Perivascular Perfusion on Contrast-Enhanced Ultrasound (CEUS) Is Associated with Inflammation in Patients with Acute Deep Vein Thrombosis

Downregulation of interleukin-6 and C-reactive protein underlies a novel inhibitory role of microRNA-136-5p in acute lower extremity deep vein thrombosis

Deep vein thrombosis (DVT) comprises a critical and common health condition with high incidence, mortality, and long-term adverse sequelae. Several differentially expressed microRNAs (miRNAs) have emerged as promising prognostic markers in DVT. The present study intended to explore the functional relevance of miR-136-5p in acute lower extremity DVT (LEDVT). Rat models of acute LEDVT were established and miR-136-5p expression was altered by agomir or antagomir to assess its effects. In addition, in vitro gain- and loss-experiments, prior to exposure to CoCl₂, were performed to investigate effects of miR-136-5p on human umbilical vein endothelial cell (HUVEC) apoptosis and levels of interleukin-6 (IL-6) and C-reactive protein (CRP). miR-136-5p was downregulated, whereas IL-6 and CRP were elevated in acute LEDVT patients. Notably, miR-136-5p was confirmed to target both IL-6 and CRP. Overexpression of miR-136-5p led to reduced length, weight, and ratio of weight to length of the venous thrombus. Furthermore, overexpressed miR-136-5p downregulated the expression of IL-6 and CRP, consequently inhibiting HUVEC apoptosis. Conjointly, our data indicate that the overexpression of miR-136-5p has the potential to bind to the 3’-UTR in the mRNAs for IL-6 and CRP and mitigate acute LEDVT, which provides a basis for new therapeutic targets in acute LEDVT treatment.

Carotid contrast-enhanced ultrasonographic assessment of disease activity in Takayasu arteritis

AIMS

To investigate the usefulness of carotid contrast-enhanced ultrasound (CEUS) in assessment of disease activity in patients with Takayasu arteritis (TA).

METHODS AND RESULTS

After screening 219 CEUS records from 124 consecutive patients followed at our clinic between October 2014 and May 2018, data were analysed from 159 carotid CEUS from 86 patients diagnosed with Type I TA. Patients were categorized based on disease activity according to National Institutes of Health criteria into two groups: active disease group (92 CEUS) and non-active disease group (67 CEUS). The enhanced intensity of carotid artery wall: (i) was higher in active disease group than in non-active disease group (3.09 ± 1.67 dB vs. 1.44 ± 1.29 dB, P < 0.0001, respectively); and (ii) had a high predictive value for TA disease activity with area under the curve (AUC) of 86.3% [95% confidence interval (CI) 79.7-92.9], sensitivity of 88.0%, and specificity of 79.1%. The latter AUC was not significantly affected (P > 0.05) when erythrocyte sedimentation rate, C-reactive protein level, or arterial wall thickness were added to assessment of disease activity in TA.

CONCLUSION

Carotid vascularization by CEUS, as sole inflammatory marker, had a high predictive value for disease activity in Type I TA.

Vascular ultrasound, the potential of integration of multiparametric ultrasound into routine clinical practice

Introduction

Ultrasound has traditionally been regarded as the first-line imaging modality for screening, diagnostic evaluation and monitoring treatment and disease progression of vascular pathology, including both the arterial and the venous branch of the vascular system. Albeit of its well-tolerated nature, wide availability and low cost, ultrasound above all, has the advantage of providing the clinician with clinically significant information related to both intraluminal irregularities and extravascular disease. Ultrasound has the potential not only to anatomically describe tissues but also to assess physiology by evaluating blood flow characteristics in real time.

Discussion

The already fundamental role of ultrasound has been even more expanded with the introduction of newer techniques like contrast-enhanced ultrasound, tissue-elastography and 3D ultrasound and the incorporation of research advances into clinical practice. The purpose of this review is to present and discuss some of the latest advances in the field of vascular ultrasound in attempt to illustrate how the adoption of multiparametric ultrasound into everyday clinical practice could address the patient's needs. Pathology and applications discussed include carotid and aortic disease, portal and peripheral venous abnormalities.

Conclusion

Widespread availability of modern technology in ultrasound devices has made the application of contrast-enhanced ultrasound, tissue elastography and 3D ultrasound feasible options, ready to contribute to the diagnostic performance of the ultrasonographic technique.