1
|
Wall C, Huang Y, Uy C, Le E, Tombetti E, Gopalan D, Manavaki R, Dweck M, Ariff B, Bennett M, Slomka P, Dey D, Mason J, Rudd J, Tarkin J. Pericoronary adipose tissue density is associated with clinical disease activity in Takayasu arteritis and coronary arterial inflammation measured by 68Ga-DOTATATE PET in atherosclerosis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Coronary artery disease (CAD) is an under-recognized complication of intense arterial inflammation in Takayasu arteritis (TAK). While pericoronary adipose tissue (PCAT) density is associated with arterial inflammation in CAD patients, this relationship has not previously been studied in TAK patients, nor directly compared with coronary arterial inflammation measured by 68Ga-DOTATATE positron emission tomography (PET).
Purpose
To compare PCAT density with clinical, biochemical and molecular imaging markers of inflammation in TAK and CAD patients.
Methods
PCAT density was quantified from computed tomography coronary angiography (CTCA) around each of the 17 coronary segments in patients with: (1) TAK and CAD, (2) atherosclerotic CAD, and (3) age and gender-matched healthy controls, using semi-automated software (Autoplaque). In TAK patients, PCAT density was compared to the Indian Takayasu Clinical Activity Score (ITAS) and high-sensitivity C-reactive protein (CRP). In CAD patients, PCAT density was compared to local arterial inflammation measured by coronary motion-frozen 68Ga-DOTATATE PET using image registration software (FusionQuant), and systemic (aortic) inflammation using 18F-fluorodeoxyglucose (FDG) PET. Data was acquired either during routine clinical care or prior research that established 68Ga-DOTATATE as an experimental marker of arterial inflammation that binds macrophage somatostatin receptor-2 in atherosclerotic plaques (NCT02021188).
Results
60 patients were included (TAK, n=20; CAD, n=20; healthy, n=20). Non-calcified plaque burden (TAK: 95.2%; CAD: 90.4%, p<0.0001) and CRP (TAK: 25.2 ±SD 16.1 mg/L; CAD: 2.5 ±SD 1.7 mg/L, p=0.04) were greater in TAK than CAD patients.
PCAT density varied significantly among the three groups (median [IQR] TAK: −72.9 [−81.2 to -66.1] Hounsfield unit [HU]; CAD: −79.9 [−88.0 to −72.2]; healthy: −83.8 [−90.1 to −75.8] HU, p<0.0001). Figure: box-plot showing the distribution of PCAT values by group, with corresponding representative multiplanar reconstructed and cross-sectional CTCA images with surrounding PCAT density displayed by color table in left anterior descending arteries.
PCAT density was significantly associated with ITAS (r=0.61, p=0.004) and CRP (r=0.43, p=0.03) in TAK patients, and coronary 68Ga-DOTATATE maximum tissue-to-blood ratio (r=0.31, p<0.001) in CAD patients. PCAT density was not associated with aortic 18F-FDG uptake in CAD patients, nor subcutaneous (pre-sternal) adipose tissue density in either disease group. No significant patient-level confounders were identified using linear mixed-effects regression modelling.
Conclusion
PCAT density measured by CTCA is greater in TAK than CAD patients, and is associated with clinical and biochemical markers of disease activity in TAK, and coronary arterial inflammation measured by 68Ga-DOTATATE PET in CAD. PCAT could be a useful, easy to measure marker of coronary inflammation and disease activity in both TAK and CAD.
PCAT density is greater in TAK than CAD
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Wellcome Trust
Collapse
Affiliation(s)
- C Wall
- University of Cambridge, Cambridge, United Kingdom
| | - Y Huang
- University of Cambridge, Cambridge, United Kingdom
| | - C Uy
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - E Le
- University of Cambridge, Cambridge, United Kingdom
| | - E Tombetti
- University Vita-Salute San Raffaele, Milan, Italy
| | - D Gopalan
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - R Manavaki
- University of Cambridge, Cambridge, United Kingdom
| | - M Dweck
- University of Edinburgh, Edinburgh, United Kingdom
| | - B Ariff
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - M Bennett
- University of Cambridge, Cambridge, United Kingdom
| | - P Slomka
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - D Dey
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - J Mason
- Imperial College London, London, United Kingdom
| | - J Rudd
- University of Cambridge, Cambridge, United Kingdom
| | - J Tarkin
- University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
2
|
LaGrandeur RG, Singhal M, Bany-Mohammed F, Uy C, Koeppel R, Zaldivar F, Haddad F, Nalbandian A, Donovan P, Cooper DM, Aslam M. Pilot feasibility study to detect mesenchymal stem cell biomarkers of bronchopulmonary dysplasia in the tracheal aspirate fluid of preterm infants. J Neonatal Perinatal Med 2018; 11:1-10. [PMID: 29689740 DOI: 10.3233/npm-181722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE This study aimed to detect novel mesenchymal stem cell peptides/biomarkers of bronchopulmonary dysplasia (BPD) in the tracheal aspirate fluid (TAF) of preterm infants. STUDY DESIGN Participants included infants less than 32 weeks' gestational age or birth weight under 1500 grams who required endotracheal intubation and mechanical ventilation within first 24 hours of life. TAF sample collection was performed at the time of the first clinically indicated routine suctioning. Standardization curves for human levels of osteopontin (Opn), macrophage colony stimulating factor 1 (Csf1), transforming growth factor beta 1 (TGF-β1), and secretory immunoglobulin A (sIgA) were generated for 15 enrolled participants. RESULTS We demonstrated that stem cell biomarkers are secreted into the TAF of preterm infants and their concentrations can be easily measured during the first week of life. CONCLUSIONS Further studies are warranted to determine a causal relationship between these biomarkers and BPD development and severity.
Collapse
Affiliation(s)
- R G LaGrandeur
- Department of Pediatrics, Division of Neonatology, University of California Irvine, Irvine, CA, USA
| | - M Singhal
- Department of Pediatrics, Division of Neonatology, University of California Irvine, Irvine, CA, USA
| | - F Bany-Mohammed
- Department of Pediatrics, Division of Neonatology, University of California Irvine, Irvine, CA, USA
| | - C Uy
- Department of Pediatrics, Division of Neonatology, University of California Irvine, Irvine, CA, USA
| | - R Koeppel
- Department of Pediatrics, Division of Neonatology, University of California Irvine, Irvine, CA, USA
| | - F Zaldivar
- Institute for Clinical and Translational Science, University of California Irvine, Irvine, CA, USA
| | - F Haddad
- Institute for Clinical and Translational Science, University of California Irvine, Irvine, CA, USA
| | - A Nalbandian
- Department of Pediatrics, Division of Neonatology, University of California Irvine, Irvine, CA, USA
| | - P Donovan
- Department of Developmental and Cellular Biology and of Biological Chemistry, University of California Irvine, Irvine, CA, USA
| | - D M Cooper
- Department of Pediatrics, Division of Pulmonology, University of California Irvine, Irvine, CA, USA
| | - M Aslam
- Department of Pediatrics, Division of Neonatology, University of California Irvine, Irvine, CA, USA
| |
Collapse
|
3
|
Abstract
Transfusion-related acute lung injury (TRALI) is a life-threatening complication of blood product transfusion characterized by sudden onset hypoxemic respiratory failure with bilateral lung infiltrates and non-cardiogenic pulmonary edema developing within 6 hours of transfusion. It is believed to be under-recognized, particularly among preterm neonates in whom co-existing developmental lung disease adds diagnostic complexity. Here we report the case of a preterm neonate who developed TRALI during a blood transfusion following PDA ligation.
Collapse
Affiliation(s)
- R G LaGrandeur
- Division of Neonatology, Department of Pediatrics, University of California Irvine Medical Center, Orange, CA, USA
| | - M Tran
- Department of Pathology, University of California Irvine Medical Center, Orange, CA, USA
| | - C Merchant
- Division of Neonatology, Department of Pediatrics, University of California Irvine Medical Center, Orange, CA, USA
| | - C Uy
- Division of Neonatology, Department of Pediatrics, University of California Irvine Medical Center, Orange, CA, USA
| |
Collapse
|
4
|
Nicolau Y, Bany-Mohammed F, Carpenter PM, Uy C. Massive pneumatosis without necrosis: A case report of Clostridium perfringens sepsis in an extremely low birth weight infant. J Neonatal Perinatal Med 2015; 8:257-61. [PMID: 26485548 DOI: 10.3233/npm-15814066] [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] [Indexed: 11/15/2022]
Abstract
Pneumatosis intestinalis and free intraperitoneal air on abdominal radiographs are considered pathognomonic signs of necrotizing enterocolitis (NEC). We report a unique case of late-onset fulminant sepsis due to Clostridium perfringens presenting with shock, extensive pneumatosis intestinalis and free intraperitoneal air in an extremely low birth weight infant without histopathological evidence of bowel necrosis or NEC.
Collapse
Affiliation(s)
- Y Nicolau
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Loma Linda University, Loma Linda, CA, USA
| | - F Bany-Mohammed
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of California Irvine, Irvine, CA,USA
| | - P M Carpenter
- Department of Pathology and Laboratory Medicine, University of California Irvine, Irvine, CA, and University of Southern California, Los Angeles, CA, USA
| | - C Uy
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of California Irvine, Irvine, CA,USA
| |
Collapse
|
5
|
Kim D, Uy C, Mandel L. Sialosis of unknown origin. N Y State Dent J 1998; 64:38-40. [PMID: 9785837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Sialosis (sialadenosis) is defined as an asymptomatic, non-inflammatory, non-neoplastic parenchymal salivary gland disease accompanied by a persistent painless bilateral swelling of the salivary glands, most commonly involving the parotid glands. There is no sex predilection, and the peak age incidence is between 30 and 70 years of age. Sialosis occurs in three different groups of patients: alcoholics, diabetics and the malnourished. An autonomic neuropathy, seen as a demyelinating polyneuropathy, seems to be the common underlying basis for this seemingly disparate group of patients with sialosis.
Collapse
Affiliation(s)
- D Kim
- Columbia University School of Dental and Oral Surgery, USA
| | | | | |
Collapse
|
6
|
Mandel L, Kim D, Uy C. Parotid gland swelling in HIV diffuse infiltrative CD8 lymphocytosis syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 85:565-8. [PMID: 9619675 DOI: 10.1016/s1079-2104(98)90292-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
HIV can affect salivary gland tissue. Parotid swellings have been observed in a subset of patients who are HIV-positive; the swellings are the result of a condition that has been termed diffuse infiltrative CD8 lymphocytosis syndrome. Initially the glandular enlargement results from a massive CD8 cell lymphoproliferation, but with time lymphoepithelial cysts become manifest. Two case reports are presented to illustrate this progression of diffuse infiltrative CD8 lymphocytosis.
Collapse
Affiliation(s)
- L Mandel
- Division of Oral and Maxillofacial Surgery, Columbia University School of Dental and Oral Surgery and Columbia Presbyterian Medical Center, New York, NY 10032, USA
| | | | | |
Collapse
|
7
|
Abstract
Five children with acquired immunodeficiency syndrome (AIDS) and clinically significant renal disease had detailed pathologic examination of renal tissue (biopsy specimens, autopsy specimens, or both). All patients had proteinuria, hypoalbuminemia, and edema; one patient had persistent azotemia. In two cases, renal disease was the first manifestation of human immunodeficiency virus (HIV) infection. All patients had progressive renal disease, and four of the five died. Pathologic studies revealed focal glomerulosclerosis and mesangial proliferative glomerulonephritis with deposits of immunoglobulins and complement demonstrated by immunofluorescence and electron microscopy. Characteristic tubuloreticular structures were also demonstrated in the glomerular endothelial or epithelial cells in two cases. Renal disease is part of the multisystem involvement in children with AIDS. The pathogenesis of renal disease is not known, but circulating immune complexes are known to occur in children with HIV infection and may be involved.
Collapse
Affiliation(s)
- E Connor
- Department of Pediatrics, Children's Hospital of New Jersey, Newark 07107
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Abstract
Urinary undiversion was performed in 31 patients. Preoperative investigation and criteria for undiversion are discussed. Renal preservation rate is stable in 28 of 31 patients and bladder function satisfactory in 30 of 31 patients. Although prolongation of life and prevention of renal deterioration are of primary concern, psychologic aspects of undiversion must also be considered. Some children who underwent urinary diversion have poor renal reserve and eventually outgrow their kidneys, thus requiring renal transplantation. Their urinary tracts must be prepared for that eventuality.
Collapse
|
9
|
Uy C, Snyder RD, Stiefel FH. Immunoglobulin assays and electrophoretic patterns in wheezing infants. Ann Allergy 1972; 30:663-7. [PMID: 4628943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|