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Callebaut K, Gijbels E, Vanbesien J, Deeren D, Van Droogenbroeck J, Emmerechts J, Moreau E. Evaluation of AQUIOS STEM, a novel method for automated CD34+ stem cell enumeration using flow cytometry. Int J Lab Hematol 2024. [PMID: 38421076 DOI: 10.1111/ijlh.14253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/04/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES Hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for various diseases. The measurement of CD34+ cells is crucial to schedule the peripheral blood stem cell collection and assess the engraftment potential of the apheresis product. The AQUIOS STEM system has been introduced as a novel application on the AQUIOS CL, a fully automated flow cytometer, for the enumeration of CD34+ hematopoietic progenitor cells (HPCs) in accordance with the The International Society for Hematotherapy and Graft Engineering guidelines. This study aimed to assess the potential of the novel AQUIOS STEM system versus currently used systems including the FACSCanto-II and the FACS Lyric flow cytometer in a multicenter study. METHODS A total of 91 samples were used for the validation of the AQUOIS STEM system, including an analytical performance evaluation by means of assessing precision, sample stability, intersample carryover, and linearity and a method comparison with the present FACS systems in use to assess analytical and clinical decision agreement. RESULTS Results showed excellent precision, with coefficient of variations <15% for dedicated quality control material and patient samples. There was no significant carry over. The fresh apheresis samples were stable when stored overnight at room temperature and at 4°C. Analytical comparison with the current systems demonstrated good correlation in peripheral blood, and minimal, clinically neglectable systematic and proportional bias in fresh apheresis products but a low correlation coefficient in cryopreserved products. CONCLUSIONS The STEM system on AQUIOS CL allows automated enumeration of CD34+ stem cells, demonstrating good analytical performance and promising overall outcomes in peripheral blood and fresh apheresis products.
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Affiliation(s)
- Kim Callebaut
- AZ Delta Medical Laboratories, AZ Delta General Hospital, Roeselare, Belgium
| | - Eva Gijbels
- Department of Laboratory Medicine, AZ Sint-Jan Hospital Brugge, Brugge, Belgium
| | - Jonathan Vanbesien
- AZ Delta Medical Laboratories, AZ Delta General Hospital, Roeselare, Belgium
| | - Dries Deeren
- AZ Delta Clinical Haematology, AZ Delta General Hospital, Roeselare, Belgium
| | | | - Jan Emmerechts
- Department of Laboratory Medicine, AZ Sint-Jan Hospital Brugge, Brugge, Belgium
| | - Elisabeth Moreau
- AZ Delta Medical Laboratories, AZ Delta General Hospital, Roeselare, Belgium
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Blomme S, De Paepe P, Devos H, Emmerechts J, Snauwaert S, Cauwelier B. Alternative genetic alterations of MYC, BCL2, and/or BCL6 in high-grade B-cell lymphoma (HGBL) and diffuse large B-cell lymphoma (DLBCL): Can we identify different prognostic subgroups? Genes Chromosomes Cancer 2024; 63:e23211. [PMID: 37897298 DOI: 10.1002/gcc.23211] [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: 07/05/2023] [Revised: 10/14/2023] [Accepted: 10/16/2023] [Indexed: 10/30/2023] Open
Abstract
High-grade B-cell lymphoma (HGBL)/diffuse large B-cell lymphoma (DLBCL) with rearrangements (R) in MYC and BCL2 and/or BCL6 are correlated with poor prognosis. Little is known about the impact of other genetic alterations (gain (G) or amplification (A)) of these genes. The aim of the study was to investigate whether we can identify new prognostic subgroups. Fluorescence in situ hybridization (FISH) results from 169 HGBL/DLBCL were retrospectively categorized into: (1) concurrent MYC-R and BCL2-R and/or BCL6-R-samples with MYC-R and BCL2-R (+/- BCL6-R); n = 21, and HGBL/DLBCL with MYC-R and BCL6-R; n = 11; (2) concurrent R and G/A in MYC and BCL2 and/or BCL6 called "alternative HGBL/DLBCL"-samples with (n = 16) or without (n = 6) BCL2 involvement; (3) BCL2 and/or BCL6 alterations without MYC involvement (n = 35); (4) concurrent G/A in MYC and BCL2 and/or BCL6 without R (n = 25); and (5) "No alterations" (n = 55). Patients with HGBL/DLBCL-MYC/BCL2 and "alternative" HGBL/DLBCL (with BCL2 involvement) had significantly worse survival rates compared to the "no alterations" group. G/A of these genes in the absence of rearrangements did not show any prognostic significance. HGBL/DLBCL with MYC-R and BCL6-R without BCL2 involvement showed a better survival rate compared to HGBL/DLBCL-MYC/BCL2. According to immunohistochemistry, "double/triple" expression (DEL/TEL) did not show a significantly worse outcome compared to absent DEL/TEL. This study highlights the continued value of FISH assessment of MYC, BCL2, and BCL6 in the initial evaluation of HGBL/DLBCL with different survival rates between several genetic subgroups.
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Affiliation(s)
- Siska Blomme
- Department of Laboratory Medicine, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| | - Pascale De Paepe
- Department of Pathology, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| | - Helena Devos
- Department of Laboratory Medicine, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| | - Jan Emmerechts
- Department of Laboratory Medicine, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| | - Sylvia Snauwaert
- Department of Clinical Hematology, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| | - Barbara Cauwelier
- Department of Laboratory Medicine, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
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Coussee A, Alliet G, Hervent AS, Vynckier L, Emmerechts J, Van Hecke S, Persijn L. Acquired factor X deficiency in a multiple myeloma without amyloidosis: a case report. Acta Clin Belg 2023; 78:524-528. [PMID: 37800976 DOI: 10.1080/17843286.2023.2265650] [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: 08/07/2023] [Accepted: 09/21/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Multiple myeloma is one of the most common hematologic malignancies. Acquired factor X deficiencies are often observed in primary (AL) amyloidosis and rarely in multiple myeloma. OBJECTIVE We report a case of an acquired factor X deficiency in a patient with a newly diagnosed IgA lambda multiple myeloma, without any evidence of concomitant amyloidosis. METHODS We present the patient's medical history, clinical and physical examinations, laboratory analysis, and outcome. RESULTS A 76-year-old male presented at the emergency department with ongoing gingival bleeding. Several analytical problems with blood sample analysis arose, which eventually led to the diagnosis of a multiple myeloma. Further exploration revealed an acquired factor X deficiency, explaining the ongoing bleeding. There was no evidence of concomitant amyloidosis. The multiple myeloma was treated, leading to complete remission of the malignancy and bleeding tendency. CONCLUSION While coagulopathy is rarely observed in patients diagnosed with multiple myeloma, considering an acquired factor X deficiency becomes relevant when such patient present with bleeding diathesis.
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Affiliation(s)
- Amber Coussee
- Department of Laboratory Medicine, AZ Damiaan, Oostende, Belgium
| | - Gudrun Alliet
- Department of Laboratory Medicine, AZ Damiaan, Oostende, Belgium
| | | | | | - Jan Emmerechts
- Department of Laboratory Medicine, AZ Sint-Jan, Brugge, Belgium
| | - Sam Van Hecke
- Department of Haematology, AZ Damiaan, Oostende, Belgium
| | - Lies Persijn
- Department of Laboratory Medicine, AZ Damiaan, Oostende, Belgium
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Blomme S, Nollet F, Boeckx N, Cauwelier B, Snauwaert S, Emmerechts J. Diagnostic utility of the lymphoid screening tube supplemented with TRBC1 for the assessment of T-cell clonality. Int J Lab Hematol 2023. [PMID: 36856131 DOI: 10.1111/ijlh.14045] [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: 07/04/2022] [Accepted: 02/06/2023] [Indexed: 03/02/2023]
Abstract
INTRODUCTION Flow cytometric panels for the investigation of lymphoproliferative disorders, such as the EuroFlow Lymphoid Screening Tube (LST), often fail to demonstrate T-cell clonality, as a suitable clonality marker was unavailable until recently. Aim of this study was to evaluate the added value of supplementing TRBC1, a flow cytometric T-cell clonality marker, to the LST. METHODS Flow cytometric analysis was performed on 830 routine samples referred to our lab for suspicion of hematological malignancy. T-cells with monotypic TRBC1-expression were additionally characterized with a 12-color T-cell tube and molecular T-cell receptor gamma gene rearrangement (TRG). RESULTS LST analysis revealed 97 (11.7%) samples with the presence of a monotypic T-cell population according to TRBC1, including 21 (2.5%) "high-count" (≥500 cells/μL blood or ≥15% of lymphocytes) and 76 (9.2%) "low-count" (<500 cells/μL blood or <15% of lymphocytes) populations. Clinical symptoms indicative for T-CLPD could be correlated to 11/21 "high-count" and 17/76 "low-count" monotypic T-cell populations. Molecular TRG analysis demonstrated a monoclonal result in 76% (16/21) of "high-count" samples and in 64% (42/66; 10 samples not tested) of "low-count" samples, but also in 9/20 samples with polytypic TRBC1 results. CONCLUSION Analysis of an LST tube supplemented with TRBC1 led to the detection of a high number of monotypic T-cell populations. The detection of numerous small monotypic T-cell populations raises the question of their clinical significance. A possible flowchart for assessment of these populations, based on the available literature, is proposed. Molecular TRG analysis is complementary and cannot be omitted from T-cell clonality assessment.
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Affiliation(s)
- S Blomme
- Department of Laboratory Medicine, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium.,Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - F Nollet
- Department of Laboratory Medicine, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| | - N Boeckx
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, KU Leuven, Leuven, Belgium
| | - B Cauwelier
- Department of Laboratory Medicine, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| | - S Snauwaert
- Department of Clinical Hematology, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| | - J Emmerechts
- Department of Laboratory Medicine, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
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Van Praet JT, De Groote M, De Bacquer D, Verhalleman E, Welvaert Z, Emmerechts J, Reynders M, De Vriese AS. Immune Senescence Markers Predict the Cellular Immune Response to BNT162b2 Vaccination in Hemodialysis Patients. Open Forum Infect Dis 2022; 9:ofac585. [PMCID: PMC9669454 DOI: 10.1093/ofid/ofac585] [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] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/28/2022] [Indexed: 11/18/2022] Open
Abstract
Abstract
Background
Chronic kidney disease is associated with increased risk of frailty and accelerated immune senescence, potentially affecting the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination.
Methods
Humoral and cellular responses against the spike protein of SARS-CoV-2 were determined in 189 COVID-naive hemodialysis patients at week 4 and 8 after vaccination with 2 doses of BNT162b2. Frailty indicators and immune senescence markers were determined at baseline to identify predictors of the immune response.
Results
Controlling for age, activities of daily living (ADLs), instrumental ADLs, walking pace, and the clinical frailty score correlated negatively and hand grip strength positively with the humoral response. Controlling for age, the proportions of memory CD4+ T cells, memory CD8+ T cells, CD28null T cells, and CD57+CD8+ T cells correlated negatively with the humoral response, whereas the proportions of memory CD4+ T cells and CD28null T cells correlated negatively and the CD4/CD8 ratio positively with the cellular response. In a multivariate model, only the proportions of memory CD4+ T cells and CD28null T cells independently predicted the cellular response.
Conclusions
Markers of immune senescence, but not frailty indicators, independently predict the cellular immune response after vaccination in hemodialysis patients, overruling the effect of chronological age.
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Affiliation(s)
- Jens T Van Praet
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV , Brugge , Belgium
- Department of Internal Medicine and Pediatrics, Ghent University , Ghent , Belgium
| | - Marie De Groote
- Department of Geriatrics, AZ Sint-Jan Brugge-Oostende AV , Brugge , Belgium
| | - Dirk De Bacquer
- Department of Public Health and Primary Care, Ghent University , Ghent , Belgium
| | - Ellen Verhalleman
- Department of Occupational Therapy, AZ Sint-Jan Brugge-Oostende AV , Brugge , Belgium
| | - Ziggy Welvaert
- Department of Occupational Therapy, AZ Sint-Jan Brugge-Oostende AV , Brugge , Belgium
| | - Jan Emmerechts
- Department of Laboratory Hematology, AZ Sint-Jan Brugge-Oostende AV , Brugge , Belgium
| | - Marijke Reynders
- Department of Medical Microbiology, AZ Sint-Jan Brugge-Oostende AV , Brugge , Belgium
| | - An S De Vriese
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV , Brugge , Belgium
- Department of Internal Medicine and Pediatrics, Ghent University , Ghent , Belgium
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Blomme S, Nollet F, Rosseel W, Bogaard N, Devos H, Emmerechts J, Cauwelier B. Routine noninvasive prenatal screening for fetal Rh D in maternal plasma—A 2‐year experience from a single center in Belgium. Transfusion 2022; 62:1103-1109. [DOI: 10.1111/trf.16868] [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] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Siska Blomme
- Department of Laboratory Medicine AZ Sint‐Jan Hospitals Brugge‐Oostende Brugge Belgium
| | - Friedel Nollet
- Department of Laboratory Medicine AZ Sint‐Jan Hospitals Brugge‐Oostende Brugge Belgium
| | - Wesley Rosseel
- Department of Laboratory Medicine AZ Sint‐Jan Hospitals Brugge‐Oostende Brugge Belgium
| | - Natalie Bogaard
- Department of Laboratory Medicine AZ Sint‐Jan Hospitals Brugge‐Oostende Brugge Belgium
| | - Helena Devos
- Department of Laboratory Medicine AZ Sint‐Jan Hospitals Brugge‐Oostende Brugge Belgium
| | - Jan Emmerechts
- Department of Laboratory Medicine AZ Sint‐Jan Hospitals Brugge‐Oostende Brugge Belgium
| | - Barbara Cauwelier
- Department of Laboratory Medicine AZ Sint‐Jan Hospitals Brugge‐Oostende Brugge Belgium
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7
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Nollet F, Vanhouteghem K, Vermeire S, Maelbrancke E, Emmerechts J, Devos H, Cauwelier B. Evaluation of next-generation sequencing-based clonality analysis of T-cell receptor gamma gene rearrangements based on a new interpretation algorithm. Int J Lab Hematol 2018; 41:242-249. [PMID: 30537135 DOI: 10.1111/ijlh.12954] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/23/2018] [Accepted: 11/01/2018] [Indexed: 12/20/2022]
Abstract
INTRODUCTION T-cell receptor gene (TRG) rearrangement profiling is an essential component of the workup at diagnosis of T-cell malignancies. TRG amplification by polymerase chain reaction (PCR) and analysis by capillary electrophoresis (PCR-CE) is mostly widely used but is hampered by a subjective interpretation of its results and possible false-positive interpretation of clonality. Several studies evaluated the advantage of TRG rearrangement analysis by Next Generation Sequencing (TRG-NGS), however few have proposed an adequate data interpretation algorithm. METHODS Eighty five fresh and 36 formalin-fixed paraffin embedded (FFPE) diagnostic samples suspected for a lymphoproliferative disorder were analyzed by PCR-CE and TRG NGS. Final clinical diagnosis was available for all fresh samples. Reproducibility, analytical specificity and sensitivity of the TRG NGS analysis was evaluated. RESULTS We propose a new interpretation algorithm for TRG NGS data analysis. PCR-CE and TRG NGS showed identical results in 66/85 (78%) of fresh samples. Sensitivities to detect T-cell malignancies were comparable (96% versus 92%, respectively). The analysis of FFPE material was significantly more successful by TRG NGS (34/36 cases) in respect to PCR-CE (16/36 cases), most likely due to the small size of the amplicons. CONCLUSION Assessment of T-cell clonality by TRG NGS has a significant added value in the diagnosis of T-cell disorders as an adjunct to PCR-CE, particularly in difficult to interpret cases or when analyzing FFPE samples.
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Affiliation(s)
- Friedel Nollet
- Department of Laboratory Medicine, AZ Sint-Jan Brugge-Oostende, Bruges, Belgium
| | | | - Stefanie Vermeire
- Department of Laboratory Medicine, AZ Sint-Jan Brugge-Oostende, Bruges, Belgium
| | - Ellen Maelbrancke
- Department of Laboratory Medicine, AZ Sint-Jan Brugge-Oostende, Bruges, Belgium
| | - Jan Emmerechts
- Department of Laboratory Medicine, AZ Sint-Jan Brugge-Oostende, Bruges, Belgium
| | - Helena Devos
- Department of Laboratory Medicine, AZ Sint-Jan Brugge-Oostende, Bruges, Belgium
| | - Barbara Cauwelier
- Department of Laboratory Medicine, AZ Sint-Jan Brugge-Oostende, Bruges, Belgium
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Muyldermans A, Florin L, Devos H, Cauwelier B, Emmerechts J. Diagnostic utility of the lymphoid screening tube supplemented with CD34 for Ogata score calculation in patients with peripheral cytopenia. ACTA ACUST UNITED AC 2018; 24:166-172. [PMID: 30334700 DOI: 10.1080/10245332.2018.1535536] [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: 10/28/2022]
Abstract
OBJECTIVES The diagnosis of myelodysplastic syndrome (MDS) is not always straightforward in the absence of objective markers such as ringed sideroblasts, an excess of blasts or clonal cytogenetic abnormalities. Moreover, the lack of specificity of morphological dysplasia makes the differentiation between MDS and other causes of peripheral cytopenia difficult. The WHO 2016 classification of MDS recognizes multiparameter flow cytometry (MFC) as an adjuvant tool for MDS diagnosis. An easily applicable MFC protocol based on CD34 and CD45 is proposed by Ogata et al. Furthermore, in the diagnostic workup of patients with peripheral cytopenia, the integration of MFC by means of a Lymphoid Screening Tube (LST) is recommended by the EuroFlow™ consortium. The aim of this study was to investigate whether the LST, supplemented with CD34, can be used to calculate the Ogata score, thereby obviating the need to run different flow cytometric tubes. METHODS Bone marrow samples from 108 patients with peripheral cytopenia were analyzed (MDS n = 32; non-MDS n = 76). The LST used in the present study was based on the tube designed by the EuroFlow™ consortium, but with addition of CD34 and without TCRγδ. RESULTS Rather low sensitivities of 55% in low-grade MDS patients and 80% in high-grade MDS patients were observed. However, a high specificity of 92% was found in the non-MDS group. CONCLUSION Besides screening for clonal lymphocytes, plasma cells and blasts, an LST supplemented with CD34 allows the calculation of the Ogata score as an adjuvant tool in the diagnostic workup of cytopenic patients suspected of MDS.
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Affiliation(s)
- Astrid Muyldermans
- a Department of Laboratory Hematology , AZ Sint-Jan Hospital , Bruges , Belgium
| | - Lisa Florin
- a Department of Laboratory Hematology , AZ Sint-Jan Hospital , Bruges , Belgium
| | - Helena Devos
- a Department of Laboratory Hematology , AZ Sint-Jan Hospital , Bruges , Belgium
| | - Barbara Cauwelier
- a Department of Laboratory Hematology , AZ Sint-Jan Hospital , Bruges , Belgium
| | - Jan Emmerechts
- a Department of Laboratory Hematology , AZ Sint-Jan Hospital , Bruges , Belgium
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Emmerechts J, De Vooght V, Haenen S, Loyen S, Van kerckhoven S, Hemmeryckx B, Vanoirbeek JAJ, Hoet PH, Nemery B, Hoylaerts MF. Thrombogenic changes in young and old mice upon subchronic exposure to air pollution in an urban roadside tunnel. Thromb Haemost 2017; 108:756-68. [DOI: 10.1160/th12-03-0161] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 07/31/2012] [Indexed: 11/05/2022]
Abstract
SummaryEpidemiological studies indicate that elderly persons are particularly susceptible to the cardiovascular health complications of air pollution, but pathophysiological mechanisms behind the increased susceptibility remain unclear. Therefore, we investigated how continuous traffic-related air pollution exposure affects haemostasis parameters in young and old mice. Young (10 weeks) and old (20 months) mice were placed in an urban roadside tunnel or in a clean environment for 25 or 26 days and markers of inflammation and endothelial cells or blood platelet activation were measured, respectively. Plasma microvesicles and pro/ anticoagulant factors were analysed, and thrombin generation analysis was performed. Despite elevated macrophage carbon load, tunnel mice showed no overt pulmonary or systemic inflammation, yet manifested reduced pulmonary thrombomudulin expression and elevated endothelial von Willebrand factor (VWF) expression in lung capillaries. In young mice, soluble P-selectin (sP-sel) increased with exposure and correlated with soluble E-selectin and VWF. Baseline plasma factor VIII (FVIII), sP-sel and VWF were higher in old mice, but did not pronouncedly increase further with exposure. Traffic-related air pollution markedly raised red blood cell and blood platelet numbers in young and old mice and procoagulant blood platelet-derived microvesicle numbers in old animals. Changes in coagulation factors and thrombin generation were mild or absent. Hence, continuous traffic-related air pollution did not trigger overt lung inflammation, yet modified pulmonary endothelial cell function and enhanced platelet activity. In old mice, subchronic exposure to polluted air raised platelet numbers, VWF, sP-sel and microvesicles to the highest values presently recorded, collectively substantiating a further elevation of thrombogenicity, already high at old age.
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Gils S, Cauwelier B, Devos H, Vanlaere I, Roggeman S, Emmerechts J. Evaluation of two automated cell counters for the analysis of hematopoietic progenitor cell apheresis products. Int J Lab Hematol 2017; 39:243-250. [PMID: 28444843 DOI: 10.1111/ijlh.12617] [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: 06/11/2016] [Accepted: 11/21/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Routine hematology parameters in hematopoietic progenitor cell apheresis products (HPC-A) are usually determined using automated cell counters. These instruments, however, are designed to analyze whole blood samples, that differ considerably from HPC-A in blood cell composition. This study evaluates the performance of two automated cell counters for the analysis of HPC-A. METHODS Routine hematology parameters [red blood cells (RBC), hematocrit (HCT), mean corpuscular volume (MCV), white blood cells (WBC), WBC differentiation, and platelets (PLT)] were determined on the Unicel DxH 800 instrument (Beckman Coulter) and the XN-350 instrument (Sysmex). Correlations with the reference methods, intrarun precision, and linearity of the analyses were studied. RESULTS Good correlations were found for almost all parameters. However, RBC count was overestimated by XN-350, using the impedance technique, as was neutrophil percentage using DxH 800. Coefficients of variation for intrarun precision were below 10% on both analyzers for all parameters, except for neutrophil percentage (14.7%) and PLT (10%) on DxH 800. Both instruments showed good linearity for all parameters, except for RBC and HCT on DxH 800. CONCLUSION With the exception of the measurement of neutrophils on DxH 800 and RBC by the impedance technique on the XN-350, routine hematology parameters in HPC-A can safely be determined using automated cell counters.
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Affiliation(s)
- S Gils
- AZ Sint-Jan hospital, Bruges, Belgium
| | | | - H Devos
- AZ Sint-Jan hospital, Bruges, Belgium
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11
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Degandt S, Coens R, Cauwelier B, Devos H, Langlois M, Emmerechts J. Evaluation of four hemoglobin separation analyzers for hemoglobinopathy diagnosis. J Clin Lab Anal 2017; 32. [PMID: 28383138 DOI: 10.1002/jcla.22224] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 11/09/2016] [Accepted: 03/05/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Four automated hemoglobin separation devices are compared in their ability to detect hemoglobinopathies, both in HbA1c and in hemoglobinopathy mode. METHODS Quality control material and 58 samples, including one heterozygous α-thalassemia sample, six heterozygote β-thalassemia samples and 32 samples with a known hemoglobin variant, were used to assess imprecision of HbF and HbA2 measurements, correlation with the gold standard and sensitivity for detecting β-thalassemia and Hb variants on D-100 (Bio-Rad Laboratories), HA 8180T (Menarini), HLC-723G8 (Tosoh Bioscience) and Capillarys 2 Flex Piercing (Sebia). RESULTS Imprecision was <10% for both HbF and HbA2 in all modes of all analyzers. Correlation studies for HbF and HbA2 demonstrated statistically significant but small biases when compared to the gold standard. All six β-thalassemia samples but one were detected on all analyzers using a HbA2 cut-off value of 3.5%. D-100, HA8180T and the Hb-pathy mode of the HLC-723G8 and the Capillarys are able to detect the most common important Hb variants (Hb C, D, E and S), but more seldom variants can be missed as they co-elute with HbA0. The HbA1c mode of the Capillarys correctly detected all measured hemoglobin variants and can therefore be used as a hemoglobinopathy screening device. This was also the case for the most common important Hb variants on the HbA1c mode of the HLC-723G8, but two rare variants were not detected. CONCLUSION This study stresses the importance for individual laboratories to know the advantages and drawbacks of their hemoglobin separation analyzer and its different modes in the diagnosis of hemoglobinopathies.
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Affiliation(s)
- Simon Degandt
- Department of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges, Belgium
| | - Rémy Coens
- Department of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges, Belgium
| | - Barbara Cauwelier
- Department of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges, Belgium
| | - Helena Devos
- Department of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges, Belgium
| | - Michel Langlois
- Department of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges, Belgium
| | - Jan Emmerechts
- Department of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges, Belgium
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12
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Criel M, Godefroid M, Deckers B, Devos H, Cauwelier B, Emmerechts J. Evaluation of the Red Blood Cell Advanced Software Application on the CellaVision DM96. Int J Lab Hematol 2016; 38:366-74. [DOI: 10.1111/ijlh.12497] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 03/14/2016] [Indexed: 12/16/2022]
Affiliation(s)
- M. Criel
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
| | - M. Godefroid
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
| | - B. Deckers
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
| | - H. Devos
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
| | - B. Cauwelier
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
| | - J. Emmerechts
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
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De Vriese AS, Caluwé R, Bailleul E, De Bacquer D, Borrey D, Van Vlem B, Vandecasteele SJ, Emmerechts J. Dose-Finding Study of Rivaroxaban in Hemodialysis Patients. Am J Kidney Dis 2015; 66:91-8. [DOI: 10.1053/j.ajkd.2015.01.022] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 01/22/2015] [Indexed: 11/11/2022]
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Van Cauwenberge MG, Depreter B, Dumoulin EN, Emmerechts J, Nollet F, Vanopdenbosch LJ. Bing-Neel syndrome: Two unexpected cases and a review of the literature. J Neurol Sci 2015; 356:19-26. [PMID: 26159625 DOI: 10.1016/j.jns.2015.06.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 10/18/2014] [Revised: 06/01/2015] [Accepted: 06/13/2015] [Indexed: 10/23/2022]
Abstract
Waldenström macroglobulinemia (WM) is a lymphoplasmacytic lymphoma characterized by the proliferation of small B-lymphocytes in the bone marrow that produce monoclonal immunoglobulin M (IgM). We describe two patients with WM who presented with neurological symptoms due to infiltration of lymphoplasmacytoid tumor cells in the central nervous system, a condition known as Bing-Neel syndrome. A literature review revealed that this syndrome is rare and commonly missed in clinical practice due to its variable presentation and a lack of awareness or knowledge. Brain and spinal magnetic resonance imaging may show a focal mass or diffuse infiltration. The diagnosis of Bing-Neel syndrome requires proof of IgM or lymphoplasmacytoid cells in cerebrospinal fluid or in a brain biopsy. Treatment with intravenous and/or intrathecal chemotherapy and cranial radiotherapy is described in literature with generally poor outcome, although a combination of these therapies seems to improve outcome. Nevertheless, insufficient data are currently available to make general treatment recommendations.
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Affiliation(s)
- M G Van Cauwenberge
- Department of Neurology, University Clinic RWTH Aachen, Germany; Department of Neurology, AZ Sint Jan Brugge Oostende, Belgium.
| | - B Depreter
- Department of Laboratory Hematology, University Hospital Ghent, Belgium
| | - E N Dumoulin
- Department of Laboratory Hematology, University Hospital Ghent, Belgium
| | - J Emmerechts
- Department of Laboratory Hematology, AZ Sint Jan Brugge Oostende, Belgium
| | - F Nollet
- Department of Laboratory Hematology, AZ Sint Jan Brugge Oostende, Belgium
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15
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Al Assaf C, Van Obbergh F, Billiet J, Lierman E, Devos T, Graux C, Hervent AS, Emmerechts J, Tousseyn T, De Paepe P, Papadopoulos P, Michaux L, Vandenberghe P. Analysis of phenotype and outcome in essential thrombocythemia with CALR or JAK2 mutations. Haematologica 2015; 100:893-7. [PMID: 25934766 DOI: 10.3324/haematol.2014.118299] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 04/27/2015] [Indexed: 11/09/2022] Open
Abstract
The JAK2 V617F mutation, the thrombopoietin receptor MPL W515K/L mutation and calreticulin (CALR) mutations are mutually exclusive in essential thrombocythemia and support a novel molecular categorization of essential thrombocythemia. CALR mutations account for approximately 30% of cases of essential thrombocythemia. In a retrospective study, we examined the frequency of MPL and CALR mutations in JAK2 V617F-negative cases of essential thrombocythemia (n=103). In addition, we compared the clinical phenotype and outcome of CALR mutant cases of essential thrombocythemia with a cohort of JAK2 V617F-positive essential thrombocythemia (n=57). CALR-positive cases represented 63.7% of double-negative cases of essential thrombocythemia, and most carried CALR type 1 or type 2 indels. However, we also identified one patient who was positive for both the JAK2 V617F and the CALR mutations. This study revealed that CALR mutant essential thrombocythemia is associated with younger age, higher platelet counts, lower erythrocyte counts, leukocyte counts, hemoglobin, and hematocrit, and increased risk of progression to myelofibrosis in comparison with JAK2 V617F-positive essential thrombocythemia. Analysis of the CALR mutant group according to indel type showed that CALR type 1 deletion is strongly associated with male gender. CALR mutant patients had a better overall survival than JAK2 V617F-positive patients, in particular patients of age 60 years or younger. In conclusion, this study in a Belgian cohort of patients supports and extends the growing body of evidence that CALR mutant cases of essential thrombocythemia are phenotypically distinct from JAK2 V617F-positive cases, with regards to clinical and hematologic presentation as well as overall survival.
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Affiliation(s)
- Carla Al Assaf
- Center for Human Genetics, KU Leuven and University Hospitals Leuven, Belgium
| | | | | | - Els Lierman
- Center for Human Genetics, KU Leuven and University Hospitals Leuven, Belgium
| | - Timothy Devos
- Department of Hematology, University Hospitals Leuven, Belgium
| | - Carlos Graux
- Department of Hematology, Mont-Godinne University Hospital, Yvoir, Belgium
| | | | | | - Thomas Tousseyn
- Department of Pathology, University Hospitals Leuven, Belgium
| | | | - Petros Papadopoulos
- Center for Human Genetics, KU Leuven and University Hospitals Leuven, Belgium
| | - Lucienne Michaux
- Center for Human Genetics, KU Leuven and University Hospitals Leuven, Belgium
| | - Peter Vandenberghe
- Center for Human Genetics, KU Leuven and University Hospitals Leuven, Belgium Department of Hematology, University Hospitals Leuven, Belgium
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Hervent AS, Godefroid M, Cauwelier B, Billiet J, Emmerechts J. Evaluation of schistocyte analysis by a novel automated digital cell morphology application. Int J Lab Hematol 2015; 37:588-96. [DOI: 10.1111/ijlh.12363] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 02/17/2015] [Indexed: 12/14/2022]
Affiliation(s)
- A.-S. Hervent
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
| | - M. Godefroid
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
| | - B. Cauwelier
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
| | - J. Billiet
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
| | - J. Emmerechts
- Department of Laboratory Hematology; AZ Sint-Jan; Bruges Belgium
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17
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Hervent AS, Schepens M, Bourgeois M, Emmerechts J. Acquired thrombin and FV inhibitors upon aortic bioprosthetic valve replacement. Haemophilia 2014; 20:e354-6. [PMID: 24948407 DOI: 10.1111/hae.12469] [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] [Subscribe] [Scholar Register] [Accepted: 05/02/2014] [Indexed: 11/29/2022]
Affiliation(s)
- A S Hervent
- Department of Laboratory Haematology, AZ Sint-Jan, Brugge, Belgium
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18
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Singh N, Van Craeyveld E, Tjwa M, Ciarka A, Emmerechts J, Droogne W, Gordts SC, Carlier V, Jacobs F, Fieuws S, Vanhaecke J, Van Cleemput J, De Geest B. Circulating apoptotic endothelial cells and apoptotic endothelial microparticles independently predict the presence of cardiac allograft vasculopathy. J Am Coll Cardiol 2012; 60:324-31. [PMID: 22813611 DOI: 10.1016/j.jacc.2012.02.065] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [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] [Received: 12/01/2011] [Revised: 02/07/2012] [Accepted: 02/18/2012] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Maintenance of endothelial homeostasis may prevent the development of cardiac allograft vasculopathy (CAV). This study investigated whether biomarkers related to endothelial injury and endothelial repair discriminate between CAV-negative and CAV-positive heart transplant recipients. BACKGROUND CAV is the most important determinant of cardiac allograft survival and a major cause of death after heart transplantation. METHODS Fifty-two patients undergoing coronary angiography between 5 and 15 years after heart transplantation were recruited in this study. Flow cytometry was applied to quantify endothelial progenitor cells (EPCs), circulating endothelial cells (CECs), and endothelial microparticles. Cell culture was used for quantification of circulating EPC number and hematopoietic progenitor cell number and for analysis of EPC function. RESULTS The EPC number and function did not differ between CAV-negative and CAV-positive patients. In univariable models, age, creatinine, steroid dose, granulocyte colony-forming units, apoptotic CECs, and apoptotic endothelial microparticles discriminated between CAV-positive and CAV-negative patients. The logistic regression model containing apoptotic CECs and apoptotic endothelial microparticles as independent predictors provided high discrimination between CAV-positive and CAV-negative patients (C-statistic 0.812; 95% confidence interval: 0.692 to 0.932). In a logistic regression model with age and creatinine as covariates, apoptotic CECs (p = 0.0112) and apoptotic endothelial microparticles (p = 0.0141) were independent predictors (C-statistic 0.855; 95% confidence interval: 0.756 to 0.953). These 2 biomarkers remained independent predictors when steroid dose was introduced in the model. CONCLUSIONS The high discriminative ability of apoptotic CECs and apoptotic endothelial microparticles is a solid foundation for the development of clinical prediction models of CAV.
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Affiliation(s)
- Neha Singh
- Center for Molecular and Vascular Biology, University of Leuven, Belgium
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19
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Bos I, De Boever P, Emmerechts J, Buekers J, Vanoirbeek J, Meeusen R, Van Poppel M, Nemery B, Nawrot T, Panis LI. Changed gene expression in brains of mice exposed to traffic in a highway tunnel. Inhal Toxicol 2012; 24:676-86. [DOI: 10.3109/08958378.2012.714004] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Inge Bos
- Flemish Institute for Technological Research (VITO),
Mol, Belgium
- Department of Human Physiology & Sports Medicine, Vrije Universiteit Brussel,
Brussels, Belgium
| | - Patrick De Boever
- Flemish Institute for Technological Research (VITO),
Mol, Belgium
- Centre for Environmental studies (CMK), Hasselt University,
Diepenbeek, Belgium
| | - Jan Emmerechts
- Center for Molecular and Vascular Biology, University of Leuven, Belgium
- Department of Public Health, Occupational and Environmental Medicine, Unit of Lung Toxicology, University of Leuven,
Leuven, Belgium
| | - Jurgen Buekers
- Flemish Institute for Technological Research (VITO),
Mol, Belgium
| | - Jeroen Vanoirbeek
- Department of Public Health, Occupational and Environmental Medicine, Unit of Lung Toxicology, University of Leuven,
Leuven, Belgium
| | - Romain Meeusen
- Department of Human Physiology & Sports Medicine, Vrije Universiteit Brussel,
Brussels, Belgium
| | | | - Benoit Nemery
- Department of Public Health, Occupational and Environmental Medicine, Unit of Lung Toxicology, University of Leuven,
Leuven, Belgium
| | - Tim Nawrot
- Centre for Environmental studies (CMK), Hasselt University,
Diepenbeek, Belgium
- Department of Public Health, Occupational and Environmental Medicine, Unit of Lung Toxicology, University of Leuven,
Leuven, Belgium
| | - Luc Int Panis
- Flemish Institute for Technological Research (VITO),
Mol, Belgium
- Transportation Research Institute (IMOB), Hasselt University,
Diepenbeek, Belgium
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20
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Tangelder M, Long C, Emmerechts J, Jacquemin M, Peerlinck K, Vanassche T, Glazer S, Giesen P, Hoylaerts M, Verhamme P. Antidote strategies to reverse anticoagulation with TB-402, a long-acting partial inhibitor of factor VIII. J Thromb Haemost 2012; 10:1371-8. [PMID: 22540161 DOI: 10.1111/j.1538-7836.2012.04762.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND TB-402 is a partially inhibiting antibody of factor VIII that is under development as a long-acting anticoagulant. PATIENTS AND METHODS The reversibility of FVIII inhibition by TB-402 was evaluated in vitro after spiking with recombinant human FVIII (rhFVIII), human plasma-derived FVIII (hpdFVIII), recombinant activated human FVII (rhFVIIa), FVIII inhibitor bypassing activity (FEIBA), and prothrombin complex concentrate (PCC). Twelve subjects were randomized to placebo or 35 or 70 IU kg(-1) rhFVIII 48 h after a single dose of 620 μg kg(-1) TB-402. TB-402 concentrations, FVIII activity (FVIII:C), activated partial thromboplastin time (APTT) and thrombin generation were measured over a period of 8 weeks. RESULTS In spiked samples, TB-402 inhibited FVIII:C by 30%, prolonged APTT by 4.5 s, and reduced the peak height in the thrombin generation assay to 56% ± 13% of the control value. In the presence of 10 μg mL(-1) TB-402, rhFVIII restored FVIII:C and APTT to the values obtained in the absence of TB-402. The inhibitory effect of TB-402 on thrombin generation was entirely reversed by rhFVIII, hpdFVIII, rhFVIIa, FEIBA, and PCC. In men, the mean half-life (t(1/2) ) of TB-402 was 14.2 days. TB-402 lowered the endogenous thrombin potential by 23% for ~ 35 days. Infusion of 35 IU kg(-1) rhFVIII had a marginal effect, whereas 70 IU kg(-1) rhFVIII restored FVIII:C, reduced APTT back to baseline for 9 h, and restored thrombin generation for ~ 3 h. CONCLUSIONS TB-402 resulted in a stable long-term anticoagulant effect. rhFVIII and other procoagulants counteracted the effect of TB-402 temporarily, and may be effective antidotes for future clinical practice.
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Affiliation(s)
- M Tangelder
- Research and Development, ThromboGenics NV, Heverlee, Belgium.
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21
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Emmerechts J, Vanassche T, Loyen S, Van Linthout I, Cludts K, Kauskot A, Long C, Jacquemin M, Hoylaerts M, Verhamme P. Partial versus complete factor VIII inhibition in a mouse model of venous thrombosis. Thromb Res 2012; 129:514-9. [DOI: 10.1016/j.thromres.2011.06.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 06/20/2011] [Accepted: 06/29/2011] [Indexed: 10/17/2022]
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Hemmeryckx B, Emmerechts J, Bovill EG, Hoylaerts MF, Lijnen HR. Effect of ageing on the murine venous circulation. Histochem Cell Biol 2012; 137:537-46. [PMID: 22252159 DOI: 10.1007/s00418-012-0913-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2012] [Indexed: 11/29/2022]
Abstract
The effect of ageing on the morphology of veins, venous valves and arteries was investigated in male wild-type mice using an adapted procedure with injection of a silicone polymer Microfil(®) that preserves morphology of the vasculature. Throughout the hind limb the arterial, but not the venous, lumen area and wall thickness were significantly greater in 24-month as compared to 10-week-old C57BL/6 mice. Venous valves were most frequently located at the sapheno-femoral vein junction in the lower extremities, and appeared thicker at the base supported by structurally intact collagen fibers, and thinner towards the proximal end of the valve leaflet, with less organized collagen. Overall, valves were less supported by structurally intact collagen at 24 months as compared to 10 weeks. Endothelial expression of CD31, endothelial protein C receptor or von Willebrand factor (VWF) was not affected by age, while thrombomodulin expression was lower in aged versus young arteries. At both ages, expression of VWF was lower at venous valves versus veins. Evaluation of the blood coagulation profile revealed that aged mice had shortened prothrombin time, elevated plasma levels of factor (F)VII, FVIII and VWF and increased neutrophil and platelet counts. Thus, our data indicate that in mice with ageing, venous valves become more fragile, in association with a procoagulant and inflammatory blood phenotype. Taken together, we found that the procoagulant state in ageing, is accompanied by mild vascular changes.
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Affiliation(s)
- Bianca Hemmeryckx
- Center for Molecular and Vascular Biology, KU Leuven, Campus Gasthuisberg, Leuven, Belgium
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23
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Emmerechts J, Loyen S, Hoylaerts M. Microparticle number or procoagulant activity are not upregulated in healthy elderly persons. Thromb Res 2012; 129:98-100. [DOI: 10.1016/j.thromres.2011.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 08/25/2011] [Accepted: 09/08/2011] [Indexed: 10/17/2022]
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Emmerechts J, Jacobs L, Van Kerckhoven S, Loyen S, Mathieu C, Fierens F, Nemery B, Nawrot TS, Hoylaerts MF. Air pollution-associated procoagulant changes: the role of circulating microvesicles. J Thromb Haemost 2012; 10:96-106. [PMID: 22066779 DOI: 10.1111/j.1538-7836.2011.04557.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Epidemiological studies suggest an association between exposure to particulate matter (PM) in air pollution and the risk of venous thromboembolism (VTE). OBJECTIVES To investigate the underlying pathophysiological pathways linking PM exposure and VTE. PATIENTS AND METHODS We assessed potential associations between PM exposure and coagulation and inflammation parameters, including circulating microvesicles, in a group of 233 patients with diabetes. RESULTS The numbers of circulating blood platelet-derived and annexin V-binding microvesicles were inversely associated with the current levels of PM(2.5) or PM(10), measured on the day of sampling. Recent past exposure to PM(10), up to 1 week prior to blood sampling, estimated at the patients' residential addresses, was associated with elevated high-sensitivity C-reactive protein (CRP), leukocytes and fibrinogen, as well as with tissue factor (TF)-dependent procoagulant changes in thrombin generation assays. When longer windows of past exposure were considered, up to 1 year preceding blood sampling, procoagulant changes were evident from the strongly increased numbers of red blood cell-derived circulating microvesicles and annexin V-binding microvesicles, but they no longer associated with TF. Past PM exposure was never associated with activated partial thromboplastin time (aPTT), prothrombin time (PT), or factor (F) VII, FVIII, FXII or D-dimers. Residential distance to a major road was only marginally correlated with procoagulant changes in FVIII and thrombin generation. CONCLUSIONS Increases in the number of microvesicles and in their procoagulant properties, rather than increases in coagulation factors per se, seem to contribute to the risk of VTE, developing during prolonged exposure to air pollutants.
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Affiliation(s)
- J Emmerechts
- Center for Molecular and Vascular Biology, Unit of Lung Toxicology, University of Leuven, Leuven, Belgium
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Hemmeryckx B, Van Hove CE, Fransen P, Emmerechts J, Kauskot A, Bult H, Lijnen HR, Hoylaerts MF. Progression of the prothrombotic state in aging Bmal1-deficient mice. Arterioscler Thromb Vasc Biol 2011; 31:2552-9. [PMID: 21799179 DOI: 10.1161/atvbaha.111.229062] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The goal of this study was to examine the functional relationship between aging endothelium and thrombogenicity in a mouse model of premature aging. METHODS AND RESULTS Coagulation tests and factors, blood cell counts, aorta endothelial function, aorta gene expression, and FeCl(3)-induced thrombosis in mesenteric blood vessels were analyzed in 10- to 30-week-old brain and muscle ARNT-like protein-1 (Bmal1)-deficient (knockout [KO]) mice and wild-type littermates. Ten-week-old KO mice manifested shortened prothrombin times (9.7 versus 11.3 seconds in wild-type) and elevated plasma fibrinogen (264 versus 172 mg/dL). At 30 weeks, factor VII (198% versus 149%), and platelet counts (2049 versus 1354 K/μL) were increased in KO mice. Gene deficiency reduced the vasoactive nitric oxide production at 10 and 30 weeks and tended to reduce and increase the protein expression of thrombomodulin and von Willebrand factor, respectively, with aging. Shortened venular and arteriolar occlusion times on FeCl(3)-induced injury in 10-week-old KO mice confirmed higher thrombogenicity, culminating in priapism, observed in 60% of 25- to 30-week-old KO males. CONCLUSION Endothelial dysfunction and a hypercoagulable state cause early arterial and venous thrombogenicity in Bmal1 KO mice. With aging, progressive endothelial dysfunction, rising platelet counts, and high factor VII further enhance thrombogenicity, provoking priapism.
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Affiliation(s)
- Bianca Hemmeryckx
- Center for Molecular and Vascular Biology, Katholieke Universiteit Leuven, Leuven, Belgium
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Abstract
Ambient environmental air pollutants include gaseous and particulate components. In polluted air, especially particulate matter seems responsible for cardiovascular complications: It consists of a heterogeneous mixture of solid and liquid particles with different diameters ranging from large thoracic to ultrafine particles, with a diameter <100 nm. Ultrafines can penetrate deeply into the lung to deposit in the alveoli. Cardiovascular manifestations result both from short-term and long-term exposure and have been linked to interference with the autonomic nervous system, direct translocation into the systemic circulation, pulmonary inflammation and oxidative stress. Thrombotic complications associated with air pollution comprise arterial and probably venous thrombogenicity. This review describes the existing epidemiological and experimental evidence to explain the rapid induction of myocardial infarction within 1-2 hours after exposure to polluted air and advances several explanations as to why more chronic exposure will lead to enhanced venous thrombogenicity. Mechanisms such as platelet activation, endothelial dysfunction, coagulation factor changes and microvesicle production are discussed.
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Affiliation(s)
- J Emmerechts
- Marc Hoylaerts, Center for Molecular and Vascular Biology, Leuven, Belgium
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27
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Abstract
Background Epidemiologic studies indirectly suggest that air pollution accelerates atherosclerosis. We hypothesized that individual exposure to particulate matter (PM) derived from fossil fuel would correlate with plasma concentrations of oxidized low-density lipoprotein (LDL), taken as a marker of atherosclerosis. We tested this hypothesis in patients with diabetes, who are at high risk for atherosclerosis. Methodology/Principal Findings In a cross-sectional study of non-smoking adult outpatients with diabetes we assessed individual chronic exposure to PM by measuring the area occupied by carbon in airway macrophages, collected by sputum induction and by determining the distance from the patient's residence to a major road, through geocoding. These exposure indices were regressed against plasma concentrations of oxidized LDL, von Willebrand factor and plasminogen activator inhibitor 1 (PAI-1). We could assess the carbon load of airway macrophages in 79 subjects (58 percent). Each doubling in the distance of residence from major roads was associated with a 0.027 µm2 decrease (95% confidence interval (CI): −0.048 to −0.0051) in the carbon load of airway macrophages. Independently from other covariates, we found that each increase of 0.25 µm2 [interquartile range (IQR)] in carbon load was associated with an increase of 7.3 U/L (95% CI: 1.3 to 13.3) in plasma oxidized LDL. Each doubling in distance of residence from major roads was associated with a decrease of −2.9 U/L (95% CI: −5.2 to −0.72) in oxidized LDL. Neither the carbon load of macrophages nor the distance from residence to major roads, were associated with plasma von Willebrand factor or PAI-1. Conclusions The observed positive association, in a susceptible group of the general population, between plasma oxidized LDL levels and either the carbon load of airway macrophages or the proximity of the subject's residence to busy roads suggests a proatherogenic effect of traffic air pollution.
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Affiliation(s)
- Lotte Jacobs
- Occupational and Environmental Medicine, Unit of Lung Toxicology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Jan Emmerechts
- Center for Molecular and Vascular Biology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Marc F. Hoylaerts
- Center for Molecular and Vascular Biology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Chantal Mathieu
- Department of Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Peter H. Hoet
- Occupational and Environmental Medicine, Unit of Lung Toxicology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Benoit Nemery
- Occupational and Environmental Medicine, Unit of Lung Toxicology, Katholieke Universiteit Leuven, Leuven, Belgium
- * E-mail:
| | - Tim S. Nawrot
- Occupational and Environmental Medicine, Unit of Lung Toxicology, Katholieke Universiteit Leuven, Leuven, Belgium
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
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28
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Emmerechts J, Hoylaerts MF. The influence of air pollution on health: mechanistic implications. Verh K Acad Geneeskd Belg 2011; 73:339-351. [PMID: 22870731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- J Emmerechts
- Center for Molecular and Vascular Biology, Department of Cardiovascular Diseases, Katholieke Universiteit Leuven O&N I Herestraat 49-B 3000 Leuven
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29
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Emmerechts J, Alfaro-Moreno E, Vanaudenaerde BM, Nemery B, Hoylaerts MF. Short-term exposure to particulate matter induces arterial but not venous thrombosis in healthy mice. J Thromb Haemost 2010; 8:2651-61. [PMID: 21029357 DOI: 10.1111/j.1538-7836.2010.04081.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Epidemiological findings suggest an association between exposure to particulate matter (PM) and venous thrombo-embolism. OBJECTIVES To investigate arterial vs. venous thrombosis, inflammation and coagulation in mice, (sub)acutely exposed to two types of PM. METHODS Various doses (25, 100 and 200 μg per animal) of urban particulate matter (UPM) or diesel exhaust particles (DEP) were intratracheally (i.t.) instilled in C57Bl6/n mice and several endpoints measured at 4, 10 and 24 h. Mice were also repeatedly exposed to 100 μg per animal on three consecutive days with endpoints measured 24 h after the last instillation. RESULTS Exposure to 200 μg per mouse UPM enhanced arterial thrombosis, but neither UPM nor DEP significantly enhanced venous thrombosis. Both types of PM induced dose-dependent increases in broncho-alveolar lavage fluid (BALF) total cell numbers (mainly neutrophils) and cytokines (IL-6, KC, MCP-1, RANTES, MIP-1α), with peaks at 4 h and overall higher values for UPM than for DEP. Systemic inflammation was limited to increased serum IL-6 levels, 4 h after UPM. Both types of PM induced similar and dose-dependent but modest increases in factor (F)VII, FVIII and fibrinogen. Three repeated instillations did not or only modestly enhance the proinflammatory and procoagulant status. CONCLUSIONS Compared with DEP, UPM induced more pronounced pulmonary inflammation, but both particle types triggered similar and mild short-term systemic effects. Hence, acute exposure to PM triggers activation of primary hemostasis in the mouse, but no substantial secondary hemostasis activation, resulting in arterial but not venous thrombogenicity.
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Affiliation(s)
- J Emmerechts
- Center for Molecular and Vascular Biology, Katholieke Universiteit Leuven, Leuven, Belgium
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Jacobs L, Emmerechts J, Mathieu C, Hoylaerts MF, Fierens F, Hoet PH, Nemery B, Nawrot TS. Air pollution related prothrombotic changes in persons with diabetes. Environ Health Perspect 2010; 118:191-6. [PMID: 20123602 PMCID: PMC2831916 DOI: 10.1289/ehp.0900942] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [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: 05/04/2009] [Accepted: 10/22/2009] [Indexed: 05/03/2023]
Abstract
BACKGROUND Population studies suggest that persons with diabetes are more sensitive to the effects of particulate matter (PM) air pollution. However, the biological mechanisms of a possible prothrombotic effect underlying this enhanced susceptibility remain largely unknown. OBJECTIVE We hypothesized that exposure to PM causes prothrombotic changes in persons with diabetes, possibly via systemic inflammation. METHODS Our study included 137 nonsmoking adults with diabetes who were outpatients at the University Hospital Leuven. Recent exposure (2 hr before examination) to ambient PM was measured at the entrance of the hospital. Individual chronic exposure to PM was assessed by measuring the area occupied by carbon in airway macrophages obtained by sputum induction. Platelet function was measured ex vivo with the PFA-100 platelet function analyzer, which simulates a damaged blood vessel; we analyzed the function of platelets in primary hemostasis under high shear conditions. Total and differential blood leukocytes were counted. RESULTS Independent of antiplatelet medication, an interquartile range (IQR) increase of 39.2 microg/m3 in PM10 (PM with aerodynamic diameter <or= 10 microm) concentration measured 2 hr before the clinical examination (recent exposure) was associated with a decrease of 21.1 sec [95% confidence interval (CI), 35.3 to 6.8] in the PFA-100 closure time (i.e., increased platelet activation) and an increase in blood leukocytes of 512 per microliter of blood (95% CI, 45.2979). Each area increase of 0.25 microm2 (IQR) in carbon load of airway macrophages (chronic exposure) was associated with an increase of 687 leukocytes per microliter of blood (95% CI, 2241,150). CONCLUSIONS A relevant increase in recent PM exposure was associated with a change in platelet function toward a greater prothrombotic tendency. The magnitude of the change was about two-thirds (in the opposite direction) of the average effect of antiplatelet medication. Diabetic patients showed evidence of proinflammatory response to both recent and chronic exposure to PM air pollution.
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Affiliation(s)
- Lotte Jacobs
- Occupational and Environmental Medicine, Unit of Lung Toxicology
| | | | - Chantal Mathieu
- Department of Endocrinology, Katholique Universiteit Leuven, Leuven, Belgium
| | | | - Frans Fierens
- Belgian interregional Environment Agency, Brussels, Belgium
| | - Peter H. Hoet
- Occupational and Environmental Medicine, Unit of Lung Toxicology
| | - Benoit Nemery
- Occupational and Environmental Medicine, Unit of Lung Toxicology
- Address correspondence to B. Nemery, K.U. Leuven, Occupational and Environmental Medicine and Pneumology, Unit of Lung Toxicology, Herestraat 49 (O&N 706), B-3000 Leuven, Belgium. Telephone: 32-16-347121. Fax: 32-16-347124. E-mail:
| | - Tim S. Nawrot
- Occupational and Environmental Medicine, Unit of Lung Toxicology
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
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