1
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Tomas L, Katra P, Badn W, Andersson L, Nilsson J, Schiopu A, Engelbertsen D, Gonçalves I, Bengtsson E, Björkbacka H. Invariant natural killer T cells and incidence of first-time coronary events: a nested case-control study. Eur Heart J Open 2023; 3:oead094. [PMID: 38025652 PMCID: PMC10630548 DOI: 10.1093/ehjopen/oead094] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/17/2023] [Accepted: 09/20/2023] [Indexed: 12/01/2023]
Abstract
Aims Invariant natural killer T (iNKT) cells, a T cell subset that is CD1d-restricted and expresses a semi-invariant T cell receptor, have been proposed to contribute to dyslipidaemia-driven cardiovascular disease due to their ability to specifically recognize lipid antigens. Studies in mice have attributed pro-atherogenic properties to iNKT cells, but studies in humans investigating associations of iNKT cells with incident coronary events (CE) are lacking. Methods and results Here, we used flow cytometry to enumerate circulating iNKT cells (CD3+ CD1d-PBS57-Tetramer+) in a case-control cohort nested within the prospective population-based Malmö Diet and Cancer Study (n = 416) to explore associations with incident first-time CE during a median follow-up of 14 years. We found a significant inverse association between CD4- and CD8- double negative (DN) iNKT cells and incident CE, with an odds ratio of 0.62 [95% confidence interval (CI) 0.38-0.99; P = 0.046] comparing the highest vs. the lowest tertile of DN iNKT cells. The association remained significant after adjustment for cardiovascular risk factors with an odds ratio of 0.57 (95% CI 0.33-0.99; P = 0.046). In contrast, total iNKT cells were not significantly associated with incident CE after adjustment, with an odds ratio of 0.74 (95% CI 0.43-1.27; P = 0.276). Conclusion Our findings indicate that animal studies suggesting an atherosclerosis-promoting role for iNKT cells may not translate to human cardiovascular disease as our data show an association between high circulating numbers of DN iNKT cells and decreased risk of incident CE.
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Affiliation(s)
- Lukas Tomas
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-214 28, Malmö, Sweden
| | - Pernilla Katra
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-214 28, Malmö, Sweden
| | - Wiaam Badn
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-214 28, Malmö, Sweden
| | - Linda Andersson
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-214 28, Malmö, Sweden
| | - Jan Nilsson
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-214 28, Malmö, Sweden
| | - Alexandru Schiopu
- Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Internal Medicine, Skåne University Hospital, Lund, Sweden
| | - Daniel Engelbertsen
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-214 28, Malmö, Sweden
| | - Isabel Gonçalves
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-214 28, Malmö, Sweden
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - Eva Bengtsson
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-214 28, Malmö, Sweden
- Faculty of Health and Society, Malmö University, Malmö, Sweden
- Biofilms – Research Center for Biointerfaces, Malmö University, Malmö, Sweden
| | - Harry Björkbacka
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, SE-214 28, Malmö, Sweden
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2
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Pekayvaz K, Gold C, Hoseinpour P, Engel A, Martinez-Navarro A, Eivers L, Coletti R, Joppich M, Dionísio F, Kaiser R, Tomas L, Janjic A, Knott M, Mehari F, Polewka V, Kirschner M, Boda A, Nicolai L, Schulz H, Titova A, Kilani B, Lorenz M, Fingerle-Rowson G, Bucala R, Enard W, Zimmer R, Weber C, Libby P, Schulz C, Massberg S, Stark K. Mural cell-derived chemokines provide a protective niche to safeguard vascular macrophages and limit chronic inflammation. Immunity 2023; 56:2325-2341.e15. [PMID: 37652021 PMCID: PMC10588993 DOI: 10.1016/j.immuni.2023.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/23/2023] [Accepted: 08/03/2023] [Indexed: 09/02/2023]
Abstract
Maladaptive, non-resolving inflammation contributes to chronic inflammatory diseases such as atherosclerosis. Because macrophages remove necrotic cells, defective macrophage programs can promote chronic inflammation with persistent tissue injury. Here, we investigated the mechanisms sustaining vascular macrophages. Intravital imaging revealed a spatiotemporal macrophage niche across vascular beds alongside mural cells (MCs)-pericytes and smooth muscle cells. Single-cell transcriptomics, co-culture, and genetic deletion experiments revealed MC-derived expression of the chemokines CCL2 and MIF, which actively preserved macrophage survival and their homeostatic functions. In atherosclerosis, this positioned macrophages in viable plaque areas, away from the necrotic core, and maintained a homeostatic macrophage phenotype. Disruption of this MC-macrophage unit via MC-specific deletion of these chemokines triggered detrimental macrophage relocalizing, exacerbated plaque necrosis, inflammation, and atheroprogression. In line, CCL2 inhibition at advanced stages of atherosclerosis showed detrimental effects. This work presents a MC-driven safeguard toward maintaining the homeostatic vascular macrophage niche.
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Affiliation(s)
- Kami Pekayvaz
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany.
| | - Christoph Gold
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Parandis Hoseinpour
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Anouk Engel
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany
| | | | - Luke Eivers
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany
| | - Raffaele Coletti
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany
| | - Markus Joppich
- Department of Informatics, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Flávio Dionísio
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Rainer Kaiser
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Lukas Tomas
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Aleksandar Janjic
- Anthropology and Human Genomics, Faculty of Biology, Ludwig-Maximilians University, Munich, Germany
| | - Maximilian Knott
- Institute of Pathology, Ludwig-Maximilian University Munich, Munich, Germany
| | - Fitsumbirhan Mehari
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany
| | - Vivien Polewka
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany
| | - Megan Kirschner
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany
| | - Annegret Boda
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany
| | - Leo Nicolai
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Heiko Schulz
- Institute of Pathology, Ludwig-Maximilian University Munich, Munich, Germany
| | - Anna Titova
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany
| | - Badr Kilani
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany
| | - Michael Lorenz
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany
| | | | - Richard Bucala
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Wolfgang Enard
- Anthropology and Human Genomics, Faculty of Biology, Ludwig-Maximilians University, Munich, Germany
| | - Ralf Zimmer
- Department of Informatics, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Christian Weber
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany; Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximillian-Universität (LMU) München, Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Peter Libby
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Christian Schulz
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Steffen Massberg
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Konstantin Stark
- Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany.
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3
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Sagray E, Tomas L, Cannon B, Wackel P, O'Leary P, Ameduri R, Brown T, Johnson J. Safe and Effective Early Use of Betablockers after Pediatric Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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4
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Dionísio F, Tomas L, Schulz C. Glycolytic side pathways regulating macrophage inflammatory phenotypes and functions. Am J Physiol Cell Physiol 2023; 324:C558-C564. [PMID: 36645667 DOI: 10.1152/ajpcell.00276.2022] [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: 01/17/2023]
Abstract
Macrophages are crucial effector cells of the innate immune system and have important roles in the initiation and resolution of inflammation as well as in tissue homeostasis. To fulfill these diverse roles, macrophages exhibit metabolic flexibility to quickly adapt to the needs of the effector functions required, as well as to the microenvironment. This metabolic flexibility is exemplified by proinflammatory macrophages, which upregulate glycolysis to both initiate and sustain the process of inflammation. Upregulation of glycolysis does not only represent a fast means of ATP generation. It also fuels glycolytic side pathways that are crucial for an effective inflammatory response by influencing the cell's redox balance as well as by providing building blocks and substrates for epigenetic reprogramming. The aim of this short review is to explore how three of these pathways - the pentose phosphate pathway, the glycerol phosphate shuttle, and the serine synthesis pathway - help macrophages sustain their proinflammatory phenotype and functions.
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Affiliation(s)
- Flávio Dionísio
- Department of Medicine I, University Hospital, Ludwig Maximilian University, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Lukas Tomas
- Department of Medicine I, University Hospital, Ludwig Maximilian University, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Christian Schulz
- Department of Medicine I, University Hospital, Ludwig Maximilian University, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
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5
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Elhag S, Stremmel C, Zehrer A, Plocke J, Hennel R, Keuper M, Knabe C, Winterhalter J, Gölling V, Tomas L, Weinberger T, Fischer M, Liu L, Wagner F, Lorenz M, Stark K, Häcker H, Schmidt-Supprian M, Völker U, Jastroch M, Lauber K, Straub T, Walzog B, Hammer E, Schulz C. Differences in Cell-Intrinsic Inflammatory Programs of Yolk Sac and Bone Marrow Macrophages. Cells 2021; 10:3564. [PMID: 34944072 PMCID: PMC8699930 DOI: 10.3390/cells10123564] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/11/2021] [Accepted: 12/15/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Tissue-resident macrophages have mixed developmental origins. They derive in variable extent from yolk sac (YS) hematopoiesis during embryonic development. Bone marrow (BM) hematopoietic progenitors give rise to tissue macrophages in postnatal life, and their contribution increases upon organ injury. Since the phenotype and functions of macrophages are modulated by the tissue of residence, the impact of their origin and developmental paths has remained incompletely understood. METHODS In order to decipher cell-intrinsic macrophage programs, we immortalized hematopoietic progenitors from YS and BM using conditional HoxB8, and carried out an in-depth functional and molecular analysis of differentiated macrophages. RESULTS While YS and BM macrophages demonstrate close similarities in terms of cellular growth, differentiation, cell death susceptibility and phagocytic properties, they display differences in cell metabolism, expression of inflammatory markers and inflammasome activation. Reduced abundance of PYCARD (ASC) and CASPASE-1 proteins in YS macrophages abrogated interleukin-1β production in response to canonical and non-canonical inflammasome activation. CONCLUSIONS Macrophage ontogeny is associated with distinct cellular programs and immune response. Our findings contribute to the understanding of the regulation and programming of macrophage functions.
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Affiliation(s)
- Sara Elhag
- Medizinische Klinik und Poliklinik I, LMU Klinikum, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (S.E.); (C.K.); (J.W.); (L.T.); (T.W.); (M.F.); (L.L.); (F.W.); (M.L.); (K.S.)
| | - Christopher Stremmel
- Medizinische Klinik und Poliklinik I, LMU Klinikum, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (S.E.); (C.K.); (J.W.); (L.T.); (T.W.); (M.F.); (L.L.); (F.W.); (M.L.); (K.S.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
| | - Annette Zehrer
- Biomedical Center, Institute of Cardiovascular Physiology and Pathophysiology, Ludwig-Maximilians-University Munich, Planegg-Martinsried, 82152 Munich, Germany; (A.Z.); (B.W.)
- Walter Brendel Center of Experimental Medicine, LMU Klinikum, Ludwig-Maximilians-Universität, 81377 Munich, Germany
| | - Josefine Plocke
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, 17475 Greifswald, Germany; (J.P.); (U.V.); (E.H.)
| | - Roman Hennel
- Department of Radiation Oncology, LMU Klinikum, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (R.H.); (K.L.)
| | - Michaela Keuper
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, 106 91 Stockholm, Sweden; (M.K.); (M.J.)
| | - Clarissa Knabe
- Medizinische Klinik und Poliklinik I, LMU Klinikum, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (S.E.); (C.K.); (J.W.); (L.T.); (T.W.); (M.F.); (L.L.); (F.W.); (M.L.); (K.S.)
| | - Julia Winterhalter
- Medizinische Klinik und Poliklinik I, LMU Klinikum, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (S.E.); (C.K.); (J.W.); (L.T.); (T.W.); (M.F.); (L.L.); (F.W.); (M.L.); (K.S.)
| | - Vanessa Gölling
- Institute of Experimental Hematology, School of Medicine, Technical University of Munich, 81675 Munich, Germany; (V.G.); (M.S.-S.)
- Center for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Lukas Tomas
- Medizinische Klinik und Poliklinik I, LMU Klinikum, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (S.E.); (C.K.); (J.W.); (L.T.); (T.W.); (M.F.); (L.L.); (F.W.); (M.L.); (K.S.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
| | - Tobias Weinberger
- Medizinische Klinik und Poliklinik I, LMU Klinikum, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (S.E.); (C.K.); (J.W.); (L.T.); (T.W.); (M.F.); (L.L.); (F.W.); (M.L.); (K.S.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
| | - Maximilian Fischer
- Medizinische Klinik und Poliklinik I, LMU Klinikum, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (S.E.); (C.K.); (J.W.); (L.T.); (T.W.); (M.F.); (L.L.); (F.W.); (M.L.); (K.S.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
| | - Lulu Liu
- Medizinische Klinik und Poliklinik I, LMU Klinikum, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (S.E.); (C.K.); (J.W.); (L.T.); (T.W.); (M.F.); (L.L.); (F.W.); (M.L.); (K.S.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
| | - Franziska Wagner
- Medizinische Klinik und Poliklinik I, LMU Klinikum, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (S.E.); (C.K.); (J.W.); (L.T.); (T.W.); (M.F.); (L.L.); (F.W.); (M.L.); (K.S.)
| | - Michael Lorenz
- Medizinische Klinik und Poliklinik I, LMU Klinikum, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (S.E.); (C.K.); (J.W.); (L.T.); (T.W.); (M.F.); (L.L.); (F.W.); (M.L.); (K.S.)
| | - Konstantin Stark
- Medizinische Klinik und Poliklinik I, LMU Klinikum, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (S.E.); (C.K.); (J.W.); (L.T.); (T.W.); (M.F.); (L.L.); (F.W.); (M.L.); (K.S.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
| | - Hans Häcker
- Division of Microbiology and Immunology, Department of Pathology, University of Utah, Salt Lake City, UT 84112, USA;
| | - Marc Schmidt-Supprian
- Institute of Experimental Hematology, School of Medicine, Technical University of Munich, 81675 Munich, Germany; (V.G.); (M.S.-S.)
- Center for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Uwe Völker
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, 17475 Greifswald, Germany; (J.P.); (U.V.); (E.H.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, 17475 Greifswald, Germany
| | - Martin Jastroch
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, 106 91 Stockholm, Sweden; (M.K.); (M.J.)
| | - Kirsten Lauber
- Department of Radiation Oncology, LMU Klinikum, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (R.H.); (K.L.)
- German Cancer Consortium (DKTK), Partner Site Munich, 80336 Munich, Germany
| | - Tobias Straub
- Core Facility Bioinformatics, Biomedical Center, Ludwig-Maximilians-University Munich, Planegg-Martinsried, 82152 Munich, Germany;
| | - Barbara Walzog
- Biomedical Center, Institute of Cardiovascular Physiology and Pathophysiology, Ludwig-Maximilians-University Munich, Planegg-Martinsried, 82152 Munich, Germany; (A.Z.); (B.W.)
- Walter Brendel Center of Experimental Medicine, LMU Klinikum, Ludwig-Maximilians-Universität, 81377 Munich, Germany
| | - Elke Hammer
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, 17475 Greifswald, Germany; (J.P.); (U.V.); (E.H.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, 17475 Greifswald, Germany
| | - Christian Schulz
- Medizinische Klinik und Poliklinik I, LMU Klinikum, Ludwig-Maximilians-Universität, 81377 Munich, Germany; (S.E.); (C.K.); (J.W.); (L.T.); (T.W.); (M.F.); (L.L.); (F.W.); (M.L.); (K.S.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
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6
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Abstract
Monocytes and macrophages play essential roles in all stages of atherosclerosis – from early precursor lesions to advanced stages of the disease. Intima-resident macrophages are among the first cells to be confronted with the influx and retention of apolipoprotein B-containing lipoproteins at the onset of hypercholesterolemia and atherosclerosis development. In this review, we outline the trafficking of monocytes and macrophages in and out of the healthy aorta, as well as the adaptation of their migratory behaviour during hypercholesterolemia. Furthermore, we discuss the functional and ontogenetic composition of the aortic pool of mononuclear phagocytes and its link to the atherosclerotic disease process. The development of mouse models of atherosclerosis regression in recent years, has enabled scientists to investigate the behaviour of monocytes and macrophages during the resolution of atherosclerosis. Herein, we describe the dynamics of these mononuclear phagocytes upon cessation of hypercholesterolemia and how they contribute to the restoration of tissue homeostasis. The aim of this review is to provide an insight into the trafficking, fate and disease-relevant dynamics of monocytes and macrophages during atherosclerosis, and to highlight remaining questions. We focus on the results of rodent studies, as analysis of cellular fates requires experimental manipulations that cannot be performed in humans but point out findings that could be replicated in human tissues. Understanding of the biology of macrophages in atherosclerosis provides an important basis for the development of therapeutic strategies to limit lesion formation and promote plaque regression.
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Affiliation(s)
- Lukas Tomas
- Department of Medicine I, University Hospital, Ludwig Maximilian University, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Filip Prica
- Department of Medicine I, University Hospital, Ludwig Maximilian University, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Christian Schulz
- Department of Medicine I, University Hospital, Ludwig Maximilian University, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
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7
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Tomas L, Bengtsson E, Andersson L, Badn W, Tengryd C, Persson A, Edsfeldt A, Nilsson PM, Schiopu A, Nilsson J, Gonçalves I, Björkbacka H. Low Levels of CD4
+
CD28
null
T Cells at Baseline Are Associated With First-Time Coronary Events in a Prospective Population-Based Case-Control Cohort. Arterioscler Thromb Vasc Biol 2020; 40:426-436. [DOI: 10.1161/atvbaha.119.313032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective:
CD4
+
CD28
null
T cells have been shown to be associated with recurrent coronary events and suggested as potential biomarker and therapeutic target. It is unknown whether CD4
+
CD28
null
T cells associate with first-time cardiovascular events. We examined CD4
+
CD28
null
T cells in a prospective population-based cohort and in patients with advanced atherosclerosis.
Approach and Results:
CD4
+
CD28
null
T cells were quantified in 272 individuals experiencing a first-time coronary event during up to 17 years of follow-up and 272 age- and sex-matched controls in a case-control study, nested within the population-based Malmö Diet and Cancer study. The highest tertile of CD4
+
CD28
null
T cells was associated with a lower incidence of first-time coronary events compared with the lowest tertile (odds ratio, 0.48 [95% CI, 0.29–0.79],
P
=0.004) when adjusting for Framingham risk factors. This association remained significant for events recorded after >9 years of follow-up, when most coronary events occurred, but not during the first 9 years of follow-up, despite similar odds ratio. Additionally, we analyzed CD4
+
CD28
null
T cells in 201 patients with advanced atherosclerosis undergoing carotid endarterectomy. The adjusted hazard ratio for cardiovascular events in patients with advanced atherosclerosis was 2.11 (95% CI, 1.10–4.05,
P
=0.024), comparing the highest with the lowest CD4
+
CD28
null
T-cell tertile.
Conclusions:
Our findings reveal complex associations between CD4
+
CD28
null
T cells and cardiovascular disease. Although we confirm the reported positive associations with an adverse prognosis in patients with already established disease, the opposite associations with first-time coronary events in the population-based cohort may limit the clinical use of CD4
+
CD28
null
T cells.
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Affiliation(s)
- Lukas Tomas
- From the Department of Clinical Sciences Malmö, Lund University, Sweden (L.T., E.B., L.A., W.B., C.T., A.P., A.E., P.M.N., A.S., J.N., I.G., H.B.)
| | - Eva Bengtsson
- From the Department of Clinical Sciences Malmö, Lund University, Sweden (L.T., E.B., L.A., W.B., C.T., A.P., A.E., P.M.N., A.S., J.N., I.G., H.B.)
| | - Linda Andersson
- From the Department of Clinical Sciences Malmö, Lund University, Sweden (L.T., E.B., L.A., W.B., C.T., A.P., A.E., P.M.N., A.S., J.N., I.G., H.B.)
| | - Wiaam Badn
- From the Department of Clinical Sciences Malmö, Lund University, Sweden (L.T., E.B., L.A., W.B., C.T., A.P., A.E., P.M.N., A.S., J.N., I.G., H.B.)
| | - Christoffer Tengryd
- From the Department of Clinical Sciences Malmö, Lund University, Sweden (L.T., E.B., L.A., W.B., C.T., A.P., A.E., P.M.N., A.S., J.N., I.G., H.B.)
| | - Ana Persson
- From the Department of Clinical Sciences Malmö, Lund University, Sweden (L.T., E.B., L.A., W.B., C.T., A.P., A.E., P.M.N., A.S., J.N., I.G., H.B.)
| | - Andreas Edsfeldt
- From the Department of Clinical Sciences Malmö, Lund University, Sweden (L.T., E.B., L.A., W.B., C.T., A.P., A.E., P.M.N., A.S., J.N., I.G., H.B.)
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden (A.E., A.S, I.G.)
| | - Peter M. Nilsson
- From the Department of Clinical Sciences Malmö, Lund University, Sweden (L.T., E.B., L.A., W.B., C.T., A.P., A.E., P.M.N., A.S., J.N., I.G., H.B.)
| | - Alexandru Schiopu
- From the Department of Clinical Sciences Malmö, Lund University, Sweden (L.T., E.B., L.A., W.B., C.T., A.P., A.E., P.M.N., A.S., J.N., I.G., H.B.)
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden (A.E., A.S, I.G.)
| | - Jan Nilsson
- From the Department of Clinical Sciences Malmö, Lund University, Sweden (L.T., E.B., L.A., W.B., C.T., A.P., A.E., P.M.N., A.S., J.N., I.G., H.B.)
| | - Isabel Gonçalves
- From the Department of Clinical Sciences Malmö, Lund University, Sweden (L.T., E.B., L.A., W.B., C.T., A.P., A.E., P.M.N., A.S., J.N., I.G., H.B.)
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden (A.E., A.S, I.G.)
| | - Harry Björkbacka
- From the Department of Clinical Sciences Malmö, Lund University, Sweden (L.T., E.B., L.A., W.B., C.T., A.P., A.E., P.M.N., A.S., J.N., I.G., H.B.)
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8
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Tomas L, Edsfeldt A, Mollet IG, Perisic Matic L, Prehn C, Adamski J, Paulsson-Berne G, Hedin U, Nilsson J, Bengtsson E, Gonçalves I, Björkbacka H. Altered metabolism distinguishes high-risk from stable carotid atherosclerotic plaques. Eur Heart J 2019; 39:2301-2310. [PMID: 29562241 PMCID: PMC6012762 DOI: 10.1093/eurheartj/ehy124] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [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: 06/12/2017] [Accepted: 02/26/2018] [Indexed: 01/13/2023] Open
Abstract
Aims Identification and treatment of the rupture prone atherosclerotic plaque remains a challenge for reducing the burden of cardiovascular disease. The interconnection of metabolic and inflammatory processes in rupture prone plaques is poorly understood. Herein, we investigate associations between metabolite profiles, inflammatory mediators and vulnerability in carotid atherosclerotic plaques. Methods and results We collected 159 carotid plaques from patients undergoing endarterectomy and measured 165 different metabolites in a targeted metabolomics approach. We identified a metabolite profile in carotid plaques that associated with histologically evaluated vulnerability and inflammatory mediators, as well as presence of symptoms in patients. The distinct metabolite profiles identified in high-risk and stable plaques were in line with different transcription levels of metabolic enzymes in the two groups, suggesting an altered metabolism in high-risk plaques. The altered metabolic signature in high-risk plaques was consistent with a change to increased glycolysis, elevated amino acid utilization and decreased fatty acid oxidation, similar to what is found in activated leucocytes and cancer cells. Conclusion These results highlight a possible key role of cellular metabolism to support inflammation and a high-risk phenotype of atherosclerotic plaques. Targeting the metabolism of atherosclerotic plaques with novel metabolic radiotracers or inhibitors might therefore be valid future approaches to identify and treat the high-risk atherosclerotic plaque.
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Affiliation(s)
- Lukas Tomas
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, Malmö, Sweden
| | - Andreas Edsfeldt
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, Malmö, Sweden.,Department of Cardiology, Skåne University Hospital, Carl-Bertil Laurells gata 9, Malmö, Sweden
| | - Inês G Mollet
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, Malmö, Sweden.,Metabolic Disorders Unit, Chronic Diseases Research Center, Universidade Nova de Lisboa, Rua Câmara Pestana 6, Lisbon, Portugal
| | - Ljubica Perisic Matic
- Department of Molecular Medicine and Surgery, Karolinska Institute, Solna, Stockhom, Sweden
| | - Cornelia Prehn
- Institute of Experimental Genetics, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstäer Landstrasse 1, Neuherberg, Germany
| | - Jerzy Adamski
- Institute of Experimental Genetics, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstäer Landstrasse 1, Neuherberg, Germany.,Institute of Experimental Genetics, Life and Food Science Center Weihenstephan, Technische Universität München, Alte Akademie 8, Freising-Weihenstephan, Germany
| | - Gabrielle Paulsson-Berne
- Department of Medicine, Cardiovascular Medicine Unit, Karolinska Institute, Solna, Stockhom, Sweden
| | - Ulf Hedin
- Department of Molecular Medicine and Surgery, Karolinska Institute, Solna, Stockhom, Sweden
| | - Jan Nilsson
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, Malmö, Sweden
| | - Eva Bengtsson
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, Malmö, Sweden
| | - Isabel Gonçalves
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, Malmö, Sweden.,Department of Cardiology, Skåne University Hospital, Carl-Bertil Laurells gata 9, Malmö, Sweden
| | - Harry Björkbacka
- Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, Malmö, Sweden
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9
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Marinković G, Grauen Larsen H, Yndigegn T, Szabo IA, Mares RG, de Camp L, Weiland M, Tomas L, Goncalves I, Nilsson J, Jovinge S, Schiopu A. Inhibition of pro-inflammatory myeloid cell responses by short-term S100A9 blockade improves cardiac function after myocardial infarction. Eur Heart J 2019; 40:2713-2723. [DOI: 10.1093/eurheartj/ehz461] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [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: 02/17/2019] [Revised: 05/20/2019] [Accepted: 07/01/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
Neutrophils have both detrimental and beneficial effects in myocardial infarction (MI), but little is known about the underlying pathways. S100A8/A9 is a pro-inflammatory alarmin abundantly expressed in neutrophils that is rapidly released in the myocardium and circulation after myocardial ischaemia. We investigated the role of S100A8/A9 in the innate immune response to MI.
Methods and results
In 524 patients with acute coronary syndrome (ACS), we found that high plasma S100A8/A9 at the time of the acute event was associated with lower left ventricular ejection fraction (EF) at 1-year and increased hospitalization for heart failure (HF) during follow-up. In wild-type C57BL/6 mice with MI induced by permanent coronary artery ligation, treatment with the S100A9 blocker ABR-238901 during the inflammatory phase of the immune response inhibited haematopoietic stem cell proliferation and myeloid cell egression from the bone marrow. The treatment reduced the numbers of neutrophils and monocytes/macrophages in the myocardium, promoted an anti-inflammatory environment, and significantly improved cardiac function compared with MI controls. To mimic the clinical scenario, we further confirmed the effects of the treatment in a mouse model of ischaemia/reperfusion. Compared with untreated mice, 3-day ABR-238901 treatment significantly improved left ventricular EF (48% vs. 35%, P = 0.002) and cardiac output (15.7 vs. 11.1 mL/min, P = 0.002) by Day 21 post-MI.
Conclusion
Short-term S100A9 blockade inhibits inflammation and improves cardiac function in murine models of MI. As an excessive S100A8/A9 release is linked to incident HF, S100A9 blockade might represent a feasible strategy to improve prognosis in ACS patients.
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Affiliation(s)
- Goran Marinković
- Department of Clinical Sciences Malmö, Lund University, CRC 91:12, Jan Waldenströms gata 35, SE-214 28, Malmö, Sweden
| | - Helena Grauen Larsen
- Department of Cardiology, Skane University Hospital Malmö, Carl-Bertil Laurells gata 9, SE-214 28 Malmö, Sweden
| | - Troels Yndigegn
- Department of Cardiology, Skane University Hospital Malmö, Carl-Bertil Laurells gata 9, SE-214 28 Malmö, Sweden
| | - Istvan Adorjan Szabo
- Department of Pathophysiology, University of Medicine, Pharmacy, Sciences and Technology of Targu-Mures, Gheorghe Marinescu str. 38, 540139 Targu-Mures, Romania
| | - Razvan Gheorghita Mares
- Department of Pathophysiology, University of Medicine, Pharmacy, Sciences and Technology of Targu-Mures, Gheorghe Marinescu str. 38, 540139 Targu-Mures, Romania
| | - Lisa de Camp
- DeVos Cardiovascular Research Program, Van Andel Institute, 333 Bostwick Ave NE, Grand Rapids, MI 49503, USA
| | - Matthew Weiland
- DeVos Cardiovascular Research Program, Van Andel Institute, 333 Bostwick Ave NE, Grand Rapids, MI 49503, USA
| | - Lukas Tomas
- Department of Clinical Sciences Malmö, Lund University, CRC 91:12, Jan Waldenströms gata 35, SE-214 28, Malmö, Sweden
| | - Isabel Goncalves
- Department of Clinical Sciences Malmö, Lund University, CRC 91:12, Jan Waldenströms gata 35, SE-214 28, Malmö, Sweden
- Department of Cardiology, Skane University Hospital Malmö, Carl-Bertil Laurells gata 9, SE-214 28 Malmö, Sweden
| | - Jan Nilsson
- Department of Clinical Sciences Malmö, Lund University, CRC 91:12, Jan Waldenströms gata 35, SE-214 28, Malmö, Sweden
| | - Stefan Jovinge
- DeVos Cardiovascular Research Program, Van Andel Institute, 333 Bostwick Ave NE, Grand Rapids, MI 49503, USA
- DeVos Cardiovascular Research Program, Fredrik Meijer Heart & Vascular Institute, Spectrum Health, 100 Michigan Street NE, Grand Rapids, MI 49503, USA
- Cardiovascular Institute, Stanford Medical School, 265 Campus Drive, Stanford, CA 94305, USA
| | - Alexandru Schiopu
- Department of Clinical Sciences Malmö, Lund University, CRC 91:12, Jan Waldenströms gata 35, SE-214 28, Malmö, Sweden
- Department of Cardiology, Skane University Hospital Malmö, Carl-Bertil Laurells gata 9, SE-214 28 Malmö, Sweden
- Department of Pathophysiology, University of Medicine, Pharmacy, Sciences and Technology of Targu-Mures, Gheorghe Marinescu str. 38, 540139 Targu-Mures, Romania
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10
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Wigren M, Rattik S, Yao Mattisson I, Tomas L, Grönberg C, Söderberg I, Alm R, Sundius L, Ljungcrantz I, Björkbacka H, Fredrikson GN, Nilsson J. Lack of Ability to Present Antigens on Major Histocompatibility Complex Class II Molecules Aggravates Atherosclerosis in ApoE
−/−
Mice. Circulation 2019; 139:2554-2566. [DOI: 10.1161/circulationaha.118.039288] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Maria Wigren
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Sara Rattik
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Ingrid Yao Mattisson
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Lukas Tomas
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Caitriona Grönberg
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Ingrid Söderberg
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Ragnar Alm
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Lena Sundius
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Irena Ljungcrantz
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | - Harry Björkbacka
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
| | | | - Jan Nilsson
- Department of Clinical Sciences Malmö, Scania University Hospital, Lund University, Sweden
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11
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Galizia Brito V, March Vecchio N, Jarma J, Tomas L, Mondragon I, Orosco A, Rivera S, Albina G, Giniger A, Scazzuso F. P751Second generation cryoballoon vs. radiofrequency ablation in paroxysmal atrial fibrillation: outcomes beyond one-year follow-up time. Europace 2018. [DOI: 10.1093/europace/euy015.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- V Galizia Brito
- Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - N March Vecchio
- Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - J Jarma
- Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - L Tomas
- Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - I Mondragon
- Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - A Orosco
- Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - S Rivera
- Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - G Albina
- Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - A Giniger
- Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - F Scazzuso
- Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
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12
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Tomas L, Vecchio N, Orosco A, Vergara J, Mondragon I, Cruz P, Rivera S, Caro M, Albina G, Giniger A, Scazzuso F. P2654Paroxysmal atrial fibrillation ablation: the blanking period as a new recurrence predictor. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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13
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Tomas L, Tomas L, Orosco A, Vergara JM, Mondragon F, Cruz P, Caro M, Reinoso M, Rivera S, Albina G, Giniger A, Scazzuso F. P880Paroxysmal atrial fibrillation ablation: the blanking period as a new recurrence predictor. Europace 2017. [DOI: 10.1093/ehjci/eux151.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Tomas L, Björkbacka H, Edsfeldt A, Danielsson A, Wigren M, Grufman H, Persson A, Prehn C, Adamski J, Nilsson J, Gonçalves I. A lipid metabolite profile in atherosclerotic plaques associated with increased inflammation and cardiovascular risk. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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15
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Seco JL, Velasco F, Manuel JS, Serrano SR, Tomas L, Velasco A. Retroperitoneal Castleman's disease. Surgery 1992; 112:850-5. [PMID: 1440235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A case of Castleman's disease localized in the retroperitoneal space is reported. A 29-year-old patient had a mass 15 cm in diameter with radial calcification. After surgical resection, both the patient's anemia and hypergammaglobulinemia disappeared. Castleman's disease should be considered when facing a solid retroperitoneal or mesenteric mass, mainly if anemia and hypergammaglobulinemia are present. Previous reports about this unusual condition are reviewed.
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Affiliation(s)
- J L Seco
- Department of Surgery, Hospital General Yagüe, Burgos, Spain
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16
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Guiteras P, Tomas L, Varas C, Augé JM, Masotti M, Crexells C, Oriol A. Five years of angiographic and clinical follow-up after successful percutaneous transluminal coronary angioplasty. Eur Heart J 1989; 10 Suppl G:42-8. [PMID: 2627948 DOI: 10.1093/eurheartj/10.suppl_g.42] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The first 67 consecutive patients (77 lesions) who underwent successful coronary angioplasty (PTCA) at our hospital were clinically followed with serial exercise testing over a 5-year (4 to 7) observation period. Two sequential angiographic controls were performed 6.9 +/- 4.6 (64 patients) and 49.5 +/- 21.6 (42 patients) months after PTCA. The 5-year risk of cardiac death was 8%, of myocardial infarction 2%, or coronary artery bypass grafting 16% and of repeat PTCA 8%. At 5 years, 67% of the patients remain asymptomatic. Restenosis greater than or equal to 70% diameter was observed within the first year after PTCA in 30% of the patients. Progression of coronary artery disease (CAD) was observed in 13 patients (20%). In the first angiographic control, CAD progression was 4% (3/77) in dilated and 3% (3/115) in non-dilated arteries (ns). In the second angiographic control, it was 7% (3/45) and 10% (8/81), respectively (ns). Thus good clinical and angiographic results are still observed after 5 years. Restenosis is an early, self-limited, time-restricted phenomenon that occurs in 30% of patients. Angioplasty does not appear to accelerate CAD progression.
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Affiliation(s)
- P Guiteras
- Department of Hemodynamics, Hospital de la Santa Creu and Sant Pau, Barcelona, Spain
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