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Bruchbacher A, Franke J, Alimohammadi A, Laukhtina E, Fajkovic H, Schmidinger M. Real-World Results of Cabozantinib Given as Alternative Schedule in Metastatic Renal Cell Carcinoma. Clin Genitourin Cancer 2024; 22:98-108. [PMID: 37926597 DOI: 10.1016/j.clgc.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/21/2023] [Accepted: 09/23/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND The multikinase-inhibitor Cabozantinib is a widely used treatment strategy in metastatic renal cell carcinoma (mRCC), either in combination with the programmed cell death protein-1 (PD-1) inhibitor nivolumab or as monotherapy. Cabozantinib is given continuously at a dose of 60 mg once daily when used as a single agent and at 40 mg when combined with nivolumab. Treatment-related adverse events (TRAE's) were shown to occur frequently. OBJECTIVE We aimed to assess the safety and efficacy of cabozantinib in patients with mRCC. Patients were treated in various lines. Furthermore, we analyzed the impact of an alternative treatment schedule in patients not able to maintain continuous dosing. PATIENTS This is a single center retrospective study from the Medical University of Vienna. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Overall response rates (ORR), progression free survival (PFS) and overall survival (OS) were evaluated for the entire cohort, by treatment line and by treatment schedule. RESULTS Between January 2014 until April 2021, 71 patients received cabozantinib. Sixty-seven patients were eligible for full evaluation. By IMDC criteria, 32.4%, 59.2%, and 8.5% were classified as favorable, intermediate and poor risk respectively. Cabozantinib was offered as a 2nd-line or 3rd-line treatment in 38.0% and 32.4% of patients, respectively. An alternative treatment schedule was offered in 39.1% of patients. Objective responses were found in 43.3% (CR 6%) of patients and the median PFS was 10.8 months (95% CI: 5.5-16.2). When compared to continuous dosing, an alternative treatment schedule was associated with longer PFS (12.2 months (95% CI: 0-25.5) vs. 6.1 months (95% CI: 0.37-11.8) (P = .014, HR 0.46 (95% CI: 0.24-0.86), respectively) and a lower frequency and severity of TRAE's. CONCLUSIONS Safety and efficacy of cabozantinib in real world is comparable to what has been observed in the pivotal trials, irrespective of the treatment line. An alternative schedule may further improve efficacy and safety.
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Affiliation(s)
| | - Johannes Franke
- Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Arman Alimohammadi
- Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Ekaterina Laukhtina
- Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Harun Fajkovic
- Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Manuela Schmidinger
- Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
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Kardoust Parizi M, Margulis V, Bagrodia A, Bekku K, Klemm J, Matsukawa A, Alimohammadi A, Motlagh RS, Mostafaei H, Laukhtina E, Shariat SF. Primary retroperitoneal lymph node dissection for clinical stage II seminoma: A systematic review and meta-analysis of safety and oncological effectiveness. Urol Oncol 2024; 42:102-109. [PMID: 38360519 DOI: 10.1016/j.urolonc.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/21/2023] [Accepted: 01/08/2024] [Indexed: 02/17/2024]
Abstract
To evaluate the oncological outcomes and safety of primary retroperitoneal lymph node dissection (RPLND) in patients with clinical stage (CS) II seminomatous testicular germ cell tumor (TGCT). A literature search using PubMed, Scopus, and Cochrane Library was conducted on July 2023 to identify relevant studies according to the Preferred Reporting Items for Systematic Review and Meta Analysis (PRISMA) guidelines. The pooled recurrence rate and treatment-related complications were calculated using a random effects model. Overall 8 studies published between 1997 and 2023 including a total of 355 patients were selected for systematic review and meta-analysis with the overall median follow-up of 38 months. The overall and infield recurrence rate were 0.14 (95% CI: 0.08-0.22) and 0.04 (95% CI: 0.00-0.11), respectively. The overall pooled rate of ≥ Clavien Dindo grade III complications was 0.04 (95% CI: 0.01-0.10); there was no significant heterogeneity (I^2 = 35.10%, P = 0.19). Antegrade ejaculation was preserved with the overall pooled rate of 0.98 (95% CI: 0.95-1.00); there was no significant heterogeneity on Chi-square and I2 tests (I^2 = 0.00%, P = 0.58). Primary RPLND is a safe and effective treatment option for patients with CS II seminomatous TGCT resulting highly promising cure rates combined with low treatment-associated adverse events, at medium-term follow-up. However, owing to the lack of comparative studies to the current standard of care and the limited follow-up, individual decision must be made with the informed patient in a shared decision process together with a multidisciplinary team.
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Affiliation(s)
- Mehdi Kardoust Parizi
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Vitaly Margulis
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Aditya Bagrodia
- Department of Urology, University of California San Diego, San Diego, CA
| | - Kensuke Bekku
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Jakob Klemm
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Akihiro Matsukawa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | - Arman Alimohammadi
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Reza Sari Motlagh
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Hadi Mostafaei
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czech Republic; Departments of Urology, Weill Cornell Medical College, New York, NY; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan.
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Kardoust Parizi M, Matsukawa A, Bekku K, Klemm J, Alimohammadi A, Laukhtina E, Karakiewicz P, Chiujdea S, Abufaraj M, Krauter J, Shariat SF. Metastatic Organotropism Differential Treatment Response in Urothelial Carcinoma: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials. Eur Urol Oncol 2023:S2588-9311(23)00246-8. [PMID: 37980251 DOI: 10.1016/j.euo.2023.11.001] [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: 08/29/2023] [Revised: 09/25/2023] [Accepted: 11/03/2023] [Indexed: 11/20/2023]
Abstract
CONTEXT The optimal therapeutic agent with respect to metastatic sites is unclear in advanced urothelial carcinoma (UC). OBJECTIVE To investigate the metastatic organotropism differential treatment response in patients with advanced or metastatic UC. EVIDENCE ACQUISITION A systematic search and network meta-analysis (NMA) was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. The primary endpoints of interest were the objective response rate, overall survival (OS), and progression-free survival with respect to different metastatic sites. EVIDENCE SYNTHESIS Twenty-six trials comprising 9082 patients met our eligibility criteria, and a formal NMA was conducted. Durvalumab plus tremelimumab as first-line systemic therapy was significantly associated with better OS than chemotherapy in visceral metastasis (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.67-0.98). Pembrolizumab as second-line systemic therapy was significantly associated with better OS than chemotherapy in patients with visceral metastasis (HR 0.75, 95% CI 0.60-0.95). Atezolizumab as second-line systemic therapy was significantly associated with better OS than chemotherapy in patients with liver metastasis (in the population of >5% of tumor-infiltrating immune cells) and lymph node metastasis (HR 0.51, 95% CI 0.28-0.96, and HR 0.59, 95% CI 0.37-0.96, respectively). CONCLUSIONS Administration of immune-oncology treatments with respect to metastatic sites in patients with advanced or metastatic UC might have a positive impact on survival outcomes in both the first- and the second-line setting. Nevertheless, further investigations focusing on metastatic organotropism differential response with reliable oncological outcomes are needed to identify the optimal management strategy for these patients. PATIENT SUMMARY Although the supporting evidence for oncological benefits of therapeutic systemic agents with respect to metastatic sites is not yet strong enough to provide a recommendation in advanced or metastatic urothelial carcinoma, clinicians may take into account tumor organotropism only in discussion with the patient fully informed on the optimal treatment decision to be taken.
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Affiliation(s)
- Mehdi Kardoust Parizi
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Akihiro Matsukawa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | - Kensuke Bekku
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Jakob Klemm
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Arman Alimohammadi
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Pierre Karakiewicz
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada
| | - Sever Chiujdea
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Spitalul Clinic Județean Mures, Universitatea de Medicina și Farmacie, Științe și Tehnologie, Targu Mures, Romania
| | - Mohammad Abufaraj
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Johanna Krauter
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Urology, Weill Cornell Medical College, New York, NY, USA.
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Gawish R, Maier B, Obermayer G, Watzenboeck ML, Gorki AD, Quattrone F, Farhat A, Lakovits K, Hladik A, Korosec A, Alimohammadi A, Mesteri I, Oberndorfer F, Oakley F, Brain J, Boon L, Lang I, Binder CJ, Knapp S. A neutrophil-B-cell axis impacts tissue damage control in a mouse model of intraabdominal bacterial infection via Cxcr4. eLife 2022; 11:78291. [PMID: 36178806 PMCID: PMC9525059 DOI: 10.7554/elife.78291] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
Sepsis is a life-threatening condition characterized by uncontrolled systemic inflammation and coagulation, leading to multiorgan failure. Therapeutic options to prevent sepsis-associated immunopathology remain scarce. Here, we established a mouse model of long-lasting disease tolerance during severe sepsis, manifested by diminished immunothrombosis and organ damage in spite of a high pathogen burden. We found that both neutrophils and B cells emerged as key regulators of tissue integrity. Enduring changes in the transcriptional profile of neutrophils include upregulated Cxcr4 expression in protected, tolerant hosts. Neutrophil Cxcr4 upregulation required the presence of B cells, suggesting that B cells promoted disease tolerance by improving tissue damage control via the suppression of neutrophils’ tissue-damaging properties. Finally, therapeutic administration of a Cxcr4 agonist successfully promoted tissue damage control and prevented liver damage during sepsis. Our findings highlight the importance of a critical B-cell/neutrophil interaction during sepsis and establish neutrophil Cxcr4 activation as a potential means to promote disease tolerance during sepsis.
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Affiliation(s)
- Riem Gawish
- Department of Medicine I, Laboratory of Infection Biology, Medical University Vienna, Vienna, Austria.,Ce-M-M-, Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Barbara Maier
- Department of Medicine I, Laboratory of Infection Biology, Medical University Vienna, Vienna, Austria.,Ce-M-M-, Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Georg Obermayer
- Ce-M-M-, Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.,Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Martin L Watzenboeck
- Department of Medicine I, Laboratory of Infection Biology, Medical University Vienna, Vienna, Austria.,Ce-M-M-, Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Anna-Dorothea Gorki
- Department of Medicine I, Laboratory of Infection Biology, Medical University Vienna, Vienna, Austria.,Ce-M-M-, Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Federica Quattrone
- Department of Medicine I, Laboratory of Infection Biology, Medical University Vienna, Vienna, Austria.,Ce-M-M-, Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Asma Farhat
- Department of Medicine I, Laboratory of Infection Biology, Medical University Vienna, Vienna, Austria.,Ce-M-M-, Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Karin Lakovits
- Department of Medicine I, Laboratory of Infection Biology, Medical University Vienna, Vienna, Austria
| | - Anastasiya Hladik
- Department of Medicine I, Laboratory of Infection Biology, Medical University Vienna, Vienna, Austria
| | - Ana Korosec
- Department of Medicine I, Laboratory of Infection Biology, Medical University Vienna, Vienna, Austria
| | - Arman Alimohammadi
- Department of Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Ildiko Mesteri
- Department of Pathology, Medical University Vienna, Vienna, Austria
| | | | - Fiona Oakley
- Newcastle Fibrosis Research Group, Biosciences Institute, Newcastle University, Newcastle, United Kingdom
| | - John Brain
- Newcastle Fibrosis Research Group, Biosciences Institute, Newcastle University, Newcastle, United Kingdom
| | - Louis Boon
- Polypharma Biologics, Utrecht, Netherlands
| | - Irene Lang
- Department of Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Christoph J Binder
- Ce-M-M-, Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.,Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Sylvia Knapp
- Department of Medicine I, Laboratory of Infection Biology, Medical University Vienna, Vienna, Austria.,Ce-M-M-, Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
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5
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Alimohammadi A, Fajkovic H, Remzi M, Shariat S, Schmidinger M. Recent pharmacological approaches for the treatment of renal cell carcinoma. Expert Rev Clin Pharmacol 2022; 15:187-195. [PMID: 35285369 DOI: 10.1080/17512433.2022.2053521] [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: 11/04/2022]
Abstract
INTRODUCTION Therapies combining either two immune check-point inhibitors (ICIs) or an ICI and a tyrosine kinase inhibitor (TKI) have been shown to improve overall survival (OS), progression-free survival (PFS) and objective response rates (ORR) in metastatic renal cell carcinoma (mRCC); moreover, unprecedented rates of complete remission (CR) have been reported. AREAS COVERED Among six randomized trials of ICI combinations, four have outperformed the TKI sunitinib in terms of OS. The CheckMate 214 trial investigated the combination of nivolumab (a programmed cell death protein 1 [PD-1] inhibitor) and ipilimumab (a cytotoxic T-lymphocyte antigen-4 [CTLA-4)] inhibitor). Three other trials evaluated combinations of an ICI and a TKI. These combinations are: 1) pembrolizumab (PD-1 inhibitor) plus axitinib, 2) nivolumab plus cabozantinib, and 3) pembrolizumab plus lenvatinib. This short review addresses the findings of these trials, comparing outcomes and discussing the challenges of decision-making in clinical practice. EXPERT OPINION Despite major improvements in outcomes with ICI combinations, not all patients benefit from this approach. Predictive biomarkers and new therapeutic approaches are urgently needed to overcome treatment failures. A growing understanding of immune escape mechanisms and the interplay between the immune response and the gut microbiota may offer additional rescue strategies beyond ICIs and TKIs.
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Affiliation(s)
- Arman Alimohammadi
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Harun Fajkovic
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Mesut Remzi
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Shahrokh Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, Weill Cornell Medical College, New York, New York, USA.,Department of Urology, University of Texas Southwestern, Dallas, Texas, USA.,Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.,Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.,Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Manuela Schmidinger
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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Winter MP, Sharma S, Altmann J, Seidl V, Panzenböck A, Alimohammadi A, Zelniker T, Redwan B, Nagel F, Santer D, Stieglbauer A, Podesser B, Sibilia M, Helbich T, Prager G, Ilhan-Mutlu A, Preusser M, Lang IM. Interruption of vascular endothelial growth factor receptor 2 signaling induces a proliferative pulmonary vasculopathy and pulmonary hypertension. Basic Res Cardiol 2020; 115:58. [PMID: 32880713 PMCID: PMC7471204 DOI: 10.1007/s00395-020-0811-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 07/16/2020] [Indexed: 11/28/2022]
Abstract
Pulmonary arterial hypertension is a severe and progressive disease characterized by a pulmonary vascular remodeling process with expansion of collateral endothelial cells and total vessel occlusion. Endothelial cells are believed to be at the forefront of the disease process. Vascular endothelial growth factor (VEGF) and its tyrosine kinase receptor, VEGF receptor-2 (VEGFR-2), play a central role in angiogenesis, endothelial cell protection, but also in the destabilization of endothelial barrier function. Therefore, we investigated the consequences of altered VEGF signaling in an experimental model, and looked for translational correlates of this observation in patients. We performed an endothelial cell-specific conditional deletion of the kinase insert domain protein receptor (kdr) gene, coding for VEGFR-2, in C57/BL6 mice (Kdr∆end) and held them in an environmental chamber with 10% FiO2 or under normoxia for 6 weeks. Kdr knockout led to a mild PH phenotype under normoxia that worsened under hypoxia. Kdr∆end mice exhibited a significant increase in pulmonary arterial wall thickness, muscularization, and VEGFR-3+ endothelial cells obliterating the pulmonary artery vessel lumen. We observed the same proliferative vasculopathy in our rodent model as seen in patients receiving anti-angiogenic therapy. Serum VEGF-a levels were elevated both in the experimental model and in humans receiving bevacizumab. Interrupted VEGF signaling leads to a pulmonary proliferative arteriopathy in rodents after direct ablative gene manipulation of Kdr. Histologically, similar vascular lesions can be observed in patients receiving anti-VEGF treatment. Our findings illustrate the importance of VEGF signaling for maintenance of pulmonary vascular patency.
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Affiliation(s)
- Max-Paul Winter
- Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Smriti Sharma
- Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Johanna Altmann
- Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Veronika Seidl
- Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Adelheid Panzenböck
- Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Arman Alimohammadi
- Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Thomas Zelniker
- Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Bassam Redwan
- Division of Thoracic Surgery and Lung Transplantation, Department of Cardiothoracic Surgery, University Hospital of Münster, Münster, Germany
| | - Felix Nagel
- Ludwig Boltzmann Cluster for Cardiovascular Research, Center of Biomedical Research, Vienna, Austria
| | - David Santer
- Ludwig Boltzmann Cluster for Cardiovascular Research, Center of Biomedical Research, Vienna, Austria
| | | | - Bruno Podesser
- Ludwig Boltzmann Cluster for Cardiovascular Research, Center of Biomedical Research, Vienna, Austria
| | - Maria Sibilia
- Department of Medicine I, Institute for Cancer Research, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Thomas Helbich
- Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - Gerald Prager
- Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Aysegül Ilhan-Mutlu
- Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Matthias Preusser
- Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Irene M Lang
- Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Hofbauer TM, Alimohammadi A, Altmann J, Sharma S, Ondracek AS, Sadushi-Kolici R, Seidl V, Mangold A, Lang IM. P6010Deficiency in milk fat globule-epidermal growth factor 8 delays thrombus resolution. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by the obstruction of pulmonary vessels by organized thrombotic and fibrotic lesions. Efferocytosis refers to the engulfment of apoptotic cells (ACs) by phagocytes, a process that is facilitated by bridging proteins. Milk fat globule-epidermal growth factor 8 (MFG-E8) connects phosphatidylserine on ACs with integrin alpha-v beta-III on phagocytes. MFG-E8-deficient mice develop auto-immune disease closely resembling systemic lupus erythematosus. In humans, decreased MFG-E8 levels were observed in patients with coronary heart disease and chronic obstructive pulmonary disease. Whether defective efferocytosis is involved in failure to resolve thrombi in CTEPH remains unknown.
Purpose
We aimed to assess whether deficiency in MFG-E8 is responsible for of chronic non-resolving thrombosis in CTEPH.
Methods
We employed a murine model of chronic thrombosis by inferior vena cava ligation, in MFG-E8 knockout (KO) or wild-type (WT) mice to assess thrombus formation and resolution. Thrombus size at days 3, 7, 14 and 28 after ligation was assessed using either histologic trichrome stainings (n=4–13 per group and time point) or in vivo high-frequency ultrasound (n=10 per group and time point). We furthermore recruited CTEPH patients (n=60, 53% female, mean age 56±11 years) and sex- and age-matched healthy controls for measurement of MFG-E8 plasma levels using ELISA. In CTEPH patients, hemodynamic measurements were performed. Human lung specimens harvested during surgery for CTEPH or from healthy controls, and isolated monocytes from whole blood of CTEPH patients or controls were analyzed using RT-qPCR.
Results
We observed substantially increased thrombus volume in MFG-E8 KO mice compared to WT, which persisted until day 14 after ligation. In human CTEPH patients, MFG-E8 in plasma was increased compared to healthy controls. Similarly, CTEPH monocytes displayed higher concentrations of MFG-E8 mRNA. Conversely, MFG-E8 expression of CTEPH pulmonary artery specimens was downregulated. No correlations between MFG-E8 levels and hemodynamic parameters were observed.
Conclusion
MFG-E8 plays an important role in thrombus resolution. In CTEPH, dysregulation of efferocytosis via impaired MFG-E8 expression in the pulmonary arteries, might drive persistence of thrombus in pulmonary arteries. The absence of a correlation between MFG-E8 and hemodynamic measures argues against pressure as a confounder of the observation.
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Affiliation(s)
- T M Hofbauer
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - A Alimohammadi
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - J Altmann
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - S Sharma
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - A S Ondracek
- Medical University of Vienna, Cardiology, Vienna, Austria
| | | | - V Seidl
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - A Mangold
- Medical University of Vienna, Cardiology, Vienna, Austria
| | - I M Lang
- Medical University of Vienna, Cardiology, Vienna, Austria
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Winter MP, Smriti S, Altmann J, Seidl V, Alimohammadi A, Redwan B, Nagel F, Santer D, Podesser B, Sibilia S, Helbich T, Prager G, Ilhan-Mutlu A, Preusser M, Lang I. 1206Endothelial cell-specific deletion of vascular endothelial growth factor receptor 2/kinase insert domain protein receptor and proliferative pulmonary vasculopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M.-P Winter
- Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology, Vienna, Austria
| | - S Smriti
- Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology, Vienna, Austria
| | - J Altmann
- Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology, Vienna, Austria
| | - V Seidl
- Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology, Vienna, Austria
| | - A Alimohammadi
- Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology, Vienna, Austria
| | - B Redwan
- University of Witten/Herdecke, Department of Thoracic Surgery, Helios University Hospital of Wuppertal, Witten, Germany
| | - F Nagel
- Medical University of Vienna, Institute of Biomedical Research, Vienna, Austria
| | - D Santer
- Medical University of Vienna, Institute of Biomedical Research, Vienna, Austria
| | - B Podesser
- Medical University of Vienna, Institute of Biomedical Research, Vienna, Austria
| | - S Sibilia
- Medical University of Vienna, Institute for Cancer Research, Department of Medicine I, Comprehensive Cancer Center,, Vienna, Austria
| | - T Helbich
- Medical University of Vienna, Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - G Prager
- Medical University of Vienna, Institute for Cancer Research, Department of Medicine I, Comprehensive Cancer Center,, Vienna, Austria
| | - A Ilhan-Mutlu
- Medical University of Vienna, Institute for Cancer Research, Department of Medicine I, Comprehensive Cancer Center,, Vienna, Austria
| | - M Preusser
- Medical University of Vienna, Institute for Cancer Research, Department of Medicine I, Comprehensive Cancer Center,, Vienna, Austria
| | - I Lang
- Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology, Vienna, Austria
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9
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Sharma S, Alimohammadi A, Chausheva S, Altmann J, Panzenboeck A, Moser B, Taghavi S, Klepetko W, Lang IM. 5067Dysregulated BMPR/TGF-beta impact fibrotic vascular remodeling during thrombosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Sharma
- Medical University of Vienna, AKH – Vienna, Cardiology Clinic, Vienna, Austria
| | - A Alimohammadi
- Medical University of Vienna, AKH – Vienna, Cardiology Clinic, Vienna, Austria
| | - S Chausheva
- Medical University of Vienna, AKH – Vienna, Cardiology Clinic, Vienna, Austria
| | - J Altmann
- Medical University of Vienna, AKH – Vienna, Cardiology Clinic, Vienna, Austria
| | - A Panzenboeck
- Medical University of Vienna, AKH – Vienna, Cardiology Clinic, Vienna, Austria
| | - B Moser
- Medical University of Vienna, Department of Surgery, Vienna, Austria
| | - S Taghavi
- Medical University of Vienna, Department of Surgery, Vienna, Austria
| | - W Klepetko
- Medical University of Vienna, Department of Surgery, Vienna, Austria
| | - I M Lang
- Medical University of Vienna, AKH – Vienna, Cardiology Clinic, Vienna, Austria
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10
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Ghaemi Z, Alimohammadi A, Farnaghi M. LaSVM-based big data learning system for dynamic prediction of air pollution in Tehran. Environ Monit Assess 2018; 190:300. [PMID: 29679160 PMCID: PMC5910457 DOI: 10.1007/s10661-018-6659-6] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 04/02/2018] [Indexed: 06/08/2023]
Abstract
Due to critical impacts of air pollution, prediction and monitoring of air quality in urban areas are important tasks. However, because of the dynamic nature and high spatio-temporal variability, prediction of the air pollutant concentrations is a complex spatio-temporal problem. Distribution of pollutant concentration is influenced by various factors such as the historical pollution data and weather conditions. Conventional methods such as the support vector machine (SVM) or artificial neural networks (ANN) show some deficiencies when huge amount of streaming data have to be analyzed for urban air pollution prediction. In order to overcome the limitations of the conventional methods and improve the performance of urban air pollution prediction in Tehran, a spatio-temporal system is designed using a LaSVM-based online algorithm. Pollutant concentration and meteorological data along with geographical parameters are continually fed to the developed online forecasting system. Performance of the system is evaluated by comparing the prediction results of the Air Quality Index (AQI) with those of a traditional SVM algorithm. Results show an outstanding increase of speed by the online algorithm while preserving the accuracy of the SVM classifier. Comparison of the hourly predictions for next coming 24 h, with those of the measured pollution data in Tehran pollution monitoring stations shows an overall accuracy of 0.71, root mean square error of 0.54 and coefficient of determination of 0.81. These results are indicators of the practical usefulness of the online algorithm for real-time spatial and temporal prediction of the urban air quality.
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Affiliation(s)
- Z. Ghaemi
- Faculty of Geodesy and Geomatics Engineering, K.N. Toosi University of Technology, No. 1346, ValiAsr Street, Mirdamad cross, Tehran, 19967-15433 Iran
| | - A. Alimohammadi
- Faculty of Geodesy and Geomatics Engineering, K.N. Toosi University of Technology, No. 1346, ValiAsr Street, Mirdamad cross, Tehran, 19967-15433 Iran
| | - M. Farnaghi
- Faculty of Geodesy and Geomatics Engineering, K.N. Toosi University of Technology, No. 1346, ValiAsr Street, Mirdamad cross, Tehran, 19967-15433 Iran
- GIS Center, Department of Physical Geography and Ecosystem Science, Lund University, Lund, Sweden
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11
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Sharma S, Alimohammadi A, Chausheva S, Altmann J, Panzenboeck A, Moser B, Taghavi S, Lang IM. P381Role of bone morphogenetic protein receptor type II in vascular remodeling during thrombosis. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Sharma
- Medical University of Vienna, AKH – Vienna, Cardiology Clinic, Vienna, Austria
| | - A Alimohammadi
- Medical University of Vienna, AKH – Vienna, Cardiology Clinic, Vienna, Austria
| | - S Chausheva
- Medical University of Vienna, AKH – Vienna, Cardiology Clinic, Vienna, Austria
| | - J Altmann
- Medical University of Vienna, AKH – Vienna, Cardiology Clinic, Vienna, Austria
| | - A Panzenboeck
- Medical University of Vienna, AKH – Vienna, Cardiology Clinic, Vienna, Austria
| | - B Moser
- Medical University of Vienna, Department of Surgery, Vienna, Austria
| | - S Taghavi
- Medical University of Vienna, Department of Surgery, Vienna, Austria
| | - I M Lang
- Medical University of Vienna, AKH – Vienna, Cardiology Clinic, Vienna, Austria
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12
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Singh A, Kiani G, Shahi R, Alimohammadi A, Raycraft T, Conway B. A220 THE EFFECT OF HOMELESSNESS ON HCV TREATMENT OUTCOMES AMONG PEOPLE WHO INJECT DRUGS. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Singh
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - G Kiani
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - R Shahi
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - A Alimohammadi
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - T Raycraft
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - B Conway
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
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13
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Kiani G, Shahi R, Raycraft T, Alimohammadi A, Singh A, Conway B. A26 TREATMENT OUTCOMES OF HCV-INFECTED PATIENS IDENTIFIED THROUGH THE COMMUNITY POP-UP CLINIC. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- G Kiani
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - R Shahi
- Vancouver Infectious Diseases Research & Care Centre Society, Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - T Raycraft
- Medicine, University of British Columbia, Vancouver, BC, Canada
| | - A Alimohammadi
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - A Singh
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - B Conway
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
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14
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Raycraft T, Singh A, Alimohammadi A, Shahi R, Kiani G, Truong D, Conway B. A173 EVALUATION OF LIVER FIBROSIS SCORES POST-HCV SVR IN PEOPLE WHO INJECT DRUGS. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Raycraft
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - A Singh
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - A Alimohammadi
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - R Shahi
- Vancouver Infectious Diseases Research & Care Centre Society, Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - G Kiani
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - D Truong
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - B Conway
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
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15
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Alimohammadi A, Kiani G, Raycraft T, Shahi R, Singh A, Conway B. A181 REAL-LIFE EFFICACY OF ELBASVIR/GRAZOPREVIR (EBV/GZV) FOR THE TREATMENT OF CHRONIC HCV GENOTYPE 1 AND 3 INFECTION. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Alimohammadi
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - G Kiani
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - T Raycraft
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - R Shahi
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - A Singh
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
| | - B Conway
- Vancouver Infectious Diseases Centre, Vancouver, BC, Canada
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16
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Winter MP, Alimohammadi A, Seidl V, Altmann J, Panzenboeck A, Sharma S, Nagel F, Santer D, Podesser B, Lang I. P729Tenascin-C deficiency in combination with chronic hypoxia leads to a Cpc-PH phenotype. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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17
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Gerges M, Gerges C, Publig M, Skoro-Sajer N, Bonderman D, Frey M, Schwarzinger I, Lechner K, Seidl V, Alimohammadi A, Winter M, Humenberger M, Eichelberger B, Panzer S, Lang I. P5367Chronic inflammation after splenectomy is a risk factor for increased thrombotic cardiovascular events. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Navarese EP, Kolodziejczak M, Winter MP, Alimohammadi A, Lang IM, Buffon A, Lip GY, Siller-Matula JM. Association of PCSK9 with platelet reactivity in patients with acute coronary syndrome treated with prasugrel or ticagrelor: The PCSK9-REACT study. Int J Cardiol 2016; 227:644-649. [PMID: 27810295 DOI: 10.1016/j.ijcard.2016.10.084] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [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: 09/07/2016] [Accepted: 10/28/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Circulating proprotein convertase subtilisin/kexin type 9 (PCSK9) enzyme might be associated with increased activation of platelets. We aimed to assess the relationship between PCSK9 levels, platelet reactivity and ischemic outcomes. METHODS Consecutive ACS patients receiving prasugrel or ticagrelor and undergoing percutaneous coronary intervention (PCI) were enrolled in a prospective, observational study. Adenosine diphosphate (ADP)-induced platelet aggregation was determined by Multiplate Analyzer in the maintenance phase of treatment with prasugrel or ticagrelor. Major adverse cardiovascular events (MACEs) defined as composite of cardiovascular death, myocardial infarction, unstable angina, stent thrombosis, repeat revascularization, ischemic stroke were evaluated at 12months. RESULTS A direct association was found between increased PCSK9 serum levels and platelet reactivity (r=0.30; p=0.004). When assessed according to tertile values of PCSK9, there was a significant increase in platelet reactivity in the upper vs lower tertile (p=0.02). Clinical outcome was available at follow-up in 178 subjects. In the upper PCSK9 tertile 13/59 (22.03%) patients experienced a clinical MACE at one year, vs 2/59 (3.39%) patients in the lower PCSK9 tertile. At one-year follow-up, PCSK9 was independently associated with increased ischemic MACEs: hazard ratio for upper vs lower PCSK9-level tertile was 2.62 (95% confidence interval 1.24-5.52; p=0.01). CONCLUSIONS These findings suggest that increased PCSK9 levels are associated with higher platelet reactivity and are a possible predictor of ischemic events in ACS patients undergoing PCI.
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Affiliation(s)
- Eliano P Navarese
- Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany; Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE research network, Europe.
| | - Michalina Kolodziejczak
- Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE research network, Europe; Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
| | - Max-Paul Winter
- Department of Cardiology, Medical University of Vienna, Austria
| | | | - Irene M Lang
- Department of Cardiology, Medical University of Vienna, Austria
| | - Antonino Buffon
- Department of Cardiology, Catholic University of Rome, Italy; Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE research network, Europe
| | - Gregory Yh Lip
- University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK; Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE research network, Europe
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19
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Winter MP, Wiesbauer F, Alimohammadi A, Blessberger H, Pavo N, Schillinger M, Huber K, Wojta J, Lang IM, Maurer G, Goliasch G. Soluble galectin-3 is associated with premature myocardial infarction. Eur J Clin Invest 2016; 46:386-91. [PMID: 26880404 DOI: 10.1111/eci.12605] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 02/11/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Inflammatory responses are pivotal in the initiation and development of premature atherosclerotic lesions. Galectin-3 represents a valuable biomarker for both progression and destabilization of atherosclerotic lesions. This study aims to assess the involvement of galectin-3 in premature myocardial infarction. DESIGN In this multicentre case-control study, we assessed circulating galectin-3 levels in 144 patients comprising 72 consecutive survivors of acute myocardial infarction (≤ 40 years) and 72 hospital controls frequency matched for age, gender and centre. RESULTS Patients with acute myocardial infarction showed significantly higher galectin-3 levels as compared to controls in the acute phase of acute myocardial infarction (2552 ± 1992 vs. 1666 ± 829 pg/mL; P < 0·001) as well as in the stable phase 1 year after the index event (3692 ± 1774 vs. 1666 ± 829 pg/mL; P < 0·001). Circulating galectin-3 was significantly and independently associated with premature myocardial infarction in the logistic regression analysis (acute phase: adj. OR per 1-SD change 2·03, 95% CI 1·30-3·19; P = 0·002; stable phase: adj. OR of 6·54 (95% CI 2·56-16·68; P < 0·001). Moreover, we observed a significant correlation between circulating galectin-3 and leucocyte count (r = 0·35, P < 0·001), non-HDL cholesterol (r = 0·23, P = 0·014) and HDL cholesterol (r = -0·29, P = 0·002). CONCLUSION We demonstrated that elevated levels of circulating galectin-3 are strongly associated with premature myocardial infarction. Galectin-3 might serve as link between dyslipidaemia as driving force of plaque formation with inflammation as initiator of plaque rupture in patients with premature acute myocardial infarction.
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Affiliation(s)
- Max-Paul Winter
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Franz Wiesbauer
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Arman Alimohammadi
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Hermann Blessberger
- Department of Cardiology, Med Campus III, Medical Faculty, Johannes Kepler University Linz, Austria
| | - Noemi Pavo
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Martin Schillinger
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Kurt Huber
- Third Medical Department, Cardiology and Intensive Care Medicine, Wilhelminen Hospital, Vienna, Austria
| | - Johann Wojta
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria.,Core Facilities, Medical University of Vienna, Vienna, Austria
| | - Irene M Lang
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Gerald Maurer
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Georg Goliasch
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
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20
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Mollalo A, Alimohammadi A, Shirzadi MR, Malek MR. Geographic information system-based analysis of the spatial and spatio-temporal distribution of zoonotic cutaneous leishmaniasis in Golestan Province, north-east of Iran. Zoonoses Public Health 2014; 62:18-28. [PMID: 24628913 DOI: 10.1111/zph.12109] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Indexed: 11/27/2022]
Abstract
Zoonotic cutaneous leishmaniasis (ZCL), a vector-borne disease, poses serious psychological as well as social and economic burden to many rural areas of Iran. The main objectives of this study were to analyse yearly spatial distribution and the possible spatial and spatio-temporal clusters of the disease to better understand spatio-temporal epidemiological aspects of ZCL in rural areas of an endemic province, located in north-east of Iran. Cross-sectional survey was performed on 2983 recorded cases during the period of 2010-2012 at village level throughout the study area. Global clustering methods including the average nearest-neighbour distance, Moran's I, general G indices and Ripley's K-function were applied to investigate the annual spatial distribution of the existing point patterns. Presence of spatial and spatio-temporal clusters was investigated using the spatial and space-time scan statistics. For each year, semivariogram analysis and all global clustering methods indicated meaningful persistent spatial autocorrelation and highly clustered distribution of ZCL, respectively. Eight significant spatial clusters, mainly located in north and northeast of the province, and one space-time cluster, observed in northern part of the province and during the period of September 2010-November 2010, were detected. Comparison of the location of ZCL clusters with environmental conditions of the study area showed that 97.8% of cases in clusters were located at low altitudes below 725 m above sea level with predominantly arid and semi-arid climates and poor socio-economic conditions. The identified clusters highlight high-risk areas requiring special plans and resources for more close monitoring and control of the disease.
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Affiliation(s)
- A Mollalo
- Department of Geo-spatial Information System (GIS), Center of Excellence in GIS, K. N. Toosi University of Technology, Tehran, Iran
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21
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Frey MK, Alias S, Winter MP, Redwan B, Stübiger G, Panzenboeck A, Alimohammadi A, Bonderman D, Jakowitsch J, Bergmeister H, Bochkov V, Preissner KT, Lang IM. Splenectomy is modifying the vascular remodeling of thrombosis. J Am Heart Assoc 2014; 3:e000772. [PMID: 24584745 PMCID: PMC3959675 DOI: 10.1161/jaha.113.000772] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Splenectomy is a clinical risk factor for complicated thrombosis. We hypothesized that the loss of the mechanical filtering function of the spleen may enrich for thrombogenic phospholipids in the circulation, thereby affecting the vascular remodeling of thrombosis. Methods and Results We investigated the effects of splenectomy both in chronic thromboembolic pulmonary hypertension (CTEPH), a human model disease for thrombus nonresolution, and in a mouse model of stagnant flow venous thrombosis mimicking deep vein thrombosis. Surgically excised thrombi from rare cases of CTEPH patients who had undergone previous splenectomy were enriched for anionic phospholipids like phosphatidylserine. Similar to human thrombi, phosphatidylserine accumulated in thrombi after splenectomy in the mouse model. A postsplenectomy state was associated with larger and more persistent thrombi. Higher counts of procoagulant platelet microparticles and increased leukocyte–platelet aggregates were observed in mice after splenectomy. Histological inspection revealed a decreased number of thrombus vessels. Phosphatidylserine‐enriched phospholipids specifically inhibited endothelial proliferation and sprouting. Conclusions After splenectomy, an increase in circulating microparticles and negatively charged phospholipids is enhanced by experimental thrombus induction. The initial increase in thrombus volume after splenectomy is due to platelet activation, and the subsequent delay of thrombus resolution is due to inhibition of thrombus angiogenesis. The data illustrate a potential mechanism of disease in CTEPH.
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Affiliation(s)
- Maria K Frey
- Department of Cardiology, Medical University Vienna, Vienna, Austria
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22
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Alias S, Redwan B, Panzenboeck A, Winter MP, Schubert U, Voswinckel R, Frey MK, Jakowitsch J, Alimohammadi A, Hobohm L, Mangold A, Bergmeister H, Sibilia M, Wagner EF, Mayer E, Klepetko W, Hoelzenbein TJ, Preissner KT, Lang IM. Defective angiogenesis delays thrombus resolution: a potential pathogenetic mechanism underlying chronic thromboembolic pulmonary hypertension. Arterioscler Thromb Vasc Biol 2014; 34:810-819. [PMID: 24526692 DOI: 10.1161/atvbaha.113.302991] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Restoration of patency is a natural target of vascular remodeling after venous thrombosis that involves vascular endothelial cells and smooth muscle cells, as well as leukocytes. Acute pulmonary emboli usually resolve <6 months. However, in some instances, thrombi transform into fibrous vascular obstructions, resulting in occlusion of the deep veins, or in chronic thromboembolic pulmonary hypertension (CTEPH). We proposed that dysregulated thrombus angiogenesis may contribute to thrombus persistence. APPROACH AND RESULTS Mice with an endothelial cell-specific conditional deletion of vascular endothelial growth factor receptor 2/kinase insert domain protein receptor were used in a model of stagnant flow venous thrombosis closely resembling human deep vein thrombosis. Biochemical and functional analyses were performed on pulmonary endarterectomy specimens from patients with CTEPH, a human model of nonresolving venous thromboembolism. Endothelial cell-specific deletion of kinase insert domain protein receptor and subsequent ablation of thrombus vascularization delayed thrombus resolution. In accordance with these findings, organized human CTEPH thrombi were largely devoid of vascular structures. Several vessel-specific genes, such as kinase insert domain protein receptor, vascular endothelial cadherin, and podoplanin, were expressed at lower levels in white CTEPH thrombi than in organizing deep vein thrombi and organizing thrombi from aortic aneurysms. In addition, red CTEPH thrombi attenuated the angiogenic response induced by vascular endothelial growth factor. CONCLUSIONS In the present work, we propose a mechanism of thrombus nonresolution demonstrating that endothelial cell-specific deletion of kinase insert domain protein receptor abates thrombus vessel formation, misguiding thrombus resolution. Medical conditions associated with the development of CTEPH may be compromising early thrombus angiogenesis.
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Affiliation(s)
- Sherin Alias
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Bassam Redwan
- Department of Cardiothoracic Surgery, University Hospital Muenster, Muenster, Germany
| | | | - Max P Winter
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Uwe Schubert
- Institute for Biochemistry, Medical School, Justus-Liebig-University, Giessen, Germany
| | - Robert Voswinckel
- Department of Lung Development and Remodeling, Max-Planck-Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Maria K Frey
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | | | | | - Lukas Hobohm
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Andreas Mangold
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Helga Bergmeister
- Department of Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - Maria Sibilia
- Institute for Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Erwin F Wagner
- Centro Nacional de Investigaciones Oncológicas, Madrid, Spain
| | - Eckhard Mayer
- Department of Thoracic Surgery, Kerckhoff Clinic Heart and Lung Centre, Bad Nauheim, Germany
| | - Walter Klepetko
- Department of Cardiothoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - Thomas J Hoelzenbein
- Department of Vascular and Endovascular Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Klaus T Preissner
- Institute for Biochemistry, Medical School, Justus-Liebig-University, Giessen, Germany
| | - Irene M Lang
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
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23
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Ghanim B, Hoda MA, Klikovits T, Winter MP, Alimohammadi A, Grusch M, Dome B, Arns M, Schenk P, Jakopovic M, Samarzija M, Brcic L, Filipits M, Laszlo V, Klepetko W, Berger W, Hegedus B. Circulating fibrinogen is a prognostic and predictive biomarker in malignant pleural mesothelioma. Br J Cancer 2014; 110:984-90. [PMID: 24434429 PMCID: PMC3929892 DOI: 10.1038/bjc.2013.815] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Revised: 12/05/2013] [Accepted: 12/10/2013] [Indexed: 02/07/2023] Open
Abstract
Background: To investigate the clinical utility of pretreatment plasma fibrinogen levels in malignant pleural mesothelioma (MPM) patients. Methods: A retrospective multicenter study was performed in histologically proven MPM patients. All fibrinogen levels were measured at the time of diagnosis and clinical data were retrospectively collected after approval of the corresponding ethics committees. Results: In total, 176 MPM patients (mean age: 63.5 years±10.4 years, 38 females and 138 males) were analysed. Most patients (n=154, 87.5%) had elevated (⩾390 mg dl−1) plasma fibrinogen levels. When patients were grouped by median fibrinogen, patients with low level (⩽627 mg dl−1) had significantly longer overall survival (OS) (19.1 months, confidence interval (CI) 14.5–23.7 months) when compared with those with high level (OS 8.5; CI 6.2–10.7 months). In multivariate survival analyses, fibrinogen was found to be an independent prognostic factor (hazard ratio 1.81, CI 1.23–2.65). Most interestingly, fibrinogen (cutoff 75th percentile per 750 mg dl−1) proved to be a predictive biomarker indicating treatment benefit achieved by surgery within multimodality therapy (interaction term: P=0.034). Accordingly, only patients below the 75th percentile benefit from surgery within multimodality therapy (31.3 vs 5.3 months OS). Conclusions: Fibrinogen is a novel independent prognostic biomarker in MPM. Most importantly, fibrinogen predicted treatment benefit achieved by surgery within multimodality therapy.
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Affiliation(s)
- B Ghanim
- 1] Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna 1090, Vienna, Austria [2] Institute of Cancer Research, Department of Internal Medicine I, Medical University of Vienna 1090, Vienna, Austria
| | - M A Hoda
- 1] Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna 1090, Vienna, Austria [2] Institute of Cancer Research, Department of Internal Medicine I, Medical University of Vienna 1090, Vienna, Austria
| | - T Klikovits
- Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna 1090, Vienna, Austria
| | - M-P Winter
- Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna 1090, Vienna, Austria
| | - A Alimohammadi
- Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna 1090, Vienna, Austria
| | - M Grusch
- Institute of Cancer Research, Department of Internal Medicine I, Medical University of Vienna 1090, Vienna, Austria
| | - B Dome
- 1] Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna 1090, Vienna, Austria [2] National Koranyi Institute of Pulmonology, Budapest 1121, Hungary [3] Department of Thoracic Surgery, National Institute of Oncology, Budapest, Hungary
| | - M Arns
- Department of Pulmonology, LKH Hochegg, 2803 Vienna, Austria
| | - P Schenk
- Department of Pulmonology, LKH Hochegg, 2803 Vienna, Austria
| | - M Jakopovic
- University of Zagreb, School of Medicine, Department for Respiratory Diseases Jordanovac, University Hospital Center, Zagreb 10000, Croatia
| | - M Samarzija
- University of Zagreb, School of Medicine, Department for Respiratory Diseases Jordanovac, University Hospital Center, Zagreb 10000, Croatia
| | - L Brcic
- University of Zagreb, School of Medicine, Institute of Pathology, Zagreb 10000, Croatia
| | - M Filipits
- Institute of Cancer Research, Department of Internal Medicine I, Medical University of Vienna 1090, Vienna, Austria
| | - V Laszlo
- 1] Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna 1090, Vienna, Austria [2] Department of Biological Physics, Eötvös University, Budapest 1117, Hungary
| | - W Klepetko
- Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna 1090, Vienna, Austria
| | - W Berger
- Institute of Cancer Research, Department of Internal Medicine I, Medical University of Vienna 1090, Vienna, Austria
| | - B Hegedus
- 1] Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna 1090, Vienna, Austria [2] Institute of Cancer Research, Department of Internal Medicine I, Medical University of Vienna 1090, Vienna, Austria [3] MTA-SE Molecular Oncology Research Group, Hungarian Academy of Sciences, Budapest 1091, Hungary
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Winter MP, Alimohammadi A, Panzenboeck A, Frey MK, Sibilia M, Alias S, Santer D, Podesser B, Nagel F, Lang IM. Formation of typical vascular lesions in a new experimental model of pulmonary arterial hypertension. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ghavamzadeh A, Alimoghaddam K, Jahani M, Hamidieh A, Mousavi S, Khatami F, Jalali A, Alimohammadi A. Hematopoietic Stem Cell Transplantation For Major Thalassemia: Nineteen Years Experience In Iran. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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26
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Alimohammadi A, Coker R, Miller R, Mitchell D, Williamson J, Clarke J. Genotypic variants of HIV-1 from peripheral blood and lungs of AIDS patients. AIDS 1997; 11:831-2. [PMID: 9143625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Abstract
✓ The insertion of sewing needles through the fontanels of an unwanted baby is apparently an ancient practice of which there are still instances. In this paper two such cases are described, one a man of 32 and the other a woman aged 31 with needles in a vertical position near the midline of the convexity of the brain. The first patient had had epileptic attacks for 8 years, and the other headache and hemiparesis for 7 months. Removal of the needles resulted in amelioration of the symptoms. The needles obviously had been introduced when the anterior fontanels were still open. The long interval before the onset of symptoms has been observed in the two other cases reported in the literature.
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