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Kurstjens S, de Baaij JHF, Overmars-Bos C, van den Munckhof ICL, Garzero V, de Vries MA, Burggraaf B, van Diepen JA, Riksen NP, Rutten JHW, Netea MG, Castro Cabezas M, Bindels RJM, Ashcroft FM, Tack CJJ, Hoenderop JGJ. Increased NEFA levels reduce blood Mg 2+ in hypertriacylglycerolaemic states via direct binding of NEFA to Mg 2. Diabetologia 2019; 62:311-321. [PMID: 30426168 PMCID: PMC6323097 DOI: 10.1007/s00125-018-4771-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 10/05/2018] [Indexed: 11/28/2022]
Abstract
AIMS/HYPOTHESIS The blood triacylglycerol level is one of the main determinants of blood Mg2+ concentration in individuals with type 2 diabetes. Hypomagnesaemia (blood Mg2+ concentration <0.7 mmol/l) has serious consequences as it increases the risk of developing type 2 diabetes and accelerates progression of the disease. This study aimed to determine the mechanism by which triacylglycerol levels affect blood Mg2+ concentrations. METHODS Using samples from 285 overweight individuals (BMI >27 kg/m2) who participated in the 300-Obesity study (an observational cross-sectional cohort study, as part of the Human Functional Genetics Projects), we investigated the association between serum Mg2+ with laboratory variables, including an extensive lipid profile. In a separate set of studies, hyperlipidaemia was induced in mice and in healthy humans via an oral lipid load, and blood Mg2+, triacylglycerol and NEFA concentrations were measured using colourimetric assays. In vitro, NEFAs harvested from albumin were added in increasing concentrations to several Mg2+-containing solutions to study the direct interaction between Mg2+ and NEFAs. RESULTS In the cohort of overweight individuals, serum Mg2+ levels were inversely correlated with triacylglycerols incorporated in large VLDL particles (r = -0.159, p ≤ 0.01). After lipid loading, we observed a postprandial increase in plasma triacylglycerol and NEFA levels and a reciprocal reduction in blood Mg2+ concentration both in mice (Δ plasma Mg2+ -0.31 mmol/l at 4 h post oral gavage) and in healthy humans (Δ plasma Mg2+ -0.07 mmol/l at 6 h post lipid intake). Further, in vitro experiments revealed that the decrease in plasma Mg2+ may be explained by direct binding of Mg2+ to NEFAs. Moreover, Mg2+ was found to bind to albumin in a NEFA-dependent manner, evidenced by the fact that Mg2+ did not bind to fatty-acid-free albumin. The NEFA-dependent reduction in the free Mg2+ concentration was not affected by the presence of physiological concentrations of other cations. CONCLUSIONS/INTERPRETATION This study shows that elevated NEFA and triacylglycerol levels directly reduce blood Mg2+ levels, in part explaining the high prevalence of hypomagnesaemia in metabolic disorders. We show that blood NEFA level affects the free Mg2+ concentration, and therefore, our data challenge how the fractional excretion of Mg2+ is calculated and interpreted in the clinic.
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Affiliation(s)
- Steef Kurstjens
- Department of Physiology (286), Radboud Institute for Molecular Life Sciences, Radboud university medical center, P. O. Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Jeroen H F de Baaij
- Department of Physiology (286), Radboud Institute for Molecular Life Sciences, Radboud university medical center, P. O. Box 9101, 6500 HB, Nijmegen, the Netherlands
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Caro Overmars-Bos
- Department of Physiology (286), Radboud Institute for Molecular Life Sciences, Radboud university medical center, P. O. Box 9101, 6500 HB, Nijmegen, the Netherlands
| | | | - Veronica Garzero
- Department of Physiology (286), Radboud Institute for Molecular Life Sciences, Radboud university medical center, P. O. Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Marijke A de Vries
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Franciscus Gasthuis Rotterdam, Rotterdam, the Netherlands
| | - Benjamin Burggraaf
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Franciscus Gasthuis Rotterdam, Rotterdam, the Netherlands
| | - Janna A van Diepen
- Department of Internal Medicine, Radboud university medical center, Nijmegen, the Netherlands
| | - Niels P Riksen
- Department of Internal Medicine, Radboud university medical center, Nijmegen, the Netherlands
| | - Joost H W Rutten
- Department of Internal Medicine, Radboud university medical center, Nijmegen, the Netherlands
| | - Mihai G Netea
- Department of Internal Medicine, Radboud university medical center, Nijmegen, the Netherlands
- Department for Genomics & Immunoregulation, Life and Medical Sciences Institute (LIMES), University of Bonn, Bonn, Germany
| | - Manuel Castro Cabezas
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Franciscus Gasthuis Rotterdam, Rotterdam, the Netherlands
| | - René J M Bindels
- Department of Physiology (286), Radboud Institute for Molecular Life Sciences, Radboud university medical center, P. O. Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Frances M Ashcroft
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Cees J J Tack
- Department of Internal Medicine, Radboud university medical center, Nijmegen, the Netherlands
| | - Joost G J Hoenderop
- Department of Physiology (286), Radboud Institute for Molecular Life Sciences, Radboud university medical center, P. O. Box 9101, 6500 HB, Nijmegen, the Netherlands.
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Burggraaf B, van Breukelen-van der Stoep DF, de Vries MA, Klop B, Liem AH, van de Geijn GJM, van der Meulen N, Birnie E, van der Zwan EM, van Zeben J, Castro Cabezas M. Effect of a treat-to-target intervention of cardiovascular risk factors on subclinical and clinical atherosclerosis in rheumatoid arthritis: a randomised clinical trial. Ann Rheum Dis 2019; 78:335-341. [PMID: 30610067 DOI: 10.1136/annrheumdis-2018-214075] [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] [Received: 07/08/2018] [Revised: 11/17/2018] [Accepted: 11/26/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND Patients with rheumatoid arthritis (RA) have an increased risk for cardiovascular disease (CVD). No long-term intervention trials on CVD risk factors have been published, and a debate on the efficacy of controlling traditional risk factors in RA is ongoing. We aimed to evaluate a treat-to-target approach versus usual care regarding traditional CVD risk factors in patients with RA. METHODS In this open-label, randomised controlled trial, patients with RA aged <70 years without prior CVD or diabetes mellitus were randomised 1:1 to either a treat-to-target approach or usual care of traditional CVD risk factors. The primary outcome was defined as change in carotid intima media thickness (cIMT) over 5 years, and the secondary outcome was a composite of first occurrence of fatal and non-fatal cardiovascular events. RESULTS A total of 320 patients (mean age 52.4 years; 69.7% female) with RA underwent randomisation and 219 patients (68.4%) completed 5 years of follow-up. The mean cIMT progression was significantly reduced in the treat-to-target group compared with usual care (0.023 [95% CI 0.011 to 0.036] mm vs 0.045 [95% CI 0.030 to 0.059] mm; p=0.028). Cardiovascular events occurred in 2 (1.3%) of the patients in the treat-to-target group vs 7 (4.7%) in those receiving usual care (p=0.048 by log-rank test). CONCLUSION This study provides evidence on the benefit of a treat-to-target approach of traditional CVD risk factors for primary prevention in patients with well-treated RA. TRIAL REGISTRATION NUMBER NTR3873.
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Affiliation(s)
- Benjamin Burggraaf
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | | | - Marijke A de Vries
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Boudewijn Klop
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Anho H Liem
- Department of Cardiology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Gert-Jan M van de Geijn
- Department of Clinical Chemistry, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Noelle van der Meulen
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Erwin Birnie
- Department of Statistics and Education, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Ellen M van der Zwan
- Department of Clinical Chemistry, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Jende van Zeben
- Department of Rheumatology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Manuel Castro Cabezas
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
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Burggraaf B, van Breukelen – van der Stoep DF, de Vries MA, Klop B, van Zeben J, van de Geijn GJM, van der Meulen N, Birnie E, Prinzen L, Castro Cabezas M. Progression of subclinical atherosclerosis in subjects with rheumatoid arthritis and the metabolic syndrome. Atherosclerosis 2018; 271:84-91. [DOI: 10.1016/j.atherosclerosis.2018.02.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 02/02/2018] [Accepted: 02/13/2018] [Indexed: 10/18/2022]
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Koks N, de Vries MA, Birnie E, Alipour A, Castro Cabezas M. Glucose-dependent leucocyte activation in familial hypercholesterolemia. Eur J Clin Invest 2017; 47:839-846. [PMID: 28815569 DOI: 10.1111/eci.12818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 08/13/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Leucocyte activation is an obligatory factor in the development of atherosclerosis. The postprandial situation has been associated to increased leucocyte activation in several disorders, such as type 2 diabetes mellitus and familial combined hyperlipidaemia. Our study aim was to evaluate the effect of post-OGTT hyperglycaemia on leucocyte activation in patients with familial hypercholesterolemia (FH). MATERIALS AND METHODS Patients who met the diagnostic criteria for heterozygous FH and healthy volunteers were asked to undergo an oral glucose tolerance test. Leucocyte activation markers CD11b and CD66b were determined by flow cytometry. Post-OGTT changes were calculated as area under the curve (AUC) and the incremental area under the curve corrected for baseline values (dAUC). The impact of being an FH patient and using statins on the time-dependent profile of the leucocyte activation markers was studied with repeated measurements analysis. RESULTS Thirteen FH patients using statins, nine FH patients without statins and 14 healthy volunteers were included. FH subjects on statins had a slightly higher HbA1c than those not using these drugs or controls. Post-OGTT glucose levels were significantly higher in patients with FH when compared to healthy controls (P = 0·001). These effects were independent from the use of statins. CONCLUSIONS Surprisingly, our study shows impaired post-OGTT glucose excursions in patients with FH compared to healthy volunteers. Post-OGTT hyperglycaemia may be related to persistent post-OGTT activation of monocytes in FH patients compared to healthy controls, and therefore, it may contribute to the development of cardiovascular disease in patients with FH.
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Affiliation(s)
- Natasja Koks
- Department of Internal Medicine, Center for Endocrinology, Diabetes and Vascular Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - Marijke A de Vries
- Department of Internal Medicine, Center for Endocrinology, Diabetes and Vascular Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - Erwin Birnie
- Department of Internal Medicine, Center for Endocrinology, Diabetes and Vascular Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands.,Department of Statistics and Education, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands.,Division of Woman and Baby, Department of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Arash Alipour
- Department of Internal Medicine, Center for Endocrinology, Diabetes and Vascular Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - Manuel Castro Cabezas
- Department of Internal Medicine, Center for Endocrinology, Diabetes and Vascular Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
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de Vries MA, van Santen SS, Klop B, van der Meulen N, van Vliet M, van de Geijn GJM, van der Zwan-van Beek EM, Birnie E, Liem AH, de Herder WW, Castro Cabezas M. Erythrocyte-bound apolipoprotein B in atherosclerosis and mortality. Eur J Clin Invest 2017; 47:289-296. [PMID: 28144944 DOI: 10.1111/eci.12728] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 08/26/2016] [Accepted: 01/16/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND The binding of apolipoprotein (apo) B-containing lipoproteins to circulating erythrocytes (ery-apoB) is associated with a decreased prevalence of atherosclerosis. In this study, we evaluated ery-apoB as a possible prognostic factor in cardiovascular events and all-cause mortality, in a prospective cohort study. MATERIALS AND METHODS Ery-apoB was measured by flow cytometry in subjects with and without cardiovascular disease (CVD). The primary endpoint was the cardiovascular event rate. Secondary endpoints were all-cause mortality and the combined endpoint of all-cause mortality and cardiovascular events (any event rate). A Cox regression analysis with univariate and multivariate analyses and Kaplan-Meier survival analysis was performed. RESULTS Follow-up data were available of 384 subjects. Subjects were divided according to high (> 2·0 au, n = 60), intermediate (0·2-2·0 au, n = 274) or low (< 0·2 au, n = 50) ery-apoB. Median follow-up was 1767 days (IQR 1564-2001). In univariate analysis, low ery-apoB was associated with increased all-cause mortality [HR 9·9 (1·2-79·0), P = 0·031] and any event rate [HR 3·4 (95% CI 1·3-8·7), P = 0·012]. In a Cox regression analysis, only a history of CVD was significantly associated with any event rate [HR 3·6 (1·6-8·0), P = 0·002], while low ery-apoB showed a trend [HR 2·4 (0·9-6·4), P = 0·07]. In a subgroup analysis, in subjects with a history of CVD, ery-apoB was significantly associated with all-cause mortality (log rank P = 0·021) and any event rate (log rank P = 0·009). CONCLUSIONS Low ery-apoB is associated with increased mortality and cardiovascular risk, especially in patients with a prior history of CVD. These subjects may benefit from more aggressive secondary prevention treatment.
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Affiliation(s)
- Marijke A de Vries
- Department of Internal Medicine, Centre for Diabetes and Vascular Medicine, Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Selvetta S van Santen
- Department of Internal Medicine, Centre for Diabetes and Vascular Medicine, Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Boudewijn Klop
- Department of Internal Medicine, Centre for Diabetes and Vascular Medicine, Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Noëlle van der Meulen
- Department of Internal Medicine, Centre for Diabetes and Vascular Medicine, Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Marjolein van Vliet
- Department of Internal Medicine, Centre for Diabetes and Vascular Medicine, Franciscus Gasthuis, Rotterdam, the Netherlands
| | | | | | - Erwin Birnie
- Department of Statistics and Education, Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Anho H Liem
- Department of Cardiology, Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Wouter W de Herder
- Department of Endocrinology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Manuel Castro Cabezas
- Department of Internal Medicine, Centre for Diabetes and Vascular Medicine, Franciscus Gasthuis, Rotterdam, the Netherlands
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de Vries MA, van der Meulen N, van de Geijn GJM, Klop B, van der Zwan EM, Prinzen L, Birnie E, Westerman EM, de Herder WW, Castro Cabezas M. Effect of a Single Dose of Vitamin D3 on Postprandial Arterial Stiffness and Inflammation in Vitamin D-Deficient Women. J Clin Endocrinol Metab 2017; 102:992-1000. [PMID: 28005440 DOI: 10.1210/jc.2016-3394] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 12/21/2016] [Indexed: 11/19/2022]
Abstract
CONTEXT Cholecalciferol (vitamin D3) improves vascular function and inflammation, potentially providing an explanation for the proposed cardiovascular protection of vitamin D. OBJECTIVE We investigated whether cholecalciferol supplementation reduces postprandial arterial dysfunction and inflammation. DESIGN Randomized, 1:1, double-blind trial. SETTING Diabetes and Vascular Center, Franciscus Gasthuis, Rotterdam, The Netherlands. PATIENTS Twenty-four healthy, premenopausal, overweight or obese, vitamin D-deficient women. INTERVENTIONS A single high (300,000 IU) or low dose (75,000 IU) of cholecalciferol. MAIN OUTCOME MEASURES The effect of low- and high-dose cholecalciferol on postprandial leukocyte activation markers, pulse wave velocity (PWV), and augmentation index (AIx) during an oral fat loading test, expressed as area under the curve (AUC). RESULTS High- and low-dose supplementation increased vitamin D by 163% ± 134% (P < 0.001) and 66% ± 59% (P < 0.001), respectively. Monocyte CD11b-AUC slightly increased after low but not high dose (6% ± 2%, P = 0.012, and 4% ± 1%, P = 0.339, respectively). There were no significant effects on postprandial PWV or AIx by high- or low-dose vitamin D. Fasting complement component 3 (C3) levels decreased by 5.9% (P = 0.004) in the high-dose group and by 4.0% (P = 0.018) in the low-dose group. CONCLUSION A single dose of vitamin D does not seem to reduce arterial stiffness and leukocyte activation in overweight, vitamin D-deficient women. Vitamin D may decrease fasting C3. Possibly, higher vitamin D concentrations may be needed to decrease inflammation and improve vascular function in overweight or obese vitamin D-deficient women.
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Affiliation(s)
- Marijke A de Vries
- Departments of Internal Medicine, Center for Diabetes and Vascular Medicine
| | | | | | - Boudewijn Klop
- Departments of Internal Medicine, Center for Diabetes and Vascular Medicine
| | | | | | - Erwin Birnie
- Statistics and Education, and
- Division of Women and Babies, Department of Obstetrics and Gynecology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | | | - Wouter W de Herder
- Department of Endocrinology, Erasmus Medical Center, 3015 CE Rotterdam, The Netherlands; and
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de Vries MA, Trompet S, Mooijaart SP, Smit RAJ, Böhringer S, Castro Cabezas M, Jukema JW. Complement receptor 1 gene polymorphisms are associated with cardiovascular risk. Atherosclerosis 2016; 257:16-21. [PMID: 28033544 PMCID: PMC7094315 DOI: 10.1016/j.atherosclerosis.2016.12.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 11/27/2016] [Accepted: 12/14/2016] [Indexed: 11/30/2022]
Abstract
Background and aims Inflammation plays a key role in atherosclerosis. The complement system is involved in atherogenesis, and the complement receptor 1 (CR1) plays a role facilitating the clearance of immune complexes from the circulation. Limited evidence suggests that CR1 may be involved in cardiovascular disease. We investigated the relationship between CR1 gene polymorphisms and cardiovascular risk. Methods Single nucleotide polymorphisms (SNPs) within the CR1 region (n = 73) on chromosome 1 were assessed in 5244 participants in PROSPER (PROspective Study of Pravastatin in the Elderly at Risk) (mean age 75.3 years), who had been randomized to pravastatin 40 mg/day or placebo and followed for a mean of 3.2 years. Logistic regression, adjusted for gender, age, country and use of pravastatin, was used to assess the association between the SNPs and cardiovascular disease. Results All 73 SNPs within the genomic region of the CR1 gene on chromosome 1 were extracted. In this region, strong LD was present leading to the occurrence of two haploblocks. Twelve of the 73 investigated CR1 SNPs were significantly associated with the risk of fatal or nonfatal myocardial infarction (all p < 0.05). Moreover, most of the associated SNPs were also associated with levels of serum C-reactive protein (CRP). The global p-value for the tail strength method to control for multiple testing was 0.0489, implying that the null hypothesis of no associated SNPs can be rejected. Conclusions These data indicate that genetic variation within the CR1 gene is associated with inflammation and the risk of incident coronary artery disease. The complement receptor 1 (CR1) may be involved in atherosclerosis. 12 SNPs within the CR1 region were associated with myocardial infarction. 7 SNPs were also associated with levels of C-reactive protein. These results imply that CR1 may be involved in atherogenesis.
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Affiliation(s)
- Marijke A de Vries
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Franciscus Gasthuis, Rotterdam, The Netherlands.
| | - Stella Trompet
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Simon P Mooijaart
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands; Institute of Evidence Based Medicine at Old Age, Leiden, The Netherlands
| | - Roelof A J Smit
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Stefan Böhringer
- Department of Medical Biostatistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Manuel Castro Cabezas
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Franciscus Gasthuis, Rotterdam, The Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
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de Vries MA, Klop B, van der Meulen N, van de Geijn GJM, Prinzen L, van der Zwan E, Birnie E, Cohen Tervaert JW, Liem AH, de Herder WW, Castro Cabezas M. Leucocyte-bound apolipoprotein B in the circulation is inversely associated with the presence of clinical and subclinical atherosclerosis. Eur J Clin Invest 2016; 46:690-7. [PMID: 27314629 DOI: 10.1111/eci.12650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 12/17/2015] [Accepted: 06/15/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Atherosclerosis is a pro-inflammatory condition, in which leucocyte activation plays an important role. The interaction between circulating leucocytes and apolipoprotein (apo) B-containing lipoproteins results in pro-inflammatory changes of these cells. We aimed to evaluate the relationship between apo B bound to circulating leucocytes and atherosclerosis. METHODS Apo B on circulating leucocytes was measured by flow cytometry in subjects with and without cardiovascular disease (CVD), expressed as mean fluorescent intensity in arbitrary units (au). Carotid intima-media thickness (cIMT) was measured using B-mode ultrasound. Data are given as median (interquartile range). RESULTS A total of 396 subjects were included, of whom 183 had a history of CVD. Compared to subjects without CVD, patients with CVD had lower apo B bound to neutrophils (12·7 au (9·8-16·2) and 14·2 au (10·1-17·5), respectively, P = 0·038) and to monocytes (2·5 au (1·7-3·1) and 2·7 (1·9-3·6) au, respectively, P = 0·025). No differences were found for lymphocyte-bound apo B. Neutrophil- and monocyte-bound apo B were inversely correlated with cIMT (Spearman's rho: -0·123, P = 0·017 and -0·108, P = 0·035, respectively). Both monocyte- and neutrophil-bound apo B were inversely associated with different factors related to the metabolic syndrome, such as body mass index, triglycerides and complement C3. There was a positive association between erythrocyte-bound apo B and apo B bound to each of the leucocyte classes, possibly reflecting a similar mechanism. Discontinuation of statins in 54 subjects did not influence leucocyte-bound apo B. CONCLUSION Unexpectedly, the presence of noninternalized apo B-containing lipoproteins on circulating neutrophil and monocyte membranes may represent a protective mechanism against atherosclerosis.
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Affiliation(s)
- Marijke A de Vries
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, St. Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Boudewijn Klop
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, St. Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Noëlle van der Meulen
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, St. Franciscus Gasthuis, Rotterdam, The Netherlands
| | | | - Lenneke Prinzen
- Department of Clinical Chemistry, St. Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Ellen van der Zwan
- Department of Clinical Chemistry, St. Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Erwin Birnie
- Department of Statistics and Education, St. Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Jan W Cohen Tervaert
- Department of Statistics and Education, St. Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Anho H Liem
- Department of Cardiology, St. Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Wouter W de Herder
- Department of Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Manuel Castro Cabezas
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, St. Franciscus Gasthuis, Rotterdam, The Netherlands
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de Vries MA, Klop B, Alipour A, van de Geijn GJM, Prinzen L, Liem AH, Valdivielso P, Rioja Villodres J, Ramírez-Bollero J, Castro Cabezas M. In vivo evidence for chylomicrons as mediators of postprandial inflammation. Atherosclerosis 2015; 243:540-5. [PMID: 26523991 DOI: 10.1016/j.atherosclerosis.2015.10.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 07/16/2015] [Revised: 10/16/2015] [Accepted: 10/20/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS The postprandial situation is a pro-inflammatory condition most likely linked to the development of atherosclerosis. We evaluated the relationship between apolipoprotein (apo) B48 and fasting and postprandial leukocyte activation markers. METHODS Leukocyte activation markers and apo B48 were determined in 80 subjects with and without coronary artery disease (CAD). Twelve healthy subjects underwent an oral fat loading test (up to 8 h). RESULTS Fasting apo B48 was significantly higher in patients with CAD (n = 47, 8.1 ± 5.2 mg/L) than in subjects without CAD (n = 33, 5.9 ± 3.9 mg/L, p = 0.022). Fasting apo B48 and triglycerides correlated positively with fasting monocyte CD11b and neutrophil CD66b expression. Plasma apo B48 and leukocyte activation markers increased after an oral fat load. No correlations were found between fasting or postprandial triglycerides and postprandial leukocyte activation markers. We observed no correlations between postprandial apo B48 and postprandial neutrophil CD11b or CD66b expression. CONCLUSION This study suggests that chylomicron remnants may be responsible for postprandial leukocyte activation in the circulation. The postprandial chylomicron response may be a stronger mediator of postprandial inflammation than postprandial triglyceridemia.
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Affiliation(s)
- Marijke A de Vries
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Rotterdam, The Netherlands
| | - Boudewijn Klop
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Rotterdam, The Netherlands
| | - Arash Alipour
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Rotterdam, The Netherlands
| | | | - Lenneke Prinzen
- Department of Clinical Chemistry, Rotterdam, The Netherlands
| | - Anho H Liem
- Department of Cardiology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Pedro Valdivielso
- Internal Medicine Unit, Hospital Virgen de la Victoria and Department of Medicine and Dermatology, IBIMA, University Málaga, Campus de Teatinos s/n, 29010 Málaga, Spain
| | - José Rioja Villodres
- Internal Medicine Unit, Hospital Virgen de la Victoria and Department of Medicine and Dermatology, IBIMA, University Málaga, Campus de Teatinos s/n, 29010 Málaga, Spain
| | - José Ramírez-Bollero
- Internal Medicine Unit, Hospital Virgen de la Victoria and Department of Medicine and Dermatology, IBIMA, University Málaga, Campus de Teatinos s/n, 29010 Málaga, Spain
| | - Manuel Castro Cabezas
- Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Rotterdam, The Netherlands.
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10
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de Vries MA, Alipour A, Klop B, van de Geijn GJM, Janssen HW, Njo TL, van der Meulen N, Rietveld AP, Liem AH, Westerman EM, de Herder WW, Cabezas MC. Glucose-dependent leukocyte activation in patients with type 2 diabetes mellitus, familial combined hyperlipidemia and healthy controls. Metabolism 2015; 64:213-7. [PMID: 25456098 DOI: 10.1016/j.metabol.2014.10.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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: 08/06/2014] [Revised: 09/27/2014] [Accepted: 10/12/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Leukocyte activation has been associated with vascular complications in type 2 diabetes mellitus (T2DM). Hyperglycemia may be involved in this leukocyte activation. Our aim was to investigate the role of elevated glucose concentrations on leukocyte activation in patients with a wide range of insulin sensitivity. METHODS Leukocyte activation was determined after ingestion of 75 gram glucose in subjects with T2DM, familial combined hyperlipidemia (FCH) and healthy controls. Leukocyte activation markers were measured by flow cytometry. Postprandial changes were calculated as the area under the curve (AUC), and the incremental area under the curve corrected for baseline values (dAUC). RESULTS 51 Subjects (20 T2DM, 17 FCH and 14 controls) were included. Fasting neutrophil CD66b expression and CD66b-AUC were respectively 36% and 39% higher in T2DM patients than in controls (p=0.004 and p=0.003). Fasting neutrophil CD66b expression correlated positively with glucose-AUC (Spearman's rho 0.481, p<0.001) and HbA1c (rho 0.433, p=0.002). Although fasting monocyte CD11b expression was not significantly different between subjects, monocyte CD11b-AUC was 26% higher in T2DM than in controls (p=0.006). Similar trends were observed for FCH patients. Monocyte CD11b-dAUC correlated positively with glucose-AUC (rho 0.322, p=0.022) and HbA1c (rho 0.319, p=0.023). CONCLUSIONS These data suggest that both acute and chronic hyperglycemia, associated with insulin resistance as seen in T2DM and FCH, are involved in the increased fasting and postprandial leukocyte activation observed in these conditions.
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MESH Headings
- Antigens, CD/blood
- Antigens, CD/metabolism
- Biomarkers/blood
- Biomarkers/metabolism
- Blood Glucose/analysis
- CD11b Antigen/blood
- CD11b Antigen/metabolism
- Cell Adhesion Molecules/blood
- Cell Adhesion Molecules/metabolism
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/immunology
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/physiopathology
- Female
- GPI-Linked Proteins/blood
- GPI-Linked Proteins/metabolism
- Glucose Tolerance Test
- Glycated Hemoglobin/analysis
- Humans
- Hyperglycemia/etiology
- Hyperlipidemia, Familial Combined/blood
- Hyperlipidemia, Familial Combined/immunology
- Hyperlipidemia, Familial Combined/metabolism
- Hyperlipidemia, Familial Combined/physiopathology
- Insulin Resistance
- Leukocytes/immunology
- Leukocytes/metabolism
- Male
- Middle Aged
- Monocytes/immunology
- Monocytes/metabolism
- Neutrophils/immunology
- Neutrophils/metabolism
- Up-Regulation
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Affiliation(s)
- Marijke A de Vries
- Department of Internal Medicine, Center for Diabetes and Cardiovascular Risk Management, Sint Franciscus Gasthuis, Rotterdam, the Netherlands.
| | - Arash Alipour
- Department of Internal Medicine, Center for Diabetes and Cardiovascular Risk Management, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Boudewijn Klop
- Department of Internal Medicine, Center for Diabetes and Cardiovascular Risk Management, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | | | - Hans W Janssen
- Department of Clinical Chemistry, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Tjin L Njo
- Department of Clinical Chemistry, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Noëlle van der Meulen
- Department of Internal Medicine, Center for Diabetes and Cardiovascular Risk Management, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Arie P Rietveld
- Department of Internal Medicine, Center for Diabetes and Cardiovascular Risk Management, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Anho H Liem
- Department of Cardiology, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Elsbeth M Westerman
- Department of Clinical Pharmacy, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Wouter W de Herder
- Department of Endocrinology, Erasmus Medical Center Rotterdam, The Netherlands
| | - Manuel Castro Cabezas
- Department of Internal Medicine, Center for Diabetes and Cardiovascular Risk Management, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
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11
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Klop B, van der Pol P, van Bruggen R, Wang Y, de Vries MA, van Santen S, O'Flynn J, van de Geijn GJM, Njo TL, Janssen HW, de Man P, Jukema JW, Rabelink TJ, Rensen PCN, van Kooten C, Cabezas MC. Differential complement activation pathways promote C3b deposition on native and acetylated LDL thereby inducing lipoprotein binding to the complement receptor 1. J Biol Chem 2014; 289:35421-30. [PMID: 25349208 DOI: 10.1074/jbc.m114.573840] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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: 01/15/2023] Open
Abstract
Lipoproteins can induce complement activation resulting in opsonization and binding of these complexes to complement receptors. We investigated the binding of opsonized native LDL and acetylated LDL (acLDL) to the complement receptor 1 (CR1). Binding of complement factors C3b, IgM, C1q, mannose-binding lectin (MBL), and properdin to LDL and acLDL were investigated by ELISA. Subsequent binding of opsonized LDL and acLDL to CR1 on CR1-transfected Chinese Hamster Ovarian cells (CHO-CR1) was tested by flow cytometry. Both native LDL and acLDL induced complement activation with subsequent C3b opsonization upon incubation with normal human serum. Opsonized LDL and acLDL bound to CR1. Binding to CHO-CR1 was reduced by EDTA, whereas MgEGTA only reduced the binding of opsonized LDL, but not of acLDL suggesting involvement of the alternative pathway in the binding of acLDL to CR1. In vitro incubations showed that LDL bound C1q, whereas acLDL bound to C1q, IgM, and properdin. MBL did neither bind to LDL nor to acLDL. The relevance of these findings was demonstrated by the fact that ex vivo up-regulation of CR1 on leukocytes was accompanied by a concomitant increased binding of apolipoprotein B-containing lipoproteins to leukocytes without changes in LDL-receptor expression. In conclusion, CR1 is able to bind opsonized native LDL and acLDL. Binding of LDL to CR1 is mediated via the classical pathway, whereas binding of acLDL is mediated via both the classical and alternative pathways. Binding of lipoproteins to CR1 may be of clinical relevance due to the ubiquitous cellular distribution of CR1.
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Affiliation(s)
- Boudewijn Klop
- From the Departments of Internal Medicine, Diabetes and Vascular Center
| | | | | | - Yanan Wang
- Department of Endocrinology and Metabolic Diseases, Einthoven Laboratory for Experimental Vascular Medicine, and
| | | | | | | | | | | | | | - Peter de Man
- Medical Microbiology, Sint Franciscus Gasthuis, 3004 BA Rotterdam, the Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, 1006 AN Leiden, the Netherlands, and
| | | | - Patrick C N Rensen
- Department of Endocrinology and Metabolic Diseases, Einthoven Laboratory for Experimental Vascular Medicine, and
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12
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de Vries MA, Alipour A, Klop B, van de Geijn GJM, Janssen HW, Njo TL, van der Meulen N, Rietveld AP, Liem AH, Westerman EM, de Herder WW, Cabezas MC. Glucose-dependent leukocyte activation in patients with type 2 diabetes mellitus, familial combined hyperlipidemia and healthy controls. Metabolism 2014. [PMID: 25456098 DOI: 10.1016/j.metabol] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Leukocyte activation has been associated with vascular complications in type 2 diabetes mellitus (T2DM). Hyperglycemia may be involved in this leukocyte activation. Our aim was to investigate the role of elevated glucose concentrations on leukocyte activation in patients with a wide range of insulin sensitivity. METHODS Leukocyte activation was determined after ingestion of 75 gram glucose in subjects with T2DM, familial combined hyperlipidemia (FCH) and healthy controls. Leukocyte activation markers were measured by flow cytometry. Postprandial changes were calculated as the area under the curve (AUC), and the incremental area under the curve corrected for baseline values (dAUC). RESULTS 51 Subjects (20 T2DM, 17 FCH and 14 controls) were included. Fasting neutrophil CD66b expression and CD66b-AUC were respectively 36% and 39% higher in T2DM patients than in controls (p=0.004 and p=0.003). Fasting neutrophil CD66b expression correlated positively with glucose-AUC (Spearman's rho 0.481, p<0.001) and HbA1c (rho 0.433, p=0.002). Although fasting monocyte CD11b expression was not significantly different between subjects, monocyte CD11b-AUC was 26% higher in T2DM than in controls (p=0.006). Similar trends were observed for FCH patients. Monocyte CD11b-dAUC correlated positively with glucose-AUC (rho 0.322, p=0.022) and HbA1c (rho 0.319, p=0.023). CONCLUSIONS These data suggest that both acute and chronic hyperglycemia, associated with insulin resistance as seen in T2DM and FCH, are involved in the increased fasting and postprandial leukocyte activation observed in these conditions.
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MESH Headings
- Antigens, CD/blood
- Antigens, CD/metabolism
- Biomarkers/blood
- Biomarkers/metabolism
- Blood Glucose/analysis
- CD11b Antigen/blood
- CD11b Antigen/metabolism
- Cell Adhesion Molecules/blood
- Cell Adhesion Molecules/metabolism
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/immunology
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/physiopathology
- Female
- GPI-Linked Proteins/blood
- GPI-Linked Proteins/metabolism
- Glucose Tolerance Test
- Glycated Hemoglobin/analysis
- Humans
- Hyperglycemia/etiology
- Hyperlipidemia, Familial Combined/blood
- Hyperlipidemia, Familial Combined/immunology
- Hyperlipidemia, Familial Combined/metabolism
- Hyperlipidemia, Familial Combined/physiopathology
- Insulin Resistance
- Leukocytes/immunology
- Leukocytes/metabolism
- Male
- Middle Aged
- Monocytes/immunology
- Monocytes/metabolism
- Neutrophils/immunology
- Neutrophils/metabolism
- Up-Regulation
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Affiliation(s)
- Marijke A de Vries
- Department of Internal Medicine, Center for Diabetes and Cardiovascular Risk Management, Sint Franciscus Gasthuis, Rotterdam, the Netherlands.
| | - Arash Alipour
- Department of Internal Medicine, Center for Diabetes and Cardiovascular Risk Management, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Boudewijn Klop
- Department of Internal Medicine, Center for Diabetes and Cardiovascular Risk Management, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | | | - Hans W Janssen
- Department of Clinical Chemistry, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Tjin L Njo
- Department of Clinical Chemistry, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Noëlle van der Meulen
- Department of Internal Medicine, Center for Diabetes and Cardiovascular Risk Management, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Arie P Rietveld
- Department of Internal Medicine, Center for Diabetes and Cardiovascular Risk Management, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Anho H Liem
- Department of Cardiology, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Elsbeth M Westerman
- Department of Clinical Pharmacy, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
| | - Wouter W de Herder
- Department of Endocrinology, Erasmus Medical Center Rotterdam, The Netherlands
| | - Manuel Castro Cabezas
- Department of Internal Medicine, Center for Diabetes and Cardiovascular Risk Management, Sint Franciscus Gasthuis, Rotterdam, the Netherlands
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Abstract
Hepatitis E virus genotype 3 is not rare in developed countries, and may cause chronic hepatitis in immunocompromised patients. This may not only lead to abnormalities in liver test and malaise, but to severe neurological symptoms as well. In this case, chronic hepatitis E infection caused encephalopathy, an atactic gait, Lhermitte's sign, incomplete bladder emptying and peripheral sensory neuropathy in a renal transplant recipient. The diagnosis was not performed until years after the onset of first symptoms and several months after the onset of neurological symptoms. If treated adequately, viral load can be reduced in over two-thirds of patients and neurological symptoms are often resolved. More widespread knowledge about this virus and its extrahepatic manifestations may lead to a quicker diagnosis, and may limit pathology. Serological screening should be added to standard pretransplant virological screening, so that, in the future, patients without antibodies could be vaccinated.
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Affiliation(s)
- Marijke A de Vries
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands
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