1
|
Başpinar O, Elibol A, Koçer D, Tokmak TT, Doğan S, Dizdar OS. Evaluation of the relationship between atherosclerosis and Helicobacter pylori infection with measurement of growth differentiation factor 15 and atherosclerosis indicators in adults with no comorbidity. Clin Investig Arterioscler 2024; 36:51-59. [PMID: 37858436 DOI: 10.1016/j.arteri.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/30/2023] [Accepted: 09/19/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND The aim of this study was to investigate presence of subclinical atherosclerosis by measuring carotid intima-media thickness (CIMT) in patients with Helicobacter pylori (HP) and to assess effects of HP on atherosclerosis by evaluating markers of atherosclerosis and blood growth differentiation factor (GDF-15) levels. MATERIALS AND METHODS This cross-sectional study included 59 patients without comorbid disease who had HP and 30 healthy controls without HP in upper endoscopic biopsy. In order to assess atherosclerosis, the CIMT measurement was performed by sonography. Serum GDF-15 level was measured by ELISA method. In all patients, atherosclerosis markers were recorded. Atherogenic indices were calculated, including Castelli risk index I and II (TG/HDL-c and LDL-c/HDL-c, respectively), plasma atherogenic index (PAI; log TG/HDL-c), non-HDL-c (TH-HDL-c) and atherogenic coefficient (AC; non-HDL-HDL-c). RESULTS The GDF-15 level and CIMT were significantly higher in HP-positive group when compared to HP-negative group (p≤0.001). There was a significant correlation between serum GDF-15 level and CIMT (r=0.445; p≤0.001). There was no correlation between other atherosclerosis markers and serum GDF-15 level or CIMT. The bacterial intensity on endoscopic specimen was only correlated with CIMT (p<0.001). Vitamin B12 and D levels were comparable among groups. CONCLUSION This study suggested that there was a correlation between GDF-15 level and subclinical atherosclerosis development in patients with HP. However, GDF-15 level, which was found to be elevated while atherogenic indices were normal, can be an earlier marker for subclinical atherosclerosis.
Collapse
Affiliation(s)
- Osman Başpinar
- Department of Internal Medicine, Kayseri City Training and Research Hospital, Kayseri, Turkey
| | - Ayça Elibol
- Department of Internal Medicine, Kayseri City Training and Research Hospital, Kayseri, Turkey
| | - Derya Koçer
- Department of Medical Biochemistry, Kayseri City Training and Research Hospital, Kayseri, Turkey
| | - Turgut Tursem Tokmak
- Department of Radiology, Kayseri City Training and Research Hospital, Kayseri, Turkey
| | - Serkan Doğan
- Department of Gastroenterology, Kayseri City Training and Research Hospital, Kayseri, Turkey
| | - Oğuzhan Sıtkı Dizdar
- Department of Internal Medicine, Kayseri City Training and Research Hospital, Kayseri, Turkey.
| |
Collapse
|
2
|
Ballester-Servera C, Alonso J, Taurón M, Rotllán N, Rodríguez C, Martínez-González J. Lysyl oxidase expression in smooth muscle cells determines the level of intima calcification in hypercholesterolemia-induced atherosclerosis. Clin Investig Arterioscler 2024:S0214-9168(24)00007-X. [PMID: 38402026 DOI: 10.1016/j.arteri.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/17/2024] [Accepted: 01/24/2024] [Indexed: 02/26/2024]
Abstract
INTRODUCTION Cardiovascular calcification is an important public health issue with an unmeet therapeutic need. We had previously shown that lysyl oxidase (LOX) activity critically influences vascular wall smooth muscle cells (VSMCs) and valvular interstitial cells (VICs) calcification by affecting extracellular matrix remodeling. We have delved into the participation of LOX in atherosclerosis and vascular calcification, as well as in the mineralization of the aortic valve. METHODS Immunohistochemical and expression studies were carried out in human atherosclerotic lesions and experimental models, valves from patients with aortic stenosis, VICs, and in a genetically modified mouse model that overexpresses LOX in CMLV (TgLOXCMLV). Hyperlipemia and atherosclerosis was induced in mice through the administration of adeno-associated viruses encoding a PCSK9 mutated form (AAV-PCSK9D374Y) combined with an atherogenic diet. RESULTS LOX expression is increased in the neointimal layer of atherosclerotic lesions from human coronary arteries and in VSMC-rich regions of atheromas developed both in the brachiocephalic artery of control (C57BL/6J) animals transduced with PCSK9D374Y and in the aortic root of ApoE-/- mice. In TgLOXCMLV mice, PCSK9D374Y transduction did not significantly alter the enhanced aortic expression of genes involved in matrix remodeling, inflammation, oxidative stress and osteoblastic differentiation. Likewise, LOX transgenesis did not alter the size or lipid content of atherosclerotic lesions in the aortic arch, brachiocephalic artery and aortic root, but exacerbated calcification. Among lysyl oxidase isoenzymes, LOX is the most expressed member of this family in highly calcified human valves, colocalizing with RUNX2 in VICs. The lower calcium deposition and decreased RUNX2 levels triggered by the overexpression of the nuclear receptor NOR-1 in VICs was associated with a reduction in LOX. CONCLUSIONS Our results show that LOX expression is increased in atherosclerotic lesions, and that overexpression of this enzyme in VSMC does not affect the size of the atheroma or its lipid content, but it does affect its degree of calcification. Further, these data suggest that the decrease in calcification driven by NOR-1 in VICs would involve a reduction in LOX. These evidences support the interest of LOX as a therapeutic target in cardiovascular calcification.
Collapse
Affiliation(s)
- Carme Ballester-Servera
- Instituto de Investigaciones Biomédicas de Barcelona-Consejo Superior de Investigaciones Científicas (IIBB-CSIC), Barcelona, España; CIBER de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud CarlosIII, Madrid, España; Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, España
| | - Judith Alonso
- Instituto de Investigaciones Biomédicas de Barcelona-Consejo Superior de Investigaciones Científicas (IIBB-CSIC), Barcelona, España; CIBER de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud CarlosIII, Madrid, España; Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, España
| | - Manel Taurón
- CIBER de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud CarlosIII, Madrid, España; Departamento de Cirugía Cardíaca, Hospital de la Santa Creu i Sant Pau-Universitat Autònoma de Barcelona (HSCSP-UAB), Barcelona, España
| | - Noemí Rotllán
- Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, España; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud CarlosIII, Madrid, España
| | - Cristina Rodríguez
- CIBER de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud CarlosIII, Madrid, España; Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, España
| | - José Martínez-González
- Instituto de Investigaciones Biomédicas de Barcelona-Consejo Superior de Investigaciones Científicas (IIBB-CSIC), Barcelona, España; CIBER de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud CarlosIII, Madrid, España; Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, España.
| |
Collapse
|
3
|
Eldin AS, Fawzy O, Mahmoud E, Elaziz OHA, Enayet AEA, Khidr EG. Serum neuregulin 1 in relation to ventricular function and subclinical atherosclerosis in type 2 diabetes patients. ENDOCRINOL DIAB NUTR 2023; 70:619-627. [PMID: 38065627 DOI: 10.1016/j.endien.2023.11.010] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/26/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND AND AIMS Neuregulin 1 (NRG-1) is one of the members of the epidermal growth factors proteins. The present study provides novel insights into the relationship between serum levels of NRG-1 and insulin resistance, subclinical atherosclerosis and cardiac dysfunction that occur in type 2 diabetes (T2D). METHODS The study included 50 patients with T2D and 40 healthy age- and gender-matched controls. Serum NRG-1 was measured using ELISA. Glycemic parameters, lipid profile and insulin resistance were assessed. Trans-thoracic echocardiography and carotid intima media thickness (CIMT) were studied for all study subjects. RESULTS T2D patients had significantly lower serum NRG-1 levels than controls. Serum NRG-1 was negatively correlated with age, fasting blood glucose, HbA1c, insulin resistance, blood urea, serum creatinine and LDL-C, and positively correlated with HDL-C, eGFR and CIMT. Regarding echocardiographic variables, serum NRG-1 was found to correlate positively with left ventricular global longitudinal strain and negatively with E/Ea ratio. NRG-1 was found to predict subclinical atherosclerosis in type 2 diabetes patients at a cut-off value<108.5pg/ml with 78% sensitivity and 80% specificity. CONCLUSIONS A robust relationship was found between serum NRG-1 levels and hyperglycemia, insulin resistance, subclinical atherosclerosis, and cardiac dysfunction in patients with type 2 diabetes. These results shed light on a possible role of NRG-1 as a potential noninvasive biomarker for detection of cardiometabolic risk in T2D.
Collapse
Affiliation(s)
- Aya Saad Eldin
- Department of Endocrinology and Metabolism, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Olfat Fawzy
- Department of Endocrinology and Metabolism, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Eman Mahmoud
- Department of Endocrinology and Metabolism, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Ola H Abd Elaziz
- Department of Cardiology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Alshimaa Ezzat A Enayet
- Department of Radio Diagnosis, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Emad Gamil Khidr
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy for Boys, Al-Azhar University, Nasr City, 11231 Cairo, Egypt.
| |
Collapse
|
4
|
Inzunza-Cervantes G, García-Fajardo EA, Martínez-Hernández FA, Zazueta-Armenta V, Hernandez-Marquez JO, Herrera-Gavilanes JR. [Coronary lithotripsy in calcified lesions: fragmented calcium]. Rev Med Inst Mex Seguro Soc 2023; 61:888-894. [PMID: 37995653 PMCID: PMC10727760 DOI: 10.5281/zenodo.10064745] [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] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/05/2023] [Indexed: 11/25/2023]
Abstract
Background Complex calcified coronary lesions are a frequent finding during percutaneous coronary intervention, representing for decades a challenge and limitation in patients with indication of revascularization, due to suboptimal angiographic results, high incidence of perioperative complications and long-term adverse events despite the multiple strategies employed, such as the use of cutting balloon, high-pressure balloons or rotational or orbital atherectomy, interventions with limitations that have hindered its routine use, recently a new plaque modification technique known as coronary intravascular lithotripsy has burst into the treatment of this complex entity, which consists in the use of a specially modified balloon for the emission of pulsatile mechanical energy (sonic pressure waves) that allows modifying the calcified plate. Clinical case By presenting a series of clinical cases and reviewing the literature, our initial experience is presented, key elements are summarized and discussed in the understanding of this new intervention technique necessary for decision making. Conclusion Coronary intravascular lithotripsy is projected as a promising technique for the modification and preparation of superficial and deep calcified coronary lesions, through microfractures that allow the apposition and effective expansion of the stent, strategy that according to different trials (Disrupt CAD series, SOLSTICE assay) and records presents a high efficiency and good safety profile, data consistent with our initial experience.
Collapse
Affiliation(s)
- Gustavo Inzunza-Cervantes
- Instituto Mexicano del Seguro Social, Centro Médico Nacional del Noroeste, Hospital de Especialidades No. 2 “Luis Donaldo Colosio Murrieta”, Servicio de Cardiología, Grupo de Investigación Cardiovascular. Ciudad Obregón, Sonora, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Erick Alfonso García-Fajardo
- Instituto Mexicano del Seguro Social, Centro Médico Nacional del Noroeste, Hospital de Especialidades No. 2 “Luis Donaldo Colosio Murrieta”, Servicio de Cardiología, Grupo de Investigación Cardiovascular. Ciudad Obregón, Sonora, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Francisco Antonio Martínez-Hernández
- Instituto Mexicano del Seguro Social, Centro Médico Nacional del Noroeste, Hospital de Especialidades No. 2 “Luis Donaldo Colosio Murrieta”, Servicio de Cardiología, Grupo de Investigación Cardiovascular. Ciudad Obregón, Sonora, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Verónica Zazueta-Armenta
- Instituto Mexicano del Seguro Social, Centro Médico Nacional del Noroeste, Hospital de Especialidades No. 2 “Luis Donaldo Colosio Murrieta”, Servicio de Cardiología, Grupo de Investigación Cardiovascular. Ciudad Obregón, Sonora, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Jesús Omar Hernandez-Marquez
- Instituto Mexicano del Seguro Social, Centro Médico Nacional del Noroeste, Hospital de Especialidades No. 2 “Luis Donaldo Colosio Murrieta”, Servicio de Cardiología, Grupo de Investigación Cardiovascular. Ciudad Obregón, Sonora, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Juan Ramón Herrera-Gavilanes
- Instituto Mexicano del Seguro Social, Centro Médico Nacional del Noroeste, Hospital de Especialidades No. 2 “Luis Donaldo Colosio Murrieta”, Servicio de Cardiología, Grupo de Investigación Cardiovascular. Ciudad Obregón, Sonora, MéxicoInstituto Mexicano del Seguro SocialMéxico
| |
Collapse
|
5
|
Schoch L, Alcover S, Padró T, Ben-Aicha S, Mendieta G, Badimon L, Vilahur G. Update of HDL in atherosclerotic cardiovascular disease. Clin Investig Arterioscler 2023; 35:297-314. [PMID: 37940388 DOI: 10.1016/j.arteri.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/13/2023] [Indexed: 11/10/2023]
Abstract
Epidemiologic evidence supported an inverse association between HDL (high-density lipoprotein) cholesterol (HDL-C) levels and atherosclerotic cardiovascular disease (ASCVD), identifying HDL-C as a major cardiovascular risk factor and postulating diverse HDL vascular- and cardioprotective functions beyond their ability to drive reverse cholesterol transport. However, the failure of several clinical trials aimed at increasing HDL-C in patients with overt cardiovascular disease brought into question whether increasing the cholesterol cargo of HDL was an effective strategy to enhance their protective properties. In parallel, substantial evidence supports that HDLs are complex and heterogeneous particles whose composition is essential for maintaining their protective functions, subsequently strengthening the "HDL quality over quantity" hypothesis. The following state-of-the-art review covers the latest understanding as per the roles of HDL in ASCVD, delves into recent advances in understanding the complexity of HDL particle composition, including proteins, lipids and other HDL-transported components and discusses on the clinical outcomes after the administration of HDL-C raising drugs with particular attention to CETP (cholesteryl ester transfer protein) inhibitors.
Collapse
Affiliation(s)
- Leonie Schoch
- Cardiovascular Program, Institut de Recerca, Hospital de la Santa Creu I Sant Pau, IIB Sant Pau, 08025 Barcelona, Spain; Faculty of Medicine, University of Barcelona (UB), 08036 Barcelona, Spain
| | - Sebastián Alcover
- Cardiovascular Program, Institut de Recerca, Hospital de la Santa Creu I Sant Pau, IIB Sant Pau, 08025 Barcelona, Spain
| | - Teresa Padró
- Cardiovascular Program, Institut de Recerca, Hospital de la Santa Creu I Sant Pau, IIB Sant Pau, 08025 Barcelona, Spain
| | | | - Guiomar Mendieta
- Cardiology Unit, Cardiovascular Clinical Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Lina Badimon
- Cardiovascular Program, Institut de Recerca, Hospital de la Santa Creu I Sant Pau, IIB Sant Pau, 08025 Barcelona, Spain; Cardiovascular Research Chair, UAB, 08025 Barcelona, Spain; CiberCV, Institute of Health Carlos III, Madrid, Spain
| | - Gemma Vilahur
- Cardiovascular Program, Institut de Recerca, Hospital de la Santa Creu I Sant Pau, IIB Sant Pau, 08025 Barcelona, Spain; CiberCV, Institute of Health Carlos III, Madrid, Spain.
| |
Collapse
|
6
|
Hamczyk MR, Nevado RM. Vascular smooth muscle cell aging: Insights from Hutchinson-Gilford progeria syndrome. Clin Investig Arterioscler 2023; 35:42-51. [PMID: 35125249 DOI: 10.1016/j.arteri.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/13/2021] [Accepted: 11/03/2021] [Indexed: 02/08/2023]
Abstract
Vascular smooth muscle cells (VSMCs) constitute the principal cellular component of the medial layer of arteries and are responsible for vessel contraction and relaxation in response to blood flow. Alterations in VSMCs can hinder vascular system function, leading to vascular stiffness, calcification and atherosclerosis, which in turn may result in life-threatening complications. Pathological changes in VSMCs typically correlate with chronological age; however, there are certain conditions and diseases, such as Hutchinson-Gilford progeria syndrome (HGPS), that can accelerate this process, resulting in premature vascular aging. HGPS is a rare genetic disorder characterized by severe VSMC loss, accelerated atherosclerosis and death from myocardial infarction or stroke during the adolescence. Because experiments with mouse models have demonstrated that alterations in VSMCs are responsible for early atherosclerosis in HGPS, studies on this disease can provide insights into the mechanisms of vascular aging and assess the relative contribution of VSMCs to this process.
Collapse
Affiliation(s)
- Magda R Hamczyk
- Departamento de Bioquímica y Biología Molecular, Instituto Universitario de Oncología (IUOPA), Universidad de Oviedo, 33006 Oviedo, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain.
| | - Rosa M Nevado
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 28029 Madrid, Spain
| |
Collapse
|
7
|
Zuriaga MA, Fuster JJ. Clonal hematopoiesis and atherosclerotic cardiovascular disease: A primer. Clin Investig Arterioscler 2023; 35:35-41. [PMID: 34879980 DOI: 10.1016/j.arteri.2021.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/23/2021] [Indexed: 02/08/2023]
Abstract
Despite current standards of care, a considerable risk of atherosclerotic cardiovascular disease remains in both primary and secondary prevention. In this setting, clonal hematopoiesis driven by somatic mutations has recently emerged as a relatively common, potent and independent risk factor for atherosclerotic cardiovascular disease and other cardiovascular conditions. Experimental studies in mice suggest that mutations in TET2 and JAK2, which are among the most common in clonal hematopoiesis, increase inflammation and are causally connected to accelerated atherosclerosis development, which may explain the link between clonal hematopoiesis and increased cardiovascular risk. In this review, we provide an overview of our current understanding of this emerging cardiovascular risk factor.
Collapse
Affiliation(s)
- María A Zuriaga
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - José J Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBER en Enfermedades Cardiovasculares (CIBER-CV), Madrid, Spain.
| |
Collapse
|
8
|
Ballester-Servera C, Cañes L, Alonso J, Puertas L, Taurón M, Rodríguez C, Martínez-González J. Nuclear receptor NOR-1 (Neuron-derived Orphan Receptor-1) in pathological vascular remodelling and vascular remodelling. Clin Investig Arterioscler 2022; 34:229-243. [PMID: 35581107 DOI: 10.1016/j.arteri.2022.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 06/15/2023]
Abstract
Vascular cells and their interaction with inflammatory cells and the immune system play a key role in pathological vascular remodeling. A large number of genes and proteins regulated in a coordinated manner by a small number of transcription factors are involved in this process. In recent years, research on a small subfamily of transcription factors, the NR4A subfamily, has had a major impact on our understanding of vascular biology. The NR4A1 (Nur77), NR4A2 (Nurr1) and NR4A3 (NOR-1) receptors are products of early response genes whose expression is induced by multiple pathophysiological and physical stimuli. Their wide distribution in different tissues and cells places them in the control of numerous processes such as cell differentiation, proliferation, survival and apoptosis, as well as inflammation and the metabolism of lipids and carbohydrates. This review analyzes the role of these receptors, particularly NOR-1, in pathological vascular remodeling associated with atherosclerosis, abdominal aortic aneurysm and pulmonary arterial hypertension.
Collapse
Affiliation(s)
- Carme Ballester-Servera
- Instituto de Investigaciones Biomédicas de Barcelona-Consejo Superior de Investigaciones Científicas (IIBB-CSIC), Barcelona, España; CIBER de Enfermedades Cardiovasculares, ISCIII, Madrid, España; Instituto de Investigación Biomédica Sant Pau, Barcelona, España
| | - Laia Cañes
- Instituto de Investigaciones Biomédicas de Barcelona-Consejo Superior de Investigaciones Científicas (IIBB-CSIC), Barcelona, España; CIBER de Enfermedades Cardiovasculares, ISCIII, Madrid, España
| | - Judith Alonso
- Instituto de Investigaciones Biomédicas de Barcelona-Consejo Superior de Investigaciones Científicas (IIBB-CSIC), Barcelona, España; CIBER de Enfermedades Cardiovasculares, ISCIII, Madrid, España; Instituto de Investigación Biomédica Sant Pau, Barcelona, España
| | - Lidia Puertas
- Instituto de Investigación Biomédica Sant Pau, Barcelona, España; Institut de Recerca Hospital de la Santa Creu i Sant Pau (IRHSCSP), Barcelona, España
| | - Manel Taurón
- Servicio de Cirugía Cardiovascular, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - Cristina Rodríguez
- CIBER de Enfermedades Cardiovasculares, ISCIII, Madrid, España; Instituto de Investigación Biomédica Sant Pau, Barcelona, España; Institut de Recerca Hospital de la Santa Creu i Sant Pau (IRHSCSP), Barcelona, España
| | - José Martínez-González
- Instituto de Investigaciones Biomédicas de Barcelona-Consejo Superior de Investigaciones Científicas (IIBB-CSIC), Barcelona, España; CIBER de Enfermedades Cardiovasculares, ISCIII, Madrid, España; Instituto de Investigación Biomédica Sant Pau, Barcelona, España.
| |
Collapse
|
9
|
Behairy MA, Shawky S, Hamed R, Bawady S, Abdelsattar HA, Bichari W. Is serum Osteopontin a predictor of carotid atherosclerosis severity among prevalent hemodialysis patients? Clin Investig Arterioscler 2022; 34:75-85. [PMID: 35144845 DOI: 10.1016/j.arteri.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/31/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIM Chronic hemodialysis (HD) patients are among the highest population risk for accelerated atherosclerosis. Osteopontin (OPN) is a multifunctional protein that is increased in chronic kidney disease that may play a role in vascular remodelling and intimal proliferation. AIM To assess the relation between OPN levels and severity of carotid atherosclerosis among prevalent HD patients. METHODS Eighty chronic HD patients underwent serum OPN levels assessment and were further classified into 3 subgroups according to the OPN tertiles' levels; sub-group 1 (lower tertile) subgroup 2 (middle tertile) and sub-group 3 (upper tertile), together with the carotid duplex and Transthoracic Doppler Echocardiography examination. RESULTS The mean carotid intima-media thickness (CIMT) was 0.89±0.14mm. Out of the studied group, 50 (62.5%) patients had atheromatous plaques and 15 patients (18.8%). had significant stenosis. The 3rd group with the upper OPN tertile (78-270ng/dl) had the highest incidence of atherosclerosis. A significant correlation between the OPN levels and the CIMT (r=0.533, p=0.001). OPN values detect atherosclerosis with diagnostic sensitivity of 70%, specificity of 69%, positive predictive value (PPV) 73%, negative predictive value (NPV) 65% with area under the curve (AUC) 0.804 (95% CI: 0.711-0.897). Serum OPN detect carotid stenosis with sensitivity of 66%, specificity of 81%, PPV 45%, NPV 91% with AUC=0.769 and detect the presence of carotid atheroma with sensitivity 70%, specificity 66.67%, PPV 77.8%, NPV 57.1% and AUC=0.767 (p-value<0.001). Moreover, serum levels of OPN were significantly positively correlated with grade of diastolic dysfunction (r=0.312, p=0.005), E/A ratio (r=0.293, p=0.008) and inversely correlated with left ventricular ejection fraction (r=-0.304, p=0.006). CONCLUSIONS Serum Osteopontin is of clinical value as a predictor biomarker of the severity of carotid atherosclerosis, presence of atheroma and carotid stenosis with high diagnostic sensitivity and specificity in chronic hemodialysis patients. Increased Osteopontin level is associated with left ventricular diastolic and systolic dysfunction in those patients.
Collapse
Affiliation(s)
- Maha A Behairy
- Internal Medicine and Nephrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Sahar Shawky
- Internal Medicine and Nephrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Reham Hamed
- Health Insurance Hospital, Internal Medicine, Egypt
| | - Somia Bawady
- Clinical Pathology, Faculty of Medicine Ain Shams University, Cairo, Egypt
| | - Hoda A Abdelsattar
- Clinical Pathology, Faculty of Medicine Ain Shams University, Cairo, Egypt
| | - Walid Bichari
- Internal Medicine and Nephrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| |
Collapse
|
10
|
Guijarro C, Cosín-Sales J. LDL cholesterol and atherosclerosis: The evidence. Clin Investig Arterioscler 2021; 33 Suppl 1:25-32. [PMID: 33966809 DOI: 10.1016/j.arteri.2020.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/31/2020] [Indexed: 11/24/2022]
Abstract
The lipid theory of atherosclerosis dates back more than a century. Despite this, some authors have questioned the relevance of hypercholesterolaemia in its development. Multiple experimental, epidemiological, and clinical evidence underpins this association. Atherosclerotic cardiovascular disease remains as the major cause of mortality in the world. Recent genetic studies of Mendelian randomisation and randomised clinical trials aimed at LDL cholesterol reduction, are summarised in this article. They, unequivocally ratify the aetiological role of LDL cholesterol in the development of atherosclerosis. Thus, LDL cholesterol lowering is the cornerstone of lipid lowering therapy for the reduction of cardiovascular complications of atherosclerosis.
Collapse
|
11
|
Escobar Cervantes C, Pérez de Isla L. Imaging techniques in atherosclerosis. Clin Investig Arterioscler 2021; 33 Suppl 1:18-24. [PMID: 33966808 DOI: 10.1016/j.arteri.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 12/22/2020] [Indexed: 06/12/2023]
Abstract
Cardiovascular imaging techniques have revolutionized the management of coronary atherosclerosis. Due to this, the assessment of the presence and extension of atherosclerotic disease in the different arterial territories is much simpler, with the advantage that they are non-invasive techniques. This chapter summarises the usefulness of the different cardiovascular imaging modalities in the diagnosis and prognostic stratification of the cardiovascular patient.
Collapse
Affiliation(s)
| | - Leopoldo Pérez de Isla
- Unidad de Imagen Cardiovascular, Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, España
| |
Collapse
|
12
|
Méndez-Barbero N, Gutiérrez-Muñoz C, Blázquez-Serra R, Martín-Ventura JL, Blanco-Colio LM. Annexins: Involvement in cholesterol homeostasis, inflammatory response and atherosclerosis. Clin Investig Arterioscler 2021; 33:206-216. [PMID: 33622609 DOI: 10.1016/j.arteri.2020.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/09/2020] [Accepted: 12/16/2020] [Indexed: 11/27/2022]
Abstract
The annexin superfamily consists of 12 proteins with a highly structural homology that binds to phospholipids depending on the availability of Ca2+-dependent. Different studies of overexpression, inhibition, or using recombinant proteins have linked the main function of these proteins to their dynamic and reversible binding to membranes. Annexins are found in multiple cellular compartments, regulating different functions, such as membrane trafficking, anchoring to the cell cytoskeleton, ion channel regulation, as well as pro- or anti-inflammatory and anticoagulant activities. The use of animals deficient in any of these annexins has established their possible functions in vivo, demonstrating that annexins can participate in relevant functions independent of Ca2+ signalling. This review will focus mainly on the role of different annexins in the pathological vascular remodelling that underlies the formation of the atherosclerotic lesion, as well as in the control of cholesterol homeostasis.
Collapse
Affiliation(s)
- Nerea Méndez-Barbero
- Laboratorio de Patología Vascular, IIS-Fundación Jiménez Díaz, Madrid, España; CIBER de Enfermedades Cardiovasculares (CIBERCV), España
| | - Carmen Gutiérrez-Muñoz
- Laboratorio de Patología Vascular, IIS-Fundación Jiménez Díaz, Madrid, España; CIBER de Enfermedades Cardiovasculares (CIBERCV), España
| | | | - José Luis Martín-Ventura
- Laboratorio de Patología Vascular, IIS-Fundación Jiménez Díaz, Madrid, España; CIBER de Enfermedades Cardiovasculares (CIBERCV), España
| | - Luis Miguel Blanco-Colio
- Laboratorio de Patología Vascular, IIS-Fundación Jiménez Díaz, Madrid, España; CIBER de Enfermedades Cardiovasculares (CIBERCV), España.
| |
Collapse
|
13
|
Yalım Z, Aldemir M, Emren SV. Association of Inflammatory Markers with Multisite Artery Disease in Patients with Peripheral Arterial Disease. Clin Investig Arterioscler 2020; 33:55-61. [PMID: 33036788 DOI: 10.1016/j.arteri.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/21/2020] [Accepted: 08/11/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Chronic inflammation plays a considerable role in atherosclerosis and may occur simultaneously in different arteries. This condition is referred to as multisite arterial disease (MSAD). We aimed to investigate the association between inflammatory markers and MSAD. METHODS In this cross-sectional study we included 526 patients with peripheral artery disease (PAD). Patients with PAD were evaluated by conventional or computed tomography angiography for the presence of coronary artery disease (CAD) and those with at least 30% stenosis were included in the study. Patients were divided into two groups: either MSAD+(PAD and CAD), Group 1) or MSAD- (only PAD without CAD, Group 2). Inflammatory markers were compared between the two groups. RESULTS Among all patients, 293 had MSAD while 233 had only PAD. The MSAD+group had higher neutrophil-to-lymphocyte ratio (NLR) and platelet-to-neutrophil ratio (PLR) (5.08±0.19, 4.67±0.51, and 207.1±6.23, 169.3±10.8, respectively, p<0.001). In multivariate analysis, HT [odds ratio (OR): 2.40 (1.61-3.59)); p<0.002], male gender [OR: 2.03 (1.29-3.17); p=0.002], DM [OR:1.56 (1.03-2.36); P=0.035], NLR [OR: 1,08 (1.02-1.16); p=0.021, and PLR [OR:1.05 (1.03-1.08); p<0.001] were found to be associated with MSAD. CONCLUSION NLR and PLR are correlated with MSAD and may indicate the extent of atherosclerosis.
Collapse
Affiliation(s)
- Zafer Yalım
- Afyonkarahisar Healty Sciences University, Afyonkarahisar, Afyon, Turkey.
| | - Mustafa Aldemir
- Health Sciences University Bursa Higher Specialization Training And Research Hospital, Department of Cardiovascular Surgery, Yuksek Ihtisas Egitim ve Arastirma Hastanesi, Bursa, Turkey
| | - Sadık Volkan Emren
- İzmir Katip Çelebi University, Departments of Cardiology, İzmir Katip Celebi Universitesi Tip Fakultesi, İzmir, Turkey
| |
Collapse
|
14
|
Pedro-Botet J, Climent E, Benaiges D. Atherosclerosis and inflammation. New therapeutic approaches. Med Clin (Barc) 2020; 155:256-262. [PMID: 32571617 DOI: 10.1016/j.medcli.2020.04.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 01/21/2023]
Abstract
The recognition of atherogenesis as an active process rather than a passive cholesterol storage disease has underlined key inflammatory mechanisms. Hence, innate and adaptive immune responses play an important role in the onset and progression of atherosclerosis. More recently, some clinical studies were designed to address the impact of anti-inflammatory intervention strategies in reducing risk of cardiovascular disease beyond the management of classic risk factors. Therefore, we review first the pathophysiological contribution of inflammation to atherosclerosis and the effect of lipid-lowering drugs on inflammatory biomarkers. Next, we address the effect of classic anti-inflammatory drugs, pharmacological therapies targeting specific inflammatory mediators and vaccines in cardiovascular prevention.
Collapse
Affiliation(s)
- Juan Pedro-Botet
- Unidad de Lípidos y Riesgo Vascular, Servicio de Endocrinología y Nutrición, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, España.
| | - Elisenda Climent
- Unidad de Lípidos y Riesgo Vascular, Servicio de Endocrinología y Nutrición, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, España
| | - David Benaiges
- Unidad de Lípidos y Riesgo Vascular, Servicio de Endocrinología y Nutrición, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, España
| |
Collapse
|
15
|
Ruiz ÁJ, Vargas-Uricoechea H, Urina-Triana M, Román-González A, Isaza D, Etayo E, Quintero A, Molina DI, Toro JM, Parra G, Merchán A, Cadena A, Yupanqui Lozano H, Cárdenas JM, Quintero ÁM, Botero R, Jaramillo M, Arteaga JM, Vesga-Angarita B, Valenzuela-Plata E, Betancur-Valencia M. Dyslipidaemias and their treatment in high complexity centres in Colombia. Clin Investig Arterioscler 2020; 32:101-110. [PMID: 32284160 DOI: 10.1016/j.arteri.2019.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 11/05/2019] [Accepted: 11/19/2019] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Data is scarce on the distribution of different types of dyslipidaemia in Colombia. The primary objective was to describe the frequency of dyslipidaemias. The secondary objectives were: frequency of cardiovascular comorbidity, statins and other lipid-lowering drugs use, frequency of statins intolerance, percentage of patients achieving c-LDL goals, and distribution of cardiovascular risk (CVR). MATERIALS AND METHODS Cross-sectional study with retrospective data collection from 461 patients diagnosed with dyslipidaemia and treated in 17 highly specialised centres distributed into six geographic and economic regions of Colombia. RESULTS Mean (SD) age was 66.4 (±12.3) years and 53.4% (246) were women. Dyslipidaemias were distributed as follows in order of frequency: mixed dyslipidaemia (51.4%), hypercholesterolaemia (41.0%), hypertriglyceridaemia (5.4%), familial hypercholesterolaemia (3.3%), and low c-HDL (0.7%). The most prescribed drugs were atorvastatin (75.7%) followed by rosuvastatin (24.9%). As for lipid control, 55% of all patients, and 28.6% of those with coronary heart disease, did not achieve their personal c-LDL goal despite treatment. The frequency of statin intolerance was 2.6% in this study. CONCLUSIONS Mixed dyslipidaemia and hypercholesterolaemia are the most frequent dyslipidaemias in Colombia. A notable percentage of patients under treatment with lipid-lowering drugs, including those with coronary heart disease, did not achieve specific c-LDL goals. This poor lipid control may worsen patient's CVR, so that therapeutic strategies need to be changed, either with statin intensification or addition of new drugs in patients with higher CVR.
Collapse
Affiliation(s)
| | | | - Miguel Urina-Triana
- Fundación del Caribe para la Investigación Biomédica-Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla, Colombia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Aydemir H, Guney I, Duran C, Gencer V, Akbayrak S, Kurku H, Akgul YSS, Can M, Ecirli S. The association of decreased testosterone with atherosclerosis and inflammation in male predialysis patients with chronic kidney disease. Clin Investig Arterioscler 2020; 32:135-143. [PMID: 32291192 DOI: 10.1016/j.arteri.2020.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 01/20/2020] [Accepted: 01/27/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the frequency of hypogonadism and its relationship to inflammation and carotid intima-media thickness (CIMT) in male patients with predialysis chronic kidney disease (CKD). METHODS A total of 105 patients with CKD, 55 (52.4%) as stage 3, 33 (31.4%) as stage 4 and 17 (16.2%) as stage 5, were enrolled into the study. Total testosterone (TT) and free testosterone (FT), interleukin 6 (IL-6), C-reactive protein (CRP) levels, and CIMT were measured. RESULTS According to TT and FT, hypogonadism was detected in 18 (17.1%) and 22 (20.9%) patients, respectively. There was no difference in terms of TT and FT, CIMT, CRP and IL-6 between the stages of CKD. According to TT, the patients with hypogonadism had significantly higher CRP and high-density lipoprotein cholesterol (HDL-cholesterol) levels (p=0.004 and p=0.005, respectively). There was no significant difference in other parameters. According to FT, the patients with hypogonadism had significantly higher CRP (p=0.017), and TT were negatively correlated with body mass index (BMI), waist circumference (WC), hip circumference, and CRP levels. FT was negatively correlated with age, waist circumference, systolic blood pressure, diastolic blood pressure (DBP) and CRP. CONCLUSIONS The frequency of hypogonadism was found around 17-21% among the patients with CKD. Despite similar IL-6 and CIMT levels, CRP was found to be higher in the patients with hypogonadism. We consider that further studies with larger populations are needed to elucidate the entity.
Collapse
Affiliation(s)
- Harun Aydemir
- The Division of Rheumatology, The Department of Internal Medicine, Meram Medical School of Necmettin Erbakan University, Konya, Turkey
| | - Ibrahim Guney
- The Division of Nephrology, The Department of Internal Medicine, Konya Health Application and Research Center, University of Health Sciences, Konya, Turkey
| | - Cevdet Duran
- The Division of Endocrinology and Metabolism, The Department of Internal Medicine, Medical School of Usak University, Usak, Turkey.
| | - Vedat Gencer
- The Division of Nephrology, The Department of Internal Medicine, Yozgat State Hospital, Yozgat, Turkey
| | - Sahabettin Akbayrak
- The Department of Radiology, Konya Health Application and Research Center, University of Health Sciences, Konya, Turkey
| | - Huseyin Kurku
- The Department of Biochemistry, Konya Health Application and Research Center, University of Health Sciences, Konya, Turkey
| | - Yavuz Sultan Selim Akgul
- The Department of Internal Medicine, Konya Health Application and Research Center, University of Health Sciences, Konya, Turkey
| | - Mustafa Can
- The Division of Endocrinology and Metabolism, The Department of Internal Medicine, Meram Medical School of Necmettin Erbakan University, Konya, Turkey
| | - Samil Ecirli
- The Department of Internal Medicine, Konya Health Application and Research Center, University of Health Sciences, Konya, Turkey
| |
Collapse
|
17
|
Abstract
Platelets, in addition to participating in atherosclerosis, play a very active role in the immune response of this disease since they have the ability to interact with various inflammatory cells, in addition to secreting cytokines, chemokines, growth factors, etc. The functions of platelets go beyond their interaction with the endothelium, as they participate in creating an inflammatory environment, which contributes to the loss of homeostasis. On the other hand, platelet-derived microparticles induce the activation of other platelets, of endothelial cells and in recruiting leukocytes. For all the above, platelets and the inflammatory environment can be considered as possible therapeutic targets to prevent the development of atherosclerosis and the events associated with it.
Collapse
Affiliation(s)
| | - Ruth A Lezama
- Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México, México
| | - Elba Reyes-Maldonado
- Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México, México
| |
Collapse
|
18
|
Ivanovski O, Nikolov IG, Davceva O, Petrushevska G. Calcification of the cavernosal bodies may be responsible for development of erectile dysfunction in uremic apolipoprotein E deficient (apoE-/-) mice. Rev Int Androl 2019; 19:25-33. [PMID: 31899189 DOI: 10.1016/j.androl.2019.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/30/2019] [Accepted: 08/08/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION AND OBJECTIVE Erectile dysfunction's physiopathology in uremia is complex and multifactorial, involving a combination of classical risk factors and specific uremia-related risk factors such as increased oxidative stress, endothelial dysfunction and inflammation. The aim of the study is to investigate the effect of chronic kidney disease (CKD) on vascular calcification and endothelial function of cavernosal bodies in apolipoprotein E deficient (apoE-/-) mice, a well known model of erectile dysfunction. MATERIALS AND METHODS Eight-week-old male apoE-/- mice were randomly assigned to the following 3 groups: (i) subtotally nephrectomised (SNX apoE-/-, 12 mice), (ii) uninephrectomised (UNX apoE-/-, 11 mice) or (iii) sham operated (sham-op apoE-/-, 15 mice). At 16 weeks after surgery, aortas and penile erectile tissues were harvested for histological studies to assess atherosclerosis, vascular calcification, nitrotyrosine staining, total collagen content and macrophage staining. RESULTS At sacrifice, SNX and UNX mice had significantly higher serum urea, total cholesterol, and triglyceride concentrations than sham-op controls. Atherosclerotic lesions in thoracic aorta were significantly larger in uremic apoE-/- mice than in controls. There were no atheromatous lesions in cavernosal bodies or penile artery observed in any group. However, SNX and UNX animals showed a significant increase in calcification score, collagen content and nitrotyrosine staining in cavernosal bodies when compared with controls. The degree of macrophage infiltration was comparable between the 3 groups. CONCLUSION In conclusion, even mild renal dysfunction, i.e., after uninephrectomy increases calcification score and aggravates endothelial function of cavernosal bodies in apoE-/- mice and this effect might be linked to increased oxidative stress in penile endothelium.
Collapse
Affiliation(s)
- Ognen Ivanovski
- University Clinic of Urology, Medical Faculty, University SS Cyril and Methodius, Skopje, Macedonia.
| | - Igor G Nikolov
- University Clinic of Nephrology, Medical Faculty, University SS Cyril and Methodius, Skopje, Macedonia
| | - Olivera Davceva
- University Clinic of Clinical Biochemistry, Medical Faculty, University SS Cyril and Methodius, Skopje, Macedonia
| | - Gordana Petrushevska
- Institute of Pathology, Medical Faculty, University SS Cyril and Methodius, Skopje, Macedonia
| |
Collapse
|
19
|
Chiquete E, Gómez-Piña JJ, Ramírez-García G, Ruiz-Ruiz E, Barrientos-Guerra JD, Toapanta-Yanchapaxi L, Flórez-Cardona JA, Flores-Silva F, Reyes-Melo I, García-Ramos G, Higuera-Calleja J, Cantú-Brito C. Enfermedad carotídea aterosclerosa y enfermedad de sustancia blanca en sujetos sin historia de infarto cerebral o isquemia cerebral transitoria. GAC MED MEX 2019; 155:350-356. [PMID: 31486781 DOI: 10.24875/gmm.19004494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Atherosclerotic carotid artery disease (CAD) is a major risk factor for cerebrovascular disease. Objective To analyze the association of major vascular risk factors with atherosclerotic CAD and white matter disease (WMD) in patients without a history of ischemic stroke. Method Risk factors were assessed with carotid examination using Doppler duplex ultrasound. Cases with a history cerebral infarction or transient ischemic attack were not included. Subjects had brain magnetic resonance imaging scans available and those with large-artery ischemic lesions were excluded. Multivariate models were constructed for the prediction of atherosclerotic CAD, significant carotid stenosis, atheroma burden and WMD. Results One-hundred and forty-five subjects were assessed (60.7% were females, mean age was 73 years). Atherosclerotic CAD was documented in 54.5%, carotid stenosis ≥ 50% in 9.0%, > 6 atheroma plaques in 7.6%, and periventricular or subcortical WMD in 28.3% (20.6% had atherosclerotic CAD and WMD concurrently). Risk factors independently associated with atherosclerotic CAD were age and hypertension; hypertension was associated with ≥ 50% carotid stenosis; age was associated with > 6 atheroma plaques; and age, diabetes and hypertension were associated with WMD. Obesity was not associated with any of the analyzed independent variables. Conclusions In asymptomatic subjects without a history of ischemic stroke, age and hypertension were the most important risk factors for macrovascular disease. Diabetes mellitus was associated with microvascular disease. Obesity alone was not a major determinant of CAD or WMD.
Collapse
Affiliation(s)
- Erwin Chiquete
- Instituto Nacional de Ciencias Médicas y de la Nutrición "Salvador Zubirán", Departamento de Neurología y Psiquiatría, Ciudad de México, México
| | - Juan José Gómez-Piña
- Instituto Nacional de Ciencias Médicas y de la Nutrición "Salvador Zubirán", Departamento de Neurología y Psiquiatría, Ciudad de México, México
| | - Guillermo Ramírez-García
- Instituto Nacional de Ciencias Médicas y de la Nutrición "Salvador Zubirán", Departamento de Neurología y Psiquiatría, Ciudad de México, México
| | - Eduardo Ruiz-Ruiz
- Instituto Nacional de Ciencias Médicas y de la Nutrición "Salvador Zubirán", Departamento de Neurología y Psiquiatría, Ciudad de México, México
| | - José Domingo Barrientos-Guerra
- Instituto Nacional de Ciencias Médicas y de la Nutrición "Salvador Zubirán", Departamento de Neurología y Psiquiatría, Ciudad de México, México
| | - Liz Toapanta-Yanchapaxi
- Instituto Nacional de Ciencias Médicas y de la Nutrición "Salvador Zubirán", Departamento de Neurología y Psiquiatría, Ciudad de México, México
| | | | - Fernando Flores-Silva
- Instituto Nacional de Ciencias Médicas y de la Nutrición "Salvador Zubirán", Departamento de Neurología y Psiquiatría, Ciudad de México, México
| | - Isael Reyes-Melo
- Instituto Nacional de Ciencias Médicas y de la Nutrición "Salvador Zubirán", Departamento de Neurología y Psiquiatría, Ciudad de México, México
| | - Guillermo García-Ramos
- Instituto Nacional de Ciencias Médicas y de la Nutrición "Salvador Zubirán", Departamento de Neurología y Psiquiatría, Ciudad de México, México
| | - Jesús Higuera-Calleja
- Instituto Nacional de Ciencias Médicas y de la Nutrición "Salvador Zubirán", Departamento de Neurorradiología, Ciudad de México, México
| | - Carlos Cantú-Brito
- Instituto Nacional de Ciencias Médicas y de la Nutrición "Salvador Zubirán", Departamento de Neurología y Psiquiatría, Ciudad de México, México
| |
Collapse
|
20
|
Marcos Jubilar M, Orbe J, Roncal C, Fernández Montero A, Colina I, Rodil R, Rodriguez JA, Zabaleta A, Paiva B, Pastrana JC, Páramo JA. Analysis of monocitary subpopulations in relation to cardiovascular risk factors. Clin Investig Arterioscler 2019; 31:152-9. [PMID: 30967277 DOI: 10.1016/j.arteri.2019.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 01/17/2019] [Accepted: 02/06/2019] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Monocytes play an important role in atherosclerotic progression having both pro and anti-inflammatory effects depending on different circulating monocyte subpopulations. The objective of this study is to characterize these subpopulations and their association with cardiovascular risk factors. METHODS Transversal study including 102 selected patients, mean age: 65 years-old (range 41-86), 69% males. A set of specific antibodies against classical monocytes (Mon1, CD14+CD16- CD300e+HLADR+), intermediate (Mon2, CD14+CD16+CD300e+HLADR+) and non-classical (Mon3, CD14-CD16+CD300e+HLADR+) was assayed. Three groups of patients were included: 17 asymptomatic with more than one cardiovascular risk factor (group 1), 56 subjects asymptomatic but with vascular pathology assessed by ultrasound or microalbuminuria (group 2) and 19 patients with a previous atherothrombotic event (group 3). The cardiovascular risk was determined by Framingham and REGICOR scores. RESULTS An association between study groups and the percentage of Mon1 and Mon2 was observed (ANOVA, p<.05), being independent of age and sex for Mon2. Likewise Mon1 and Mon2 subpopulations were associated with cardiovascular adverse events (β=0.86, p=.02 y β=0.1 p=.002, respectively), independently of age and sex in the case of Mon2. Moreover the percentage of Mon3 was associated with the presence of several cardiovascular risk factors (β=0.21, p=.04) in the univariate analysis. In addition, there was a correlation between the levels of Mon1 and Mon2 and leukocytes (r=0.7, p<.001 and r=0.26, p=.01, respectively). CONCLUSIONS The analysis of monocyte subpopulations may be clinically useful to stratify the inflammatory profile related to the different cardiovascular risk groups.
Collapse
|
21
|
Pérez Sorí Y, Herrera Moya VA, Puig Reyes I, Moreno-Martínez FL, Bermúdez Alemán R, Rodríguez Millares T, Fleites Medina A. Histology of atherosclerotic plaque from coronary arteries of deceased patients after coronary artery bypass graft surgery. Clin Investig Arterioscler 2018; 31:63-72. [PMID: 30262443 DOI: 10.1016/j.arteri.2018.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 07/01/2018] [Accepted: 07/16/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM Ischaemic heart disease is an important health problem. The characteristics of atherosclerotic plaques determine patient outcome. The aim of this study was to determine the histological grade of coronary atherosclerotic lesions in deceased patients after coronary artery bypass graft surgery, and to identify the complications of the severe plaques. METHOD A descriptive, cross-sectional, prospective study was carried out on 21 anatomical pieces of deceased patients over a period of 3 years. The epicardial coronary arteries were sectioned transversally every 1cm, and the odd numbered fragments and the regions of the anastomosis with the grafts were selected. They were embedded in paraffin, stained with haematoxylin-eosin, and the histological slides were studied using an Olympus BHM microscope. RESULTS An age over 50 years (85.7%), male gender (81.0%), and smoking (66.7%) predominated. Peri-operative infarction (38.1%) and cardiogenic shock (33.3%) were the main direct causes of death. The majority of the grafts were of venous origin (64.6%), and 149 lesions were detected, of which 116 (77.8%) were severe plaques, and 47.4% of them were located in the left anterior descending artery. The large majority (81.9%) of the lesions were located in the arterial segments proximal to the graft. A total of 255 histological complications were detected in the severe plaques, with 75.0% showing calcification. Hypertensive patients had more plaques with more complications, but no statistically significant association was found between these variables. CONCLUSIONS Severe plaques predominated, mostly located in the proximal segments of the coronary arteries, and the left anterior descending was the most affected artery. Calcification was the most observed complication in the severe plaques.
Collapse
Affiliation(s)
- Yanet Pérez Sorí
- Universidad de Ciencias Médicas de Villa Clara, Villa Clara, Cuba
| | | | | | | | | | | | | |
Collapse
|
22
|
Figueira L, González JC. Effect of resveratrol on seric vascular endothelial growth factor concentrations during atherosclerosis. Clin Investig Arterioscler 2018; 30:209-216. [PMID: 30253861 DOI: 10.1016/j.arteri.2018.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 04/08/2018] [Accepted: 04/13/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Although it is known that resveratrol has anti-inflammatory and anti-atherogenic actions, its effect on vascular endothelial growth factor (VEGF) in atherosclerosis is unknown. OBJECTIVE To evaluate the effect of resveratrol on serum concentrations of VEGF during the progression and evolution of atherosclerosis, as well as and its evolution over time in rabbits fed with a cholesterol diet. MATERIALS AND METHODS A total of 48 New Zealand white male rabbits were randomly divided into four groups of 12 rabbits: group1 (control): standard diet (commercial rabbit food); group2: cholesterol diet (0.5% cholesterol); group3 (control resveratrol): standard diet (commercial rabbit food) and resveratrol (2mg/Kg); group4: cholesterol diet (0.5% cholesterol) and resveratrol (2mg/Kg), for 12weeks. Blood samples of overnight-fasted rabbits were collected at baseline and the sixth and twelfth weeks, and the lipid profile, VEGF, and C-reactive protein (CRP) levels were determined. Half of the animals were sacrificed on the sixth or twelfth week, and the aorta was dissected for histological studies. RESULTS VEGF and CRP levels were significantly higher in groups2 and 4 than in groups1 and 3, respectively, from the 6th week (p<0.001). VEGF and CRP were significantly lower in group4 than in group2 on 12th week (p<0.004). Supplementation of resveratrol reduced the formation of atherosclerotic lesions. CONCLUSIONS Serum VEGF and CRP levels are early markers of atherosclerosis. Oral supplementation of resveratrol exerts anti-inflammatory and anti-atherosclerotic effects, decreasing serum concentrations of VEGF and CRP and the formation and evolution of atherosclerotic lesions.
Collapse
Affiliation(s)
- Leticia Figueira
- Escuela de Bioanálisis, Laboratorio de Investigación y Postgrado de la Escuela de Bioanálisis (LIPEB), Facultad de Ciencias de la Salud, Universidad de Carabobo, Naguanagua, Carabobo, Venezuela.
| | - Julio César González
- Escuela de Bioanálisis, Laboratorio de Investigación y Postgrado de la Escuela de Bioanálisis (LIPEB), Facultad de Ciencias de la Salud, Universidad de Carabobo, Naguanagua, Carabobo, Venezuela; Laboratorio Clínico Julio César González, Valencia, Carabobo, Venezuela
| |
Collapse
|
23
|
Páramo Fernández JA. Atherosclerosis and clonal hematopoyesis: A new risk factor. Clin Investig Arterioscler 2018; 30:133-6. [PMID: 29699715 DOI: 10.1016/j.arteri.2018.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 02/23/2018] [Accepted: 03/05/2018] [Indexed: 01/08/2023]
Abstract
Recent research has revealed that clonal hematopoyesis of indeterminate potential (CHIP) characterized by the acquisition of somatic mutations in hematopoietic stem cells, is not only a common age-related disorder and a premalignant condition, but it is also associated with the development of atherosclerotic vascular diseases. Mutations in DNMT3A, TET2 and ASXL1 were each individually associated with coronary heart disease, stroke and coronary calcification. Therefore, CHIP emerges as a new risk factor for atherosclerotic vascular pathologies and its detection may be relevant as a new therapeutic target in order to modify the natural course of the disease.
Collapse
|
24
|
Arroyo-Rodríguez C, Brito-Zurita OR, Sandoval-Navarrete S, Solis-Vásquez R, Ornelas-Aguirre JM, Olea-Hernández C, Vásquez-Serna C, Castelan-Ojeda AM. Risk factors for three-vessel coronary artery disease in patients of Northwest Mexico. Arch Cardiol Mex 2018; 88:423-431. [PMID: 29598917 DOI: 10.1016/j.acmx.2018.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 02/12/2018] [Accepted: 02/22/2018] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Three-vessel coronary artery disease is an advanced manifestation of atherosclerosis, with high prevalence in Mexico. OBJECTIVE The aim of this study was to describe coronary risk factors in a group of patients with three-vessel coronary artery disease in Northwest Mexico. METHODS A cross sectional study was conducted on a population with three-vessel coronary artery disease from May 2015 to February 2016. The disease was defined when ≥70% stenosis was present in each major epicardial coronary artery. Anthropometric and biochemical parameters were measured in each patient. Ankle-Brachial Index was measured with vascular ultrasound, and Syntax score calculation with an on-line application. Statistical analysis for qualitative differences was performed using Pearson X2 test, with p<0.05 being considered as significant. RESULTS The study included 100 patients, of whom 75 were male (mean age 63±9 years) and 25 female (mean age 69±9 years). The coronary risk factors observed were diabetes (58%), hypertension (86%), smoking (68%), dyslipidaemia (100%), metabolic syndrome (71%), and obesity/overweight (75%). Diabetes and metabolic syndrome prevalence was higher in women (p=0.03), but smoking was higher in men (76%, p=0.003). Ankle-Brachial Index was abnormal in 58% of patients, the mean Syntax score was in 36.9±11.5, and the prevalence of left main coronary heart disease was 36%. CONCLUSIONS This group of patients with complex coronary lesions has a high prevalence of coronary risk factors, which could represent a worse prognosis.
Collapse
Affiliation(s)
- Cuitlahuac Arroyo-Rodríguez
- Cardiology Department, Hospital Number 2, High Specialty Medical Unit, Northwest National Medical Center of the Instituto Mexicano del Seguro Social at Ciudad Obregón, Sonora, Mexico
| | | | - Santiago Sandoval-Navarrete
- Hemodinamic Department, Hospital Number 2, High Specialty Medical Unit, Northwest National Medical Center of the Instituto Mexicano del Seguro Social at Ciudad Obregón, Sonora, Mexico
| | - Rogelio Solis-Vásquez
- Cardiology Department, Hospital Number 2, High Specialty Medical Unit, Northwest National Medical Center of the Instituto Mexicano del Seguro Social at Ciudad Obregón, Sonora, Mexico
| | - José Manuel Ornelas-Aguirre
- Research and Education Department, Hospital Number 2, High Specialty Medical Unit, Northwest National Medical Center of the Instituto Mexicano del Seguro Social at Ciudad Obregón, Sonora, Mexico; Health Sciences Department, University of Sonora at Ciudad Obregón, Sonora, Mexico.
| | - Celestino Olea-Hernández
- Cardiology Department, Hospital Number 2, High Specialty Medical Unit, Northwest National Medical Center of the Instituto Mexicano del Seguro Social at Ciudad Obregón, Sonora, Mexico
| | - César Vásquez-Serna
- Cardiology Department, Hospital Number 2, High Specialty Medical Unit, Northwest National Medical Center of the Instituto Mexicano del Seguro Social at Ciudad Obregón, Sonora, Mexico
| | - Amanda Marcela Castelan-Ojeda
- Cardiology Department, Hospital Number 2, High Specialty Medical Unit, Northwest National Medical Center of the Instituto Mexicano del Seguro Social at Ciudad Obregón, Sonora, Mexico
| |
Collapse
|
25
|
Del Campo L, Hamczyk MR, Andrés V, Martínez-González J, Rodríguez C. Mechanisms of vascular aging: What can we learn from Hutchinson-Gilford progeria syndrome? Clin Investig Arterioscler 2018; 30:120-132. [PMID: 29602596 DOI: 10.1016/j.arteri.2017.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 12/21/2017] [Accepted: 12/22/2017] [Indexed: 01/07/2023]
Abstract
Aging is the main risk factor for cardiovascular disease (CVD). The increased prevalence of CVD is partly due to the global increase in life expectancy. In this context, it is essential to identify the mechanisms by which aging induces CVD, with the ultimate aim of reducing its incidence. Both atherosclerosis and heart failure significantly contribute to age-associated CVD morbidity and mortality. Hutchinson-Gilford progeria syndrome (HGPS) is a rare genetic disorder caused by the synthesis of progerin, which is noted for accelerated aging and CVD. This mutant form of prelamin A induces generalised atherosclerosis, vascular calcification, and cardiac electrophysiological abnormalities, leading to premature aging and death, mainly due to myocardial infarction and stroke. This review discusses the main vascular structural and functional abnormalities during physiological and premature aging, as well as the mechanisms involved in the exacerbated CVD and accelerated aging induced by the accumulation of progerin and prelamin A. Both proteins are expressed in non-HGPS individuals, and physiological aging shares many features of progeria. Research into HGPS could therefore shed light on novel mechanisms involved in the physiological aging of the cardiovascular system.
Collapse
Affiliation(s)
- Lara Del Campo
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, España; CIBER de Enfermedades Cardiovasculares (CIBERCV), España
| | - Magda R Hamczyk
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, España; CIBER de Enfermedades Cardiovasculares (CIBERCV), España
| | - Vicente Andrés
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, España; CIBER de Enfermedades Cardiovasculares (CIBERCV), España.
| | - José Martínez-González
- CIBER de Enfermedades Cardiovasculares (CIBERCV), España; Instituto de Investigaciones Biomédicas de Barcelona (IIBB-CSIC), IIB-Sant Pau, Barcelona, España
| | - Cristina Rodríguez
- CIBER de Enfermedades Cardiovasculares (CIBERCV), España; Institut de Recerca del Hospital de la Santa Creu i Sant Pau-Programa ICCC, IIB-Sant Pau, Barcelona, España.
| | | |
Collapse
|
26
|
Carbayo Herencia JA, Simarro Rueda M, Palazón Bru A, Molina Escribano F, Ponce García I, Artigao Ródenas LM, Caldevilla Bernardo D, Divisón Garrote JA, Gil Guillén VF. Evaluation of non-HDL cholesterol as a predictor of non-fatal cardiovascular events in a prospective population cohort. Clin Investig Arterioscler 2018; 30:64-71. [PMID: 29395492 DOI: 10.1016/j.arteri.2017.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Non-HDL cholesterol (non-HDL-C) is becoming relevant both in its participation in cardiovascular risk assessment and as a therapeutic target. The objective of the present study was to assess the independent predictive capacity of both non-HDL-C and LDL-C (the main priority in dyslipidemias to reduce cardiovascular risk), in cardiovascular morbidity in a population-based sample. METHODS A prospective cohort study involving 1186 individuals in the non-HDL-C group and 1177 in the LDL-C group, followed for 10.7years (SD=2.2), who had not had any previous cardiovascular event. The predictor variables included in the adjustment were: gender, age, arterial hypertension, diabetes mellitus, smoker status and non-HDL-C in one group. In the other group, consisting of patients presenting TG levels of 400mg/dL, non-HDL-C was replaced by LDL-C. Survival curves (Kaplan-Meier) were calculated and two Cox regression models were applied, one for each group. RESULTS Non-HDL-C group presented 6.2% of non-fatal cardiovascular episodes during follow-up and the LDL-C group 6.0%. After adjustment, for each 30mg/dL increase in non-HDL-C, the incidence of new non-fatal cardiovascular events increased by 31% (HR=1.31, 95%CI: 1.06-1.61; P=.018) and in the LDL-C group by 27% (HR=1.27, 95%CI: 0.97-1.61, P=.068). CONCLUSIONS After a follow-up of 10.7years, non-HDL-C has been shown in our population as a prognostic factor of non-fatal cardiovascular disease, but not LDL-C, although its HR is close to statistical significance.
Collapse
Affiliation(s)
- Julio A Carbayo Herencia
- Unidad de Lípidos, Hospital Quirónsalud, Albacete, España; Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, Alicante, España; Cátedra de Riesgo Cardiovacular, Universidad Católica de San Antonio (UCAM), Murcia, España.
| | - Marta Simarro Rueda
- Medicina Familiar y Comunitaria, Centro de Salud «Zona IV», Albacete, España
| | - Antonio Palazón Bru
- Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, Alicante, España
| | | | - Isabel Ponce García
- Medicina Familiar y Comunitaria, Centro de Salud Ayna, Ayna, Albacete, España
| | | | | | - Juan A Divisón Garrote
- Medicina Familiar y Comunitaria, Centro de Salud Casas Ibáñez, Casas Ibáñez, Albacete, España; Cátedra de Medicina Familiar y Comunitaria, Grado de Medicina, UCAM, Murcia, España
| | | | | |
Collapse
|
27
|
Lopez-Pedrera C, Aguirre-Zamorano MÁ, Pérez-Sánchez C. Mechanisms of atherosclerosis and cardiovascular disease in antiphospholipid syndrome and systemic lupus erythematosus. New therapeutic approaches. Med Clin (Barc) 2017; 149:160-169. [PMID: 28619369 DOI: 10.1016/j.medcli.2017.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/30/2017] [Accepted: 05/02/2017] [Indexed: 12/16/2022]
Abstract
Systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) are 2 highly related autoimmune-rheumatic diseases associated with an increased risk of developing cardiovascular (CV) diseases. Despite the great progresses made in understanding the pathological mechanisms leading to CV diseases in those pathologies, there is still the unmet need to improve long term prognosis. CV diseases in SLE and APS is thought to happen as the result of a complex interaction between traditional CV risk factors, immune deregulation and disease activity, including the synergic effect of cytokines, chemokines, adipokines, proteases, autoantibodies, adhesion receptors, oxidative stress and a plethora of intracellular signalling molecules. Genomic and epigenomic analyses have further allowed the identification of specific signatures explaining the proathero-thrombotic profiles of APS and SLE patients. This review examines the complex role of these heterogeneous factors, and analyses new therapeutic approaches under study to reduce the CV risk in these autoimmune disorders.
Collapse
Affiliation(s)
- Chary Lopez-Pedrera
- Servicio de Reumatología, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España.
| | - M Ángeles Aguirre-Zamorano
- Servicio de Reumatología, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España
| | - Carlos Pérez-Sánchez
- Servicio de Reumatología, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España
| |
Collapse
|
28
|
Mota-Cobian A, Alonso-Farto JC, Fernández-Friera L, Sánchez-González J, López-Melgar B, Jiménez-Borreguero LJ, Fuster V, Ruiz-Cabello J, España S. The effect of tissue-segmented attenuation maps on PET quantification with a special focus on large arteries. Rev Esp Med Nucl Imagen Mol 2017. [PMID: 28641952 DOI: 10.1016/j.remn.2017.03.008] [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: 11/24/2022]
Abstract
OBJECTIVES Accuracy on quantitative PET image analysis relies on the correct application of attenuation correction which is one of the major challenges for PET/MRI that remains to be solved. The purpose of this study is to evaluate the effect of MRI-based attenuation maps and the use of flexible coils on the quantitative accuracy of PET images with a special focus on large arteries. MATERIALS AND METHODS PET/CT data from eight oncologic patients was used. PET data was reconstructed using attenuation maps with different level of detail emulating several approaches available on current PET/MRI scanners. PET images obtained with CT-based and MRI-based attenuation maps were compared to evaluate the quantitative biases obtained. The quantitative effect produced by flexible MRI receiver coils on the attenuation maps was also studied. RESULTS The use of simpler attenuation maps produced increased biases between PET data reconstructed with CT-based and MRI-based attenuation maps for fat, non-fat soft-tissues and bone. Biases in lung were very high due to the large heterogeneity and inter-patient variability of the lung. The quantification on large arteries had small deviations except for the case when flexible coils were used. The TBR provided smaller biases in all cases as it cancelled out the similar deviations obtained for arteries and reference veins. CONCLUSIONS Simplified attenuation maps used on PET/MRI significantly increase the quantitative variability of PET images especially on lungs and bones. The quantification of PET images acquired with PET/MRI scanners applied to studies of atherosclerosis has small deviations, especially when the TBR is considered.
Collapse
Affiliation(s)
- A Mota-Cobian
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, España
| | - J C Alonso-Farto
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, España; Hospital General Universitario Gregorio Marañón, Madrid, España
| | - L Fernández-Friera
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, España; Hospital Universitario Montepríncipe, Madrid, España
| | | | - B López-Melgar
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, España; Hospital Universitario Montepríncipe, Madrid, España
| | - L J Jiménez-Borreguero
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, España; Hospital Universitario La Princesa, Madrid, España
| | - V Fuster
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, España; Mount Sinai School of Medicine, New York, NY, EE.UU
| | - J Ruiz-Cabello
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, España; Ciber de Enfermedades Respiratorias (CIBERES), Madrid, España
| | - S España
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, España.
| |
Collapse
|
29
|
Ribalta J, Alipour A, Sánchez-Cabo F, Vallvé JC, Njo T, Álvarez R, Janssen H, Liem A, Dopazo A, Castro-Cabezas M. Differential leucocyte RNA expression in the coronary arteries compared to systemic circulation discriminates between patients with and those without coronary artery disease. Clin Investig Arterioscler 2017; 29:60-66. [PMID: 28188023 DOI: 10.1016/j.arteri.2016.11.003] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/16/2016] [Accepted: 11/17/2016] [Indexed: 11/17/2022]
Abstract
AIMS To test the hypothesis that the pattern of gene expression in circulating leukocytes may differ between vascular compartments, depending on the presence or absence of atherosclerosis, we evaluated the regional vascular differences in patterns of inflammatory cell activation. METHODS Patients (n=8) with angiographically-established coronary artery disease (CAD+) and 8 without (CAD-) had blood samples taken from a peripheral vein as well as from left and right coronary arteries. Samples were pooled resulting in 4 CAD+ samples versus 4 CAD- samples and hybridised to a Whole Human Genome Microarray 4×44K. RESULTS CAD- patients had a similar gene expression profile across the different sites. CAD+ patients had statistically significant different gene expression patterns in venous vs. right and left coronary artery compartments. The expression pattern observed in the right coronary was where the most differences in gene expression were observed in CAD+ vs. CAD- patients. Overall, 1964 genes were differentially expressed between CAD+ and CAD-. Of these, 1052 were less expressed in CAD+ and 912 were more expressed in CAD+. Up to 12 of the 20 most differentially expressed genes appeared to reflect different phases of the atherosclerosis process: endothelial dysfunction, lipid accumulation, and smooth muscle cell proliferation. CONCLUSIONS Gene expression of circulating leukocytes differentiates CAD+ from CAD- patients. Gene expression is significantly different between coronary arteries and the systemic circulation in CAD+ patients, but not in CAD- patients. Gene expression is significantly different between CAD+ and CAD- subjects, and appears to reflect the atherosclerosis process. These intra-individual differences may be an additional feature of established coronary artery disease.
Collapse
Affiliation(s)
- Josep Ribalta
- Unitat de Recerca en Lípids i Arteriosclerosi, Facultat de Medicina, Hospital Universitari de Sant Joan de Reus, Universitat Rovira i Virgili, Institut d'Investigació Sanitària Pere Virgili, CIBERDEM, Reus, Spain.
| | - Arash Alipour
- Department of Internal Medicine, Centre for Diabetes and Vascular Medicine, St Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Fátima Sánchez-Cabo
- Genomics Unit, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Joan-Carles Vallvé
- Unitat de Recerca en Lípids i Arteriosclerosi, Facultat de Medicina, Hospital Universitari de Sant Joan de Reus, Universitat Rovira i Virgili, Institut d'Investigació Sanitària Pere Virgili, CIBERDEM, Reus, Spain
| | - Tjin Njo
- Department of Clinical Chemistry, St Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Rebeca Álvarez
- Genomics Unit, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Hans Janssen
- Department of Clinical Chemistry, St Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Anho Liem
- Department of Cardiology, St. Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Ana Dopazo
- Genomics Unit, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Manuel Castro-Cabezas
- Department of Internal Medicine, Centre for Diabetes and Vascular Medicine, St Franciscus Gasthuis, Rotterdam, The Netherlands
| |
Collapse
|
30
|
Lazaro I, Oguiza A, Recio C, Lopez-Sanz L, Bernal S, Egido J, Gomez-Guerrero C. Interplay between HSP90 and Nrf2 pathways in diabetes-associated atherosclerosis. Clin Investig Arterioscler 2017; 29:51-9. [PMID: 28188022 DOI: 10.1016/j.arteri.2016.10.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 10/03/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Oxidative stress and inflammation are determinant processes in the development of diabetic vascular complications. Heat shock protein 90 (HSP90) overexpression in atherosclerotic plaques plays a role in sustaining inflammatory mechanisms, and its specific inhibition prevents atherosclerosis. The present work investigates, in a mouse model of diabetes-driven atherosclerosis, whether atheroprotection by pharmacological HSP90 inhibition is accomplished by bolstering antioxidant defense mechanisms headed by nuclear factor erythroid-derived 2-like 2 (Nrf2). METHODS Streptozotocin-induced diabetic apolipoprotein E-deficient mice were randomized to receive vehicle or HSP90 inhibitor (17-dimethylaminoethylamino-17-demethoxygeldanamycin, 4mg/kg) for 10 weeks. Aortic root sections were analyzed for plaque size and composition, transcription factor activity, and expression of inflammatory and antioxidant markers. In vitro studies were performed in murine macrophages cultured under hyperglycemic conditions. RESULTS Treatment with HSP90 inhibitor promoted the activation of Nrf2 in the aortic tissue of diabetic mice (predominantly localized in macrophages and smooth muscle cells) and also in cultured cells. Nrf2 induction was associated with a concomitant inhibition of nuclear factor-κB (NF-κB) in atherosclerotic plaques, thus resulting in a significant reduction in lesion size and inflammatory component (leukocytes and cytokines). Furthermore, atheroprotection by HSP90 inhibition was linked to the induction of cytoprotective HSP70, antioxidant enzymes (heme oxygenase-1, superoxide dismutase and catalase) and autophagy machinery (LC3 and p62/SQSTM1) in aortic tissue. CONCLUSION HSP90 inhibition protects from atherosclerosis in experimental diabetes through the induction of Nrf2-dependent cytoprotective mechanisms, reinforcing its therapeutic potential.
Collapse
|
31
|
Whayne TF Jr. PCSK9 inhibitors in the current management of atherosclerosis. Arch Cardiol Mex 2017; 87:43-8. [PMID: 28038950 DOI: 10.1016/j.acmx.2016.11.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 11/28/2016] [Accepted: 11/29/2016] [Indexed: 11/23/2022] Open
Abstract
The history of proprotein convertase subtilisin/kexin type 9 (PCSK9) in medical science is fascinating and the evolution of knowledge of its function has resulted in new medications of major importance for the cardiovascular (CV) patient. PCSK9 functions as a negative control or feedback for the cell surface receptors for low-density lipoprotein including its component of cholesterol (LDL-C). The initial and key findings were that different abnormalities of PCSK9 can result in an increase or a decrease of LDL-C because of more or less suppression of cell surface receptors. These observations gave hints and awoke interest that it might be possible to prepare monoclonal antibodies to PCSK9 and decrease its activity, after which there should be more active LDL-C cell receptors. The rest is a fascinating story that currently has resulted in two PCSK9 inhibitors, alirocumab and evolocumab, which, on average, decrease LDL-C approximately 50%. Nevertheless, if there are no contraindications, statins remain the standard of prevention for the high-risk CV patient and this includes both secondary and primary prevention. The new inhibitors are for the patient that does not attain the desired target for LDL-C reduction while taking a maximum statin dose or who does not tolerate any statin dose whatsoever. Atherosclerosis can be considered a metabolic disease and the clinician needs to realize this and think more and more of CV prevention. These inhibitors can contribute to both the stabilization and regression of atherosclerotic plaques and thereby avoid or delay major adverse cardiac events. (United States).
Collapse
|
32
|
Martín Giménez VM, Ruiz-Roso MB, Camargo AB, Kassuha D, Manucha W. Nanotechnology, a new paradigm in atherosclerosis treatment. Clin Investig Arterioscler 2016; 29:224-230. [PMID: 27914728 DOI: 10.1016/j.arteri.2016.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/27/2016] [Accepted: 09/29/2016] [Indexed: 10/20/2022]
Abstract
Atherosclerosis, a known and prevalent disease, causes progressive deterioration of affected vessels, inducing a blood flow reduction with different complications, and its symptoms usually manifest in advanced stages of the disease. Therefore, the classic therapeutic alternatives are insufficient because the damages are many times irreversible. For this reason, there is a need to implement intelligent forms of drug administration and develop new therapeutic targets that reduce the progression of atherosclerotic lesion. The implementation of new tools for prevention, diagnosis and treatment of this cardiovascular disease is of special interest, focusing our attention on achieving a more effective control of the immune system. Finally, this review highlights the latest knowledge about nanotechnology as a powerful, modern, and promising therapeutic alternative applied to atherosclerotic disease, as well as warning of the potential complications with their use.
Collapse
Affiliation(s)
- Virna M Martín Giménez
- Instituto de Investigación en Ciencias Químicas, Facultad de Ciencias de la Alimentación, Bioquímicas y Farmacéuticas, Universidad Católica de Cuyo, San Juan, San Juan, Argentina
| | - María Belén Ruiz-Roso
- Departamento de Fisiología, Facultad de Medicina, Universidad Complutense, Madrid, España
| | - Alejandra Beatriz Camargo
- IBAM, UNCuyo, CONICET, Facultad de Ciencias Agrarias, Chacras de Coria, Luján, Mendoza, Argentina; Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Cuyo, Mendoza, Argentina
| | - Diego Kassuha
- Instituto de Investigación en Ciencias Químicas, Facultad de Ciencias de la Alimentación, Bioquímicas y Farmacéuticas, Universidad Católica de Cuyo, San Juan, San Juan, Argentina
| | - Walter Manucha
- Instituto de Medicina y Biología Experimental de Cuyo, Consejo Nacional de Investigación Científica y Tecnológica (IMBECU-CONICET), Argentina; Laboratorio de Farmacología Experimental Básica y Traslacional, Área de Farmacología, Departamento de Patología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza, Argentina.
| |
Collapse
|
33
|
Páramo JA, Civeira F. [Is regression of atherosclerotic plaque possible?]. Clin Investig Arterioscler 2017; 29:46-50. [PMID: 27692635 DOI: 10.1016/j.arteri.2016.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 05/17/2016] [Indexed: 12/21/2022]
Abstract
As it is well-known, a thrombus evolving into a disrupted/eroded atherosclerotic plaque causes most acute coronary syndromes. Plaque stabilization via reduction of the lipid core and/or thickening of the fibrous cap is one of the possible mechanisms accounted for the clinical benefits displayed by different anti-atherosclerotic strategies. The concept of plaque stabilization was developed to explain how lipid-lowering agents could decrease adverse coronary events without substantial modifications of the atherosclerotic lesion ('angiographic paradox'). A number of imaging modalities (vascular ultrasound and virtual histology, MRI, optical coherence tomography, positron tomography, etc.) are used for non-invasive assessment of atherosclerosis; most of them can identify plaque volume and composition beyond lumen stenosis. An 'aggressive' lipid-lowering strategy is able to reduce the plaque burden and the incidence of cardiovascular events; this may be attributable, at least in part, to plaque-stabilizing effects.
Collapse
|
34
|
Perales-Torres AL, Castillo-Ruíz O, Castañeda Licón MT, Alemán-Castillo SE, Jiménez Andrade JM. [Diabetes and type of diet as determinant factor in the progression of atherosclerosis]. Arch Cardiol Mex 2016; 86:326-334. [PMID: 26775035 DOI: 10.1016/j.acmx.2015.12.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 12/02/2015] [Accepted: 12/02/2015] [Indexed: 11/30/2022] Open
Abstract
The purpose of this review is to analyze the biochemical progression of atherosclerotic plaque and its association with diet and diabetes. This study shows the scientific evidence of demonstrating that diabetic patients present high levels of fatty acids like palmitic acid and linoleic acid in their atheroma plaques in comparison with non-diabetic patients. This study also establishes how patients with diabetes mellitus have a higher prevalence of atherosclerotic heart diseases in the form of Coronary Thrombosis and have different anatomopathological appearance like higher necrotic core and thin fibrotic layer than the general population. Furthermore this review describes the different anatomopathological appearance and cellular changes involved in the formation of these plaques and how diet can affect the development of these plaques.
Collapse
Affiliation(s)
| | - Octelina Castillo-Ruíz
- Departamento de Nutrición y Alimentos, Universidad Autónoma de Tamaulipas, Reynosa, Tamaulipas, México.
| | | | | | | |
Collapse
|
35
|
López Morales CM, Brito Zurita OR, González Heredia R, Cruz López M, Méndez Padrón A, Matute Briseño JA. [Placental atherosclerosis and markers of endothelial dysfunction in infants born to mothers with gestational diabetes]. Med Clin (Barc) 2016; 147:95-100. [PMID: 27242015 DOI: 10.1016/j.medcli.2016.03.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 03/18/2016] [Accepted: 03/31/2016] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND OBJECTIVE The pathophysiology of gestational diabetes itself causes hyperstimulation of adipose tissue and of the placenta cells increasing the production of inflammatory cytokines, which cause changes in the tissues exposed such as the placenta and foetus. Therefore, the objective of this study was to compare metabolic markers and endothelial dysfunction in umbilical cord blood, as well as to determine the presence of atherosclerosis in the placentas of newborn infants of patients with gestational diabetes and in patients with normally progressing pregnancies. PATIENTS AND METHOD An analytical cross-sectional study was carried out in 84 patients, obtaining data such as age, smoking and weight gain in pregnancy; the gestational age of the newborns was determined by Capurro, and their weight and destination subsequent to birth, the placentas were also collected in order to look for atherosclerosis through histological studies and glucose, insulin, VLDL-C, HDL-C, triglycerides, cholesterol, fibrinogen, PCR and markers of endothelial dysfunction (adiponectin, VCAM-1, ICAM-1 and IL-6) were determined in blood samples obtained from the umbilical cord. RESULTS Placental atherosclerosis presented in 28.94% of the group with gestational diabetes compared to 10.52% of the group with normally progressing pregnancies (P=.044); differences were found in glucose, cholesterol, triglycerides, fibrinogen, HOMA-IR, PCR-us, HDL-C, not in VLDL-C. Twenty-one point five percent of the newborns of the gestational diabetes patients required hospitalization, against 5.2% in the control group, CONCLUSIONS Pregnancies that involve diabetes have higher proportion of atherosclerosis, hospitalization of the newborn, insulin resistance, as well as elevation of markers associated with inflammation and endothelial dysfunction in umbilical cord blood.
Collapse
Affiliation(s)
- Cruz Mónica López Morales
- Coordinación Auxiliar de Investigación, Instituto Mexicano del Seguro Social, Delegación de Sonora, Obregón, Sonora, México.
| | - Olga Rosa Brito Zurita
- Dirección de Educación e Investigación, Unidad Médica de Alta Especialidad, Instituto Mexicano del Seguro Social, Obregón, Sonora, México
| | - Ricardo González Heredia
- Centro de Investigación Educativa y Formación Docente, Instituto Mexicano del Seguro Social, Obregón, Sonora, México
| | - Miguel Cruz López
- Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Obregón, Sonora, México
| | - Araceli Méndez Padrón
- Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Obregón, Sonora, México
| | - Juan Antonio Matute Briseño
- Departamento de Patología, Hospital General Regional 1, Instituto Mexicano del Seguro Social, Obregón, Sonora, México
| |
Collapse
|
36
|
Riera-Borrull M, Sabench F, del Castillo D, Camps J, Joven J. Exploring the effects of the atherosclerosis progression and the choice of affected arteries in the design of experiments with Apolipoprotein E-deficient mice. Clin Investig Arterioscler 2016; 28:82-6. [PMID: 26899621 DOI: 10.1016/j.arteri.2015.10.005] [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] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 10/07/2015] [Indexed: 11/18/2022]
Abstract
The objective of this study is to explore the longitudinal progression of atherosclerosis and the correlation between methods to measure the lesion in apolipoprotein E-deficient mice. Atherosclerosis progression was assessed by measurements of foam cell-rich depositions in their proximal aortas, and/or in surgically excised arteries, to assess the histological luminal narrowing. A longitudinal study was performed by comparing the values for carotid, aorta, and femoral and iliac arteries using common histological techniques. There were no significant differences in progression between different arteries, but correlation with the classical measurement of atherosclerosis in the aortic root was poor. Each laboratory requires specific standardization. Carotid arteries were sensitive to atherosclerosis in these mice, and progression was exponential. In conclusion, morphometric data show the importance of the choice of the duration of treatment, the appropriate controls, and the age at which to begin the experiments.
Collapse
Affiliation(s)
- Marta Riera-Borrull
- Unitat de Recerca Biomèdica, Hospital Universitari Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, carrer Sant Llorenç 21, 43201 Reus, Spain
| | - Fàtima Sabench
- Servei de Cirurgia General i de l'Aparell Digestiu, Hospital Universitari Sant Joan, Universitat Rovira i Virgili, carrer Sant Llorenç 21, 43201 Reus, Spain
| | - Daniel del Castillo
- Servei de Cirurgia General i de l'Aparell Digestiu, Hospital Universitari Sant Joan, Universitat Rovira i Virgili, carrer Sant Llorenç 21, 43201 Reus, Spain
| | - Jordi Camps
- Unitat de Recerca Biomèdica, Hospital Universitari Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, carrer Sant Llorenç 21, 43201 Reus, Spain.
| | - Jorge Joven
- Unitat de Recerca Biomèdica, Hospital Universitari Sant Joan, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, carrer Sant Llorenç 21, 43201 Reus, Spain.
| |
Collapse
|
37
|
Fierro-Macías AE, Floriano-Sánchez E, Mena-Burciaga VM, Gutiérrez-Leonard H, Lara-Padilla E, Abarca-Rojano E, Fierro-Almanzán AE. [Association between IGF system and PAPP-A in coronary atherosclerosis]. Arch Cardiol Mex 2016; 86:148-56. [PMID: 26906607 DOI: 10.1016/j.acmx.2015.12.006] [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] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 12/23/2015] [Accepted: 12/24/2015] [Indexed: 11/28/2022] Open
Abstract
Atherosclerosis is a condition that involves multiple pathophysiological mechanisms and whose knowledge has not been fully elucidated. Often, scientific advances on the atherogenic pathophysiology generate that molecules not previously considered in the scene of this disease, were attributed actions on the onset or progression of it. A representative example is the study of a new mechanism involved in the atherogenic process, consisting of the association between the insulin-like growth factor (IGF) system and pregnancy-associated plasma protein-A (PAPP-A). Insulin-like growth factor system is a family of peptides that include 3 peptide hormones, 4 transmembrane receptors and 6 binding proteins. Insulin-like growth factor-1 (IGF-1) is the main ligand of the IGF system involved in coronary atherosclerosis. IGF-1 exerts its effects via activation of the IGF-1R receptor on vascular smooth muscle cells or macrophages. In vascular smooth muscle cells promotes migration and prevents apoptosis which increases plaque stability while in macrophages reduces reverse cholesterol transport leading to the formation of foam cells. Regulation of IGF-1 endothelial bioavailability is carried out by IGFBP proteases, mainly by PAPP-A. In this review, we address the mechanisms between IGF system and PAPP-A in atherosclerosis with emphasis on molecular effects on vascular smooth muscle cells and macrophages.
Collapse
Affiliation(s)
- Alfonso Eduardo Fierro-Macías
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, México, DF, México.
| | - Esaú Floriano-Sánchez
- Laboratorio Multidisciplinario de Investigación, Escuela Militar de Graduados de Sanidad, Secretaría de la Defensa Nacional (SEDENA), México, DF, México
| | - Victoria Michelle Mena-Burciaga
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, México, DF, México
| | - Hugo Gutiérrez-Leonard
- Departamento de Hemodinamia, Hospital Central Militar, Secretaría de la Defensa Nacional (SEDENA), México, DF, México
| | - Eleazar Lara-Padilla
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, México, DF, México
| | - Edgar Abarca-Rojano
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, México, DF, México
| | - Alfonso Edmundo Fierro-Almanzán
- Departamento de Cirugía, Hospital General Regional N.(o) 66, Instituto Mexicano del Seguro Social (IMSS), Ciudad Juárez, Chihuahua, México
| |
Collapse
|
38
|
Zárate A, Manuel-Apolinar L, Basurto L, De la Chesnaye E, Saldívar I. [Cholesterol and atherosclerosis. Historical considerations and treatment]. Arch Cardiol Mex 2016; 86:163-9. [PMID: 26774359 DOI: 10.1016/j.acmx.2015.12.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 12/02/2015] [Accepted: 12/06/2015] [Indexed: 11/21/2022] Open
Abstract
Cholesterol is a precursor of steroid hormones and an essential component of the cell membrane, however, altered regulation of the synthesis, absorption and excretion of cholesterol predispose to cardiovascular diseases of atherosclerotic origin. Despite, the recognition of historical events for 200 years, starting with Michel Chevreul naming «cholesterol»; later on, Lobstein coining the term atherosclerosis and Marchand introducing it, Anichkov identifying cholesterol in atheromatous plaque, and Brown and Goldstein discovering LDL receptor; as well as the emerging of different drugs, such as fibrates, statins and cetrapibs this decade, promising to increase HDL and the most recent ezetimibe and anti-PCSK9 to inhibit the degradation of LDL receptor, however morbidity has not been reduced in cardiovascular disease.
Collapse
|
39
|
Campos CM, Garcia-Garcia HM, Muramatsu T, de Araujo Gonçalves P, Onuma Y, Dudek D, Thuesen L, Webster MWI, Kitslaar P, Veldhof S, Reiber JHC, Nieman K, Ormiston JA, Serruys PW. Impact of the Everolimus-eluting Bioresorbable Scaffold in Coronary Atherosclerosis. ACTA ACUST UNITED AC 2015; 69:109-16. [PMID: 26739828 DOI: 10.1016/j.rec.2015.07.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 07/28/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION AND OBJECTIVES The Absorb bioresorbable vascular scaffold has been shown to decrease total plaque areas in the treated segment. However, it is unknown whether plaque size is modified in scaffolded segments only or whether the modification extends to other coronary segments. METHODS Absorb Cohort A is a single-arm, prospective study, with safety and imaging endpoints, in which 30 patients underwent percutaneous coronary intervention with the first generation Absorb bioresorbable vascular scaffold. Noninvasive multislice computed tomography imaging was performed in 18 patients at 18 months and 5 years of follow-up. The present study was an intrapatient comparison of matched segments (normalized by the segment length) of the scaffolded region with nonintervened segments for lumen volume, vessel volume, plaque volume, plaque burden, and percent change in plaque atheroma volume. RESULTS All 18 scaffolded segments could be analyzed. In the nonintervened segments, 1 of 72 segments had a motion artifact and was excluded. Serial comparison showed that the scaffolded segments showed no significant change in the mean plaque burden, total atheroma volume, total lumen volume, or vessel volume between 18 months and 5 years. Conversely, the untreated segments showed a significant increase in plaque burden (2.7 ± 6.5%; P < .01) and normalized plaque volumes (8.0 ± 22.8mm(3); P < .01). This resulted in a significant difference in plaque burden between scaffolded and nonintervened segments (P = .03). CONCLUSIONS In this small series, the Absorb bioresorbable vascular scaffold showed the potential to provide an additional benefit to pharmacological therapy in locally reducing progression of percent plaque burden. These findings need to be confirmed in larger studies.
Collapse
Affiliation(s)
- Carlos M Campos
- Department of Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands; Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil; Department of Interventional Cardiology, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Hector M Garcia-Garcia
- Department of Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands.
| | - Takashi Muramatsu
- Department of Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands; Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - Pedro de Araujo Gonçalves
- Cardiology Department, Hospital de Santa Cruz, CHLO, Lisbon, Portugal; Hospital da Luz, Cardiovascular Center, ESS, Lisbon, Portugal; CEDOC, Chronic Diseases Research Center, FCM-NOVA, Lisbon, Portugal
| | - Yoshinobu Onuma
- Department of Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands
| | | | - Leif Thuesen
- Department of Cardiology, Aarhus University Hospital, Skejby, Denmark
| | | | - Pieter Kitslaar
- Medis Medical Imaging Systems, B.V., Leiden, The Netherlands; Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Johan H C Reiber
- Medis Medical Imaging Systems, B.V., Leiden, The Netherlands; Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Koen Nieman
- Department of Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands; Department of Radiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Patrick W Serruys
- International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom
| |
Collapse
|
40
|
Zabalza M, Subirana I, Lluis-Ganella C, Sayols-Baixeras S, de Groot E, Arnold R, Cenarro A, Ramos R, Marrugat J, Elosua R. Association Between Coronary Artery Disease Genetic Variants and Subclinical Atherosclerosis: An Association Study and Meta-analysis. ACTA ACUST UNITED AC 2015; 68:869-77. [PMID: 25804320 DOI: 10.1016/j.rec.2014.10.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 10/29/2014] [Indexed: 01/01/2023]
Abstract
INTRODUCTION AND OBJECTIVES Recent studies have identified several genetic variants associated with coronary artery disease. Some of these genetic variants are not associated with classical cardiovascular risk factors and the mechanism of such associations is unclear. The aim of the study was to determine whether these genetic variants are related to subclinical atherosclerosis measured by carotid intima media thickness, carotid stiffness, and ankle brachial index. METHODS A cross-sectional study nested in the follow-up of the REGICOR cohort was undertaken. The study included 2667 individuals. Subclinical atherosclerosis measurements were performed with standardized methods. Nine genetic variants were genotyped to assess associations with subclinical atherosclerosis, individually and in a weighted genetic risk score. A systematic review and meta-analysis of previous studies that analyzed these associations was undertaken. RESULTS Neither the selected genetic variants nor the genetic risk score were significantly associated with subclinical atherosclerosis. In the meta-analysis, the rs1746048 (CXCL12; n = 10581) risk allele was directly associated with carotid intima-media thickness (β = 0.008; 95% confidence interval, 0.001-0.015), whereas the rs6725887 (WDR12; n = 7801) risk allele was inversely associated with this thickness (β = -0.013; 95% confidence interval, -0.024 to -0.003). CONCLUSIONS The analyzed genetic variants seem to mediate their association with coronary artery disease through different mechanisms. Our results generate the hypothesis that the CXCL12 variant appears to influence coronary artery disease risk through arterial remodeling and thickening, whereas the WDR12 risk variant could be related to higher plaque vulnerability.
Collapse
Affiliation(s)
- Michel Zabalza
- Servicio de Cardiología, Hospital Universitario Josep Trueta, Girona, Spain; Grupo de Epidemiología y Genética Cardiovascular, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Facultad de Medicina, Universidad de Girona, Girona, Spain
| | - Isaac Subirana
- Grupo de Epidemiología y Genética Cardiovascular, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; CIBER de Epidemiología y Salud Pública, Barcelona, Spain
| | - Carla Lluis-Ganella
- Grupo de Epidemiología y Genética Cardiovascular, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
| | - Sergi Sayols-Baixeras
- Grupo de Epidemiología y Genética Cardiovascular, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
| | - Eric de Groot
- Academic Medical Center, Thoracic Surgery, Amsterdam, The Netherlands; Imagelab Online & Cardiovascular, Science Park, Matrix II, 1.08, Amsterdam, The Netherlands
| | - Roman Arnold
- ICICORELAB, Hospital Clínico Universitario, Valladolid, Spain
| | - Ana Cenarro
- Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - Rafel Ramos
- Unidad de Investigación en Atención Primaria, Institut d'Investigació en Atenció Primària (IDIAP) Jordi Gol, y Unidad Docente de Medicina de Familia de Girona, Institut Català de la Salut (ICS), Girona, Spain; Facultad de Medicina, Universidad de Girona, Girona, Spain
| | - Jaume Marrugat
- Grupo de Epidemiología y Genética Cardiovascular, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
| | - Roberto Elosua
- Grupo de Epidemiología y Genética Cardiovascular, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain.
| |
Collapse
|
41
|
Mazón-Ramos P, Cordero A, González-Juanatey JR, Bertomeu Martínez V, Delgado E, Vitale G, Fernández-Anaya S. Control of cardiovascular risk factors in revascularized patients with diabetes: a subanalysis of the ICP-Bypass study. ACTA ACUST UNITED AC 2014; 68:115-20. [PMID: 25224523 DOI: 10.1016/j.rec.2014.03.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 03/12/2014] [Indexed: 01/18/2023]
Abstract
INTRODUCTION AND OBJECTIVES Patients with type 2 diabetes and revascularized coronary disease are a group with very high cardiovascular risk that has been rarely studied. This ICP-Bypass substudy analyzes the clinical characteristics and risk factor control of these patients. METHODS The analysis selected patients with type 2 diabetes who had participated in an earlier multicenter, observational, cross-sectional study (ICP-Bypass) conducted in 2293 patients > 18 years of age who had undergone coronary surgery or percutaneous coronary intervention. Demographic and therapeutic variables, as well as clinical and analytical parameters, were collected and comparatively analyzed. RESULTS The mean age (standard deviation) of the 771 diabetic patients included in the analysis was 67.7 (9.6) years (71.4% men; mean time since revascularization, 3.5 years). Most (57.8%) were receiving treatment with oral hypoglycemics alone, whereas 30.4% were receiving insulin alone or in combination. The mean glycohemoglobin figure was 7.1% (in 70%,<7.5%); 74.8% had been diagnosed with dyslipidemia. Mean low-density lipoprotein cholesterol was 93.5 mg/dL (in 73%, > 70 mg/dL). Among these patients, 93.6% were receiving statins and 18.7% a statin combined with ezetimib. A total of 78.1% had been diagnosed with hypertension; systolic/diastolic blood pressure was < 130/80 mmHg in 52% and < 140/90 mmHg in 93%. CONCLUSIONS Cardiovascular risk and prevention may be improved in revascularized diabetic patients in Spain through further control of risk factors, particularly dyslipidemia. Patients with glycohemoglobin > 7.5% should be individually assessed in terms of glycemic targets.
Collapse
Affiliation(s)
- Pilar Mazón-Ramos
- Servicio de Cardiología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain.
| | - Alberto Cordero
- Servicio de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
| | - José Ramón González-Juanatey
- Servicio de Cardiología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | | | - Elías Delgado
- Servicio de Endocrinología, Hospital Central de Asturias, Oviedo, Asturias, Spain
| | | | | |
Collapse
|
42
|
Fernández-Laso V, Sastre C, Egido J, Martín-Ventura JL, Blanco-Colio LM. [Atorvastatin inhibits the atherosclerotic lesion induced by tumor necrosis factor-like weak inducer of apoptosis in apolipoprotein E deficient mice]. Clin Investig Arterioscler 2014; 27:17-25. [PMID: 25027757 DOI: 10.1016/j.arteri.2014.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 04/24/2014] [Accepted: 04/29/2014] [Indexed: 11/20/2022]
Abstract
AIM Interaction of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) with its receptor Fn14 accelerates atherosclerotic plaque development in ApoE deficient mice (ApoE KO). In this work, an analysis has been made on the effect of an HMG-CoA reductase inhibitor, atorvastatin, on atherosclerotic plaque development accelerated by TWEAK in ApoE KO mice. MATERIALS AND METHODS Eight week-old ApoE KO mice were fed with a high cholesterol diet for 4 weeks. The animals were then randomized into 3 groups: mice injected i.p. with saline, recombinant TWEAK (10 μg/kg/twice a week), or recombinant TWEAK plus atorvastatin (1 mg/kg/day) for 4 weeks. The lesion size, cellular composition, lipid and collagen content were analyzed, as well as inflammatory response in atherosclerotic plaques present in aortic root of mice. RESULTS TWEAK treated mice showed an increase in atherosclerotic plaque size, as well as in collagen/lipid ratio compared with control mice. In addition, macrophage content, MCP-1 and RANTES expression, and NF-κB activation were augmented in atherosclerotic plaques present in aortic root of TWEAK treated mice compared with control mice. Treatment with atorvastatin prevented all these changes induced by TWEAK in atherosclerotic lesions. Atorvastatin treatment also decreased Fn14 expression in the atherosclerotic plaques of ApoE KO mice. CONCLUSIONS Atorvastatin prevents the pro-atherogenic effects induced by TWEAK in ApoE KO mice, which could be related to the inhibition of Fn14 expression. The results of this study provide new information on the beneficial effects of statin treatment in cardiovascular diseases.
Collapse
Affiliation(s)
- Valvanera Fernández-Laso
- Laboratorio de Patología Vascular, Instituto de Investigación Sanitaria (ISS)-Fundación Jiménez Díaz, Madrid, España
| | - Cristina Sastre
- Laboratorio de Patología Vascular, Instituto de Investigación Sanitaria (ISS)-Fundación Jiménez Díaz, Madrid, España
| | - Jesús Egido
- Laboratorio de Patología Vascular, Instituto de Investigación Sanitaria (ISS)-Fundación Jiménez Díaz, Madrid, España
| | - Jose L Martín-Ventura
- Laboratorio de Patología Vascular, Instituto de Investigación Sanitaria (ISS)-Fundación Jiménez Díaz, Madrid, España
| | - Luis M Blanco-Colio
- Laboratorio de Patología Vascular, Instituto de Investigación Sanitaria (ISS)-Fundación Jiménez Díaz, Madrid, España.
| |
Collapse
|
43
|
Rodríguez Vargas N, Martínez Pérez TP, Martínez García R, Garriga Reyes M, Ortega Soto M, Rojas T. [Dyslipidemia in schoolchildren with a history of a high birth weight]. Clin Investig Arterioscler 2014; 26:224-8. [PMID: 24703200 DOI: 10.1016/j.arteri.2014.02.006] [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] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 02/19/2014] [Accepted: 02/26/2014] [Indexed: 10/25/2022]
Abstract
UNLABELLED The process of atherosclerosis begins at early ages and is closely related to plasma lipid levels, specifically, an increase in low density lipoprotein (LDL), very low density lipoprotein (VLDL), and a decrease in high density lipoprotein (HDL). OBJECTIVE To determine if high birth weight, or macrosomia, is of predictive value for dyslipidemia in school children. METHODS A descriptive study with a case control design was conducted on two groups of children; one group of 140 children with a history of macrosomia, and another group of 100 children with normal weight at birth, born between January 1992 and December 1995. The aim was the early identification of atherosclerotic risk factors in school children with high weight at birth. Anthropometric variables and lipid profile were studied (cholesterol, HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol, and triglycerides). RESULTS There were significant differences between the mean weights of the two groups. There were no significant statistical differences between the two groups in the cholesterol levels (93.57% normal and 6.43% abnormal in the study group, and 90.00% normal and 10.00% abnormal in the control group), or in the values of HDL cholesterol. LDL cholesterol was abnormal in more children in the control group, and abnormal values of triglycerides were observed in 14.00% of cases in the study group 0.00% in the control group. CONCLUSION High birth weight is not a predictive factor for hypercholesterolemia or HDL and LDL-cholesterol esters, but is positive for triglycerides in our study.
Collapse
Affiliation(s)
- Nuris Rodríguez Vargas
- Facultad de Ciencias Mèdicas Manuel Fajardo, Universidad Médica de La Habana, La Habana, Cuba.
| | | | - Rolando Martínez García
- Facultad de Ciencias Médicas Carlos J. Finlay, Universidad Mèdica de La Habana, La Habana, Cuba
| | | | - Manuel Ortega Soto
- Hospital Clínico Quirúrgico Comandante Manuel Fajardo, Universidad Médica de La Habana, La Habana, Cuba
| | - Teresa Rojas
- Facultad de Ciencias Mèdicas Manuel Fajardo, Universidad Médica de La Habana, La Habana, Cuba
| |
Collapse
|
44
|
Abstract
Endothelial glycocalyx is a layer composed by glycosaminoglycans, proteoglycans and glycoproteins attached to the vascular endothelial luminal surface. It has several physiological roles: shear stress mechanotransduction to the endothelial cells, regulation of fluids and macromolecules vascular permeability, of coagulation cascade activation and fibrinolysis, and protects the endothelium from platelets and leukocytes adhesion. In general, glycocalyx protects vascular wall against pathogenic insults. The glycocalyx may be damaged by abnormal shear stress, reactive oxygen species, hypernatremia, hyperglycemia, hypercholesterolemia and inflammatory molecules, resulting in endothelial dysfunction, enhanced vascular permeability, lipoproteins leakage to subendothelial space, activation of plasma coagulation, and increased adherence of platelets and leukocytes to the endothelial cells. Shredding of glycocalyx appears as an important initial step in the pathophysiology of vascular diseases.
Collapse
|
45
|
Galicia López A, Olguín Ortega L, Saavedra MA, Méndez Cruz R, Jimenez Flores R, García de la Peña M. Increased concentrations of soluble CD40 ligand platelet in patients with primary antiphospholipidic syndrome. ACTA ACUST UNITED AC 2013; 9:216-20. [PMID: 23453663 DOI: 10.1016/j.reuma.2012.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 10/07/2012] [Accepted: 10/11/2012] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To determine the concentrations of sCD40L in patients with PAPS, and establish its association with the number of thrombosis. PATIENTS AND METHODS We included patients with PAPS and healthy controls of the same age and sex. For analysis, patients with PAPS were divided into 2 groups: 1) patients with 1 thrombosis, and 2) patients with >1 thrombosis. Soluble CD40L concentrations were determined by ELISA method. RESULTS sCD40L concentrations were significantly higher in patients with PAPS compared with the controls (9.72 ng ± 11.23 ng/ml vs. 4.69 ± 4.04 ng/ml) (P=.04) There was no association between serum levels of sCD40L and the number of thrombosis (1 thrombosis: 9.81 ± 9.87 ng/ml vs 9.63 ± 12.75 ng/ml in ≥ 1thrombosis (P=.13). In women with pregnancy and abortions, (13 patients) concentrations of sCD40L were higher than in those patients without a history of abortion (26 patients) but without statically significant difference (12.11 ± 16.46 ng/ml vs. 8.80 ± 8.61 ng/ml) (P=.33). There was no correlation between levels of sCD40L and the total number of thrombosis. CONCLUSIONS Patients with PAPS have higher concentrations of sCD40L compared with healthy subjects, although this is not associated with a greater number of thrombosis. Among patients with PAPS, there is a tendency to higher concentrations of sCD40L in women with pregnancy and history of abortion. Since the platelet is the main cellular source of sCD40L, is possible that this pathway plays a pathogenic role in patients with PAPS.
Collapse
|