V.); (I.S.)
| | - Sonia Vázquez
- Department of Hematology, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain; (A.C.); (D.M.-C.); (J.R.C.); (S.V.); (I.S.)
| | - Carmen Palomo-Antequera
- Department of Internal Medicine, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain;
- Bone Metabolism, Vascular Metabolism and Chronic Inflammatory Diseases Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - Alfredo Andreu
- Department of Pharmacology, University of Navarra, 31008 Pamplona, Spain;
| | - Álvaro Fernández-Pardo
- Hemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (Á.F.-P.); (J.O.); (P.M.)
| | - Julia Oto
- Hemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (Á.F.-P.); (J.O.); (P.M.)
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
- Department of Medicine, University of Oviedo, 33006 Oviedo, Spain
| | - Inmaculada Soto
- Department of Hematology, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain; (A.C.); (D.M.-C.); (J.R.C.); (S.V.); (I.S.)
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain;
| | - Pilar Medina
- Hemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (Á.F.-P.); (J.O.); (P.M.)
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11
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Bussini L, Turco ERD, Pasquini Z, Scolz K, Amedeo A, Beci G, Giglia M, Tedeschi S, Pascale R, Ambretti S, Pericàs JM, Giannella M, Carvalho-Brugger S, Gutiérrez L, Viale P, Bartoletti M. risk factors for persistent enterococcal bacteremia: a multicenter retrospective study. J Glob Antimicrob Resist 2022; 29:386-389. [DOI: 10.1016/j.jgar.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 10/18/2022] Open
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12
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Galian-Gay L, Escalona Silva RA, Teixidó-Turà G, Casas G, Ferrer-Sistach E, Mitroi C, Mingo S, Monivas V, Saura D, Vidal B, Trasca L, Moral S, Calvo F, Castiñeira Busto M, Sánchez V, Gonzalez A, Guzman G, Mora MN, Arnau Vives M, Peteiro J, Bouzas A, Mas-Stachurska A, González-Alujas T, Gutiérrez L, Fernandez-Galera R, Valente F, Guala A, Ruiz-Muñoz A, Avilés CAS, Palomares JFR, Ferreira I, Evangelista A. Prognosis of Paradoxical Low-Flow Low-Gradient Aortic Stenosis: A Severe, Non-critical Form, With Surgical Treatment Benefits. Front Cardiovasc Med 2022; 9:852954. [PMID: 35433871 PMCID: PMC9011160 DOI: 10.3389/fcvm.2022.852954] [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: 01/11/2022] [Accepted: 02/07/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives To determine the risk of mortality and need for aortic valve replacement (AVR) in patients with low-flow low-gradient (LFLG) aortic stenosis (AS). Methods A longitudinal multicentre study including consecutive patients with severe AS (aortic valve area [AVA] < 1.0 cm2) and normal left ventricular ejection fraction (LVEF). Patients were classified as: high-gradient (HG, mean gradient ≥ 40 mmHg), normal-flow low-gradient (NFLG, mean gradient < 40 mmHg, indexed systolic volume (SVi) > 35 ml/m2) and LFLG (mean gradient < 40 mmHg, SVi ≤ 35 ml/m2). Results Of 1,391 patients, 147 (10.5%) had LFLG, 752 (54.1%) HG, and 492 (35.4%) NFLG. Echocardiographic parameters of the LFLG group showed similar AVA to the HG group but with less severity in the dimensionless index, calcification, and hypertrophy. The HG group required AVR earlier than NFLG (p < 0.001) and LFLG (p < 0.001), with no differences between LFLG and NFLG groups (p = 0.358). Overall mortality was 27.7% (CI 95% 25.3–30.1) with no differences among groups (p = 0.319). The impact of AVR in terms of overall mortality reduction was observed the most in patients with HG (hazard ratio [HR]: 0.17; 95% CI: 0.12–0.23; p < 0.001), followed by patients with LFLG (HR: 0.25; 95% CI: 0.13–0.49; p < 0.001), and finally patients with NFLG (HR: 0.29; 95% CI: 0.20–0.44; p < 0.001), with a risk reduction of 84, 75, and 71%, respectively. Conclusions Paradoxical LFLG AS affects 10.5% of severe AS, and has a lower need for AVR than the HG group and similar to the NFLG group, with no differences in mortality. AVR had a lower impact on LFLG AS compared with HG AS. Therefore, the findings of the present study showed LFLG AS to have an intermediate clinical risk profile between the HG and NFHG groups.
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Affiliation(s)
- Laura Galian-Gay
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Roxana Andreina Escalona Silva
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gisela Teixidó-Turà
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Guillem Casas
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Ferrer-Sistach
- Department of Cardiology, Hospital Universitari Germans Tries i Pujol, Badalona, Spain
| | - Cristina Mitroi
- Department of Cardiology, Hospital Puerta de Hierro - Majadahonda, Madrid, Spain
| | - Susana Mingo
- Department of Cardiology, Hospital Puerta de Hierro - Majadahonda, Madrid, Spain
| | - Vanessa Monivas
- Department of Cardiology, Hospital Puerta de Hierro - Majadahonda, Madrid, Spain
| | - Daniel Saura
- Department of Cardiology, CIBER-CV, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Bàrbara Vidal
- Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Livia Trasca
- Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sergio Moral
- Department of Cardiology, Hospital Josep Trueta, Girona, Spain
| | - Francisco Calvo
- Department of Cardiology, Hospital Alvaro Cunqueiro, Vigo, Spain
| | | | - Violeta Sánchez
- Department of Cardiology, CIBER-CV, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Ariana Gonzalez
- Department of Cardiology, Hospital Ramón y Cajal, Madrid, Spain
| | - Gabriela Guzman
- Department of Cardiology, Hospital Universitario La Paz, Madrid, Spain
| | - Marta Noris Mora
- Department of Cardiology, Hospital Universitario Son Espases, IdISBa, Mallorca, Spain
| | | | - Jesús Peteiro
- Department of Cardiology, CIBER-CV, Complexo Hospitalario Universitario A Coruña, Coruña, Spain
| | - Alberto Bouzas
- Department of Cardiology, CIBER-CV, Complexo Hospitalario Universitario A Coruña, Coruña, Spain
| | | | - Teresa González-Alujas
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Gutiérrez
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rubén Fernandez-Galera
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Filipa Valente
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andrea Guala
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Aroa Ruiz-Muñoz
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cesar Augusto Sao Avilés
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José F. Rodríguez Palomares
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ignacio Ferreira
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
- Ignacio Ferreira
| | - Artur Evangelista
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
- *Correspondence: Artur Evangelista
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Fernández-Fuertes J, Arias-Fernández T, Acebes-Huerta A, Álvarez-Rico M, Gutiérrez L. Clinical Response After Treatment of Knee Osteoarthritis With a Standardized, Closed-System, Low-Cost Platelet-Rich Plasma Product: 1-Year Outcomes. Orthop J Sports Med 2022; 10:23259671221076496. [PMID: 35387363 PMCID: PMC8977725 DOI: 10.1177/23259671221076496] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/23/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Intra-articular infiltration of platelet-rich plasma (PRP) is an alternative
therapeutic option to classic hyaluronic acid for the treatment of
symptomatic knee osteoarthritis (KOA). However, variation in preparation
methods and quality assessment of PRP makes the study of its real clinical
efficacy difficult. Purpose: To (1) evaluate the clinical efficacy of a characterized PRP product prepared
in a standardized manner and in a closed-system for the treatment of KOA and
to (2) evaluate the association of the clinical response to PRP-related
variables. Study Design: Case series; Level of evidence, 4. Methods: We recruited 130 patients with nonoperative KOA and evaluated them for 1
year. PRP was prepared from a donation of autologous blood, obtaining 3
aliquots of approximately 10mL of product, which were frozen, allowing
platelet disruption, platelet factor release, and long-term storage, until
administration. Patients were treated 3 consecutive times every 4 weeks with
an intra-articular PRP knee injection under sterile conditions. Complete
blood count was performed on the whole-blood sample and the processed PRP
before freezing it, for product quality assessment. Patients were assessed
using the Western Ontario and McMaster Universities Osteoarthritis Index
(WOMAC) and basic satisfaction scale at 3 months, 6 months, and 1 year after
intervention. Results: Quality assessment confirmed a leukocyte-poor PRP product (white blood cell
count, 0.09 ± 0.09 × 109/L) with a high platelet purity (platelet
count, 630.86 ± 191.75 × 109/L). WOMAC scores improved, and basic
satisfaction was achieved in 70% of patients. No adverse events were
reported. No correlations were observed between PRP quality parameters and
clinical results. PRP complete treatment production costs were €108/US$125
(€36/US$41.6 per injection). Conclusion: This standardized PRP production method resulted in improved WOMAC scores at
1 year postoperatively in 70% of patients with KOA. This technique was safe
and affordable and ensured consecutive infiltrations with the same product
to each patient.
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Affiliation(s)
- Judit Fernández-Fuertes
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
- Department of Orthopedics and Trauma Surgery, Hospital Universitario de Cabueñes (CAHU), Gijón, Asturias, Spain
| | - Tamara Arias-Fernández
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
- Department of Hematology, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, Spain
| | - Andrea Acebes-Huerta
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
| | - Marlene Álvarez-Rico
- Department of Orthopedics and Trauma Surgery, Hospital Universitario de Cabueñes (CAHU), Gijón, Asturias, Spain
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
- Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain
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14
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Ruiz-Muñoz A, Guala A, Dux-Santoy L, Teixidó-Turà G, Servato ML, Valente F, Garrido-Oliver J, Galian-Gay L, Gutiérrez L, Fernandez-Galera R, Casas G, González-Alujas T, Cuéllar-Calabria H, Johnson KM, Wieben O, Ferreira-Gonzalez I, Evangelista A, Rodriguez-Palomares J. False lumen rotational flow and aortic stiffness are associated with aortic growth rate in patients with chronic aortic dissection of the descending aorta: a 4D flow cardiovascular magnetic resonance study. J Cardiovasc Magn Reson 2022; 24:20. [PMID: 35346239 PMCID: PMC8962590 DOI: 10.1186/s12968-022-00852-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 03/14/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Patency of the false lumen in chronic aortic dissection (AD) is associated with aortic dilation and long-term aortic events. However, predictors of adverse outcomes in this population are limited. The aim of this study was to evaluate the relationship between aortic growth rate and false lumen flow dynamics and biomechanics in patients with chronic, patent AD. METHODS Patients with a chronic AD with patent false lumen in the descending aorta and no genetic connective tissue disorder underwent an imaging follow-up including a contrast-enhanced 4D flow cardiovascular magnetic resonance (CMR) protocol and two consecutive computed tomography angiograms (CTA) acquired at least 1 year apart. A comprehensive analysis of anatomical features (including thrombus quantification), and false lumen flow dynamics and biomechanics (pulse wave velocity) was performed. RESULTS Fifty-four consecutive patients with a chronic, patent false lumen in the descending aorta were included (35 surgically-treated type A AD with residual tear and 19 medically-treated type B AD). Median follow-up was 40 months. The in-plane rotational flow, pulse wave velocity and the percentage of thrombus in the false lumen were positively related to aortic growth rate (p = 0.006, 0.017, and 0.037, respectively), whereas wall shear stress showed a trend for a positive association (p = 0.060). These results were found irrespectively of the type of AD. CONCLUSIONS In patients with chronic AD and patent false lumen of the descending aorta, rotational flow, pulse wave velocity and wall shear stress are positively related to aortic growth rate, and should be implemented in the follow-up algorithm of these patients. Further prospective studies are needed to confirm if the assessment of these parameters helps to identify patients at higher risk of adverse clinical events.
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Affiliation(s)
- Aroa Ruiz-Muñoz
- Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Hospital Universitari Vall d´Hebron, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Andrea Guala
- Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Gisela Teixidó-Turà
- Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Hospital Universitari Vall d´Hebron, Barcelona, Spain
| | - Maria Luz Servato
- Department of Cardiology, Hospital Universitari Vall d´Hebron, Barcelona, Spain
| | - Filipa Valente
- Department of Cardiology, Hospital Universitari Vall d´Hebron, Barcelona, Spain
| | | | - Laura Galian-Gay
- Department of Cardiology, Hospital Universitari Vall d´Hebron, Barcelona, Spain
| | - Laura Gutiérrez
- Department of Cardiology, Hospital Universitari Vall d´Hebron, Barcelona, Spain
| | | | - Guillem Casas
- Department of Cardiology, Hospital Universitari Vall d´Hebron, Barcelona, Spain
| | | | - Hug Cuéllar-Calabria
- Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Department of Radiology, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Kevin M. Johnson
- Departments of Medical Physics & Radiology, University of Wisconsin, Madison, WI USA
| | - Oliver Wieben
- Departments of Medical Physics & Radiology, University of Wisconsin, Madison, WI USA
| | - Ignacio Ferreira-Gonzalez
- Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Department of Cardiology, Hospital Universitari Vall d´Hebron, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
| | - Arturo Evangelista
- Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Hospital Universitari Vall d´Hebron, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Instituto del Corazón. Quirónsalud-Teknon, Barcelona, Spain
| | - Jose Rodriguez-Palomares
- Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Hospital Universitari Vall d´Hebron, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
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15
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Servato ML, Teixidó-Turá G, Sabate-Rotes A, Galian-Gay L, Gutiérrez L, Valente F, Fernandez-Galera R, Casas G, López-Sainz A, González-Alujas MT, Sao-Aviles A, Ferreira I, Rodríguez-Palomares J, Evangelista A. Are Aortic Root and Ascending Aorta Diameters Measured by the Pediatric versus the Adult American Society of Echocardiography Guidelines Interchangeable? J Clin Med 2021; 10:jcm10225290. [PMID: 34830571 PMCID: PMC8617792 DOI: 10.3390/jcm10225290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 10/22/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 11/16/2022] Open
Abstract
Ascending aorta diameters have important clinical value in the diagnosis, follow-up, and surgical indication of many aortic diseases. However, there is no uniformity among experts regarding ascending aorta diameter quantification by echocardiography. The aim of this study was to compare maximum aortic root and ascending aorta diameters determined by the diastolic leading edge (DLE) and the systolic inner edge (SIE) conventions in adult and pediatric patients with inherited cardiovascular diseases. Transthoracic echocardiograms were performed in 328 consecutive patients (260 adults and 68 children). Aorta diameters were measured twice at the root and ascending aorta by the DLE convention following the 2015 American Society of Echocardiography (ASE) adult guidelines and the SIE convention following the 2010 ASE pediatric guidelines. Comparison of the diameters measured by the two conventions in the overall population showed a non-significant underestimation of the diameter measured by the SIE convention at root level of 0.28 mm (CI -1.36; 1.93) and at tubular ascending aorta level of 0.17 mm (CI -1.69; 2.03). Intraobserver and interobserver variability were excellent. Maximum aorta diameter measured by the leading edge convention in end-diastole and the inner edge convention in mid-systole had similar values to a mild non-significant underestimation of the inner-to-inner method that permits them to be interchangeable when used in clinical practice.
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Affiliation(s)
- Maria Luz Servato
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (M.L.S.); (G.T.-T.); (L.G.-G.); (L.G.); (F.V.); (R.F.-G.); (G.C.); (A.L.-S.); (M.T.G.-A.); (A.S.-A.); (I.F.); (J.R.-P.)
| | - Gisela Teixidó-Turá
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (M.L.S.); (G.T.-T.); (L.G.-G.); (L.G.); (F.V.); (R.F.-G.); (G.C.); (A.L.-S.); (M.T.G.-A.); (A.S.-A.); (I.F.); (J.R.-P.)
| | - Anna Sabate-Rotes
- Department of Pediatric Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain;
| | - Laura Galian-Gay
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (M.L.S.); (G.T.-T.); (L.G.-G.); (L.G.); (F.V.); (R.F.-G.); (G.C.); (A.L.-S.); (M.T.G.-A.); (A.S.-A.); (I.F.); (J.R.-P.)
| | - Laura Gutiérrez
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (M.L.S.); (G.T.-T.); (L.G.-G.); (L.G.); (F.V.); (R.F.-G.); (G.C.); (A.L.-S.); (M.T.G.-A.); (A.S.-A.); (I.F.); (J.R.-P.)
| | - Filipa Valente
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (M.L.S.); (G.T.-T.); (L.G.-G.); (L.G.); (F.V.); (R.F.-G.); (G.C.); (A.L.-S.); (M.T.G.-A.); (A.S.-A.); (I.F.); (J.R.-P.)
| | - Ruben Fernandez-Galera
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (M.L.S.); (G.T.-T.); (L.G.-G.); (L.G.); (F.V.); (R.F.-G.); (G.C.); (A.L.-S.); (M.T.G.-A.); (A.S.-A.); (I.F.); (J.R.-P.)
| | - Guillem Casas
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (M.L.S.); (G.T.-T.); (L.G.-G.); (L.G.); (F.V.); (R.F.-G.); (G.C.); (A.L.-S.); (M.T.G.-A.); (A.S.-A.); (I.F.); (J.R.-P.)
| | - Angela López-Sainz
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (M.L.S.); (G.T.-T.); (L.G.-G.); (L.G.); (F.V.); (R.F.-G.); (G.C.); (A.L.-S.); (M.T.G.-A.); (A.S.-A.); (I.F.); (J.R.-P.)
| | - M. Teresa González-Alujas
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (M.L.S.); (G.T.-T.); (L.G.-G.); (L.G.); (F.V.); (R.F.-G.); (G.C.); (A.L.-S.); (M.T.G.-A.); (A.S.-A.); (I.F.); (J.R.-P.)
| | - Augusto Sao-Aviles
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (M.L.S.); (G.T.-T.); (L.G.-G.); (L.G.); (F.V.); (R.F.-G.); (G.C.); (A.L.-S.); (M.T.G.-A.); (A.S.-A.); (I.F.); (J.R.-P.)
| | - Ignacio Ferreira
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (M.L.S.); (G.T.-T.); (L.G.-G.); (L.G.); (F.V.); (R.F.-G.); (G.C.); (A.L.-S.); (M.T.G.-A.); (A.S.-A.); (I.F.); (J.R.-P.)
| | - Jose Rodríguez-Palomares
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (M.L.S.); (G.T.-T.); (L.G.-G.); (L.G.); (F.V.); (R.F.-G.); (G.C.); (A.L.-S.); (M.T.G.-A.); (A.S.-A.); (I.F.); (J.R.-P.)
| | - Arturo Evangelista
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (M.L.S.); (G.T.-T.); (L.G.-G.); (L.G.); (F.V.); (R.F.-G.); (G.C.); (A.L.-S.); (M.T.G.-A.); (A.S.-A.); (I.F.); (J.R.-P.)
- Teknon Medical Center-Quirón Salud, Heart Institute, 08022 Barcelona, Spain
- Correspondence:
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16
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Lopez A, Dentamaro I, Galian L, Calvo F, Alegret JM, Sanchez V, Citro R, Moreo A, Chirillo F, Colonna P, Carrero MC, Bossone E, Moral S, Sao-Aviles A, Gutiérrez L, Teixido-Tura G, Rodríguez-Palomares J, Evangelista A. Predictors of Ascending Aorta Enlargement and Valvular Dysfunction Progression in Patients with Bicuspid Aortic Valve. J Clin Med 2021; 10:jcm10225264. [PMID: 34830546 PMCID: PMC8621265 DOI: 10.3390/jcm10225264] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 12/01/2022] Open
Abstract
Bicuspid aortic valve (BAV) patients are at high risk of developing progressive aortic valve dysfunction and ascending aorta dilation. However, the progression of the disease is not well defined. We aimed to assess mid-long-term aorta dilation and valve dysfunction progression and their predictors. Patients were referred from cardiac outpatient clinics to the echocardiographic laboratories of 10 tertiary hospitals and followed clinically and by echocardiography for >5 years. Seven hundred and eighteen patients with BAV (median age 47.8 years [IQR 33–62], 69.2% male) were recruited. BAV without raphe was observed in 11.3%. After a median follow-up of 7.2 years [IQR5–8], mean aortic root growth rate was 0.23 ± 0.15 mm/year. On multivariate analysis, rapid aortic root dilation (>0.35 mm/year) was associated with male sex, hypertension, presence of raphe and aortic regurgitation. Annual ascending aorta growth rate was 0.43 ± 0.32 mm/year. Rapid ascending aorta dilation was related only to hypertension. Variables associated with aortic stenosis and regurgitation progression, adjusted by follow-up time, were presence of raphe, hypertension and dyslipidemia and basal valvular dysfunction, respectively. Intrinsic BAV characteristics and cardiovascular risk factors were associated with aorta dilation and valvular dysfunction progression, taking into account the inherent limitations of our study-design. Strict and early control of cardiovascular risk factors is mandatory in BAV patients.
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Affiliation(s)
- Angela Lopez
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (A.L.); (I.D.); (L.G.); (A.S.-A.); (L.G.); (G.T.-T.); (J.R.-P.)
| | - Ilaria Dentamaro
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (A.L.); (I.D.); (L.G.); (A.S.-A.); (L.G.); (G.T.-T.); (J.R.-P.)
| | - Laura Galian
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (A.L.); (I.D.); (L.G.); (A.S.-A.); (L.G.); (G.T.-T.); (J.R.-P.)
| | - Francisco Calvo
- Cardiology Department, Hospital Alvaro Cunqueiro, 36213 Vigo, Spain;
| | - Josep M. Alegret
- Cardiology Department, Hospital Universitari Sant Joan de Reus, IISPV, Universitat Rovira i Virgili, 43204 Reus, Spain;
| | - Violeta Sanchez
- Cardiology Department, University Hospital 12 de Octubre, 28041 Madrid, Spain;
| | - Rodolfo Citro
- Cardiology Department, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84125 Salerno, Italy;
| | - Antonella Moreo
- Cardiology Department, Niguarda Ca’ Granda Hospital, 20162 Milan, Italy;
| | - Fabio Chirillo
- Cardiology Department, Bassano del Grappa General Hospital, 36061 Bassano Del Grappa, Italy;
| | - Paolo Colonna
- Cardiology Department, Polyclinic Hospital of Bari, 70124 Bari, Italy;
| | - María Celeste Carrero
- Instituto Cardiovascular San Isidro, Sanatorio Las Lomas, Buenos Aires 3031, Argentina;
| | - Eduardo Bossone
- Cardiology Department, Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli, 80131 Napoli, Italy;
| | - Sergio Moral
- Servei de Cardiologia, Hospital Josep Trueta, 17007 Girona, Spain;
| | - Augusto Sao-Aviles
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (A.L.); (I.D.); (L.G.); (A.S.-A.); (L.G.); (G.T.-T.); (J.R.-P.)
| | - Laura Gutiérrez
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (A.L.); (I.D.); (L.G.); (A.S.-A.); (L.G.); (G.T.-T.); (J.R.-P.)
| | - Gisela Teixido-Tura
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (A.L.); (I.D.); (L.G.); (A.S.-A.); (L.G.); (G.T.-T.); (J.R.-P.)
| | - Jose Rodríguez-Palomares
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (A.L.); (I.D.); (L.G.); (A.S.-A.); (L.G.); (G.T.-T.); (J.R.-P.)
| | - Arturo Evangelista
- Department of Cardiology, University Hospital Vall d’Hebron, CIBERCV, 08035 Barcelona, Spain; (A.L.); (I.D.); (L.G.); (A.S.-A.); (L.G.); (G.T.-T.); (J.R.-P.)
- Heart Institute, Teknon Medical Center-Quirón Salud, 08022 Barcelona, Spain
- Correspondence:
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17
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Guala A, Dux-Santoy L, Teixido-Tura G, Ruiz-Muñoz A, Galian-Gay L, Servato ML, Valente F, Gutiérrez L, González-Alujas T, Johnson KM, Wieben O, Casas-Masnou G, Sao Avilés A, Fernandez-Galera R, Ferreira-Gonzalez I, Evangelista A, Rodríguez-Palomares JF. Wall Shear Stress Predicts Aortic Dilation in Patients With Bicuspid Aortic Valve. JACC Cardiovasc Imaging 2021; 15:46-56. [PMID: 34801463 DOI: 10.1016/j.jcmg.2021.09.023] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [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: 07/16/2021] [Accepted: 09/17/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVES This study sought to assess the predictive value of wall shear stress (WSS) for colocalized ascending aorta (AAo) growth rate (GR) in patients with bicuspid aortic valve (BAV). BACKGROUND BAV is associated with AAo dilation, but there is limited knowledge about possible predictors of aortic dilation in BAV patients with BAV. An increased WSS has been related to aortic wall damage in patients with BAV, but no previous prospective study tested its predictive value for dilation rate. Recently, a registration-based technique for the semiautomatic mapping of aortic GR has been presented and validated. METHODS Forty-seven patients with BAV free from valvular dysfunction prospectively underwent 4-dimensional flow cardiac magnetic resonance to compute WSS and subsequent follow-up with 2 electrocardiogram-gated high-resolution contrast-enhanced computed tomography angiograms for GR assessment. RESULTS During a median follow-up duration of 43 months, mid AAo GR was 0.24 mm/year. WSS and its circumferential component showed statistically significant association with mid AAo GR in bivariate (P = 0.049 and P = 0.014, respectively) and in multivariate analysis corrected for stroke volume and either baseline AAo diameter (P = 0.046 and P = 0.014, respectively) or z-score (P = 0.036 and P = 0.012, respectively). GR mapping further detailed that GR was heterogeneous in the AAo and that circumferential WSS, but not WSS magnitude, showed statistically significant positive associations with GR in the regions with the fastest growth. CONCLUSIONS 4D flow cardiac magnetic resonance-derived WSS and, in particular, its circumferential component predict progressive dilation of the ascending aorta in patients with BAV. Thus, the assessment of WSS may be considered in the follow-up of these patients.
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Affiliation(s)
- Andrea Guala
- Vall d'Hebron Institut de Recerca, Barcelona, Spain; Biomedical Research Networking Center on Cardiovascular Diseases, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Gisela Teixido-Tura
- Vall d'Hebron Institut de Recerca, Barcelona, Spain; Biomedical Research Networking Center on Cardiovascular Diseases, Instituto de Salud Carlos III, Madrid, Spain; Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Aroa Ruiz-Muñoz
- Vall d'Hebron Institut de Recerca, Barcelona, Spain; Biomedical Research Networking Center on Cardiovascular Diseases, Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Galian-Gay
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Maria Luz Servato
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Filipa Valente
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Laura Gutiérrez
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Kevin M Johnson
- Departments of Medical Physics and Radiology, University of Wisconsin, Wisconsin, USA
| | - Oliver Wieben
- Departments of Medical Physics and Radiology, University of Wisconsin, Wisconsin, USA
| | | | | | | | - Ignacio Ferreira-Gonzalez
- Vall d'Hebron Institut de Recerca, Barcelona, Spain; Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain; CIBER-ESP, Instituto de Salud Carlos III, Madrid, Spain
| | - Arturo Evangelista
- Vall d'Hebron Institut de Recerca, Barcelona, Spain; Biomedical Research Networking Center on Cardiovascular Diseases, Instituto de Salud Carlos III, Madrid, Spain; Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain; Instituto del Corazón, Quirónsalud-Teknon, Barcelona, Spain
| | - Jose F Rodríguez-Palomares
- Vall d'Hebron Institut de Recerca, Barcelona, Spain; Biomedical Research Networking Center on Cardiovascular Diseases, Instituto de Salud Carlos III, Madrid, Spain; Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain.
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18
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Dux-Santoy L, Rodríguez-Palomares JF, Teixidó-Turà G, Ruiz-Muñoz A, Casas G, Valente F, Servato ML, Galian-Gay L, Gutiérrez L, González-Alujas T, Fernández-Galera R, Evangelista A, Ferreira-González I, Guala A. Registration-based semi-automatic assessment of aortic diameter growth rate from contrast-enhanced computed tomography outperforms manual quantification. Eur Radiol 2021; 32:1997-2009. [PMID: 34655311 DOI: 10.1007/s00330-021-08273-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 04/27/2021] [Revised: 07/29/2021] [Accepted: 08/14/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Manual assessment of aortic diameters on double-oblique reformatted computed tomography angiograms (CTA) is considered the current standard, although the reproducibility for growth rates has not been reported. Deformable registration of CTA has been proposed to provide 3D aortic diameters and growth maps, but validation is lacking. This study aimed to quantify accuracy and inter-observer reproducibility of registration-based and manual assessment of aortic diameters and growth rates. METHODS Forty patients with ≥ 2 CTA acquired at least 6 months apart were included. Aortic diameters and growth rate were obtained in the aortic root and the entire thoracic aorta using deformable image registration by two independent observers, and compared with the current standard at typical anatomical landmarks. RESULTS Compared with manual assessment, the registration-based technique presented low bias (0.46 mm), excellent agreement (ICC = 0.99), and similar inter-observer reproducibility (ICC = 0.99 for both) for aortic diameters; and low bias (0.10 mm/year), good agreement (ICC = 0.82), and much higher inter-observer reproducibility for growth rates (root: ICC = 0.96 vs 0.68; thoracic aorta: ICC = 0.96 vs 0.80). Registration-based growth rate reproducibility over a 6-month-long follow-up was similar to that obtained by manual assessment after 2.7 years (LoA = [- 0.01, 0.33] vs [- 0.13, 0.21] mm/year, respectively). Mapping of diameter and growth rate was highly reproducible (ICC > 0.9) in the whole thoracic aorta. CONCLUSIONS Registration-based assessment of aortic dilation on CTA is accurate and substantially more reproducible than the current standard, even at follow-up as short as 6 months, and provides robust 3D mapping of aortic diameters and growth rates beyond the pre-established anatomic landmarks. KEY POINTS • Registration-based semi-automatic assessment of progressive aortic dilation on CTA is accurate and substantially more reproducible than the current standard. • The registration-based technique allows robust growth rate assessment at follow-up as short as 6 months, with a similar reproducibility to that obtained by manual assessment at around 3 years. • The use of image registration provides robust 3D mapping of aortic diameters and growth rates beyond the pre-established anatomic landmarks.
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Affiliation(s)
| | - Jose F Rodríguez-Palomares
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.
- Department of Cardiology, Hospital Universitari Vall D'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain.
- Universitat Autònoma de Barcelona, Bellaterra, Spain.
| | - Gisela Teixidó-Turà
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Hospital Universitari Vall D'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Aroa Ruiz-Muñoz
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
| | - Guillem Casas
- Department of Cardiology, Hospital Universitari Vall D'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Filipa Valente
- Department of Cardiology, Hospital Universitari Vall D'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Maria Luz Servato
- Department of Cardiology, Hospital Universitari Vall D'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Laura Galian-Gay
- Department of Cardiology, Hospital Universitari Vall D'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Laura Gutiérrez
- Department of Cardiology, Hospital Universitari Vall D'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Teresa González-Alujas
- Department of Cardiology, Hospital Universitari Vall D'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Rubén Fernández-Galera
- Department of Cardiology, Hospital Universitari Vall D'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Arturo Evangelista
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Hospital Universitari Vall D'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
- Instituto del Corazón. Quirónsalud-Teknon, Barcelona, Spain
| | - Ignacio Ferreira-González
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.
- Department of Cardiology, Hospital Universitari Vall D'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain.
- Universitat Autònoma de Barcelona, Bellaterra, Spain.
- CIBER de Epidemiología y Salud Pública, CIBERESP, Instituto de Salud Carlos III, Madrid, Spain.
| | - Andrea Guala
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
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19
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Acebes-Huerta A, Martínez-Botía P, Martín Martín C, Bernardo Á, Rodríguez AR, Vicente-Ayuso MC, Benavente Cuesta C, Gutiérrez L. Immunophenotyping and Cell Sorting of Human MKs from Human Primary Sources or Differentiated In Vitro from Hematopoietic Progenitors. J Vis Exp 2021. [PMID: 34424238 DOI: 10.3791/62569] [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] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Megakaryocyte (MK) differentiation encompasses a number of endomitotic cycles that result in a highly polyploid (reaching even >64N) and extremely large cell (40-60 µm). As opposed to the fast-increasing knowledge in megakaryopoiesis at the cell biology and molecular level, the characterization of megakaryopoiesis by flow cytometry is limited to the identification of mature MKs using lineage-specific surface markers, while earlier MK differentiation stages remain unexplored. Here, we present an immunophenotyping strategy that allows the identification of successive MK differentiation stages, with increasing ploidy status, in human primary sources or in vitro cultures with a panel integrating MK specific and non-specific surface markers. Despite its size and fragility, MKs can be immunophenotyped using the above-mentioned panel and enriched by fluorescence-activated cell sorting under specific conditions of pressure and nozzle diameter. This approach facilitates multi-Omics studies, with the aim to better understand the complexity of megakaryopoiesis and platelet production in humans. A better characterization of megakaryopoiesis may pose fundamental in the diagnosis or prognosis of lineage-related pathologies and malignancy.
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Affiliation(s)
- Andrea Acebes-Huerta
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA)
| | - Patricia Martínez-Botía
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA)
| | | | - Ángel Bernardo
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA); Clinical Diagnosis Laboratory - Dept. of Hematology, Hospital Universitario Central de Asturias (HUCA)
| | - Adrián R Rodríguez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA)
| | | | - Celina Benavente Cuesta
- Department of Hematology, Instituto de Investigación Sanitaria San Carlos (IdISSC), Hospital Clínico San Carlos (HCSC)
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA); Dept. of Medicine, University of Oviedo;
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20
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Lozano ML, Segú-Vergés C, Coma M, Álvarez-Roman MT, González-Porras JR, Gutiérrez L, Valcárcel D, Butta N. Elucidating the Mechanism of Action of the Attributed Immunomodulatory Role of Eltrombopag in Primary Immune Thrombocytopenia: An In Silico Approach. Int J Mol Sci 2021; 22:ijms22136907. [PMID: 34199099 PMCID: PMC8269123 DOI: 10.3390/ijms22136907] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/18/2021] [Accepted: 06/23/2021] [Indexed: 12/13/2022] Open
Abstract
Eltrombopag is a thrombopoietin receptor (MPL) agonist approved for the treatment of primary immune thrombocytopenia (ITP). Recent evidence shows that some patients may sustain platelet counts following eltrombopag discontinuation. The systemic immunomodulatory response that resolves ITP in some patients could result from an increase in platelet mass, caused either by the direct action of eltrombopag on megakaryocytes through MPL stimulation, or potential MPL-independent actions on other cell types. To uncover the possible mechanisms of action of eltrombopag, in silico analyses were performed, including a systems biology-based approach, a therapeutic performance mapping system, and structural analyses. Through manual curation of the available bibliography, 56 key proteins were identified and integrated into the ITP interactome analysis. Mathematical models (94.92% mean accuracy) were obtained to elucidate potential MPL-dependent pathways in non-megakaryocytic cell subtypes. In addition to the effects on megakaryocytes and platelet numbers, the results were consistent with MPL-mediated effects on other cells, which could involve interferon-gamma, transforming growth factor-beta, peroxisome proliferator-activated receptor-gamma, and forkhead box protein P3 pathways. Structural analyses indicated that effects on three apoptosis-related proteins (BCL2L1, BCL2, BAX) from the Bcl-2 family may be off-target effects of eltrombopag. In conclusion, this study proposes new hypotheses regarding the immunomodulatory functions of eltrombopag in patients with ITP.
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MESH Headings
- Benzoates/chemistry
- Benzoates/pharmacology
- Benzoates/therapeutic use
- Biomarkers
- Disease Management
- Disease Susceptibility
- Humans
- Hydrazines/chemistry
- Hydrazines/pharmacology
- Hydrazines/therapeutic use
- Immunomodulation/drug effects
- Models, Biological
- Models, Molecular
- Molecular Targeted Therapy/methods
- Protein Interaction Mapping
- Protein Interaction Maps
- Purpura, Thrombocytopenic, Idiopathic/drug therapy
- Purpura, Thrombocytopenic, Idiopathic/etiology
- Purpura, Thrombocytopenic, Idiopathic/metabolism
- Pyrazoles/chemistry
- Pyrazoles/pharmacology
- Pyrazoles/therapeutic use
- Receptors, Thrombopoietin/antagonists & inhibitors
- Receptors, Thrombopoietin/chemistry
- Receptors, Thrombopoietin/metabolism
- Signal Transduction/drug effects
- Structure-Activity Relationship
- T-Lymphocytes/drug effects
- T-Lymphocytes/immunology
- T-Lymphocytes/metabolism
- Treatment Outcome
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Affiliation(s)
- Maria L. Lozano
- Hospital General Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CB15/00055-CIBERER, 30007 Murcia, Spain
- Correspondence: (M.L.L.); (N.B.)
| | - Cristina Segú-Vergés
- Anaxomics Biotech S.L., Diputació 237, 1°, 1, 08007 Barcelona, Spain; (C.S.-V.); (M.C.)
| | - Mireia Coma
- Anaxomics Biotech S.L., Diputació 237, 1°, 1, 08007 Barcelona, Spain; (C.S.-V.); (M.C.)
| | - María T. Álvarez-Roman
- Unidad de Trombosis y Hemostasia, Servicio de Hematología, Hospital Universitario La Paz, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Paseo de la Castellana 261, 28046 Madrid, Spain;
| | - José R. González-Porras
- Unidad de Hemostasia y Trombosis, Servicio de Hematología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain;
| | - Laura Gutiérrez
- Grupo de Investigación en Plaquetas, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Departamento de Medicina, Universidad de Oviedo, 33071 Oviedo, Spain;
| | - David Valcárcel
- Servicio Hematología, Vall d´Hebron Insitute of Oncology (VHIO), Hospital Univesitario Vall d’Hebron, Universitat Autònoma de Barcelona, Centro Cellex, Natzaret, 115-117, 08035 Barcelona, Spain;
| | - Nora Butta
- Instituto de Investigación HospitaUniversitario La Paz (IdiPAZ), Paseo de la Castellana 261, 28046 Madrid, Spain
- Correspondence: (M.L.L.); (N.B.)
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21
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Ruiz-Muñoz A, Guala A, Rodriguez-Palomares J, Dux-Santoy L, Servato L, Lopez-Sainz A, La Mura L, Granato C, Limeres J, Gonzalez-Alujas T, Galián-Gay L, Gutiérrez L, Johnson K, Wieben O, Sao-Aviles A, Ferreira-Gonzalez I, Evangelista A, Teixido-Tura G. Aortic flow dynamics and stiffness in Loeys-Dietz syndrome patients: a comparison with healthy volunteers and Marfan syndrome patients. Eur Heart J Cardiovasc Imaging 2021; 23:641-649. [PMID: 34104946 DOI: 10.1093/ehjci/jeab069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Indexed: 11/14/2022] Open
Abstract
AIMS To assess aortic flow and stiffness in patients with Loeys-Dietz syndrome (LDS) by 4D flow and cine cardiovascular magnetic resonance (CMR) and compare the results with those of healthy volunteers (HV) and Marfan syndrome (MFS) patients. METHODS AND RESULTS Twenty-one LDS and 44 MFS patients with no previous aortic dissection or surgery and 35 HV underwent non-contrast-enhanced 4D flow CMR. In-plane rotational flow (IRF), systolic flow reversal ratio (SFRR), and aortic diameters were obtained at 20 planes from the ascending (AAo) to the proximal descending aorta (DAo). IRF and SFRR were also quantified for aortic regions (proximal and distal AAo, arch and proximal DAo). Peak-systolic wall shear stress (WSS) maps were also estimated. Aortic stiffness was quantified using pulse wave velocity (PWV) and proximal AAo longitudinal strain. Compared to HV, LDS patients had lower rotational flow at the distal AAo (P = 0.002), arch (P = 0.002), and proximal DAo (P < 0.001) even after adjustment for age, stroke volume, and local diameter. LDS patients had higher SFRR in the proximal DAo compared to both HV (P = 0.024) and MFS patients (P = 0.015), even after adjustment for age and local diameter. Axial and circumferential WSS in LDS patients were lower than in HV. AAo circumferential WSS was lower in LDS compared to MFS patients. AAo and DAo PWV and proximal AAo longitudinal strain revealed stiffer aortas in LDS patients compared to HV (P = 0.007, 0.005, and 0.029, respectively) but no differences vs. MFS patients. CONCLUSION Greater aortic stiffness as well as impaired IRF and WSS were present in LDS patients compared to HV. Conversely, similar aortic stiffness and overlapping aortic flow features were found in Loeys-Dietz and Marfan patients.
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Affiliation(s)
- Aroa Ruiz-Muñoz
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Andrea Guala
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Jose Rodriguez-Palomares
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | | | - Luz Servato
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Angela Lopez-Sainz
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Lucia La Mura
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Department of Advanced Biomedical Sciences, University Federico II. Naples, Naples, Italy
| | - Chiara Granato
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Javier Limeres
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Teresa Gonzalez-Alujas
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Laura Galián-Gay
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Laura Gutiérrez
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Kevin Johnson
- Department of Medical Physics and Radiology, University of Wisconsin, Madison, WI, USA
| | - Oliver Wieben
- Department of Medical Physics and Radiology, University of Wisconsin, Madison, WI, USA
| | - Augusto Sao-Aviles
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Ignacio Ferreira-Gonzalez
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035 Barcelona, Spain
- CIBER-ESP, Instituto de Salud Carlos III, Madrid, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Arturo Evangelista
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
- Instituto del Corazón. Quirónsalud-Teknon. Barcelona, Spain
| | - Gisela Teixido-Tura
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron 119-129, 08035 Barcelona, Spain
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22
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Lopez-Sainz A, Mila L, Rodriguez-Palomares J, Limeres J, Granato C, La Mura L, Sabaté A, Guala A, Gutiérrez L, Galian-Gay L, Sao-Aviles A, Bellmunt S, Rodriguez R, Cuellar-Calabria H, Roque A, Ferreira-González I, Evangelista A, Teixido-Tura G. Aortic Branch Aneurysms and Vascular Risk in Patients With Marfan Syndrome. J Am Coll Cardiol 2021; 77:3005-3012. [PMID: 34140103 DOI: 10.1016/j.jacc.2021.04.054] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 03/01/2021] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Aortic branch aneurysms are not included in the diagnostic criteria for Marfan syndrome (MFS); however, their prevalence and eventual prognostic significance are unknown. OBJECTIVES The goal of this study was to assess the prevalence of aortic branch aneurysms in MFS and their relationship with aortic prognosis. METHODS MFS patients with a pathogenic FBN1 genetic variant and at least one magnetic resonance or computed tomography angiography study assessing aortic branches were included. Aortic events and those related to aneurysm complications were recorded during follow-up. RESULTS A total of 104 aneurysms were detected in 50 (26.7%) of the 187 patients with MFS (mean age 37.9 ± 14.4 years; 54% male) included in this study, with the iliac artery being the most common location (45 aneurysms). Thirty-one patients (62%) had >1 peripheral aneurysm, and surgery was performed in 5 (4.8%). Patients with aneurysms were older (41.9 ± 12.7 years vs. 36.7 ± 14.8 years; p = 0.040) and had more dilated aortic root (42.2 ± 6.4 mm vs. 38.8 ± 8.0 mm; p = 0.044) and dyslipidemia (31.0% vs. 9.7%; p = 0.001). In a subgroup of 95 patients with no previous aortic surgery or dissection followed up for 3.3 ± 2.6 years, the presence of arterial aneurysms was associated with a greater need for aortic surgery (hazard ratio: 3.4; 95% confidence interval: 1.1 to 10.3; p = 0.028) in a multivariable Cox analysis adjusted for age and aortic diameter. CONCLUSIONS Aortic branch aneurysms are present in one-quarter of patients with MFS and are related to age and aortic dilation, and they independently predict the need for aortic surgery. The systematic use of whole-body vascular assessment is recommended to identify other sites of vascular involvement at risk for complications and to define the subgroup of patients with more aggressive aortic disease.
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Affiliation(s)
- Angela Lopez-Sainz
- Department of Cardiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain; Grupo de Enfermedades Cardiovasculares, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Laia Mila
- Department of Cardiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain; Grupo de Enfermedades Cardiovasculares, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; CIBERCV Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Jose Rodriguez-Palomares
- Department of Cardiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain; Grupo de Enfermedades Cardiovasculares, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; CIBERCV Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Limeres
- Department of Cardiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain; Grupo de Enfermedades Cardiovasculares, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; CIBERCV Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Chiara Granato
- Grupo de Enfermedades Cardiovasculares, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Lucia La Mura
- Grupo de Enfermedades Cardiovasculares, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Ana Sabaté
- Department of Pediatric Cardiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Andrea Guala
- Grupo de Enfermedades Cardiovasculares, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; CIBERCV Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Gutiérrez
- Department of Cardiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain; Grupo de Enfermedades Cardiovasculares, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; CIBERCV Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Galian-Gay
- Department of Cardiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain; Grupo de Enfermedades Cardiovasculares, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; CIBERCV Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Augusto Sao-Aviles
- Grupo de Enfermedades Cardiovasculares, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Sergi Bellmunt
- Department of Angiology, Vascular and Endovascular Surgery, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Rafael Rodriguez
- Department of Cardiac Surgery, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Hug Cuellar-Calabria
- Department of Radiology, IDI (Institut de Diagnòstic per la Imatge), Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Albert Roque
- Department of Radiology, IDI (Institut de Diagnòstic per la Imatge), Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Ignacio Ferreira-González
- Department of Cardiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain; Grupo de Enfermedades Cardiovasculares, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; CIBERESP Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Artur Evangelista
- Department of Cardiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain; Grupo de Enfermedades Cardiovasculares, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; CIBERCV Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain.
| | - Gisela Teixido-Tura
- Department of Cardiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain; Grupo de Enfermedades Cardiovasculares, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; CIBERCV Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain.
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23
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Bonet M, Vázquez S, García E, Visus M, Jové D, Ripol O, Solé C, Gutiérrez L, Morales-Rull JL, Montero Á, Algara M, Arenas M, Mira M. Saving time in the radiotherapy procedures for COVID-19 pneumonia treatment. A single-institution experience. Clin Transl Oncol 2021; 23:2344-2349. [PMID: 34013493 PMCID: PMC8133050 DOI: 10.1007/s12094-021-02634-5] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/29/2021] [Indexed: 12/19/2022]
Abstract
Background The use of low dose radiotherapy (LD-RT) for the treatment of COVID-19 pneumonia is supported by biological rationale for its immunomodulatory effect. Some institutions have started to treat these patients showing encouraging results. To shorten procedure times is crucial for the comfort of symptomatic patients receiving respiratory support and to optimize institutional facilities. Patients and methods At our institution, LD-RT is offered to hospitalized patients with COVID-19 pneumonia and signs of early cytokine-released syndrome on behalf of a multicenter study. We designed a coordinated process flow starting from the patient transfer to the simulation CT-scan (first-step), to the end of the LD-RT treatment (last step). The times spent on each step of the process flow were evaluated. Results Mean age of treated patients was 83 (72–91) years-old. The timing parameters of the first 10 consecutive patients were analyzed. Except for the first (dummy run), patients were managed from the first to the last step in a median of 38 min (25–58, SD 10.67). The most time-consuming sub-process was the contouring of the treatment volumes and dosimetry. Conclusions LD-RT is not only an encouraging option for COVID-19 pneumonia patients, but a convenient and feasible procedure if performed in a coordinated way by reducing procedure times.
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Affiliation(s)
- M Bonet
- Radiation Oncology Department, Hospital Universitari Arnau de Vilanova, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain.
| | - S Vázquez
- Radiation Oncology Department, Hospital Universitari Arnau de Vilanova, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain
| | - E García
- Radiation Oncology Department, Hospital Universitari Arnau de Vilanova, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain
- IRBLleida (Institut de Recerca Biomèdica de Lleida. Fundació Doctor Pifarré), Lleida, Spain
| | - M Visus
- Radiation Physics and Radioprotection Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - D Jové
- Radiation Physics and Radioprotection Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - O Ripol
- Radiation Physics and Radioprotection Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - C Solé
- Internal Medicine Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - L Gutiérrez
- Internal Medicine Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - J L Morales-Rull
- IRBLleida (Institut de Recerca Biomèdica de Lleida. Fundació Doctor Pifarré), Lleida, Spain
- Internal Medicine Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Á Montero
- Radiation Oncology Department, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - M Algara
- Radiation Oncology Department, Parc de Salut Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Arenas
- Radiation Oncology Department, Hospital Universitari Sant Joan de Reus, Universitat Rovira I VIrgili, Reus, Spain
| | - M Mira
- Radiation Oncology Department, Hospital Universitari Arnau de Vilanova, Av. Alcalde Rovira Roure, 80, 25198, Lleida, Spain
- IRBLleida (Institut de Recerca Biomèdica de Lleida. Fundació Doctor Pifarré), Lleida, Spain
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24
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Guala A, Evangelista A, Teixido-Tura G, La Mura L, Dux-Santoy L, Ruiz-Muñoz A, Valente F, Galian-Gay L, Gutiérrez L, González-Alujas T, Dentamaro I, Johnson KM, Wieben O, Sao Avilés A, Ferreira-Gonzalez I, Rodríguez-Palomares JF. Leaflet fusion length is associated with aortic dilation and flow alterations in non-dysfunctional bicuspid aortic valve. Eur Radiol 2021; 31:9262-9272. [PMID: 33977309 DOI: 10.1007/s00330-021-08016-3] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/15/2021] [Accepted: 04/26/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Bicuspid aortic valve (BAV), the most common congenital valve defect, is associated with increased risk of aortic dilation and related complications; however, current risk assessment is not effective. Most of BAV have three leaflets with a fusion between two of them of variable length. This study aimed to ascertain whether the extent of leaflet fusion (often called raphe) is related to aortic dilation and flow abnormalities in BAV with no significant valvular dysfunction. METHODS One hundred and twenty BAV patients with no significant valvular dysfunction or history of surgical repair or aortic valve replacement were consecutively and prospectively enrolled (September 2014-October 2018). Cardiac magnetic resonance protocol included a 4D flow sequence for haemodynamic assessment. Moreover, a stack of double-oblique cine images of the aortic valve were used to quantify fusion length (in systole) and leaflet length (diastole). Inter- and intra-observer reproducibility was tested in 30 randomly selected patients. RESULTS Aortic valve leaflet fusion was measurable in 112 of 120 (93%) cases with good reproducibility (ICC = 0.826). Fusion length varied greatly (range: 2.3-15.4 mm; mean: 7.8 ± 3.2 mm). After correction for demographic and clinical conditions, fusion length was independently associated with diameter and z-score at the sinus of Valsalva (p = 0.002 and p = 0.002, respectively) and ascending aorta (p = 0.028 and p = 0.046). Fusion length was positively related to flow asymmetry, vortices and circumferential wall shear stress, thereby possibly providing a pathophysiological link with aortic dilation. CONCLUSIONS Aortic valve fusion length is related to aortic dilation and flow abnormalities in BAV patients. KEY POINTS • The length of the fusion between leaflets in non-dysfunctional bicuspid aortic valves varies substantially and can be reliably measured by cine CMR. • Aortic valve leaflet fusion length is independently related to aortic sinus and ascending aorta diameter. • Increased flow asymmetry, circumferential wall shear stress and presence of vortices are positively related to aortic valve leaflet fusion length.
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Affiliation(s)
- Andrea Guala
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain. .,CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.
| | - Arturo Evangelista
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain. .,CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain. .,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain. .,Instituto del Corazón, Quirónsalud-Teknon, Barcelona, Spain. .,Universitat Autònoma de Barcelona, Bellaterra, Spain.
| | - Gisela Teixido-Tura
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Lucia La Mura
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Lydia Dux-Santoy
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Filipa Valente
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Laura Galian-Gay
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Laura Gutiérrez
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Ilaria Dentamaro
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Cardiology, Hospital "F. Miulli", Acquaviva delle Fonti, Italy
| | - Kevin M Johnson
- Departments of Medical Physics & Radiology, University of Wisconsin, Madison, WI, USA
| | - Oliver Wieben
- Departments of Medical Physics & Radiology, University of Wisconsin, Madison, WI, USA
| | | | - Ignacio Ferreira-Gonzalez
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain.,CIBER-ESP, Instituto de Salud Carlos III, Madrid, Spain
| | - Jose F Rodríguez-Palomares
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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25
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Martínez-Botía P, Bernardo Á, Acebes-Huerta A, Caro A, Leoz B, Martínez-Carballeira D, Palomo-Antequera C, Soto I, Gutiérrez L. Clinical Management of Hypertension, Inflammation and Thrombosis in Hospitalized COVID-19 Patients: Impact on Survival and Concerns. J Clin Med 2021; 10:jcm10051073. [PMID: 33806709 PMCID: PMC7961450 DOI: 10.3390/jcm10051073] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/13/2021] [Accepted: 02/24/2021] [Indexed: 02/06/2023] Open
Abstract
The most severe clinical manifestations of the Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are due to an unbalanced immune response and a pro-thrombotic hemostatic disturbance, with arterial hypertension or diabetes as acknowledged risk factors. While waiting for a specific treatment, the clinical management of hospitalized patients is still a matter of debate, and the effectiveness of treatments to manage clinical manifestations and comorbidities has been questioned. In this study, we aim to assess the impact of the clinical management of arterial hypertension, inflammation and thrombosis on the survival of COVID-19 patients. The Spanish cohorts included in this observational retrospective study are from HM Hospitales (2035 patients) and from Hospital Universitario Central de Asturias (72 patients). Kaplan Meier survival curves, Cox regression and propensity score matching analyses were employed, considering demographic variables, comorbidities and treatment arms (when opportune) as covariates. The management of arterial hypertension with angiotensin-converting enzyme 2 (ACE2) inhibitors or angiotensin receptor blockers is not detrimental, as was initially reported, and neither was the use of non-steroidal anti-inflammatory drugs (NSAIDs). On the contrary, our analysis shows that the use on itself of corticosteroids is not beneficial. Importantly, the management of COVID-19 patients with low molecular weight heparin (LMWH) as an anticoagulant significantly improves the survival of hospitalized patients. These results delineate the current treatment options under debate, supporting the effectiveness of thrombosis prophylaxis on COVID-19 patients as a first-line treatment without the need for compromising the treatment of comorbidities, while suggesting cautiousness when administering corticosteroids.
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Affiliation(s)
- Patricia Martínez-Botía
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (P.M.-B.); (Á.B.); (A.A.-H.); (A.C.); (D.M.-C.)
| | - Ángel Bernardo
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (P.M.-B.); (Á.B.); (A.A.-H.); (A.C.); (D.M.-C.)
- Clinical Diagnosis Laboratory, Department of Hematology, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain
| | - Andrea Acebes-Huerta
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (P.M.-B.); (Á.B.); (A.A.-H.); (A.C.); (D.M.-C.)
| | - Alberto Caro
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (P.M.-B.); (Á.B.); (A.A.-H.); (A.C.); (D.M.-C.)
- Department of Hematology, Hemostasis Section, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain
| | - Blanca Leoz
- Department of Intensive Medicine, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain;
- Translational Microbiology Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - Daniel Martínez-Carballeira
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (P.M.-B.); (Á.B.); (A.A.-H.); (A.C.); (D.M.-C.)
- Department of Hematology, Hemostasis Section, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain
| | - Carmen Palomo-Antequera
- Department of Internal Medicine, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain;
- Bone Metabolism, Vascular Metabolism and Chronic Inflammatory Diseases Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - Inmaculada Soto
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (P.M.-B.); (Á.B.); (A.A.-H.); (A.C.); (D.M.-C.)
- Department of Hematology, Hemostasis Section, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain
- Correspondence: (I.S.); (L.G.)
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (P.M.-B.); (Á.B.); (A.A.-H.); (A.C.); (D.M.-C.)
- Department of Medicine, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Spain
- Correspondence: (I.S.); (L.G.)
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26
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Ruiz-Muñoz A, Valente F, Dux-Santoy L, Guala A, Teixidó-Turà G, Galián-Gay L, Gutiérrez L, Fernández-Galera R, Casas G, González-Alujas T, Ferreira-González I, Evangelista A, Rodríguez-Palomares J. Diagnostic value of quantitative parameters for myocardial perfusion assessment in patients with suspected coronary artery disease by single- and dual-energy computed tomography myocardial perfusion imaging. Int J Cardiol Heart Vasc 2021; 32:100721. [PMID: 33604450 PMCID: PMC7873634 DOI: 10.1016/j.ijcha.2021.100721] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/09/2021] [Accepted: 01/14/2021] [Indexed: 12/01/2022]
Abstract
Purpose To compare performance of visual and quantitative analyses for detecting myocardial ischaemia from single- and dual-energy computed tomography (CT) in patients with suspected coronary artery disease (CAD). Methods Eighty-four patients with suspected CAD were scheduled for dual-energy cardiac CT at rest (CTA) and pharmacological stress (CTP). Myocardial CT perfusion was analysed visually and using three parameters: mean attenuation density (MA), transmural perfusion ratio (TPR) and myocardial perfusion reserve index (MPRI), on both single-energy CT and CT-based iodine images. Significant CAD was defined in AHA-segments by concomitant myocardial hypoperfusion identified visually or quantitatively (parameter < threshold) and coronary stenosis detected by CTA. Single-photon emission CT and invasive coronary angiography were used as reference. Perfusion-parameter cut-off values were calculated in a randomly-selected subgroup of 30 patients. Results The best-performing thresholds for TPR, MPRI and MA were 0.96, 23 and 0.5 for single-energy CT and 0.97, 47 and 0.3 for iodine imaging. For both CT-imaging modalities, TPR yielded the highest area under receiver operating characteristic curve (AUC) (0.99 and 0.97 for single-energy CT and iodine imaging, respectively, in vessel-based analysis) compared to visual analysis, MA and MPRI. Visual interpretation on iodine imaging resulted in higher AUC compared to that on single-energy CT in per-vessel (AUC: 0.93 vs 0.86, respectively) and per-patient (0.94 vs 0.93) analyses. Conclusion Transmural perfusion ratio on both CT-imaging modalities is the best-performing parameter for detecting myocardial ischaemia compared to visual method and other perfusion parameters. Visual analysis on CT-based iodine imaging outperforms that on single-energy CT.
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Affiliation(s)
- Aroa Ruiz-Muñoz
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Filipa Valente
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lydia Dux-Santoy
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andrea Guala
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gisela Teixidó-Turà
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Galián-Gay
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Gutiérrez
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rubén Fernández-Galera
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Guillem Casas
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Teresa González-Alujas
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ignacio Ferreira-González
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
| | - Arturo Evangelista
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Rodríguez-Palomares
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.,CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.,Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
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27
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Martínez-Botía P, Acebes-Huerta A, Seghatchian J, Gutiérrez L. On the Quest for In Vitro Platelet Production by Re-Tailoring the Concepts of Megakaryocyte Differentiation. ACTA ACUST UNITED AC 2020; 56:medicina56120671. [PMID: 33287459 PMCID: PMC7761839 DOI: 10.3390/medicina56120671] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 12/14/2022]
Abstract
The demand of platelet transfusions is steadily growing worldwide, inter-donor variation, donor dependency, or storability/viability being the main contributing factors to the current global, donor-dependent platelet concentrate shortage concern. In vitro platelet production has been proposed as a plausible alternative to cover, at least partially, the increasing demand. However, in practice, such a logical production strategy does not lack complexity, and hence, efforts are focused internationally on developing large scale industrial methods and technologies to provide efficient, viable, and functional platelet production. This would allow obtaining not only sufficient numbers of platelets but also functional ones fit for all clinical purposes and civil scenarios. In this review, we cover the evolution around the in vitro culture and differentiation of megakaryocytes into platelets, the progress made thus far to bring the culture concept from basic research towards good manufacturing practices certified production, and subsequent clinical trial studies. However, little is known about how these in vitro products should be stored or whether any safety measure should be implemented (e.g., pathogen reduction technology), as well as their quality assessment (how to isolate platelets from the rest of the culture cells, debris, microvesicles, or what their molecular and functional profile is). Importantly, we highlight how the scientific community has overcome the old dogmas and how the new perspectives influence the future of platelet-based therapy for transfusion purposes.
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Affiliation(s)
- Patricia Martínez-Botía
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (P.M.-B.); (A.A.-H.)
- Department of Medicine, University of Oviedo, 33003 Oviedo, Spain
| | - Andrea Acebes-Huerta
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (P.M.-B.); (A.A.-H.)
| | - Jerard Seghatchian
- International Consultancy in Strategic Safety/Quality Improvements of Blood-Derived Bioproducts and Suppliers Quality Audit/Inspection, London NW3 3AA, UK;
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain; (P.M.-B.); (A.A.-H.)
- Department of Medicine, University of Oviedo, 33003 Oviedo, Spain
- Correspondence:
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28
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Scheenstra MR, Martínez-Botía P, Acebes-Huerta A, Brouwer RWW, Caballero-Sánchez N, Gillemans N, De Bleser P, Nota B, De Cuyper IM, Salunkhe V, Woltman AM, van de Laar L, Rijkers E, Demmers JAA, van IJcken WFJ, Philipsen S, van den Berg TK, Kuijpers TW, Gutiérrez L. Comparison of the PU.1 transcriptional regulome and interactome in human and mouse inflammatory dendritic cells. J Leukoc Biol 2020; 110:735-751. [PMID: 33289106 DOI: 10.1002/jlb.6a1219-711rrr] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 11/18/2020] [Accepted: 11/18/2020] [Indexed: 12/17/2022] Open
Abstract
Dendritic cells (DCs) are key immune modulators and are able to mount immune responses or tolerance. DC differentiation and activation imply a plethora of molecular and cellular responses, including transcriptional changes. PU.1 is a highly expressed transcription factor in DCs and coordinates relevant aspects of DC biology. Due to their role as immune regulators, DCs pose as a promising immunotherapy tool. However, some of their functional features, such as survival, activation, or migration, are compromised due to the limitations to simulate in vitro the physiologic DC differentiation process. A better knowledge of transcriptional programs would allow the identification of potential targets for manipulation with the aim of obtaining "qualified" DCs for immunotherapy purposes. Most of the current knowledge regarding DC biology derives from studies using mouse models, which not always find a parallel in human. In the present study, we dissect the PU.1 transcriptional regulome and interactome in mouse and human DCs, in the steady state or LPS activated. The PU.1 transcriptional regulome was identified by performing PU.1 chromatin immunoprecipitation followed by high-throughput sequencing and pairing these data with RNAsequencing data. The PU.1 interactome was identified by performing PU.1 immunoprecipitation followed by mass spectrometry analysis. Our results portray PU.1 as a pivotal factor that plays an important role in the regulation of genes required for proper DC activation and function, and assures the repression of nonlineage genes. The interspecies differences between human and mouse DCs are surprisingly substantial, highlighting the need to study the biology of human DCs.
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Affiliation(s)
- Maaike R Scheenstra
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
- Division of Infectious Diseases and Immunology, Department of Biomolecular Health Sciences, Utrecht University, Utrecht, The Netherlands
| | | | - Andrea Acebes-Huerta
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Rutger W W Brouwer
- Center for Biomics, Erasmus MC, Rotterdam, The Netherlands
- Department of Cell Biology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Nynke Gillemans
- Department of Cell Biology, Erasmus MC, Rotterdam, The Netherlands
| | - Pieter De Bleser
- Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
- VIB Center for Inflammation Research, Data Mining and Modeling for Biomedicine, Ghent, Belgium
| | - Benjamin Nota
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Iris M De Cuyper
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Vishal Salunkhe
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Andrea M Woltman
- Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, The Netherlands
- Current Address: Institute of Medical Education Research Rotterdam, Erasmus MC, Rotterdam, The Netherlands
| | - Lianne van de Laar
- Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, The Netherlands
| | | | | | - Wilfred F J van IJcken
- Center for Biomics, Erasmus MC, Rotterdam, The Netherlands
- Department of Cell Biology, Erasmus MC, Rotterdam, The Netherlands
| | - Sjaak Philipsen
- Department of Cell Biology, Erasmus MC, Rotterdam, The Netherlands
| | - Timo K van den Berg
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Taco W Kuijpers
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
- Laboratory of Immunotherapy, Sanquin Research and Landsteiner Laboratory, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Center, Vrije University, Amsterdam, The Netherlands
| | - Laura Gutiérrez
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- University of Oviedo, Oviedo, Spain
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29
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Papadopoulos P, Kafasi A, De Cuyper IM, Barroca V, Lewandowski D, Kadri Z, Veldthuis M, Berghuis J, Gillemans N, Benavente Cuesta CM, Grosveld FG, van Zwieten R, Philipsen S, Vernet M, Gutiérrez L, Patrinos GP. Mild dyserythropoiesis and β-like globin gene expression imbalance due to the loss of histone chaperone ASF1B. Hum Genomics 2020; 14:39. [PMID: 33066815 PMCID: PMC7566067 DOI: 10.1186/s40246-020-00283-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 09/10/2020] [Indexed: 01/09/2023] Open
Abstract
The expression of the human β-like globin genes follows a well-orchestrated developmental pattern, undergoing two essential switches, the first one during the first weeks of gestation (ε to γ), and the second one during the perinatal period (γ to β). The γ- to β-globin gene switching mechanism includes suppression of fetal (γ-globin, HbF) and activation of adult (β-globin, HbA) globin gene transcription. In hereditary persistence of fetal hemoglobin (HPFH), the γ-globin suppression mechanism is impaired leaving these individuals with unusual elevated levels of fetal hemoglobin (HbF) in adulthood. Recently, the transcription factors KLF1 and BCL11A have been established as master regulators of the γ- to β-globin switch. Previously, a genomic variant in the KLF1 gene, identified by linkage analysis performed on twenty-seven members of a Maltese family, was found to be associated with HPFH. However, variation in the levels of HbF among family members, and those from other reported families carrying genetic variants in KLF1, suggests additional contributors to globin switching. ASF1B was downregulated in the family members with HPFH. Here, we investigate the role of ASF1B in γ- to β-globin switching and erythropoiesis in vivo. Mouse-human interspecies ASF1B protein identity is 91.6%. By means of knockdown functional assays in human primary erythroid cultures and analysis of the erythroid lineage in Asf1b knockout mice, we provide evidence that ASF1B is a novel contributor to steady-state erythroid differentiation, and while its loss affects the balance of globin expression, it has no major role in hemoglobin switching.
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Affiliation(s)
- Petros Papadopoulos
- Department of Cell Biology, Erasmus MC, Rotterdam, The Netherlands.
- Department of Hematology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain.
| | - Athanassia Kafasi
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, AMC, UvA, Amsterdam, The Netherlands
| | - Iris M De Cuyper
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, AMC, UvA, Amsterdam, The Netherlands
| | - Vilma Barroca
- UMR Stabilité Génétique Cellules Souches et Radiations, Université de Paris and Université de Paris-Saclay, CEA, 18 route du Panorama, 92260, Fontenay-aux-Roses, France
- U1274, Inserm, 18 route du Panorama, 92260, Fontenay-aux-Roses, France
| | - Daniel Lewandowski
- UMR Stabilité Génétique Cellules Souches et Radiations, Université de Paris and Université de Paris-Saclay, CEA, 18 route du Panorama, 92260, Fontenay-aux-Roses, France
- U1274, Inserm, 18 route du Panorama, 92260, Fontenay-aux-Roses, France
| | - Zahra Kadri
- Division of Innovative Therapies, UMR1184, Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses, France
| | - Martijn Veldthuis
- Laboratory of Red Blood Cell Diagnostics, Sanquin Diagnostics, Amsterdam, The Netherlands
| | - Jeffrey Berghuis
- Laboratory of Red Blood Cell Diagnostics, Sanquin Diagnostics, Amsterdam, The Netherlands
| | - Nynke Gillemans
- Department of Cell Biology, Erasmus MC, Rotterdam, The Netherlands
| | - Celina María Benavente Cuesta
- Department of Hematology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Frank G Grosveld
- Department of Cell Biology, Erasmus MC, Rotterdam, The Netherlands
| | - Rob van Zwieten
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, AMC, UvA, Amsterdam, The Netherlands
- Laboratory of Red Blood Cell Diagnostics, Sanquin Diagnostics, Amsterdam, The Netherlands
| | - Sjaak Philipsen
- Department of Cell Biology, Erasmus MC, Rotterdam, The Netherlands
| | - Muriel Vernet
- UMR Stabilité Génétique Cellules Souches et Radiations, Université de Paris and Université de Paris-Saclay, CEA, 18 route du Panorama, 92260, Fontenay-aux-Roses, France
| | - Laura Gutiérrez
- Department of Cell Biology, Erasmus MC, Rotterdam, The Netherlands
- Department of Hematology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, AMC, UvA, Amsterdam, The Netherlands
- Platelet Research Lab -Instituto de Investigación Sanitaria del Principado de Asturias (ISPA)-, Department of Medicine -University of Oviedo-, Oviedo, Spain
| | - George P Patrinos
- Laboratory of Pharmacogenomics and Individualized Therapy, Department of Pharmacy, University of Patras School of Health Sciences, Patras, Greece
- Department of Pathology, College of Medicine and Health Sciences and Zayed Center of Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
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Guala A, Teixidó-Tura G, Rodríguez-Palomares J, Ruiz-Muñoz A, Dux-Santoy L, Villalva N, Granato C, Galian L, Gutiérrez L, González-Alujas T, Sanchez V, Forteza A, García-Dorado D, Evangelista A. Proximal aorta longitudinal strain predicts aortic root dilation rate and aortic events in Marfan syndrome. Eur Heart J 2020; 40:2047-2055. [PMID: 30977783 DOI: 10.1093/eurheartj/ehz191] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [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: 07/19/2018] [Revised: 10/15/2018] [Accepted: 03/22/2019] [Indexed: 12/31/2022] Open
Abstract
AIMS Life expectancy in Marfan syndrome patients has improved thanks to the early detection of aortic dilation and prophylactic aortic root surgery. Current international clinical guidelines support the use of aortic root diameter as a predictor of complications. However, other imaging markers are needed to improve risk stratification. This study aim to ascertain whether proximal aorta longitudinal and circumferential strain and distensibility assessed by cardiac magnetic resonance (CMR) predict the aortic root dilation rate and aortic events in Marfan syndrome. METHODS AND RESULTS One hundred and seventeen Marfan patients with no previous aortic dissection, cardiac/aortic surgery, or moderate/severe aortic regurgitation were prospectively included in a multicentre protocol of clinical and imaging follow-up. At baseline, CMR was performed and proximal aorta longitudinal strain and ascending aorta circumferential strain and distensibility were obtained. During follow-up (85.7 [75.0-93.2] months), the annual growth rate of aortic root diameter was 0.62 ± 0.65 mm/year. Fifteen patients underwent elective surgical aortic root replacement and four presented aortic dissection. Once corrected for baseline clinical and demographic characteristics and aortic root diameter, proximal aorta longitudinal strain, but not circumferential strain and distensibility, was an independent predictor of the aortic root diameter growth rate (P = 0.001, P = 0.823, and P = 0.997, respectively), z-score growth rate (P = 0.013, P = 0.672, and P = 0.680, respectively), and aortic events (P = 0.023, P = 0.096, and P = 0.237, respectively). CONCLUSION Proximal aorta longitudinal strain is independently related to the aortic root dilation rate and aortic events in addition to aortic root diameter, clinical risk factors, and demographic characteristics in Marfan syndrome patients.
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Affiliation(s)
- Andrea Guala
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Gisela Teixidó-Tura
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Jose Rodríguez-Palomares
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Aroa Ruiz-Muñoz
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Lydia Dux-Santoy
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Nicolas Villalva
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Chiara Granato
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Laura Galian
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Laura Gutiérrez
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Teresa González-Alujas
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Violeta Sanchez
- Department of Cardiology, Hospital doce de Octubre, Avenida Cordoba, Madrid, Spain
| | - Alberto Forteza
- Department of Cardiac Surgery, Hospital Puerta de Hierro. Calle Manuel de Falla, 1, Majadahonda, Spain
| | - David García-Dorado
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Artur Evangelista
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
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Abstract
Over the last decade there has been a worldwide increase in the demand of platelet concentrates (PCs) for transfusion. This is, to a great extent, due to a growing and aging population with the concomitant increase in the incidence of onco-hematological diseases, which require frequent platelet (PLT) transfusions. Currently, PLTs are sourced uniquely from donations, and their storage time is limited only to a few days. The necessity to store PCs at room temperature (to minimize loss of PLT functional integrity), poses a major risk for bacterial contamination. While the implementation of pathogen reduction treatments (PRTs) and new-generation PLT additive solutions have allowed the extension of the shelf life and a safer PLT transfusion product, the concern of PCs shortage still pressures the scientific community to find alternative solutions with the aim of meeting the PLT transfusion increasing demand. In this concise report, we will focus on the efforts made to produce, in in vitro culture, high yields of viable and functional PLTs for transfusion purposes in a cost-effective manner, meeting not only current Good Manufacturing Practices (cGMPs), but also transfusion safety standards.
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Affiliation(s)
- Patricia Martínez-Botía
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Dept. of Medicine, University of Oviedo, Spain
| | - Andrea Acebes-Huerta
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Jerard Seghatchian
- International Consultancy in Strategic Advices on Safety Improvements of Blood-Derived Bioproducts and Suppliers Quality Audit / Inspection, London, England, UK
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Dept. of Medicine, University of Oviedo, Spain.
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Velasco Á, Rodríguez-Revuelta J, Olié E, Abad I, Fernández-Peláez A, Cazals A, Guillaume S, de la Fuente-Tomás L, Jiménez-Treviño L, Gutiérrez L, García-Portilla P, Bobes J, Courtet P, Sáiz PA. Neutrophil-to-lymphocyte ratio: A potential new peripheral biomarker of suicidal behavior. Eur Psychiatry 2020; 63:e14. [PMID: 32093807 PMCID: PMC7315873 DOI: 10.1192/j.eurpsy.2019.20] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 10/28/2019] [Accepted: 12/15/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) have emerged as important peripheral inflammatory biomarkers. Recent data suggest a possible role of the immune system in the pathophysiology of suicidal behavior (SB). The aim of this study is to evaluate the association among NLR, MLR, and PLR and SB in patients with major depressive disorder (MDD), and to test its validity as a biomarker for suicidality. METHODS We evaluated 538 patients with MDD (mean age [standard deviation] = 43.87 [14.36] years; females: 68.8%). A logistic regression model was estimated to determine the independent factors associated with suicide risk in patients with and without a history of suicide attempt (SA). RESULTS Three hundred ninety-three patients (74.7%) had a personal history of SA. Patients with a previous SA were more frequently female (71.9% vs. 59.6%; p = 0.007), significantly younger (41.20 vs. 51.77 years; p < 0.001), had lower depression severity at enrolment (15.58 vs. 18.42; p < 0.000), and significantly higher mean NLR and PLR ratios (2.27 vs. 1.68, p = 0.001; 127.90 vs. 109.97, p = 0.007, respectively). In the final logistic regression model, after controlling for age, sex, and depression severity, NLR was significantly associated with SB (β = 0.489, p = 0.000; odds ratio [95% confidence intervals] = 1.631 [1.266-2.102]). We propose a cut-off value of NLR = 1.30 (sensitivity = 75% and specificity = 35%). CONCLUSIONS Our data suggest that NLR may be a valuable, reproducible, easily accessible, and cost-effective strategy to determine suicide risk in MDD.
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Affiliation(s)
- Ángela Velasco
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Julia Rodríguez-Revuelta
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Mental Health Services of Principado de Asturias (SESPA), Oviedo, Spain
| | - Emilie Olié
- Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital, CHU Montpellier—Inserm U1061, University of Montpellier, Montpellier, France
- Fondation FondaMental, Créteil, France
| | - Iciar Abad
- Mental Health Services of Principado de Asturias (SESPA), Oviedo, Spain
| | | | - Aurélie Cazals
- Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital, CHU Montpellier—Inserm U1061, University of Montpellier, Montpellier, France
- Fondation FondaMental, Créteil, France
| | - Sébastien Guillaume
- Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital, CHU Montpellier—Inserm U1061, University of Montpellier, Montpellier, France
- Fondation FondaMental, Créteil, France
| | - Lorena de la Fuente-Tomás
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Luis Jiménez-Treviño
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Mental Health Services of Principado de Asturias (SESPA), Oviedo, Spain
| | - Laura Gutiérrez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Paz García-Portilla
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Mental Health Services of Principado de Asturias (SESPA), Oviedo, Spain
| | - Julio Bobes
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Mental Health Services of Principado de Asturias (SESPA), Oviedo, Spain
| | - Philippe Courtet
- Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital, CHU Montpellier—Inserm U1061, University of Montpellier, Montpellier, France
- Fondation FondaMental, Créteil, France
| | - Pilar A. Sáiz
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Mental Health Services of Principado de Asturias (SESPA), Oviedo, Spain
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Hansen M, Zeddies S, Meinders M, di Summa F, Rollmann E, van Alphen FP, Hoogendijk AJ, Moore KS, Halbach M, Gutiérrez L, van den Biggelaar M, Thijssen-Timmer DC, Auburger GW, van den Akker E, von Lindern M. The RNA-Binding Protein ATXN2 is Expressed during Megakaryopoiesis and May Control Timing of Gene Expression. Int J Mol Sci 2020; 21:ijms21030967. [PMID: 32024018 PMCID: PMC7037754 DOI: 10.3390/ijms21030967] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/21/2020] [Accepted: 01/30/2020] [Indexed: 12/13/2022] Open
Abstract
Megakaryopoiesis is the process during which megakaryoblasts differentiate to polyploid megakaryocytes that can subsequently shed thousands of platelets in the circulation. Megakaryocytes accumulate mRNA during their maturation, which is required for the correct spatio-temporal production of cytoskeletal proteins, membranes and platelet-specific granules, and for the subsequent shedding of thousands of platelets per cell. Gene expression profiling identified the RNA binding protein ATAXIN2 (ATXN2) as a putative novel regulator of megakaryopoiesis. ATXN2 expression is high in CD34+/CD41+ megakaryoblasts and sharply decreases upon maturation to megakaryocytes. ATXN2 associates with DDX6 suggesting that it may mediate repression of mRNA translation during early megakaryopoiesis. Comparative transcriptome and proteome analysis on megakaryoid cells (MEG-01) with differential ATXN2 expression identified ATXN2 dependent gene expression of mRNA and protein involved in processes linked to hemostasis. Mice deficient for Atxn2 did not display differences in bleeding times, but the expression of key surface receptors on platelets, such as ITGB3 (carries the CD61 antigen) and CD31 (PECAM1), was deregulated and platelet aggregation upon specific triggers was reduced.
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Affiliation(s)
- Marten Hansen
- Department Hematopoiesis, Sanquin Research, and Landsteiner Laboratory, Amsterdam University Medical Centre, 1066CX Amsterdam, The Netherlands; (M.H.); (S.Z.); (F.d.S.); (K.S.M.); (D.C.T.-T.); (E.v.d.A.)
| | - Sabrina Zeddies
- Department Hematopoiesis, Sanquin Research, and Landsteiner Laboratory, Amsterdam University Medical Centre, 1066CX Amsterdam, The Netherlands; (M.H.); (S.Z.); (F.d.S.); (K.S.M.); (D.C.T.-T.); (E.v.d.A.)
| | - Marjolein Meinders
- Department Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam,1066CX Amsterdam, The Netherlands; (M.M.); (L.G.)
| | - Franca di Summa
- Department Hematopoiesis, Sanquin Research, and Landsteiner Laboratory, Amsterdam University Medical Centre, 1066CX Amsterdam, The Netherlands; (M.H.); (S.Z.); (F.d.S.); (K.S.M.); (D.C.T.-T.); (E.v.d.A.)
| | - Ewa Rollmann
- Experimental Neurology, Goethe University Medical School, 60528 Frankfurt am Main, Germany; (E.R.); (M.H.)
| | - Floris P.J. van Alphen
- Department of Molecular and Cellular Hemostasis, Sanquin Research, 1066CX Amsterdam, The Netherlands (A.J.H.); (M.v.d.B.)
| | - Arjan J. Hoogendijk
- Department of Molecular and Cellular Hemostasis, Sanquin Research, 1066CX Amsterdam, The Netherlands (A.J.H.); (M.v.d.B.)
| | - Kat S. Moore
- Department Hematopoiesis, Sanquin Research, and Landsteiner Laboratory, Amsterdam University Medical Centre, 1066CX Amsterdam, The Netherlands; (M.H.); (S.Z.); (F.d.S.); (K.S.M.); (D.C.T.-T.); (E.v.d.A.)
| | - Melanie Halbach
- Experimental Neurology, Goethe University Medical School, 60528 Frankfurt am Main, Germany; (E.R.); (M.H.)
| | - Laura Gutiérrez
- Department Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam,1066CX Amsterdam, The Netherlands; (M.M.); (L.G.)
| | - Maartje van den Biggelaar
- Department of Molecular and Cellular Hemostasis, Sanquin Research, 1066CX Amsterdam, The Netherlands (A.J.H.); (M.v.d.B.)
| | - Daphne C. Thijssen-Timmer
- Department Hematopoiesis, Sanquin Research, and Landsteiner Laboratory, Amsterdam University Medical Centre, 1066CX Amsterdam, The Netherlands; (M.H.); (S.Z.); (F.d.S.); (K.S.M.); (D.C.T.-T.); (E.v.d.A.)
| | - Georg W.J. Auburger
- Experimental Neurology, Goethe University Medical School, 60528 Frankfurt am Main, Germany; (E.R.); (M.H.)
| | - Emile van den Akker
- Department Hematopoiesis, Sanquin Research, and Landsteiner Laboratory, Amsterdam University Medical Centre, 1066CX Amsterdam, The Netherlands; (M.H.); (S.Z.); (F.d.S.); (K.S.M.); (D.C.T.-T.); (E.v.d.A.)
| | - Marieke von Lindern
- Department Hematopoiesis, Sanquin Research, and Landsteiner Laboratory, Amsterdam University Medical Centre, 1066CX Amsterdam, The Netherlands; (M.H.); (S.Z.); (F.d.S.); (K.S.M.); (D.C.T.-T.); (E.v.d.A.)
- Correspondence: ; Tel.: +31-6-1203-7801
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Acebes-Huerta A, Arias-Fernández T, Bernardo Á, Muñoz-Turrillas MC, Fernández-Fuertes J, Seghatchian J, Gutiérrez L. Platelet-derived bio-products: Classification update, applications, concerns and new perspectives. Transfus Apher Sci 2019; 59:102716. [PMID: 31928859 DOI: 10.1016/j.transci.2019.102716] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 12/13/2022]
Abstract
Platelet derived bio-products in the form of platelet rich plasma, plasma rich in growth factors, or plasma-free platelet releasates, are being studied worldwide with the aim of proving their efficacy in tissue regeneration within many different clinical areas, such as traumatology, maxillofacial surgery, ophthalmology, dermatology and otorhinolaryngology, amongst others. The current lack of consensus in the preparation method and application form, or in the quality assessment of each bio-product, precludes adequate interpretation of the relevance of reported clinical outcomes, and, while many in clinicians are very positive about them, many are sceptic. Relevant aspects of these products are considered to propose a classification nomenclature which would aid a comprehensive comparison of clinical outcomes of bio-products of the same characteristics. Finally, the uses of platelet-derived bio-products in in vitro culture (for cell therapy purposes) as a substitute of animal-origin sera, and other future perspectives of applications of platelet-derived bio-products are discussed.
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Affiliation(s)
- Andrea Acebes-Huerta
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Tamara Arias-Fernández
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Ángel Bernardo
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Hospital Universitario Central de Asturias (HUCA), Laboratorio de Diagnóstico Clínico Hematología, Oviedo, Spain
| | - María Carmen Muñoz-Turrillas
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Centro Comunitario de Sangre y Tejidos de Asturias, Oviedo, Spain
| | - Judit Fernández-Fuertes
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Cabueñes Hospital Universitario (CAHU), Servicio de Cirugía Ortopédica y Traumatología (COT), Gijón, Spain
| | - Jerard Seghatchian
- International consultancy in blood components quality / safety and DDR strategies, London, UK
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Dept. of Medicine, University of Oviedo, Spain.
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Dux-Santoy L, Guala A, Sotelo J, Uribe S, Teixidó-Turà G, Ruiz-Muñoz A, Hurtado DE, Valente F, Galian-Gay L, Gutiérrez L, González-Alujas T, Johnson KM, Wieben O, Ferreira I, Evangelista A, Rodríguez-Palomares JF. Low and Oscillatory Wall Shear Stress Is Not Related to Aortic Dilation in Patients With Bicuspid Aortic Valve: A Time-Resolved 3-Dimensional Phase-Contrast Magnetic Resonance Imaging Study. Arterioscler Thromb Vasc Biol 2019; 40:e10-e20. [PMID: 31801375 PMCID: PMC7771642 DOI: 10.1161/atvbaha.119.313636] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Supplemental Digital Content is available in the text. Objective: To assess the relationship between regional wall shear stress (WSS) and oscillatory shear index (OSI) and aortic dilation in patients with bicuspid aortic valve (BAV). Approach and Results: Forty-six consecutive patients with BAV (63% with right-left-coronary-cusp fusion, aortic diameter ≤ 45 mm and no severe valvular disease) and 44 healthy volunteers were studied by time-resolved 3-dimensional phase-contrast magnetic resonance imaging. WSS and OSI were quantified at different levels of the ascending aorta and the aortic arch, and regional WSS and OSI maps were obtained. Seventy percent of BAV had ascending aorta dilation. Compared with healthy volunteers, patients with BAV had increased WSS and decreased OSI in most of the ascending aorta and the aortic arch. In both BAV and healthy volunteers, regions of high WSS matched regions of low OSI and vice versa. No regions of both low WSS and high OSI were identified in BAV compared with healthy volunteers. Patients with BAV with dilated compared with nondilated aorta presented low and oscillatory WSS in the aortic arch, but not in the ascending aorta where dilation is more prevalent. Furthermore, no regions of concomitant low WSS and high OSI were identified when BAV were compared according to leaflet fusion pattern, despite the well-known differences in regional dilation prevalence. Conclusions: Regions with low WSS and high OSI do not match those with the highest prevalence of dilation in patients with BAV, thus providing no evidence to support the low and oscillatory shear stress theory in the pathogenesis of proximal aorta dilation in the presence of BAV.
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Affiliation(s)
- Lydia Dux-Santoy
- From the Department of Cardiology, CIBERCV, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d´Hebron, Barcelona, Spain (L.D.-S., A.G., G.T.-.T., A.R.-M., F.V., L.G.-.G., L.G., T.G.-A., I.F., A.E., J.F.R.P.)
| | - Andrea Guala
- From the Department of Cardiology, CIBERCV, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d´Hebron, Barcelona, Spain (L.D.-S., A.G., G.T.-.T., A.R.-M., F.V., L.G.-.G., L.G., T.G.-A., I.F., A.E., J.F.R.P.)
| | - Julio Sotelo
- Biomedical Imaging Center (J.S., S.U.), Pontificia Universidad Católica de Chile, Santiago.,Department of Electrical Engineering, School of Engineering (J.S.), Pontificia Universidad Católica de Chile, Santiago.,Millennium Nucleus for Cardiovascular Magnetic Resonance, Santiago, Chile (J.S., S.U., D.E.H.)
| | - Sergio Uribe
- Biomedical Imaging Center (J.S., S.U.), Pontificia Universidad Católica de Chile, Santiago.,Department of Radiology, School of Medicine (S.U.), Pontificia Universidad Católica de Chile, Santiago.,Millennium Nucleus for Cardiovascular Magnetic Resonance, Santiago, Chile (J.S., S.U., D.E.H.)
| | - Gisela Teixidó-Turà
- From the Department of Cardiology, CIBERCV, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d´Hebron, Barcelona, Spain (L.D.-S., A.G., G.T.-.T., A.R.-M., F.V., L.G.-.G., L.G., T.G.-A., I.F., A.E., J.F.R.P.)
| | - Aroa Ruiz-Muñoz
- From the Department of Cardiology, CIBERCV, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d´Hebron, Barcelona, Spain (L.D.-S., A.G., G.T.-.T., A.R.-M., F.V., L.G.-.G., L.G., T.G.-A., I.F., A.E., J.F.R.P.)
| | - Daniel E Hurtado
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine, and Biological Sciences (D.E.H.), Pontificia Universidad Católica de Chile, Santiago.,Department of Structural and Geotechnical Engineering, Schools of Engineering (D.E.H.), Pontificia Universidad Católica de Chile, Santiago.,Millennium Nucleus for Cardiovascular Magnetic Resonance, Santiago, Chile (J.S., S.U., D.E.H.)
| | - Filipa Valente
- From the Department of Cardiology, CIBERCV, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d´Hebron, Barcelona, Spain (L.D.-S., A.G., G.T.-.T., A.R.-M., F.V., L.G.-.G., L.G., T.G.-A., I.F., A.E., J.F.R.P.)
| | - Laura Galian-Gay
- From the Department of Cardiology, CIBERCV, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d´Hebron, Barcelona, Spain (L.D.-S., A.G., G.T.-.T., A.R.-M., F.V., L.G.-.G., L.G., T.G.-A., I.F., A.E., J.F.R.P.)
| | - Laura Gutiérrez
- From the Department of Cardiology, CIBERCV, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d´Hebron, Barcelona, Spain (L.D.-S., A.G., G.T.-.T., A.R.-M., F.V., L.G.-.G., L.G., T.G.-A., I.F., A.E., J.F.R.P.)
| | - Teresa González-Alujas
- From the Department of Cardiology, CIBERCV, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d´Hebron, Barcelona, Spain (L.D.-S., A.G., G.T.-.T., A.R.-M., F.V., L.G.-.G., L.G., T.G.-A., I.F., A.E., J.F.R.P.)
| | - Kevin M Johnson
- Department of Medical Physics (K.M.J., O.W.), University of Wisconsin-Madison.,Department of Radiology (K.M.J., O.W.), University of Wisconsin-Madison
| | - Oliver Wieben
- Department of Medical Physics (K.M.J., O.W.), University of Wisconsin-Madison.,Department of Radiology (K.M.J., O.W.), University of Wisconsin-Madison
| | - Ignacio Ferreira
- From the Department of Cardiology, CIBERCV, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d´Hebron, Barcelona, Spain (L.D.-S., A.G., G.T.-.T., A.R.-M., F.V., L.G.-.G., L.G., T.G.-A., I.F., A.E., J.F.R.P.)
| | - Arturo Evangelista
- From the Department of Cardiology, CIBERCV, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d´Hebron, Barcelona, Spain (L.D.-S., A.G., G.T.-.T., A.R.-M., F.V., L.G.-.G., L.G., T.G.-A., I.F., A.E., J.F.R.P.)
| | - José F Rodríguez-Palomares
- From the Department of Cardiology, CIBERCV, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d´Hebron, Barcelona, Spain (L.D.-S., A.G., G.T.-.T., A.R.-M., F.V., L.G.-.G., L.G., T.G.-A., I.F., A.E., J.F.R.P.)
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Gutiérrez L, Caballero N, Fernández-Calleja L, Karkoulia E, Strouboulis J. Regulation of GATA1 levels in erythropoiesis. IUBMB Life 2019; 72:89-105. [PMID: 31769197 DOI: 10.1002/iub.2192] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [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: 09/16/2019] [Accepted: 10/14/2019] [Indexed: 12/15/2022]
Abstract
GATA1 is considered as the "master" transcription factor in erythropoiesis. It regulates at the transcriptional level all aspects of erythroid maturation and function, as revealed by gene knockout studies in mice and by genome-wide occupancies in erythroid cells. The GATA1 protein contains two zinc finger domains and an N-terminal transactivation domain. GATA1 translation results in the production of the full-length protein and of a shorter variant (GATA1s) lacking the N-terminal transactivation domain, which is functionally deficient in supporting erythropoiesis. GATA1 protein abundance is highly regulated in erythroid cells at different levels, including transcription, mRNA translation, posttranslational modifications, and protein degradation, in a differentiation-stage-specific manner. Maintaining high GATA1 protein levels is essential in the early stages of erythroid maturation, whereas downregulating GATA1 protein levels is a necessary step in terminal erythroid differentiation. The importance of maintaining proper GATA1 protein homeostasis in erythropoiesis is demonstrated by the fact that both GATA1 loss and its overexpression result in lethal anemia. Importantly, alterations in any of those GATA1 regulatory checkpoints have been recognized as an important cause of hematological disorders such as dyserythropoiesis (with or without thrombocytopenia), β-thalassemia, Diamond-Blackfan anemia, myelodysplasia, or leukemia. In this review, we provide an overview of the multilevel regulation of GATA1 protein homeostasis in erythropoiesis and of its deregulation in hematological disease.
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Affiliation(s)
- Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Department of Medicine, Universidad de Oviedo, Oviedo, Spain
| | - Noemí Caballero
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Luis Fernández-Calleja
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Elena Karkoulia
- Institute of Molecular Biology and Biotechnology, Foundation of Research & Technology Hellas, Heraklion, Crete, Greece
| | - John Strouboulis
- Cancer Comprehensive Center, School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
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37
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Scully D, Sfyri P, Wilkinson HN, Acebes-Huerta A, Verpoorten S, Muñoz-Turrillas MC, Parnell A, Patel K, Hardman MJ, Gutiérrez L, Matsakas A. Optimising platelet secretomes to deliver robust tissue-specific regeneration. J Tissue Eng Regen Med 2019; 14:82-98. [PMID: 31603629 DOI: 10.1002/term.2965] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 05/10/2019] [Revised: 09/04/2019] [Accepted: 09/09/2019] [Indexed: 12/19/2022]
Abstract
Promoting cell proliferation is the cornerstone of most tissue regeneration therapies. As platelet-based applications promote cell division and can be customised for tissue-specific efficacy, this makes them strong candidates for developing novel regenerative therapies. Therefore, the aim of this study was to determine if platelet releasate could be optimised to promote cellular proliferation and differentiation of specific tissues. Growth factors in platelet releasate were profiled for physiological and supraphysiological platelet concentrations. We analysed the effect of physiological and supraphysiological releasate on C2C12 skeletal myoblasts, H9C2 rat cardiomyocytes, human dermal fibroblasts (HDF), HaCaT keratinocytes, and chondrocytes. Cellular proliferation and differentiation were assessed through proliferation assays, mRNA, and protein expression. We show that supraphysiological releasate is not simply a concentrated version of physiological releasate. Physiological releasate promoted C2C12, HDF, and chondrocyte proliferation with no effect on H9C2 or HaCaT cells. Supraphysiological releasate induced stronger proliferation in C2C12 and HDF cells compared with physiological releasate. Importantly, supraphysiological releasate induced proliferation of H9C2 cells. The proliferative effects of skeletal and cardiac muscle cells were in part driven by vascular endothelial growth factor alpha. Furthermore, supraphysiological releasate induced differentiation of H9C2 and C2C12, HDF, and keratinocytes. This study provides insights into the ability of releasate to promote muscle, heart, skin, and cartilage cell proliferation and differentiation and highlights the importance of optimising releasate composition for tissue-specific regeneration.
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Affiliation(s)
- David Scully
- Molecular Physiology Laboratory, Centre for Atherothrombosis & Metabolic Disease, Hull York Medical School, University of Hull, Hull, UK
| | - Peggy Sfyri
- Molecular Physiology Laboratory, Centre for Atherothrombosis & Metabolic Disease, Hull York Medical School, University of Hull, Hull, UK
| | - Holly N Wilkinson
- Molecular Physiology Laboratory, Centre for Atherothrombosis & Metabolic Disease, Hull York Medical School, University of Hull, Hull, UK
| | - Andrea Acebes-Huerta
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Sandrine Verpoorten
- Molecular Physiology Laboratory, Centre for Atherothrombosis & Metabolic Disease, Hull York Medical School, University of Hull, Hull, UK
| | - María Carmen Muñoz-Turrillas
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Centro Comunitario de Sangre y Tejidos, de Asturias, Oviedo, Spain
| | - Andrew Parnell
- School of Biological Sciences, University of Reading, Reading, UK
| | - Ketan Patel
- School of Biological Sciences, University of Reading, Reading, UK
| | - Matthew J Hardman
- Molecular Physiology Laboratory, Centre for Atherothrombosis & Metabolic Disease, Hull York Medical School, University of Hull, Hull, UK
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Antonios Matsakas
- Molecular Physiology Laboratory, Centre for Atherothrombosis & Metabolic Disease, Hull York Medical School, University of Hull, Hull, UK
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Guala A, Teixido-Tura G, Dux-Santoy L, Granato C, Ruiz-Muñoz A, Valente F, Galian-Gay L, Gutiérrez L, González-Alujas T, Johnson KM, Wieben O, Sao Avilés A, Evangelista A, Rodriguez-Palomares J. Decreased rotational flow and circumferential wall shear stress as early markers of descending aorta dilation in Marfan syndrome: a 4D flow CMR study. J Cardiovasc Magn Reson 2019; 21:63. [PMID: 31607265 PMCID: PMC6791020 DOI: 10.1186/s12968-019-0572-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 08/28/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Diseases of the descending aorta have emerged as a clinical issue in Marfan syndrome following improvements in proximal aorta surgical treatment and the consequent increase in life expectancy. Although a role for hemodynamic alterations in the etiology of descending aorta disease in Marfan patients has been suggested, whether flow characteristics may be useful as early markers remains to be determined. METHODS Seventy-five Marfan patients and 48 healthy subjects were prospectively enrolled. In- and through-plane vortexes were computed by 4D flow cardiovascular magnetic resonance (CMR) in the thoracic aorta through the quantification of in-plane rotational flow and systolic flow reversal ratio, respectively. Regional pulse wave velocity and axial and circumferential wall shear stress maps were also computed. RESULTS In-plane rotational flow and circumferential wall shear stress were reduced in Marfan patients in the distal ascending aorta and in proximal descending aorta, even in the 20 patients free of aortic dilation. Multivariate analysis showed reduced in-plane rotational flow to be independently related to descending aorta pulse wave velocity. Conversely, systolic flow reversal ratio and axial wall shear stress were altered in unselected Marfan patients but not in the subgroup without dilation. In multivariate regression analysis proximal descending aorta axial (p = 0.014) and circumferential (p = 0.034) wall shear stress were independently related to local diameter. CONCLUSIONS Reduced rotational flow is present in the aorta of Marfan patients even in the absence of dilation, is related to aortic stiffness and drives abnormal circumferential wall shear stress. Axial and circumferential wall shear stress are independently related to proximal descending aorta dilation beyond clinical factors. In-plane rotational flow and circumferential wall shear stress may be considered as an early marker of descending aorta dilation in Marfan patients.
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Affiliation(s)
- A. Guala
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - G. Teixido-Tura
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - L. Dux-Santoy
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - C. Granato
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - A. Ruiz-Muñoz
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - F. Valente
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - L. Galian-Gay
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - L. Gutiérrez
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - T. González-Alujas
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - K. M. Johnson
- Departments of Medical Physics & Radiology, University of Wisconsin – Madison, Madison, WI USA
| | - O. Wieben
- Departments of Medical Physics & Radiology, University of Wisconsin – Madison, Madison, WI USA
| | - A. Sao Avilés
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - A. Evangelista
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - J. Rodriguez-Palomares
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
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Ojea-Pérez AM, Acebes-Huerta A, Arias-Fernández T, Gutiérrez L, Muñoz-Turrillas MC. Implementation of a closed platelet-rich-plasma preparation method using the local blood bank infrastructure at the Principality of Asturias (Spain): Back to basic methodology and a demographics perspective after 1 year. Transfus Apher Sci 2019; 58:701-704. [PMID: 31451380 DOI: 10.1016/j.transci.2019.08.016] [Citation(s) in RCA: 5] [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] [Indexed: 01/18/2023]
Abstract
Platelet-rich plasma (PRP) is used with increasing demand as autologous adjuvant therapy in many areas of regenerative medicine, thanks to the platelet rich content of growth factors and bio-active molecules. However, to date there is a lack of consensus on PRP preparation methods, on processing and application forms, on clinical application guidelines and on knowledge-based composition at the cellular and molecular level, making difficult the assessment of clinical results from different groups in different clinical areas. Here we describe the implementation of PRP production on a closed-system using the infrastructure of a certified blood bank, detailing methodology, and validation and production results 1 year after its implementation. Our methodology provides a reproducible, safe, practical and yet affordable PRP bio-product that will allow further studies to better define PRP applications in regenerative medicine and personalized therapeutic regimes.
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Affiliation(s)
| | - Andrea Acebes-Huerta
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Tamara Arias-Fernández
- Centro Comunitario de Sangre y Tejidos de Asturias, Oviedo, Spain; Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Dept. of Medicine, University of Oviedo, Spain.
| | - María Carmen Muñoz-Turrillas
- Centro Comunitario de Sangre y Tejidos de Asturias, Oviedo, Spain; Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
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40
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Del Sol-Fernández S, Portilla-Tundidor Y, Gutiérrez L, Odio OF, Reguera E, Barber DF, Morales MP. Flower-like Mn-Doped Magnetic Nanoparticles Functionalized with α vβ 3-Integrin-Ligand to Efficiently Induce Intracellular Heat after Alternating Magnetic Field Exposition, Triggering Glioma Cell Death. ACS Appl Mater Interfaces 2019; 11:26648-26663. [PMID: 31287950 DOI: 10.1021/acsami.9b08318] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Despite the potential of magnetic nanoparticles (NPs) to mediate intracellular hyperthermia when exposed to an alternating magnetic field (AMF), several studies indicate that the intracellular heating capacity of magnetic NPs depends on factors such as cytoplasm viscosity, nanoparticle aggregation within subcellular compartments, and dipolar interactions. In this work, we report the design and synthesis of monodispersed flowerlike superparamagnetic manganese iron oxide NPs with maximized SAR (specific absorption rate) and evaluate their efficacy as intracellular heaters in the human tumor-derived glioblastoma cell line U87MG. Three main strategies to tune the particle anisotropy of the core and the surface to reach the maximum heating efficiency were adopted: (1) varying the crystalline anisotropy by inserting a low amount of Mn2+ in the inverse spinel structure, (2) varying the NP shape to add an additional anisotropy source while keeping the superparamagnetic behavior, and (3) maximizing NP-cell affinity through conjugation with a biological targeting molecule to reach the NP concentration required to increase the temperature within the cell. We investigate possible effects produced by these improved NPs under the AMF (f = 96 kHz, H = 47 kA/m) exposure in the glioblastoma cell line U87MG by monitoring the expression of hsp70 gene and reactive oxygen species (ROS) production, as both effects have been described to be induced by increasing the intracellular temperature. The induced cell responses include cellular membrane permeabilization and rupture with concomitant high ROS appearance and hsp70 expression, followed by cell death. The responses were largely limited to cells that contained the NPs exposed to the AMF. Our results indicate that the developed strategies to optimize particle anisotropy in this work are a promising guidance to improve the heating efficiency of magnetic NPs in the human glioma cell line.
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Affiliation(s)
- S Del Sol-Fernández
- Instituto Politécnico Nacional, Centro de Investigación en Ciencia Aplicada y Tecnología Avanzada, Unidad Legaria (CICATA-Legaria) , Calz Legaria 694, Col. Irrigación , 11500 Ciudad de México , Mexico
| | - Y Portilla-Tundidor
- Department of Immunology and Oncology and Nanobiomedicine Initiative , Centro Nacional de Biotecnología (CNB-CSIC) , Darwin 3 , 28049 Madrid , Spain
| | - L Gutiérrez
- Departamento de Química Analítica , Universidad de Zaragoza, Instituto de Nanociencia de Aragón, Instituto de Ciencia de Materiales de Aragón (ICMA-CSIC) and CIBER-BBN , 50009 Zaragoza , Spain
| | - O F Odio
- Instituto Politécnico Nacional, Centro de Investigación en Ciencia Aplicada y Tecnología Avanzada, Unidad Legaria (CICATA-Legaria) , Calz Legaria 694, Col. Irrigación , 11500 Ciudad de México , Mexico
| | - E Reguera
- Instituto Politécnico Nacional, Centro de Investigación en Ciencia Aplicada y Tecnología Avanzada, Unidad Legaria (CICATA-Legaria) , Calz Legaria 694, Col. Irrigación , 11500 Ciudad de México , Mexico
| | - D F Barber
- Department of Immunology and Oncology and Nanobiomedicine Initiative , Centro Nacional de Biotecnología (CNB-CSIC) , Darwin 3 , 28049 Madrid , Spain
| | - M P Morales
- Department of Energy, Environment and Health , Instituto de Ciencia de Materiales de Madrid (ICMM-CSIC) , Sor Juana Ines de la Cruz 3 , 28049 Madrid , Spain
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Guala A, Teixidó-Tura G, Rodríguez-Palomares J, Ruiz-Muñoz A, Dux-Santoy L, Villalva N, Granato C, Galian L, Gutiérrez L, González-Alujas T, Sanchez V, Forteza A, García-Dorado D, Evangelista A. Proximal aorta longitudinal strain predicts aortic root dilation rate and aortic events in Marfan syndrome. Eur Heart J 2019. [PMID: 30977783 DOI: 10.1093/eurheart/ehz191] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
AIMS Life expectancy in Marfan syndrome patients has improved thanks to the early detection of aortic dilation and prophylactic aortic root surgery. Current international clinical guidelines support the use of aortic root diameter as a predictor of complications. However, other imaging markers are needed to improve risk stratification. This study aim to ascertain whether proximal aorta longitudinal and circumferential strain and distensibility assessed by cardiac magnetic resonance (CMR) predict the aortic root dilation rate and aortic events in Marfan syndrome. METHODS AND RESULTS One hundred and seventeen Marfan patients with no previous aortic dissection, cardiac/aortic surgery, or moderate/severe aortic regurgitation were prospectively included in a multicentre protocol of clinical and imaging follow-up. At baseline, CMR was performed and proximal aorta longitudinal strain and ascending aorta circumferential strain and distensibility were obtained. During follow-up (85.7 [75.0-93.2] months), the annual growth rate of aortic root diameter was 0.62 ± 0.65 mm/year. Fifteen patients underwent elective surgical aortic root replacement and four presented aortic dissection. Once corrected for baseline clinical and demographic characteristics and aortic root diameter, proximal aorta longitudinal strain, but not circumferential strain and distensibility, was an independent predictor of the aortic root diameter growth rate (P = 0.001, P = 0.823, and P = 0.997, respectively), z-score growth rate (P = 0.013, P = 0.672, and P = 0.680, respectively), and aortic events (P = 0.023, P = 0.096, and P = 0.237, respectively). CONCLUSION Proximal aorta longitudinal strain is independently related to the aortic root dilation rate and aortic events in addition to aortic root diameter, clinical risk factors, and demographic characteristics in Marfan syndrome patients.
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Affiliation(s)
- Andrea Guala
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Gisela Teixidó-Tura
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Jose Rodríguez-Palomares
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Aroa Ruiz-Muñoz
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Lydia Dux-Santoy
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Nicolas Villalva
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Chiara Granato
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Laura Galian
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Laura Gutiérrez
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Teresa González-Alujas
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Violeta Sanchez
- Department of Cardiology, Hospital doce de Octubre, Avenida Cordoba, Madrid, Spain
| | - Alberto Forteza
- Department of Cardiac Surgery, Hospital Puerta de Hierro. Calle Manuel de Falla, 1, Majadahonda, Spain
| | - David García-Dorado
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
| | - Artur Evangelista
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Vall d'Hebron institut de Recerca, Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, Spain
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Defagó MD, Elorriaga N, Eynard AR, Poggio R, Gutiérrez L, Irazola VE, Rubinstein AL. Associations between major dietary patterns and biomarkers of endothelial dysfunction in two urban midsized cities in Argentina. Nutrition 2019; 67-68:110521. [PMID: 31446214 DOI: 10.1016/j.nut.2019.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 05/10/2018] [Revised: 05/15/2019] [Accepted: 06/09/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We examined whether dietary patterns (DPS) are associated with endothelial dysfunction (ED) markers in an Argentinian population. RESEARCH METHODS & PROCEDURES The sample in this cross-sectional study was derived from 1,983 subjects from two mid-sized cities in Argentina who were involved in the CESCAS I Study. To define DP, a food-frequency questionnaire was applied. In a subsample randomly selected from the primary cohort, serum concentrations of C-reactive protein (hs-CRP), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1 (sICAM-1), and soluble E selectin (sSELE) were determined. Correlations and multiple linear regression models were used to assess the relation between each quartile of DP adherence score and ED markers (Q1 lowest adherence; Q4 highest adherence). RESULTS Three DPs were identified: Traditional (TDP), Prudent (PDP), and Convenience and processed (CDP). TDP was characterized by higher intake of refined grains, red meat, whole fat dairy products, vegetable oils, and "mate", a traditional South American infused drink; PDP was characterized by higher intake of vegetables, fruit, low-fat dairy products, whole grains, and legumes; and CDP consisted mainly of processed meat, snacks, pizza, and "empanadas", a stuffed bread served baked or fried. Lower scores (Q2, Q3) in TDP were inversely associated with concentrations of sSELE (P < 0.0001 and P < 0.05, respectively). In PDP, higher scores were inversely associated with hs-CRP, whereas lower scores showed a positive relation with sSELE (P < 0.05). Contrariwise, higher scores in CDP were directly associated with sSELE concentrations (P < 0.05). CONCLUSION Adherence for each DP identified is differentially related to ED markers in the studied population.
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Affiliation(s)
- María Daniela Defagó
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET, Universidad Nacional de Córdoba, Ciudad Universitaria, Córdoba, Argentina; Centro de Excelencia en Salud Cardiovascular para el Cono Sur (CESCAS/SACECH), Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina; Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Edificio Escuelas, Ciudad Universitaria, Córdoba, Argentina.
| | - Natalia Elorriaga
- Centro de Excelencia en Salud Cardiovascular para el Cono Sur (CESCAS/SACECH), Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Aldo Renato Eynard
- Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Edificio Escuelas, Ciudad Universitaria, Córdoba, Argentina
| | - Rosana Poggio
- Centro de Excelencia en Salud Cardiovascular para el Cono Sur (CESCAS/SACECH), Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Laura Gutiérrez
- Centro de Excelencia en Salud Cardiovascular para el Cono Sur (CESCAS/SACECH), Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Vilma Edith Irazola
- Centro de Excelencia en Salud Cardiovascular para el Cono Sur (CESCAS/SACECH), Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Adolfo Luis Rubinstein
- Centro de Excelencia en Salud Cardiovascular para el Cono Sur (CESCAS/SACECH), Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
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Evangelista A, Maldonado G, Gruosso D, Gutiérrez L, Granato C, Villalva N, Galian L, González-Alujas T, Teixido G, Rodríguez-Palomares J. The current role of echocardiography in acute aortic syndrome. Echo Res Pract 2019; 6:R53-R63. [PMID: 30921764 PMCID: PMC6454227 DOI: 10.1530/erp-18-0058] [Citation(s) in RCA: 20] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/06/2019] [Indexed: 01/16/2023] Open
Abstract
Acute aortic syndrome (AAS) comprises a range of interrelated conditions caused by disruption of the medial layer of the aortic wall, including aortic dissection, intramural haematoma and penetrating aortic ulcer. Since mortality from AAS is high, a prompt and accurate diagnosis using imaging techniques is paramount. Both transthoracic (TTE) and transoesophageal echocardiography (TEE) are useful in the diagnosis of AAS. TTE should be the first imaging technique to evaluate patients with thoracic pain in the emergency room. Should AAS be suspected, contrast administration is recommended when images are not definitive. TEE allows high-quality images in thoracic aorta. The main drawback of this technique is that it is semi-invasive and the presence of a blind area that limits visualisation of the distal ascending aorta near. TEE identifies the location and size of the entry tear, secondary communications, true lumen compression and the dynamic flow pattern of false lumen. Although computed tomography (CT) is the most used imaging technique in the diagnosis of AAS, echocardiography offers complementary information relevant for its management. The best imaging strategy for appropriately diagnosing and assessing AAS is to combine CT, mainly ECG-gated contrast-enhanced CT, and TTE. Currently, TEE tends to be carried out in the operating theatre immediately before surgical or endovascular therapy and in monitoring their results. The aims of this review are to establish the current role of echocardiography in the diagnosis and management of AAS based on its advantages and limitations.
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Affiliation(s)
- Arturo Evangelista
- Cardiovascular Imaging Department, University Hospital Vall d'Hebron, CIBER-CV, Barcelona, Spain
| | - Giuliana Maldonado
- Cardiovascular Imaging Department, Instituto del Corazon, Quironsalud Teknon, Barcelona, Spain
| | - Domenico Gruosso
- Cardiovascular Imaging Department, University Hospital Vall d'Hebron, CIBER-CV, Barcelona, Spain
| | - Laura Gutiérrez
- Cardiovascular Imaging Department, University Hospital Vall d'Hebron, CIBER-CV, Barcelona, Spain
| | - Chiara Granato
- Cardiovascular Imaging Department, University Hospital Vall d'Hebron, CIBER-CV, Barcelona, Spain
| | - Nicolas Villalva
- Cardiovascular Imaging Department, University Hospital Vall d'Hebron, CIBER-CV, Barcelona, Spain
| | - Laura Galian
- Cardiovascular Imaging Department, University Hospital Vall d'Hebron, CIBER-CV, Barcelona, Spain
| | - Teresa González-Alujas
- Cardiovascular Imaging Department, University Hospital Vall d'Hebron, CIBER-CV, Barcelona, Spain
| | - Gisela Teixido
- Cardiovascular Imaging Department, University Hospital Vall d'Hebron, CIBER-CV, Barcelona, Spain
| | - Jose Rodríguez-Palomares
- Cardiovascular Imaging Department, University Hospital Vall d'Hebron, CIBER-CV, Barcelona, Spain
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Guala A, Rodriguez-Palomares J, Dux-Santoy L, Teixido-Tura G, Maldonado G, Galian L, Huguet M, Valente F, Gutiérrez L, González-Alujas T, Johnson KM, Wieben O, Sao Avilés A, Garcia-Dorado D, Evangelista A. Influence of Aortic Dilation on the Regional Aortic Stiffness of Bicuspid Aortic Valve Assessed by 4-Dimensional Flow Cardiac Magnetic Resonance. JACC Cardiovasc Imaging 2019; 12:1020-1029. [DOI: 10.1016/j.jcmg.2018.03.017] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/08/2018] [Accepted: 03/20/2018] [Indexed: 01/16/2023]
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Ferri C, Weich N, Gutiérrez L, De Brasi C, Bengió M, Zapata P, Fundia A, Larripa I. Single nucleotide polymorphism in PTEN-Long gene: A risk factor in chronic myeloid leukemia. Gene 2019; 694:71-75. [DOI: 10.1016/j.gene.2019.01.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/05/2019] [Accepted: 01/22/2019] [Indexed: 02/01/2023]
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Dux-Santoy L, Guala A, Teixidó-Turà G, Ruiz-Muñoz A, Maldonado G, Villalva N, Galian L, Valente F, Gutiérrez L, González-Alujas T, Sao-Avilés A, Johnson KM, Wieben O, Huguet M, García-Dorado D, Evangelista A, Rodríguez-Palomares JF. Increased rotational flow in the proximal aortic arch is associated with its dilation in bicuspid aortic valve disease. Eur Heart J Cardiovasc Imaging 2019; 20:1407-1417. [DOI: 10.1093/ehjci/jez046] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [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: 09/10/2018] [Accepted: 02/28/2019] [Indexed: 12/11/2022] Open
Abstract
Abstract
Aims
Aortic dilation in bicuspid aortic valve (BAV) might extend to the proximal arch. Arch flow dynamics and their relationship with this segment dilation are still unexplored. Using 4D-flow cardiovascular magnetic resonance, we analysed flow dynamics in the arch for each BAV morphotype and their association with this segment dilation.
Methods and results
One hundred and eleven BAV patients (aortic diameters ≤55 mm, non-severe valvular disease), 21 age-matched tricuspid aortic valve (TAV) patients with dilated arch and 24 healthy volunteers (HV) underwent 4D-flow. BAV were classified per fusion morphotype: 75% right-left (RL-BAV), and per arch dilation: 57% dilated, mainly affecting the right-noncoronary (RN) BAV (86% dilated vs. 47% in RL-BAV). Peak velocity, jet angle, normalized displacement, in-plane rotational flow (IRF), wall shear stress, and systolic flow reversal ratio (SFRR) were calculated along the thoracic aorta. ANCOVA and multivariate linear regression analyses were used to identify correlates of arch dilation. BAV had higher rotational flow and eccentricity than TAV in the proximal arch. Dilated compared with non-dilated BAV had higher IRF being more pronounced in the RN-morphotype. RN-BAV, IRF, and SFRR were independently associated with arch dilation. Aortic stenosis and male sex were independently associated with arch dilation in RL-BAV. Flow parameters associated with dilation converged to the values found in HV in the distal arch.
Conclusion
Increased rotational flow could explain dilation of the proximal arch in RN-BAV and in RL-BAV patients of male sex and with valvular stenosis. These patients may benefit from a closer follow-up with cardiac magnetic resonance or computed tomography.
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Affiliation(s)
- Lydia Dux-Santoy
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Andrea Guala
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Gisela Teixidó-Turà
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Aroa Ruiz-Muñoz
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Giuliana Maldonado
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Nicolás Villalva
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Laura Galian
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Filipa Valente
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Laura Gutiérrez
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Teresa González-Alujas
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Augusto Sao-Avilés
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Kevin M Johnson
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI 53705-2275, USA
- Department of Radiology, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI 53792, USA
| | - Oliver Wieben
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI 53705-2275, USA
- Department of Radiology, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI 53792, USA
| | - Marina Huguet
- Cardiac Imaging Unit, Pilar-Quirón Hospital, Carrer de Balmes 271, 08006 Barcelona, Spain
| | - David García-Dorado
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - Arturo Evangelista
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
| | - José F Rodríguez-Palomares
- Department of Cardiology, CIBER-CV, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119–129, 08035 Barcelona, Spain
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Scully D, Sfyri P, Verpoorten S, Papadopoulos P, Muñoz‐Turrillas MC, Mitchell R, Aburima A, Patel K, Gutiérrez L, Naseem KM, Matsakas A. Platelet releasate promotes skeletal myogenesis by increasing muscle stem cell commitment to differentiation and accelerates muscle regeneration following acute injury. Acta Physiol (Oxf) 2019; 225:e13207. [PMID: 30339324 DOI: 10.1111/apha.13207] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 07/09/2018] [Revised: 09/27/2018] [Accepted: 10/14/2018] [Indexed: 12/11/2022]
Abstract
AIM The use of platelets as biomaterials has gained intense research interest. However, the mechanisms regarding platelet-mediated skeletal myogenesis remain to be established. The aim of this study was to determine the role of platelet releasate in skeletal myogenesis and muscle stem cell fate in vitro and ex vivo respectively. METHODS We analysed the effect of platelet releasate on proliferation and differentiation of C2C12 myoblasts by means of cell proliferation assays, immunohistochemistry, gene expression and cell bioenergetics. We expanded in vitro findings on single muscle fibres by determining the effect of platelet releasate on murine skeletal muscle stem cells using protein expression profiles for key myogenic regulatory factors. RESULTS TRAP6 and collagen used for releasate preparation had a more pronounced effect on myoblast proliferation vs thrombin and sonicated platelets (P < 0.05). In addition, platelet concentration positively correlated with myoblast proliferation. Platelet releasate increased myoblast and muscle stem cell proliferation in a dose-dependent manner, which was mitigated by VEGFR and PDGFR inhibition. Inhibition of VEGFR and PDGFR ablated MyoD expression on proliferating muscle stem cells, compromising their commitment to differentiation in muscle fibres (P < 0.001). Platelet releasate was detrimental to myoblast fusion and affected differentiation of myoblasts in a temporal manner. Most importantly, we show that platelet releasate promotes skeletal myogenesis through the PDGF/VEGF-Cyclin D1-MyoD-Scrib-Myogenin axis and accelerates skeletal muscle regeneration after acute injury. CONCLUSION This study provides novel mechanistic insights on the role of platelet releasate in skeletal myogenesis and set the physiological basis for exploiting platelets as biomaterials in regenerative medicine.
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Affiliation(s)
- David Scully
- Molecular Physiology Laboratory, Centre for Atherothrombotic and Metabolic Disease, Hull York Medical School University of Hull Hull UK
| | - Peggy Sfyri
- Molecular Physiology Laboratory, Centre for Atherothrombotic and Metabolic Disease, Hull York Medical School University of Hull Hull UK
| | - Sandrine Verpoorten
- Molecular Physiology Laboratory, Centre for Atherothrombotic and Metabolic Disease, Hull York Medical School University of Hull Hull UK
| | - Petros Papadopoulos
- Department of Hematology, Instituto de Investigación Sanitaria San Carlos (IdISSC) Hospital Clínico San Carlos Madrid Spain
| | - María Carmen Muñoz‐Turrillas
- Centro Comunitario de Sangre y Tejidos de Asturias and Instituto de Investigación Sanitaria del Principado de Asturias (ISPA) Oviedo Spain
| | - Robert Mitchell
- School of Biological Sciences University of Reading Reading UK
| | - Ahmed Aburima
- Molecular Physiology Laboratory, Centre for Atherothrombotic and Metabolic Disease, Hull York Medical School University of Hull Hull UK
| | - Ketan Patel
- School of Biological Sciences University of Reading Reading UK
| | - Laura Gutiérrez
- Department of Medicine Universidad de Oviedo and Instituto de Investigación Sanitaria del Principado de Asturias (ISPA) Oviedo Spain
| | - Khalid M. Naseem
- Leeds Institute of Cardiovascular and Metabolic Medicine University of Leeds Leeds UK
| | - Antonios Matsakas
- Molecular Physiology Laboratory, Centre for Atherothrombotic and Metabolic Disease, Hull York Medical School University of Hull Hull UK
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Salgado MV, Coxson P, Konfino J, Penko J, Irazola VE, Gutiérrez L, Fernández A, Mejía R. Update of the cardiovascular disease policy model to predict cardiovascular events in Argentina. Medicina (B Aires) 2019; 79:438-444. [PMID: 31829945] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death in Argentina. Computer simulation models allow to extrapolate evidence to broader populations than the originally studied, over longer timeframes, and to compare different subpopulations. The Cardiovascular Disease Policy Model (CVDPM) is a computer simulation state transition model used to represent and project future CVD mortality and morbidity in the population 35 years-old and older. The objective of this study was to update Argentina's version of the CVDPM. For this purpose, information from the 2010 National Census, the 2013 National Risk Factor Survey, CESCAS I study, and PrEViSTA study were used to update the dynamics of population size, demographics, and CVD risk factor distributions over time. Model projections were later calibrated by comparing them to actual data on CVD events and mortality in the year 2010 (baseline year) in Argentina. Country statistics for people 35 years-old and older reported for 2010 a total of 41 219 myocardial infarctions (MIs), 58 658 strokes, and 281 710 total deaths. The CVDPM, in turn, predicted 41 265 MIs (difference: 0.11%), 58 584 strokes (difference: 0.13%), and 280 707 total deaths (difference: 0.36%) in the same population. In all cases, the final version of the model predicted the actual number of events with an accuracy superior to 99.5%, and could be used to forecast the changes in CVD incidence and mortality after the implementation of public policies.
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Affiliation(s)
- M Victoria Salgado
- Centro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina. E-mail:
| | - Pam Coxson
- Center for Vulnerable Populations, University of California San Francisco, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Jonatan Konfino
- Centro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina
| | - Joanne Penko
- Center for Vulnerable Populations, University of California San Francisco, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Vilma E Irazola
- Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
- Centro de Excelencia en Salud Cardiovascular para América del Sur (CESCAS), Buenos Aires, Argentina
| | - Laura Gutiérrez
- Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
- Centro de Excelencia en Salud Cardiovascular para América del Sur (CESCAS), Buenos Aires, Argentina
| | - Alicia Fernández
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Raúl Mejía
- Centro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina
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Ruiz-Casado A, Gutiérrez L, Sánchez A, Manso M. Lengua geográfica inducida por inhibidores de la angiogénesis. Rev Clin Esp 2018; 218:501-502. [DOI: 10.1016/j.rce.2018.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 07/18/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
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Ledesma C, Rosario C, Gracia-Mora J, Tapia G, Gutiérrez L, Sumano H. Antibacterial activity of amoxicillin in vitro and its oral bioavailability in broiler chickens under the influence of 3 water sanitizers. Poult Sci 2018; 97:2391-2399. [PMID: 29897502 DOI: 10.3382/ps/pey114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 03/12/2018] [Indexed: 11/20/2022] Open
Abstract
The interaction of 3 water sanitizers (sodium hypochlorite, iodine-polyvinylpyrrolidone, and citrate) utilized in poultry production on antibacterial activity and bioavailability of amoxicillin trihydrate (AMX) were studied. Sanitizers were mixed with AMX in prepared water, the resulting substances were regarded as amoxicillin-sanitizer products (ASP). First, the in vitro antibacterial activity of each ASP was compared to that of AMX. Then, pharmacokinetics (PK) of ASP and AMX diluted in prepared water, were carried out in broiler-chickens. Amoxicillin or ASP (20 mg/kg) from different concentrations of sanitizers was directly placed into the chicken's crop and blood samples were taken. Basic PK parameters were obtained. Serum activity/concentrations of AMX were assessed by agar diffusion and corroborated with high performance liquid chromatography. Results show that ASP of AMX/sodium hypochlorite decrease both, the antimicrobial activity of in vitro AMX and its relative bioavailability (Fr) assessed with the maximum serum concentration (Cmax), the area under the concentration-time curve, and the mean residence time (MRT) (3.80 μg/mL, 2.70 μg/mL·h, and 0.59 h, respectively), compared to the AMX administered alone (12.54 μg/mL, 44.02 μg/mL·h, and MRT 2.78 h). ASP from amoxicillin/ionophore, reduced the Cmax (10.62 μg/mL), Fr (94.67%), and MRT (2.07 h), at the highest tested concentrations. In contrast, the 2 highest concentrations of the citrate sanitizer increased the Cmax (15.07 and 15.47 μg/mL), Fr (119 and 132%), and MRT (3.32 and 4.06 h) and their in vitro antimicrobial activity. Interactions between the tested water sanitizers and AMX modify the Cmax, Fr, MRT of the latter, altering the PK/pharmacodymanic ratios for a time-dependent antibiotic. Results also reveal that the use of amoxicillin trihydrate administered through the drinking water does not meet the required PK/pharmacodymanic ratios. Thus, it is here postulated that this antibiotic should be administered at least twice a day and that its interaction with water sanitizers should be considered.
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Affiliation(s)
- C Ledesma
- Department of Physiology and Pharmacology, School of Veterinary Medicine, National Autonomous University of Mexico, Av. Universidad 3000, Coyoacán, Mexico City 04510, Mexico
| | - C Rosario
- Department of Avian Medicine, School of Veterinary Medicine, National Autonomous University of Mexico, Av. Universidad 3000, Coyoacán, Mexico City 04510, Mexico
| | - J Gracia-Mora
- Department Nuclear and Inorganic Chemistry, School of Chemistry, National Autonomous University of Mexico, Av. Universidad 3000, Coyoacán, Mexico City 04510, Mexico
| | - G Tapia
- Department of Genetic and Biostatistics, School of Veterinary Medicine, National Autonomous University of Mexico, Av. Universidad 3000, Coyoacán, Mexico City 04510, Mexico
| | - L Gutiérrez
- Department of Physiology and Pharmacology, School of Veterinary Medicine, National Autonomous University of Mexico, Av. Universidad 3000, Coyoacán, Mexico City 04510, Mexico
| | - H Sumano
- Department of Physiology and Pharmacology, School of Veterinary Medicine, National Autonomous University of Mexico, Av. Universidad 3000, Coyoacán, Mexico City 04510, Mexico
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