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Helin T, Palviainen M, Lemponen M, Maaninka K, Siljander P, Joutsi-Korhonen L. Increased circulating platelet-derived extracellular vesicles in severe COVID-19 disease. Platelets 2024; 35:2313362. [PMID: 38380806 DOI: 10.1080/09537104.2024.2313362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/27/2024] [Indexed: 02/22/2024]
Abstract
Coagulation disturbances are major contributors to COVID-19 pathogenicity, but limited data exist on the involvement of extracellular vesicles (EVs) and residual cells (RCs). Fifty hospitalized COVID-19 patients stratified by their D-dimer levels into high (>1.5 mg/L, n = 15) or low (≤1.5 mg/l, n = 35) and 10 healthy controls were assessed for medium-sized EVs (mEVs; 200-1000 nm) and large EVs/RCs (1000-4000 nm) by high sensitivity flow cytometry. EVs were analyzed for CD61, CD235a, CD45, and CD31, commonly used to detect platelets, red blood cells, leukocytes or endothelial cells, respectively, whilst phosphatidyl serine EVs/RCs were detected by lactadherin-binding implicating procoagulant catalytic surface. Small EV detection (sEVs; 50-200 nm) and CD41a (platelet integrin) colocalization with general EV markers CD9, CD63, and CD81 were performed by single particle interferometric reflectance imaging sensor. Patients with increased D-dimer exhibited the highest number of RCs and sEVs irrespective of cell origin (p < .05). Platelet activation, reflected by increased CD61+ and lactadherin+ mEV and RC levels, associated with coagulation disturbances. Patients with low D-dimer could be discriminated from controls by tetraspanin signatures of the CD41a+ sEVs, suggesting the changes in the circulating platelet sEV subpopulations may offer added prognostic value during COVID progression.
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Affiliation(s)
- Tuukka Helin
- HUS Diagnostics Centre, HUSLAB Clinical Chemistry, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Mari Palviainen
- EV group, Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, and CURED, Drug Research Program, Faculty of Pharmacy, Division of Pharmaceutical Biosciences, University of Helsinki, Helsinki, Finland
- EV core, Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Marja Lemponen
- HUS Diagnostics Centre, HUSLAB Clinical Chemistry, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Katariina Maaninka
- EV group, Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, and CURED, Drug Research Program, Faculty of Pharmacy, Division of Pharmaceutical Biosciences, University of Helsinki, Helsinki, Finland
- EV core, Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Pia Siljander
- EV group, Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, and CURED, Drug Research Program, Faculty of Pharmacy, Division of Pharmaceutical Biosciences, University of Helsinki, Helsinki, Finland
- EV core, Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Lotta Joutsi-Korhonen
- HUS Diagnostics Centre, HUSLAB Clinical Chemistry, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Szanto T, Helin T, Joutsi-Korhonen L, Lehtinen AE, El Beayni N, Lepäntalo A, Lassila R. Development of a Coagulation Disorders Unit. Semin Thromb Hemost 2024. [PMID: 38373723 DOI: 10.1055/s-0044-1779633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Our Coagulation Disorders Unit in Helsinki, Finland, provides 24/7 services for local and national hospitals and colleagues upon requests regarding bleeding and thrombosis diagnostics and management, including follow-up. The unit has a tight connection between the clinic and laboratory, and its maintenance and sharing knowledge and observations have been priorities, already for over 20 years and will continue to be of major importance. The consultation service is provided by phone during daytime and on-call hours, and in written form sent electronically to the consulting stakeholders. Thrombosis and hemostasis-targeted outpatient clinics are also available for the patients referred to the center. Writing local guidance and official guidelines, Nordic, European and international collaboration, and educational activities including social communication are critical elements for the Coagulation Disorders Unit. Alertness to acute coagulation abnormalities, such as occurred during COVID-19 and vaccine-induced thrombosis and thrombocytopenia, and development of strategies to manage cross-disciplinary problems are topics which call upon broad networking. The Nordic community has an ongoing historical meeting, which has been circulating among coagulation centers for the past 56 years. At the European level, the European Association of Haemophilia and Allied Disorders focuses on bleeding disorders and their management, including safety surveillance. The International Society of Thrombosis and Haemostasis offers excellent basic and clinical benchmarks for any Coagulation Disorders Unit. We hope that the description of the development and implementation of our Coagulation Disorders Unit in Helsinki achieves international interest and broadens international collaboration. Finally, we congratulate STH on its great contributions around the globe and for providing a vivid forum to foster the discipline of thrombosis and hemostasis.
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Affiliation(s)
- Timea Szanto
- Coagulation Disorders Unit, Department of Hematology, Comprehensive Cancer Centre, Comprehensive Care Centre of Hemophilia and Allied Disorders (EAHAD), Helsinki University Hospital, Helsinki, Finland
- Research Program Unit in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tuukka Helin
- Department of Clinical Chemistry, HUS Diagnostic Centre, Helsinki University Hospital, Helsinki, Finland
| | - Lotta Joutsi-Korhonen
- Department of Clinical Chemistry, HUS Diagnostic Centre, Helsinki University Hospital, Helsinki, Finland
| | - Anna-Elina Lehtinen
- Coagulation Disorders Unit, Department of Hematology, Comprehensive Cancer Centre, Comprehensive Care Centre of Hemophilia and Allied Disorders (EAHAD), Helsinki University Hospital, Helsinki, Finland
| | - Nancy El Beayni
- Coagulation Disorders Unit, Department of Hematology, Comprehensive Cancer Centre, Comprehensive Care Centre of Hemophilia and Allied Disorders (EAHAD), Helsinki University Hospital, Helsinki, Finland
| | - Aino Lepäntalo
- Coagulation Disorders Unit, Department of Hematology, Comprehensive Cancer Centre, Comprehensive Care Centre of Hemophilia and Allied Disorders (EAHAD), Helsinki University Hospital, Helsinki, Finland
| | - Riitta Lassila
- Coagulation Disorders Unit, Department of Hematology, Comprehensive Cancer Centre, Comprehensive Care Centre of Hemophilia and Allied Disorders (EAHAD), Helsinki University Hospital, Helsinki, Finland
- Research Program Unit in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Susila S, Helin T, Lauronen J, Joutsi-Korhonen L, Ilmakunnas M. In vitro comparison of cold-stored whole blood and reconstituted whole blood. Vox Sang 2023. [PMID: 37166393 DOI: 10.1111/vox.13441] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/27/2023] [Accepted: 04/27/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Cold-stored whole blood (CSWB) is increasingly used in damage control resuscitation. Haemostatic function of CSWB seems superior to that of reconstituted whole blood, and it is sufficiently preserved for 14-21 days. To provide evidence for a yet insufficiently studied aspect of prehospital CSWB use, we compared in vitro haemostatic properties of CSWB and currently used in-hospital and prehospital blood component therapies. MATERIALS AND METHODS Blood was obtained from 24 O RhD positive male donors. Three products were prepared: CSWB, in-hospital component therapy (red blood cells [RBCs], OctaplasLG and platelets 1:1:1) and prehospital component therapy (RBCs and lyophilized plasma 1:1). Samples were drawn on days 1 and 14 of CSWB or RBC cold storage. On day 14, platelet concentrates at their expiry (5 days) were used for 1:1:1 mixing. Conventional clotting assays, rotational thromboelastometry, thrombin formation and platelet function were assessed. RESULTS Haemoglobin, platelet count, fibrinogen and coagulation factor levels remained closest to physiological in CSWB. Factor VIII activity decreased markedly by day 14 in CSWB. The decline in platelet function was prominent in CSWB. However, CSWB on day 14 yielded physiological EXTEM MCF, suggesting haemostatically sufficient platelet function. Despite haemodilution and lower coagulation factor levels, in-hospital component therapy was haemostatically adequate. Prehospital component therapy formed the weakest clots. Thrombin formation potential remained comparable and stable in all groups. CONCLUSION Current prehospital component therapy fails to offer the clotting potential that CSWB does. CSWB and current in-hospital 1:1:1 component therapy show similar haemostatic potential until 14 days of storage.
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Affiliation(s)
- Sanna Susila
- Department of Anesthesiology and Intensive Care Medicine, Päijät-Häme Central Hospital, Lahti, Finland
- Finnish Red Cross Blood Service, Helsinki, Finland
| | - Tuukka Helin
- Department of Clinical Chemistry, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Lotta Joutsi-Korhonen
- Department of Clinical Chemistry, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Minna Ilmakunnas
- Finnish Red Cross Blood Service, Helsinki, Finland
- Meilahti Hospital Blood Bank, Department of Clinical Chemistry, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Anesthesiology and Intensive Care Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Helin T, Tirri T, Korkala H, Lappalainen K, Joutsi-Korhonen L. Laboratory Assessment of Unfractionated Heparin (UFH) with Activated Clotting Time (ACT) and Anti-Xa Activity during Peripheral Arterial Angiographic Procedure. Diagnostics (Basel) 2023; 13:diagnostics13081489. [PMID: 37189590 DOI: 10.3390/diagnostics13081489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/13/2023] [Accepted: 04/13/2023] [Indexed: 05/17/2023] Open
Abstract
Activated clotting time (ACT) is used in cardiac surgery for monitoring unfractionated heparin (UFH). In endovascular radiology, ACT use is less established. We aimed to test the validity of ACT in UFH monitoring in endovascular radiology. We recruited 15 patients undergoing endovascular radiologic procedure. ACT was measured with ICT Hemochron® device as point-of-care (1) before standard UFH bolus, (2) immediately after the bolus, and in some cases (3) 1 h into the procedure or a combination thereof (altogether 32 measurements). A total of two different cuvettes, ACT-LR and ACT+ were tested. A reference method of chromogenic anti-Xa was used. Blood count, APTT, thrombin time and antithrombin activity were also measured. UFH levels (anti-Xa) varied between 0.3-2.1 IU/mL (median 0.8) and correlated with ACT-LR moderately (R2 = 0.73). The corresponding ACT-LR values were 146-337 s (median 214). ACT-LR and ACT+ measurements correlated only modestly with one another at this lower UFH level, with ACT-LR being more sensitive. Thrombin time and APTT were unmeasurably high after the UFH dose, rendering them of limited use in this indication. We adopted an ACT target of >200-250 s in endovascular radiology based on this study. While ACT correlation with anti-Xa is suboptimal, the readily available point-of-care nature increases its suitability.
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Affiliation(s)
- Tuukka Helin
- Department of Clinical Chemistry, HUS Diagnostic Center, Helsinki University Hospital, P.O. Box 720, 00029 Helsinki, Finland
- Department of Clinical Chemistry, University of Helsinki, 00014 Helsinki, Finland
| | - Tomi Tirri
- Department of Clinical Chemistry, HUS Diagnostic Center, Helsinki University Hospital, P.O. Box 720, 00029 Helsinki, Finland
- Department of Clinical Chemistry, University of Helsinki, 00014 Helsinki, Finland
| | - Heidi Korkala
- Department of Radiology, HUS Diagnostic Center, Helsinki University Hospital, P.O. Box 320, 00029 Helsinki, Finland
| | - Kimmo Lappalainen
- Department of Radiology, HUS Diagnostic Center, Helsinki University Hospital, P.O. Box 320, 00029 Helsinki, Finland
| | - Lotta Joutsi-Korhonen
- Department of Clinical Chemistry, HUS Diagnostic Center, Helsinki University Hospital, P.O. Box 720, 00029 Helsinki, Finland
- Department of Clinical Chemistry, University of Helsinki, 00014 Helsinki, Finland
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Tanner LM, Kunishima S, Lehtinen E, Helin T, Volmonen K, Lassila R, Pöyhönen M. Platelet function and filamin A expression in two families with novel FLNA gene mutations associated with periventricular nodular heterotopia and panlobular emphysema. Am J Med Genet A 2022; 188:1716-1722. [PMID: 35156755 PMCID: PMC9303863 DOI: 10.1002/ajmg.a.62690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 01/15/2022] [Accepted: 01/28/2022] [Indexed: 11/22/2022]
Abstract
Pathogenic variants of the X‐linked FLNA gene encoding filamin A protein have been associated with a wide spectrum of symptoms, including the recently described pulmonary phenotype with childhood‐onset panlobular emphysema. We describe three female patients from two families with novel heterozygous FLNA variants c.5837_2del and c.508C > T. Analysis of immunofluorescence of peripheral blood smears and platelet function was performed for all patients. FLNA‐negative platelets were observed, suggesting that these variants result in the loss of a functional protein product. All three patients also had periventricular nodular heterotopia and panlobular emphysema. However, they had considerably milder symptoms and later age of onset than in the previously reported cases. Therefore, patients with pathogenic FLNA variants should be studied actively for lung involvement even in the absence of pronounced respiratory symptoms. Conversely, any patient with unexplained panlobular emphysema should be analyzed for pathogenic FLNA variants. We also suggest that immunofluorescence analysis is a useful tool for investigating the pathogenicity of novel FLNA variants.
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Affiliation(s)
- Laura M Tanner
- HUSLAB Department of Clinical Genetics, Helsinki University Hospital, Helsinki, Finland.,Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
| | - Shinji Kunishima
- Department of Medical Technology, Gifu University of Medical Science, Gifu, Japan
| | - Elina Lehtinen
- Coagulation Disorders Unit, Helsinki University Hospital, Research Program Unit in Systems Oncology, University of Helsinki, Helsinki, Finland
| | - Tuukka Helin
- HUSLAB Department of Chemistry and Microbiology, Helsinki University Hospital, Helsinki, Finland
| | - Kirsi Volmonen
- HUS Medical Imaging Center, Helsinki University Hospital, Helsinki, Finland
| | - Riitta Lassila
- Coagulation Disorders Unit, Helsinki University Hospital, Research Program Unit in Systems Oncology, University of Helsinki, Helsinki, Finland.,HUSLAB Department of Chemistry and Microbiology, Helsinki University Hospital, Helsinki, Finland
| | - Minna Pöyhönen
- HUSLAB Department of Clinical Genetics, Helsinki University Hospital, Helsinki, Finland.,Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
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Pitkänen HH, Jouppila A, Helin T, Dulipati V, Kotimaa J, Meri S, Kantele A, Jalkanen P, Julkunen I, Lassila R. COVID-19 adenovirus vaccine triggers antibodies against PF4 complexes to activate complement and platelets. Thromb Res 2021; 208:129-137. [PMID: 34768097 PMCID: PMC8571998 DOI: 10.1016/j.thromres.2021.10.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/14/2021] [Accepted: 10/28/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Vaccine-induced thrombotic thrombocytopenia (VITT) is a rare coagulation disorder reported after administration of COVID-19 adenovirus-vectored vaccines. VITT is mediated by anti-platelet factor 4 (PF4) antibodies activating platelets through the Fcγ-receptor II (FcγRII), and it is associated with strong fibrin turnover. The complement system is involved in several other immunothrombotic entities, but its impact on VITT is not established. OBJECTIVE To assess antibodies in interaction with the activation of platelets and complement triggered by VITT. METHODS Antibodies against adenovirus type 2 hexon protein, ChAdOx1 adenoviral vector-specific IgG and PF4 were analyzed by enzyme immunoassays from VITT patients (n = 5). The EDTA plasma samples of the patients and controls were used to measure both terminal complement complexes (TCC) by ELISA and aggregation of healthy donor platelets. We studied the effects of human immunoglobulin (IVIG) and glycoprotein IIb/IIIa inhibitor (GPIIb/IIIa) on spontaneous and collagen-induced platelet aggregation supplemented with VITT plasma. RESULTS None of the patients had experienced a COVID-19 infection. Antibody analyses confirmed the immunogenicity of the adenovirus-vectored ChAdOx1 vaccine. Moreover, VITT plasma had anti-PF4 antibodies and elevated TCC levels as a sign of complement activation. In isolated healthy donor platelets, VITT patient plasma caused marked, spontaneous aggregation of platelets, which was abolished by eptifibatide and high-dose therapeutic IVIG. CONCLUSIONS Our findings suggest that VITT is triggered by antibodies against adenovirus vector and PF4-polyanion complexes which strongly co-activate complement and platelets. The spontaneous platelet aggregation was suppressed by IVIG or eptifibatide, indicating that besides FcγRII, also GPIIb/IIIa receptor exerts platelet procoagulant role in VITT.
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Affiliation(s)
- Hanna H. Pitkänen
- Helsinki University, Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland,Clinical Research Institute Helsinki University Hospital, Helsinki, Finland
| | - Annukka Jouppila
- Clinical Research Institute Helsinki University Hospital, Helsinki, Finland
| | - Tuukka Helin
- HUSLAB, Clinical Chemistry, Helsinki University Hospital and University of Helsinki
| | - Vinaya Dulipati
- Department of Bacteriology and Immunology and Translational Immunology Research Program, University of Helsinki, Finland
| | - Juha Kotimaa
- Department of Bacteriology and Immunology and Translational Immunology Research Program, University of Helsinki, Finland
| | - Seppo Meri
- Department of Bacteriology and Immunology and Translational Immunology Research Program, University of Helsinki, Finland,HUSLAB, Helsinki University Hospital, Finland
| | - Anu Kantele
- Meilahti Infectious Diseases and Vaccine Research Center, MeVac, Department of Infectious Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Pinja Jalkanen
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Ilkka Julkunen
- Institute of Biomedicine, University of Turku, Turku, Finland,Turku University Hospital, Clinical Microbiology, Turku, Finland
| | - Riitta Lassila
- Department of Hematology, Coagulation Disorders Unit, Helsinki University Hospital, Helsinki, Finland,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Finland,Finnish Institute for Health and Welfare, Helsinki, Finland,Corresponding author at: Coagulation Disorders Unit, Department of Hematology and Comprehensive Cancer Center, Laboratory Services, HUCH, PL 372, 00029 Helsinki, Finland
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Jyrkila H, Kaartinen K, Martola L, Halminen O, Haukka J, Linna M, Mustonen P, Putaala J, Helin T, Kouki E, Luojus A, Tiili P, Hartikainen J, Airaksinen K, Lehto M. Renal function and use of medication preceding new-onset atrial fibrillation – results from the nationwide FinACAF study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and aims
Chronic kidney disease (CKD) is a global public health problem with an increasing number of patients due to obesity, hypertension, diabetes, and aging. CKD is an independent risk factor for atrial fibrillation (AF) and the incidence of AF in patients with CKD is two- to threefold higher compared to the general population. The relationship between CKD and AF is bidirectional, and the incidence of renal insufficiency is higher in patients with AF. Both AF and CKD are associated with increased risk of stroke and systemic thromboembolism, as well as an increased bleeding risk. The Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) study is a nationwide study among AF patients conducted as a retrospective register-based linkage study combining data from several Finnish health care registers. We aimed to characterize demographics and medications of patients with new-onset AF included FinACAF according to stages of renal function.
Method
The FinACAF study includes data from 411000 patients covering all Finnish AF patients from 1 January 2004 to 31 December 2018. Using national unique personal identification numbers, individual patients' data from ten nationwide population registries and six regional laboratory databases were linked together. The inclusion criteria of this substudy were all patients 20 years or older with a new-onset AF diagnosis between January 2010 and December 2018 and a measured estimated glomerular filtration rate (eGFR) within the proximity of the AF diagnosis. Drug purchases (date, Anatomical Therapeutic Chemical (ATC) codes, and amount) were obtained from the National Prescription Register upheld by the Social Insurance Institution of Finland.
Results
147001 patients from the initial FinACAF cohort were included in this substudy. The mean age at the time of AF diagnosis was 73 years (range 20 to 107 years), 48.9% of the patients were female. The mean age of AF patients increased in various stages of glomerular filtration at the cohort entry during 2010–2018. Baseline medications are shown in Table. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) at the cohort entry decreased from 27.4% to 22.1% during 2010–2018 (p<0.001).
Conclusions
Medications were used increasingly with worsening renal function, except for NSAIDs.
NSAIDs use remained remarkably high in all stages of renal function, albeit much less with the lowest eGFRs. The number of patients with lipid-lowering medication was unexpectedly low considering the high cardiovascular risk in patients with impaired renal function.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): This work was supported by Aarne Koskelo Foundation, Yrjö Jahnsson Foundation, The Finnish Foundation for Cardiovascular Research, and Helsinki and Uusimaa Hospital District research fund (TYH2019309).
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Affiliation(s)
- H Jyrkila
- Helsinki University Hospital and University of Helsinki, Department of Nephrology and Heart and Lung Center, Helsinki, Finland
| | - K Kaartinen
- Helsinki University Hospital and University of Helsinki, Department of Nephrology, Helsinki, Finland
| | - L Martola
- Helsinki University Hospital and University of Helsinki, Department of Nephrology, Helsinki, Finland
| | - O Halminen
- Aalto University, Department of Industrial Engineering and Management, Espoo, Finland
| | - J Haukka
- University of Helsinki, Faculty of Medicine, Helsinki, Finland
| | - M Linna
- Aalto University, Department of Industrial Engineering and Management, Espoo, Finland
| | - P Mustonen
- Central Finland Health Care District, Department of Internal Medicine, Jyvaskyla, Finland
| | - J Putaala
- Helsinki University Hospital and University of Helsinki, Department of Neurology, Helsinki, Finland
| | - T Helin
- University of Helsinki and HUSLAB, Helsinki University Hospital, Clinical Chemistry and Coagulation Disorders Unit, Helsinki, Finland
| | - E Kouki
- Helsinki University Hospital and University of Helsinki, Heart and Lung Center, Helsinki, Finland
| | - A Luojus
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - P Tiili
- Helsinki University Hospital and University of Helsinki, Heart and Lung Center and Department of Neurology, Helsinki, Finland
| | - J Hartikainen
- Kuopio University Hospital and University of Eastern Finland, Heart Center, Department of Cardiology, Kuopio, Finland
| | - K.E.J Airaksinen
- Turku University Hospital and University of Turku, Department of Cardiology, Turku, Finland
| | - M Lehto
- Helsinki University Hospital and University of Helsinki, Heart and Lung Center, Helsinki, Finland
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Helin T, Lemponen M, Lassila R, Joutsi-Korhonen L. Comparison of novel thrombin generation methods with established techniques is mandatory. Res Pract Thromb Haemost 2021; 5:e12522. [PMID: 34013154 PMCID: PMC8110435 DOI: 10.1002/rth2.12522] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/06/2021] [Accepted: 04/06/2021] [Indexed: 11/10/2022] Open
Affiliation(s)
- Tuukka Helin
- Clinical Chemistry HUS Diagnostic Center University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Marja Lemponen
- Clinical Chemistry HUS Diagnostic Center University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Riitta Lassila
- Coagulation Disorders Unit Research Program Unit in Systems Oncology Helsinki University Hospital University of Helsinki Helsinki Finland
| | - Lotta Joutsi-Korhonen
- Clinical Chemistry HUS Diagnostic Center University of Helsinki and Helsinki University Hospital Helsinki Finland
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Helin T, Joutsi-Korhonen L, Lassila R. Clinical use and laboratory testing of oral anticoagulation therapy: experience from Finland. ACTA ACUST UNITED AC 2019. [DOI: 10.21037/aob.2019.07.01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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10
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Siltari A, Helin T, Wickholm N, Lassila R, Korpela R, Kautiainen H, Vapaatalo H. Can Vascular Calcification be Associated with Warfarin Treatment? Clin Ther 2016; 38:e25. [DOI: 10.1016/j.clinthera.2016.07.146] [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: 11/16/2022]
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Helin T, Haahtela S, Haahtela T. No effect of oral treatment with an intestinal bacterial strain, Lactobacillus rhamnosus (ATCC 53103), on birch-pollen allergy: a placebo-controlled double-blind study. Allergy 2002; 57:243-6. [PMID: 11906339 DOI: 10.1034/j.1398-9995.2002.1s3299.x] [Citation(s) in RCA: 174] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Oral probiotic bacteriotherapy with Lactobacillus rhamnosus has given promising results in small children with food allergy. We studied the effects of similar therapy in teenagers and young adults, who were allergic to birch pollen and apple food and had intermittent symptoms of atopic allergy and/or mild asthma. METHODS We conducted a double-blind, placebo-controlled study, in which respiratory and eye symptoms and use of medications in two groups were compared. Open oral challenge tests with a slice of apple were performed trice: before, during and after the birch-pollen season. There were 18 patients in each group. They used Lactobacillus rhamnosus for 5.5 months; 2.5 months before the pollen season, 1 month during the season (May), and 2 months after. RESULTS The results were negative. The treatment did not alleviate the symptoms of the patients or reduce their use of medication during the birch-pollen season or the subsequent 2 months. The treatment did not significantly affect the symptoms caused by apple in the oral challenge tests. CONCLUSIONS We found no indication of a beneficial treatment effect in our patients. As the number of patients was relatively small, conclusions should be drawn with caution.
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Affiliation(s)
- T Helin
- Division of Allergy, Helsinki University Central Hospital, Helsinki Finland
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Veres G, Helin T, Arato A, Färkkilä M, Kantele A, Suomalainen H, Savilahti E. Increased expression of intercellular adhesion molecule-1 and mucosal adhesion molecule alpha4beta7 integrin in small intestinal mucosa of adult patients with food allergy. Clin Immunol 2001; 99:353-9. [PMID: 11358431 DOI: 10.1006/clim.2001.5032] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The mechanisms of adverse reactions to foods in the gastrointestinal tract are poorly understood. Previous studies of other atopic diseases and animal models suggest that adhesion molecules and mucosal lymphocytes may be implicated in the pathogenesis of food allergy (FA). The aim of our study was to investigate the expression of adhesion molecules and mucosal lymphocytes in duodena of patients with food allergies and of controls. Ten patients with FA to cereals (wheat, oats, and rye) or cow's milk and 9 control patients were included in the study. Quantitative analysis and immunohistochemical stainings for two pairs of adhesion molecules (intercellular adhesion molecule-1 (ICAM-1), lymphocyte function-associated antigen-1 (LFA-1), alpha4beta7 integrin, and mucosal addressin cell adhesion molecule (MAdCAM-1) and lymphocyte markers on endoscopic duodenal biopsy specimens were performed. The villous structure and density of LFA-1-positive cells were normal in every biopsy specimen, but the patients had significantly more alpha4beta7+ cells in the intraepithelial space (P = 0.01). The expression of ICAM-1 in the lamina propria of patients with FA was also substantially increased (P = 0.003); however, staining with MAdCAM showed no intergroup difference. Moreover, we found significantly increased CD4+ and HLA-DR+ cells in the lamina propria of patients, in comparison to the controls, P = 0.05 and P = 0.04, respectively. The densities of CD3, CD8, HLA-DP, T cell receptor alphabeta+ and gammadelta+ cells and IgA-, IgA1-, and IgA2-containing cells did not differ in the two groups studied. Our results suggest that the increased expression of ICAM-1 and alpha4beta7 integrin may play an important role in the pathogenesis of food hypersensitivity and with the elevation of CD4- and HLA-DR-positive cells reflect a stage of inflammation in the structurally normal intestines.
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Affiliation(s)
- G Veres
- Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
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Abstract
Occupational sensitization to senna is seldom reported. We describe a 21-year-old male atopic factory worker who developed IgE-mediated asthma and rhinoconjunctivitis 5 months after exposure to senna while he was working for a company manufacturing hair dyes. In the bronchial challenge test with senna, he exhibited a strong reaction. The skin prick test gave a 12-mm wheal reaction. The radioallergosorbent test (RAST) with senna was highly positive (33.6 PRU/ml, class 4), and could not be inhibited with pollens or foods. In protein staining with SDS-PAGE, two heavy bands were detected in senna at about 14 and 25 kDa, and two faint bands were visible at 19 and 21 kDa, In IgE immunoblotting with the patient's serum, one heavy band was detected at about 16 and four faint bands at 23, 25, 28, and 38 kDa. The patient became symptom free after he had changed his job within the same company.
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Affiliation(s)
- T Helin
- Helsinki University Central Hospital, Department of Allergic Diseases, Finland
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Helin T, Virkkala T, Rosengård S, Taskinen E. [Relapsing polychondritis in the lower respiratory tract]. Duodecim 1992; 108:163-7. [PMID: 1365997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Affiliation(s)
- T Helin
- HYKS:n keuhkosairauksien klinikka, Helsinki
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