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Miljoen H, Favere K, Van De Heyning C, Corteville B, Dausin C, Herbots L, Teulingkx T, Bekhuis Y, Lyssens M, Bogaert J, Heidbuchel H, Claessen G. Low rates of myocardial fibrosis and ventricular arrhythmias in recreational athletes after SARS-CoV-2 infection. Front Cardiovasc Med 2024; 11:1372028. [PMID: 38628312 PMCID: PMC11018940 DOI: 10.3389/fcvm.2024.1372028] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 02/26/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction High rates of cardiac involvement were reported in the beginning of the coronavirus disease 2019 (COVID-19) pandemic. This led to anxiety in the athletic population. The current study was set up to assess the prevalence of myocardial fibrosis and ventricular arrhythmias in recreational athletes with the recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods Consecutive adult recreational athletes (≥18 years old, ≥4 h of mixed type or endurance sports/week) underwent systematic cardiac evaluation after a prior confirmed COVID-19 infection. Evaluation included clinical history, electrocardiogram (ECG), 5-day Holter monitoring, and cardiac magnetic resonance (CMR) imaging with simultaneous measurement of high-sensitive cardiac Troponin I. Data from asymptomatic or mildly symptomatic athletes (Group 1) were compared with those with moderate to severe symptoms (Groups 2-3). Furthermore, a comparison with a historical control group of athletes without COVID-19 (Master@Heart) was made. Results In total, 35 athletes (18 Group 1, 10 female, 36.9 ± 2.2 years, mean 143 ± 20 days following diagnosis) were evaluated. The baseline characteristics for the Group 1 and Groups 2-3 athletes were similar. None of the athletes showed overt myocarditis on CMR based on the updated Lake Louise criteria for diagnosis of myocarditis. The prevalence of non-ischemic late gadolinium enhancement [1 (6%) Group 1 vs. 2 (12%) Groups 2-3; p = 0.603] or ventricular arrhythmias [1 Group 1 athlete showed non-sustained ventricular tachycardia (vs. 0 in Groups 2-3: p = 1.000)] were not statistically different between the groups. When the male athletes were compared with the Master@Heart athletes, again no differences regarding these criteria were found. Conclusion In our series of recreational athletes with prior confirmed COVID-19, we found no evidence of ongoing myocarditis, and no more detection of fibrosis or ventricular arrhythmias than in a comparable athletic pre-COVID cohort. This points to a much lower cardiac involvement of COVID-19 in athletes than originally suggested.
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Affiliation(s)
- Hielko Miljoen
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
- Research Group Cardiovascular Diseases, Department GENCOR, University of Antwerp, Antwerp, Belgium
| | - Kasper Favere
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
- Research Group Cardiovascular Diseases, Department GENCOR, University of Antwerp, Antwerp, Belgium
- Department of Internal Medicine, Ghent University, Ghent, Belgium
| | - Caroline Van De Heyning
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
- Research Group Cardiovascular Diseases, Department GENCOR, University of Antwerp, Antwerp, Belgium
| | - Ben Corteville
- Department of Cardiology, Jan Palfijn Hospital, Ghent, Belgium
| | - Christophe Dausin
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Lieven Herbots
- Department of Cardiology, Hartcentrum, Jessa Hospital, Hasselt, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | | | - Youri Bekhuis
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Department of Cardiology, Leuven University Hospitals, Leuven, Belgium
- Department of Cardiovascular Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Malou Lyssens
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Jan Bogaert
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Hein Heidbuchel
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
- Research Group Cardiovascular Diseases, Department GENCOR, University of Antwerp, Antwerp, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Guido Claessen
- Department of Cardiology, Hartcentrum, Jessa Hospital, Hasselt, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
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Bosman M, Krüger DN, Favere K, De Meyer GRY, Franssen C, Van Craenenbroeck EM, Guns PJ. Dexrazoxane does not mitigate early vascular toxicity induced by doxorubicin in mice. PLoS One 2023; 18:e0294848. [PMID: 38015959 PMCID: PMC10684076 DOI: 10.1371/journal.pone.0294848] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/08/2023] [Indexed: 11/30/2023] Open
Abstract
Apart from cardiotoxicity, the chemotherapeutic agent doxorubicin (DOX) provokes acute and long-term vascular toxicity. Dexrazoxane (DEXRA) is an effective drug for treatment of DOX-induced cardiotoxicity, yet it remains currently unknown whether DEXRA prevents vascular toxicity associated with DOX. Accordingly, the present study aimed to evaluate the protective potential of DEXRA against DOX-related vascular toxicity in a previously-established in vivo and ex vivo model of vascular dysfunction induced by 16 hour (h) DOX exposure. Vascular function was evaluated in the thoracic aorta in organ baths, 16h after administration of DOX (4 mg/kg) or DOX with DEXRA (40 mg/kg) to male C57BL6/J mice. In parallel, vascular reactivity was evaluated after ex vivo incubation (16h) of murine aortic segments with DOX (1 μM) or DOX with DEXRA (10 μM). In both in vivo and ex vivo experiments, DOX impaired acetylcholine-stimulated endothelium-dependent vasodilation. In the ex vivo setting, DOX additionally attenuated phenylephrine-elicited vascular smooth muscle cell (VSMC) contraction. Importantly, DEXRA failed to prevent DOX-induced endothelial dysfunction and hypocontraction. Furthermore, RT-qPCR and Western blotting showed that DOX decreased the protein levels of topoisomerase-IIβ (TOP-IIβ), a key target of DEXRA, in the heart, but not in the aorta. Additionally, the effect of N-acetylcysteine (NAC, 10 μM), a reactive oxygen species (ROS) scavenger, was evaluated ex vivo. NAC did not prevent DOX-induced impairment of acetylcholine-stimulated vasodilation. In conclusion, our results show that DEXRA fails to prevent vascular toxicity resulting from 16h DOX treatment. This may relate to DOX provoking vascular toxicity in a ROS- and TOP-IIβ-independent way, at least in the evaluated acute setting. However, it is important to mention that these findings only apply to the acute (16h) treatment period, and further research is warranted to delineate the therapeutic potential of DEXRA against vascular toxicity associated with longer-term repetitive DOX dosing.
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Affiliation(s)
- Matthias Bosman
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Antwerp, Belgium
| | - Dustin N. Krüger
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Antwerp, Belgium
| | - Kasper Favere
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Antwerp, Belgium
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Guido R. Y. De Meyer
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Antwerp, Belgium
| | - Constantijn Franssen
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Emeline M. Van Craenenbroeck
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Pieter-Jan Guns
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Antwerp, Belgium
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3
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Bosman M, Krüger D, Van Assche C, Boen H, Neutel C, Favere K, Franssen C, Martinet W, Roth L, De Meyer GRY, Cillero-Pastor B, Delrue L, Heggermont W, Van Craenenbroeck EM, Guns PJ. Doxorubicin-induced cardiovascular toxicity: a longitudinal evaluation of functional and molecular markers. Cardiovasc Res 2023; 119:2579-2590. [PMID: 37625456 PMCID: PMC10676457 DOI: 10.1093/cvr/cvad136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 06/19/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
AIMS Apart from cardiotoxicity, the chemotherapeutic doxorubicin (DOX) induces vascular toxicity, represented by arterial stiffness and endothelial dysfunction. Both parameters are of interest for cardiovascular risk stratification as they are independent predictors of future cardiovascular events in the general population. However, the time course of DOX-induced cardiovascular toxicity remains unclear. Moreover, current biomarkers for cardiovascular toxicity prove insufficient. Here, we longitudinally evaluated functional and molecular markers of DOX-induced cardiovascular toxicity in a murine model. Molecular markers were further validated in patient plasma. METHODS AND RESULTS DOX (4 mg/kg) or saline (vehicle) was administered intra-peritoneally to young, male mice weekly for 6 weeks. In vivo cardiovascular function and ex vivo arterial stiffness and vascular reactivity were evaluated at baseline, during DOX therapy (Weeks 2 and 4) and after therapy cessation (Weeks 6, 9, and 15). Left ventricular ejection fraction (LVEF) declined from Week 4 in the DOX group. DOX increased arterial stiffness in vivo and ex vivo at Week 2, which reverted thereafter. Importantly, DOX-induced arterial stiffness preceded reduced LVEF. Further, DOX impaired endothelium-dependent vasodilation at Weeks 2 and 6, which recovered at Weeks 9 and 15. Conversely, contraction with phenylephrine was consistently higher in the DOX-treated group. Furthermore, proteomic analysis on aortic tissue identified increased thrombospondin-1 (THBS1) and alpha-1-antichymotrypsin (SERPINA3) at Weeks 2 and 6. Up-regulated THBS1 and SERPINA3 persisted during follow-up. Finally, THBS1 and SERPINA3 were quantified in plasma of patients. Cancer survivors with anthracycline-induced cardiotoxicity (AICT; LVEF < 50%) showed elevated THBS1 and SERPINA3 levels compared with age-matched control patients (LVEF ≥ 60%). CONCLUSIONS DOX increased arterial stiffness and impaired endothelial function, which both preceded reduced LVEF. Vascular dysfunction restored after DOX therapy cessation, whereas cardiac dysfunction persisted. Further, we identified SERPINA3 and THBS1 as promising biomarkers of DOX-induced cardiovascular toxicity, which were confirmed in AICT patients.
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Affiliation(s)
- Matthias Bosman
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp B-2610, Belgium
| | - Dustin Krüger
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp B-2610, Belgium
| | - Charles Van Assche
- Research Group M4I—Imaging Mass Spectrometry (IMS); Faculty of Health, Medicine and Life Sciences, Maastricht MultiModal Molecular Imaging Institute, Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands
| | - Hanne Boen
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp B-2610, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Drie Eikenstraat 655, Edegem B-2650, Belgium
| | - Cédric Neutel
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp B-2610, Belgium
| | - Kasper Favere
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp B-2610, Belgium
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp B-2610, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Drie Eikenstraat 655, Edegem B-2650, Belgium
| | - Constantijn Franssen
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp B-2610, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Drie Eikenstraat 655, Edegem B-2650, Belgium
| | - Wim Martinet
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp B-2610, Belgium
| | - Lynn Roth
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp B-2610, Belgium
| | - Guido R Y De Meyer
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp B-2610, Belgium
| | - Berta Cillero-Pastor
- Research Group M4I—Imaging Mass Spectrometry (IMS); Faculty of Health, Medicine and Life Sciences, Maastricht MultiModal Molecular Imaging Institute, Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands
- Department of Cell Biology-Inspired Tissue Engineering, Institute for Technology-Inspired Regenerative Medicine, Universiteitssingel 40, 6229 ER Maastricht/Room C3.577, PO Box 616, Maastricht 6200 MD, The Netherlands
| | - Leen Delrue
- Department of Cardiology, Cardiovascular Center OLV Hospital Aalst, Moorselbaan 164, Aalst B-9300, Belgium
| | - Ward Heggermont
- Department of Cardiology, Cardiovascular Center OLV Hospital Aalst, Moorselbaan 164, Aalst B-9300, Belgium
- Department of Cardiology, Center for Molecular and Vascular Biology, KU Leuven, Herestraat 49, Leuven B-3000, Belgium
| | - Emeline M Van Craenenbroeck
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp B-2610, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Drie Eikenstraat 655, Edegem B-2650, Belgium
| | - Pieter-Jan Guns
- Laboratory of Physiopharmacology, Faculty of Medicine and Health Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Campus Drie Eiken, University of Antwerp, Universiteitsplein 1, Antwerp B-2610, Belgium
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4
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De Bosscher R, Dausin C, Claus P, Bogaert J, Dymarkowski S, Goetschalckx K, Ghekiere O, Van De Heyning CM, Van Herck P, Paelinck B, Addouli HE, La Gerche A, Herbots L, Willems R, Heidbuchel H, Claessen G, Claeys M, Hespel P, Dresselaers T, Miljoen H, Belmans A, Favere K, Vermeulen D, Witvrouwen I, Hansen D, Eijnde BO, Thijs D, Vanvoorden P, Van Soest S. Lifelong endurance exercise and its relation with coronary atherosclerosis. Eur Heart J 2023; 44:2388-2399. [PMID: 36881712 PMCID: PMC10327878 DOI: 10.1093/eurheartj/ehad152] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Abstract
AIMS The impact of long-term endurance sport participation (on top of a healthy lifestyle) on coronary atherosclerosis and acute cardiac events remains controversial. METHODS AND RESULTS The Master@Heart study is a well-balanced prospective observational cohort study. Overall, 191 lifelong master endurance athletes, 191 late-onset athletes (endurance sports initiation after 30 years of age), and 176 healthy non-athletes, all male with a low cardiovascular risk profile, were included. Peak oxygen uptake quantified fitness. The primary endpoint was the prevalence of coronary plaques (calcified, mixed, and non-calcified) on computed tomography coronary angiography. Analyses were corrected for multiple cardiovascular risk factors. The median age was 55 (50-60) years in all groups. Lifelong and late-onset athletes had higher peak oxygen uptake than non-athletes [159 (143-177) vs. 155 (138-169) vs. 122 (108-138) % predicted]. Lifelong endurance sports was associated with having ≥1 coronary plaque [odds ratio (OR) 1.86, 95% confidence interval (CI) 1.17-2.94], ≥ 1 proximal plaque (OR 1.96, 95% CI 1.24-3.11), ≥ 1 calcified plaques (OR 1.58, 95% CI 1.01-2.49), ≥ 1 calcified proximal plaque (OR 2.07, 95% CI 1.28-3.35), ≥ 1 non-calcified plaque (OR 1.95, 95% CI 1.12-3.40), ≥ 1 non-calcified proximal plaque (OR 2.80, 95% CI 1.39-5.65), and ≥1 mixed plaque (OR 1.78, 95% CI 1.06-2.99) as compared to a healthy non-athletic lifestyle. CONCLUSION Lifelong endurance sport participation is not associated with a more favourable coronary plaque composition compared to a healthy lifestyle. Lifelong endurance athletes had more coronary plaques, including more non-calcified plaques in proximal segments, than fit and healthy individuals with a similarly low cardiovascular risk profile. Longitudinal research is needed to reconcile these findings with the risk of cardiovascular events at the higher end of the endurance exercise spectrum.
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Affiliation(s)
- Ruben De Bosscher
- Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
- Division of Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Christophe Dausin
- Department of Movement Sciences, KU Leuven, Tervuursevest 101, 3001 Leuven, Belgium
| | - Piet Claus
- Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Jan Bogaert
- Division of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Steven Dymarkowski
- Division of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Kaatje Goetschalckx
- Division of Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Olivier Ghekiere
- Division of Radiology, Jessa Ziekenhuis, Stadsomvaat 11, 3500 Hasselt, Belgium
- Department of Medicine and Life Sciences, University of Hasselt, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Caroline M Van De Heyning
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Paul Van Herck
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Bernard Paelinck
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Haroun El Addouli
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - André La Gerche
- Department of Cardiology, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Victoria 3004, Australia
| | - Lieven Herbots
- Department of Medicine and Life Sciences, University of Hasselt, Stadsomvaart 11, 3500 Hasselt, Belgium
- Division of Cardiology, Hartcentrum, Jessa Ziekenhuis, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Rik Willems
- Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
- Division of Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Hein Heidbuchel
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Guido Claessen
- Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
- Department of Medicine and Life Sciences, University of Hasselt, Stadsomvaart 11, 3500 Hasselt, Belgium
- Department of Cardiology, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Victoria 3004, Australia
- Division of Cardiology, Hartcentrum, Jessa Ziekenhuis, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Mathias Claeys
- Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
- Division of Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Peter Hespel
- Department of Movement Sciences, KU Leuven, Tervuursevest 101, 3001 Leuven, Belgium
| | - Tom Dresselaers
- Division of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Hielko Miljoen
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Ann Belmans
- I-BioStat, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Kasper Favere
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Dorien Vermeulen
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Isabel Witvrouwen
- Division of Cardiology, University Hospital Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
- Cardiovascular Research, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Dominique Hansen
- Department of Medicine and Life Sciences, University of Hasselt, Stadsomvaart 11, 3500 Hasselt, Belgium
- REVAL/BIOMED, Hasselt University, Agoralaan Gebouw C, 3590 Diepenbeek, Belgium
| | - Bert Op’t Eijnde
- Department of Medicine and Life Sciences, University of Hasselt, Stadsomvaart 11, 3500 Hasselt, Belgium
- REVAL/BIOMED, Hasselt University, Agoralaan Gebouw C, 3590 Diepenbeek, Belgium
| | - Daisy Thijs
- Department of Medicine and Life Sciences, University of Hasselt, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Peter Vanvoorden
- Department of Medicine and Life Sciences, University of Hasselt, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - Sofie Van Soest
- Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
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Eens S, Van Hecke M, Favere K, Tousseyn T, Guns PJ, Roskams T, Heidbuchel H. B-cell lymphoblastic lymphoma following intravenous BNT162b2 mRNA booster in a BALB/c mouse: A case report. Front Oncol 2023; 13:1158124. [PMID: 37197431 PMCID: PMC10183601 DOI: 10.3389/fonc.2023.1158124] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/13/2023] [Indexed: 05/19/2023] Open
Abstract
Unprecedented immunization campaigns have been rolled out worldwide in an attempt to contain the ongoing COVID-19 pandemic. Multiple vaccines were brought to the market, among two utilizing novel messenger ribonucleic acid technology. Despite their undisputed success in decreasing COVID-19-associated hospitalizations and mortality, various adverse events have been reported. The emergence of malignant lymphoma is one of such rare adverse events that has raised concern, although an understanding of the mechanisms potentially involved remains lacking. Herein, we present the first case of B-cell lymphoblastic lymphoma following intravenous high-dose mRNA COVID-19 vaccination (BNT162b2) in a BALB/c mouse. Two days following booster vaccination (i.e., 16 days after prime), at only 14 weeks of age, our animal suffered spontaneous death with marked organomegaly and diffuse malignant infiltration of multiple extranodal organs (heart, lung, liver, kidney, spleen) by lymphoid neoplasm. Immunohistochemical examination revealed organ sections positive for CD19, terminal deoxynucleotidyl transferase, and c-MYC, compatible with a B-cell lymphoblastic lymphoma immunophenotype. Our murine case adds to previous clinical reports on malignant lymphoma development following novel mRNA COVID-19 vaccination, although a demonstration of direct causality remains difficult. Extra vigilance is required, with conscientious reporting of similar cases and a further investigation of the mechanisms of action explaining the aforementioned association.
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Affiliation(s)
- Sander Eens
- Laboratory of Physiopharmacology, Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton (GENCOR), University of Antwerp, Antwerp, Belgium
- Research Group Cardiovascular Diseases, Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton (GENCOR), University of Antwerp, Antwerp, Belgium
- *Correspondence: Sander Eens,
| | - Manon Van Hecke
- Laboratory of Translational Cell and Tissue Research, Department of Imaging and Pathology, University of Leuven, Leuven, Belgium
| | - Kasper Favere
- Laboratory of Physiopharmacology, Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton (GENCOR), University of Antwerp, Antwerp, Belgium
- Research Group Cardiovascular Diseases, Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton (GENCOR), University of Antwerp, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
- Department of Internal Medicine, Ghent University, Ghent, Belgium
| | - Thomas Tousseyn
- Laboratory of Translational Cell and Tissue Research, Department of Imaging and Pathology, University of Leuven, Leuven, Belgium
| | - Pieter-Jan Guns
- Laboratory of Physiopharmacology, Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton (GENCOR), University of Antwerp, Antwerp, Belgium
| | - Tania Roskams
- Laboratory of Translational Cell and Tissue Research, Department of Imaging and Pathology, University of Leuven, Leuven, Belgium
| | - Hein Heidbuchel
- Research Group Cardiovascular Diseases, Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton (GENCOR), University of Antwerp, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
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6
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Miljoen H, Bekhuis Y, Roeykens J, Taha K, Frankinouille R, Michielsen M, Van de Heyning CM, Cornelissen V, Favere K, Eens S, Gielen J, Goetschalckx K, Heidbuchel H, Claessen G. Effect of BNT162b2 mRNA booster vaccination on VO
2
max
in recreational athletes: A prospective cohort study. Health Sci Rep 2022; 5:e929. [PMCID: PMC9679380 DOI: 10.1002/hsr2.929] [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: 06/08/2022] [Revised: 09/27/2022] [Accepted: 10/24/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Hielko Miljoen
- Department of Cardiology Antwerp University Hospital Antwerp Belgium
- Department of Medicine and Health Sciences University of Antwerp Antwerp Belgium
| | - Youri Bekhuis
- Department of Cardiovascular Sciences Cardiology, KU Leuven Leuven Belgium
- Department of Cardiovascular Diseases University Hospitals Leuven Leuven Belgium
- Faculty of Medicine and Life Sciences, Cardiology and Organ Systems University of Hasselt Hasselt Belgium
| | - Johan Roeykens
- Department of Cardiology Antwerp University Hospital Antwerp Belgium
- Department of Medicine and Health Sciences University of Antwerp Antwerp Belgium
| | - Karim Taha
- Department of Cardiovascular Sciences Cardiology, KU Leuven Leuven Belgium
- Department of Cardiology University Medical Center Utrecht Utrecht The Netherlands
| | - Rudi Frankinouille
- Department of Cardiology Antwerp University Hospital Antwerp Belgium
- Department of Medicine and Health Sciences University of Antwerp Antwerp Belgium
| | - Matthijs Michielsen
- Department of Rehabilitation Sciences, Group Rehabilitation in Internal Disorders KU Leuven Leuven Belgium
| | - Caroline M. Van de Heyning
- Department of Cardiology Antwerp University Hospital Antwerp Belgium
- Department of Medicine and Health Sciences University of Antwerp Antwerp Belgium
| | - Véronique Cornelissen
- Department of Rehabilitation Sciences, Group Rehabilitation in Internal Disorders KU Leuven Leuven Belgium
| | - Kasper Favere
- Department of Medicine and Health Sciences University of Antwerp Antwerp Belgium
- Department of Internal Medicine Ghent University Ghent Belgium
| | - Sander Eens
- Department of Medicine and Health Sciences University of Antwerp Antwerp Belgium
| | - Jan Gielen
- Department of Medicine and Health Sciences University of Antwerp Antwerp Belgium
- Department of Radiology Antwerp University Hospital Antwerp Belgium
| | - Kaatje Goetschalckx
- Department of Cardiovascular Diseases University Hospitals Leuven Leuven Belgium
| | - Hein Heidbuchel
- Department of Cardiology Antwerp University Hospital Antwerp Belgium
- Department of Medicine and Health Sciences University of Antwerp Antwerp Belgium
- Faculty of Medicine and Life Sciences, Cardiology and Organ Systems University of Hasselt Hasselt Belgium
| | - Guido Claessen
- Department of Cardiovascular Sciences Cardiology, KU Leuven Leuven Belgium
- Department of Cardiovascular Diseases University Hospitals Leuven Leuven Belgium
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7
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Favere K, Van Fraeyenhove J, Jacobs G, Bosman M, Eens S, De Sutter J, Miljoen H, Guns PJ, De Keulenaer GW, Segers VFM, Heidbuchel H. Cardiac electrophysiology studies in mice via the transjugular route: a comprehensive practical guide. Am J Physiol Heart Circ Physiol 2022; 323:H763-H773. [PMID: 36018757 DOI: 10.1152/ajpheart.00337.2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Indexed: 11/22/2022]
Abstract
Cardiac arrhythmias are associated with cardiovascular morbidity and mortality. Cardiac electrophysiology studies (EPS) use intracardiac catheter recording and stimulation for profound evaluation of the heart's electrical properties. The main clinical application is investigation and treatment of rhythm disorders. These techniques have been translated to the murine setting to open opportunities for detailed evaluation of the impact of different characteristics (including genetics) and interventions on cardiac electrophysiology and -pathology. Currently, a detailed description of the technique of murine transjugular EPS (which is the standard route of catheter introduction) is lacking. This article provides detailed information on EPS in mice via the transjugular route. This includes catheter placement, stimulation protocols, intracardiac tracing interpretation, artefact reduction and surface ECG recording. In addition, reference values as obtained in C57BL/6N mice are presented for common electrophysiological parameters. This detailed methodological description aims to increase accessibility and standardisation of EPS in mice. Ultimately, also human research and patient care may benefit from translation of the knowledge obtained in preclinical models using this technique.
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Affiliation(s)
- Kasper Favere
- Laboratory of Physiopharmacology, GENCOR, University of Antwerp, Antwerp, Belgium.,Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp, Belgium.,Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium.,Department of Internal Medicine, Ghent University, Ghent, Belgium
| | - Jens Van Fraeyenhove
- Laboratory of Physiopharmacology, GENCOR, University of Antwerp, Antwerp, Belgium
| | - Griet Jacobs
- Laboratory of Physiopharmacology, GENCOR, University of Antwerp, Antwerp, Belgium
| | - Matthias Bosman
- Laboratory of Physiopharmacology, GENCOR, University of Antwerp, Antwerp, Belgium
| | - Sander Eens
- Laboratory of Physiopharmacology, GENCOR, University of Antwerp, Antwerp, Belgium.,Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp, Belgium
| | - Johan De Sutter
- Department of Internal Medicine, Ghent University, Ghent, Belgium
| | - Hielko Miljoen
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
| | - Pieter-Jan Guns
- Laboratory of Physiopharmacology, GENCOR, University of Antwerp, Antwerp, Belgium
| | - Gilles W De Keulenaer
- Laboratory of Physiopharmacology, GENCOR, University of Antwerp, Antwerp, Belgium.,Department of Cardiology, ZNA Middelheim Hospital, Antwerp, Belgium
| | - Vincent F M Segers
- Laboratory of Physiopharmacology, GENCOR, University of Antwerp, Antwerp, Belgium.,Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp, Belgium.,Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
| | - Hein Heidbuchel
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Antwerp, Belgium.,Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
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8
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Favere K, Van Hecke M, Eens S, Bosman M, Stobbelaar K, Delputte P, De Sutter J, Roskams T, Heidbuchel H, Guns P. Fibrotic remodelling after coxsackievirus-induced myocarditis in mice. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.151] [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
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Research Foundation Flanders
Introduction
Myocarditis is an inflammatory disease of the heart with viral infections being the most common aetiology. Often, myocardial fibrosis (MF) is observed during the resolution of myocarditis. MF is a strong independent predictor for outcome in patients with myocarditis. Nevertheless, the late stages of disease, encompassing fibrogenesis and arrhythmogenesis, have been underappreciated in viral myocarditis research to date.
Purpose
The primary aim of this study was to characterise the natural history of coxsackievirus B3 (CVB3)-induced myocarditis in C57BL/6J mice, with emphasis on fibrogenesis and its electrical impact. Secondary aims were 1) to study the impact of inoculation dose and sex on the course of disease, and 2) to develop an in-house histopathological scoring system for inflammation and fibrosis.
Methods
C57BL/6J mice (12 weeks old; n=154) received intraperitoneal injection with CVB3 (Nancy strain). Male mice received 5 x 10^5 (regular dose)(RD) or 5 x 10^6 (high dose) plaque-forming units, whereas female mice received the RD only. Mice injected with PBS served as control groups. Animals were sacrificed 7, 14, 28, 56 and 77 days after CVB3 or PBS injection. Inflammation (haematoxylin-eosin) and fibrosis (Picrosirius red (PSR)) were evaluated histologically. Arrhythmogenicity was assessed through right ventricular programmed stimulation.
Results
CVB3 animals sacrificed or with spontaneous death within 14 days after inoculation showed cardiac infiltration in all (100%) and necrosis in 88% (35/40). In male CVB3-infected mice, premature mortality was ±20% in both regular and high dose groups, occurring between 9 and 23 days post inoculation. No mortality was observed in the female group (p<0.025 for comparison male and female RD). Cardiac inflammation had resolved in the majority of animals at day 77. Perivascular fibrosis was seen in both infected and control mice. Pericellular fibrosis and organised scarring were seen in CVB3-infected animals only, and mainly became evident 56 and 77 days after inoculation (51% of infected animals). Also total cross-sectional PSR-positive area was 2-3-fold higher in CVB-infected mice compared to sex-matched controls, independent of inoculation dose (p<0.05). At the 56- and 77-day timepoint, nonsustained ventricular tachycardia was induced in 17% (5/29) of the intervention animals (all with pericellular fibrosis or scarring) and none (0/14) of the control animals, but this did not reach statistical significance (p=0.098).
Conclusion
We report on the characterisation of fibrotic remodelling in a CVB3-induced myocarditis mouse model. Fibrotic remodelling was seen in a majority of mice after 8 to 11 weeks. It was associated with a numerical (but not significant) increased arrhythmogenicity, requiring further exploration given the clinical significance of fibrotic remodelling. Further research on the molecular pathways and cellular interactions triggered by myocarditis is ongoing.
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Affiliation(s)
- K Favere
- University of Antwerp , Antwerp , Belgium
| | | | - S Eens
- University of Antwerp , Antwerp , Belgium
| | - M Bosman
- University of Antwerp , Antwerp , Belgium
| | | | - P Delputte
- University of Antwerp , Antwerp , Belgium
| | | | - T Roskams
- University of Leuven , Leuven , Belgium
| | | | - P Guns
- University of Antwerp , Antwerp , Belgium
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9
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Favere K, Bosman M, Klingel K, Heymans S, Van Linthout S, Delputte PL, De Sutter J, Heidbuchel H, Guns PJ. Toll-Like Receptors: Are They Taking a Toll on the Heart in Viral Myocarditis? Viruses 2021; 13:v13061003. [PMID: 34072044 PMCID: PMC8227433 DOI: 10.3390/v13061003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 12/30/2022] Open
Abstract
Myocarditis is an inflammatory disease of the heart with viral infections being the most common aetiology. Its complex biology remains poorly understood and its clinical management is one of the most challenging in the field of cardiology. Toll-like receptors (TLRs), a family of evolutionarily conserved pattern recognition receptors, are increasingly known to be implicated in the pathophysiology of viral myocarditis. Their central role in innate and adaptive immune responses, and in the inflammatory reaction that ensues, indeed makes them prime candidates to profoundly affect every stage of the disease process. This review describes the pathogenesis and pathophysiology of viral myocarditis, and scrutinises the role of TLRs in every phase. We conclude with directions for future research in this field.
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Affiliation(s)
- Kasper Favere
- Laboratory of Physiopharmacology, GENCOR, University of Antwerp, 2610 Antwerp, Belgium; (M.B.); (P.-J.G.)
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, 2610 Antwerp, Belgium;
- Department of Cardiology, Antwerp University Hospital, 2650 Antwerp, Belgium
- Department of Internal Medicine, Ghent University, 9000 Ghent, Belgium;
- Correspondence:
| | - Matthias Bosman
- Laboratory of Physiopharmacology, GENCOR, University of Antwerp, 2610 Antwerp, Belgium; (M.B.); (P.-J.G.)
| | - Karin Klingel
- Cardiopathology, Institute for Pathology, University Hospital Tuebingen, 72076 Tuebingen, Germany;
| | - Stephane Heymans
- Department of Cardiology, Maastricht University, 6229 ER Maastricht, The Netherlands;
- Centre for Molecular and Vascular Biology, KU Leuven, 3000 Leuven, Belgium
| | - Sophie Van Linthout
- BIH Center for Regenerative Therapies (BCRT), Berlin Institute of Health (BIH) at Charité, Universitätsmedizin Berlin, 10117 Berlin, Germany;
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, 10785 Berlin, Germany
| | - Peter L. Delputte
- Laboratory of Microbiology, Parasitology and Hygiene, University of Antwerp, 2610 Antwerp, Belgium;
| | - Johan De Sutter
- Department of Internal Medicine, Ghent University, 9000 Ghent, Belgium;
| | - Hein Heidbuchel
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, 2610 Antwerp, Belgium;
- Department of Cardiology, Antwerp University Hospital, 2650 Antwerp, Belgium
| | - Pieter-Jan Guns
- Laboratory of Physiopharmacology, GENCOR, University of Antwerp, 2610 Antwerp, Belgium; (M.B.); (P.-J.G.)
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10
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Bosman M, Favere K, Neutel CHG, Jacobs G, De Meyer GRY, Martinet W, Van Craenenbroeck EM, Guns PJDF. Doxorubicin induces arterial stiffness: A comprehensive in vivo and ex vivo evaluation of vascular toxicity in mice. Toxicol Lett 2021; 346:23-33. [PMID: 33895255 DOI: 10.1016/j.toxlet.2021.04.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 11/20/2020] [Revised: 03/29/2021] [Accepted: 04/20/2021] [Indexed: 01/09/2023]
Abstract
Arterial stiffness is an important predictor of cardiovascular risk. Clinical studies have demonstrated that arterial stiffness increases in cancer patients treated with the chemotherapeutic doxorubicin (DOX). However, the mechanisms of DOX-induced arterial stiffness remain largely unknown. This study aimed to evaluate artery stiffening in DOX-treated mice using in vivo and ex vivo techniques. Male C57BL/6J mice were treated for 2 weeks with 2 mg/kg (low dose) or 4 mg/kg (high dose) of DOX weekly. Arterial stiffness was assessed in vivo with ultrasound imaging (abdominal aorta pulse wave velocity (aaPWV)) and applanation tonometry (carotid-femoral PWV) combined with ex vivo vascular stiffness and reactivity evaluation. The high dose increased aaPWV, while cfPWV did not reach statistical significance. Phenylephrine (PE)-contracted aortic segments showed a higher Peterson's modulus (Ep) in the high dose group, while Ep did not differ when vascular smooth muscle cells (VSMCs) were relaxed by a NO donor (DEANO). In addition, aortic rings of DOX-treated mice showed increased PE contraction, decreased basal nitric oxide (NO) index and impaired acetylcholine-induced endothelium-dependent relaxation. DOX treatment contributed to endothelial cell loss and reduced endothelial nitric oxide synthase (eNOS) expression in the aorta. In conclusion, we have replicated DOX-induced arterial stiffness in a murine model and this aortic stiffness is driven by impaired endothelial function, contributing to increased vascular tone.
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Affiliation(s)
- Matthias Bosman
- University of Antwerp, Faculty of Medicine and Health Sciences, Laboratory of Physiopharmacology, Campus Drie Eiken, Universiteitsplein 1, B-2610, Antwerp, Belgium.
| | - Kasper Favere
- University of Antwerp, Faculty of Medicine and Health Sciences, Laboratory of Physiopharmacology, Campus Drie Eiken, Universiteitsplein 1, B-2610, Antwerp, Belgium; University of Antwerp, Research Group Cardiovascular Diseases, GENCOR, Antwerp, Belgium; Ghent University, Faculty of Medicine and Health Sciences, Department of Internal Medicine, C. Heymanslaan 10, B-9000, Ghent, Belgium; Antwerp University Hospital (UZA), Department of Cardiology, Drie Eikenstraat 655, B-2650, Edegem, Belgium
| | - Cédric H G Neutel
- University of Antwerp, Faculty of Medicine and Health Sciences, Laboratory of Physiopharmacology, Campus Drie Eiken, Universiteitsplein 1, B-2610, Antwerp, Belgium
| | - Griet Jacobs
- University of Antwerp, Faculty of Medicine and Health Sciences, Laboratory of Physiopharmacology, Campus Drie Eiken, Universiteitsplein 1, B-2610, Antwerp, Belgium
| | - Guido R Y De Meyer
- University of Antwerp, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Laboratory of Physiopharmacology, Campus Drie Eiken, Universiteitsplein 1, B-2610, Antwerp, Belgium
| | - Wim Martinet
- University of Antwerp, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Laboratory of Physiopharmacology, Campus Drie Eiken, Universiteitsplein 1, B-2610, Antwerp, Belgium
| | - Emeline M Van Craenenbroeck
- University of Antwerp, Research Group Cardiovascular Diseases, GENCOR, Antwerp, Belgium; Antwerp University Hospital (UZA), Department of Cardiology, Drie Eikenstraat 655, B-2650, Edegem, Belgium
| | - Pieter-Jan D F Guns
- University of Antwerp, Faculty of Medicine and Health Sciences, Laboratory of Physiopharmacology, Campus Drie Eiken, Universiteitsplein 1, B-2610, Antwerp, Belgium
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11
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Favere K, Bosman M, Delputte PL, Favoreel HW, Van Craenenbroeck EM, De Sutter J, Witvrouwen I, De Meyer GRY, Heidbuchel H, Guns PJDF. A systematic literature review on the effects of exercise on human Toll-like receptor expression. Exerc Immunol Rev 2021; 27:84-124. [PMID: 33965901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Toll-like receptors (TLRs) are a family of transmembrane pattern recognition receptors that are mainly expressed on immune cells. Recognition of various exogenous and endogenous molecular patterns activates the TLR signalling cascade, which orchestrates an inflammatory immune response. Dysfunctional immune responses, including aberrant TLR signalling, are increasingly implicated in the associations between sedentarism, chronic low-grade systemic inflammation and various non-communicable diseases. Conversely, exercise exerts anti-inflammatory effects, which could be conferred through its immunomodulatory properties, potentially affecting TLRs. This study aims to systematically review the effects of exercise on human TLR expression. METHOD A systematic literature search of Pubmed, Embase, The Cochrane Library and SPORTDiscus for articles addressing the impact of exercise (as isolated intervention) on TLRs in humans was conducted, ending in February 2020. RESULTS A total of 66 articles were included. The publications were categorised according to exercise modality and duration: acute resistance exercise (4 studies), acute aerobic exercise (26 studies), resistance training program (9 studies), aerobic training program (16 studies), combined (i.e. resistance and aerobic) training program (8 studies) and chronic exercise not otherwise classifiable (9 studies). Five articles investigated more than one of the aforementioned exercise categories. Several trends could be discerned with regard to the TLR response in the different exercise categories. Acute resistance exercise seemed to elicit TLR upregulation, whereas acute aerobic exercise had less activating potential with the majority of responses being neutral or, especially in healthy participants, downregulatory. Chronic resistance and combined exercise programs predominantly resulted in unaltered or decreased TLR levels. In the chronic aerobic exercise category, mixed effects were observed, but the majority of measurements demonstrated unchanged TLR expression. CONCLUSION Currently published research supports an interplay between exercise and TLR signalling, which seems to depend on the characteristics of the exercise. However, there was large heterogeneity in the study designs and methodologies. Therefore, additional research is required to further corroborate these findings, to define its pathophysiological implications and to elucidate the mechanism(s) linking exercise to TLR signalling.
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Affiliation(s)
- Kasper Favere
- Laboratory of Physiopharmacology, GENCOR, University of Antwerp, Belgium
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital, Belgium
- Department of Internal Medicine, Ghent University, Belgium
| | - Matthias Bosman
- Laboratory of Physiopharmacology, GENCOR, University of Antwerp, Belgium
| | - Peter L Delputte
- Laboratory of Microbiology, Parasitology and Hygiene, University of Antwerp, Belgium
| | - Herman W Favoreel
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Emeline M Van Craenenbroeck
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital, Belgium
| | | | - Isabel Witvrouwen
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital, Belgium
| | - Guido R Y De Meyer
- Laboratory of Physiopharmacology, GENCOR, University of Antwerp, Belgium
| | - Hein Heidbuchel
- Research Group Cardiovascular Diseases, GENCOR, University of Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital, Belgium
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12
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Waked B, Favere K, Marrannes J, De Wulf D, Decaestecker J. Transjugular intrahepatic portosystemic shunt placement for symptomatic non- bleeding anorectal varices in nodular regenerative hyperplasia. Acta Gastroenterol Belg 2020; 83:331-333. [PMID: 32603056] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In this paper we present the case of a male 55-year old patient with known ulcerative colitis and nodular regenerative hyperplasia, a rare form of noncirrhotic portal hypertension. He presented four visits to the emergency department with rapidly progressive anal discomfort. After two weeks a transjugular intrahepatic portosystemic shunt was placed using the gun-sight technique with immediate relief of the unbearable anal pain and pressure. To our knowledge, this is the first case where transjugular intrahepatic portosystemic shunt placement is applied for non- bleeding, congestive anorectal varices.
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Affiliation(s)
- B Waked
- Ghent University Hospital, Department of Gastroenterology, 9000 Ghent, Belgium
| | - K Favere
- Ghent University Hospital, Department of Internal Medicine, 9000 Ghent, Belgium
| | - J Marrannes
- Academic Hospital Roeselare, Department of Radiology, 8800 Roeselare, Belgium
| | - D De Wulf
- Academic Hospital Roeselare, Department of Gastroenterology, 8800 Roeselare, Belgium
| | - J Decaestecker
- Academic Hospital Roeselare, Department of Gastroenterology, 8800 Roeselare, Belgium
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13
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Favere K, Vanderbiest K, Bresseleers J, Depuydt P. Benign gastrobronchial fistula following oesophagectomy in a patient presenting with respiratory failure. BMJ Case Rep 2019; 12:12/9/e228537. [PMID: 31488439 DOI: 10.1136/bcr-2018-228537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Benign gastrobronchial fistula (GBF) is a rare but potentially life-threatening complication of oesophagectomy for malignancy. We present a case of GBF post Ivor-Lewis surgery manifesting as pulmonary sepsis and type II respiratory failure. Clues to the diagnosis were persistent hypercapnia despite high minute ventilation, aspiration of gastric content through the endotracheal tube and accumulation of air in the nasogastric drainage bag. Flexible bronchoscopy confirmed the diagnosis. Surgical exploration identified necrosis of the proximal stomach as causative factor. Despite reconstruction of the oesophagogastric anastomosis and interposition of an intercostal muscle flap, the patient developed a new episode of type II respiratory failure. Bronchoscopy revealed in situ recurrence of the fistula. Patency of the fistula was proven through application of methylene blue with subsequent gastroscopy. A conservative, symptom-based, management was conducted. The patient died 6 hours later.
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Affiliation(s)
- Kasper Favere
- Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
| | - Klaas Vanderbiest
- Intensive Care Department, Universitair Ziekenhuis Gent, Gent, Belgium
| | - Jan Bresseleers
- Intensive Care Department, Universitair Ziekenhuis Gent, Gent, Belgium
| | - Pieter Depuydt
- Intensive Care Department, Universitair Ziekenhuis Gent, Gent, Belgium
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14
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Peeters G, Debbaut C, Friebel A, Cornillie P, De Vos WH, Favere K, Vander Elst I, Vandecasteele T, Johann T, Van Hoorebeke L, Monbaliu D, Drasdo D, Hoehme S, Laleman W, Segers P. Quantitative analysis of hepatic macro- and microvascular alterations during cirrhogenesis in the rat. J Anat 2018; 232:485-496. [PMID: 29205328 PMCID: PMC5807949 DOI: 10.1111/joa.12760] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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] [Accepted: 11/09/2017] [Indexed: 12/13/2022] Open
Abstract
Cirrhosis represents the end-stage of any persistent chronically active liver disease. It is characterized by the complete replacement of normal liver tissue by fibrosis, regenerative nodules, and complete fibrotic vascularized septa. The resulting angioarchitectural distortion contributes to an increasing intrahepatic vascular resistance, impeding liver perfusion and leading to portal hypertension. To date, knowledge on the dynamically evolving pathological changes of the hepatic vasculature during cirrhogenesis remains limited. More specifically, detailed anatomical data on the vascular adaptations during disease development is lacking. To address this need, we studied the 3D architecture of the hepatic vasculature during induction of cirrhogenesis in a rat model. Cirrhosis was chemically induced with thioacetamide (TAA). At predefined time points, the hepatic vasculature was fixed and visualized using a combination of vascular corrosion casting and deep tissue microscopy. Three-dimensional reconstruction and data-fitting enabled cirrhogenic features to extracted at multiple scales, portraying the impact of cirrhosis on the hepatic vasculature. At the macrolevel, we noticed that regenerative nodules severely compressed pliant venous vessels from 12 weeks of TAA intoxication onwards. Especially hepatic veins were highly affected by this compression, with collapsed vessel segments severely reducing perfusion capabilities. At the microlevel, we discovered zone-specific sinusoidal degeneration, with sinusoids located near the surface being more affected than those in the middle of a liver lobe. Our data shed light on and quantify the evolving angioarchitecture during cirrhogenesis. These findings may prove helpful for future targeted invasive interventions.
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Affiliation(s)
- Geert Peeters
- IBiTech – bioMMedaDepartment of Electronics and Information SystemsGhent UniversityGentBelgium
| | - Charlotte Debbaut
- IBiTech – bioMMedaDepartment of Electronics and Information SystemsGhent UniversityGentBelgium
| | - Adrian Friebel
- Interdisciplinary Centre for Bioinformatics (IZBI)University of LeipzigLeipzigGermany
- Institute of Computer ScienceUniversity of LeipzigLeipzigGermany
| | - Pieter Cornillie
- Department of MorphologyFaculty of Veterinary MedicineGhent UniversityGentBelgium
| | - Winnok H. De Vos
- Laboratory of Cell Biology and HistologyDepartment of Veterinary SciencesUniversity of AntwerpAntwerpBelgium
- Cell Systems and ImagingDepartment of Molecular BiotechnologyUniversity of GhentGentBelgium
| | - Kasper Favere
- IBiTech – bioMMedaDepartment of Electronics and Information SystemsGhent UniversityGentBelgium
| | | | - Tim Vandecasteele
- Department of MorphologyFaculty of Veterinary MedicineGhent UniversityGentBelgium
| | - Tim Johann
- Interdisciplinary Centre for Bioinformatics (IZBI)University of LeipzigLeipzigGermany
- LJLLINRIA Paris & Sorbonne Universités UPMC Univ Paris 6ParisFrance
| | - Luc Van Hoorebeke
- Centre for X‐Ray TomographyDepartment of Physics and AstronomyGhent UniversityGentBelgium
| | - Diethard Monbaliu
- Department of Microbiology and ImmunologyKU LeuvenLeuvenBelgium
- Department of Abdominal Transplant SurgeryUniversity Hospitals LeuvenLeuvenBelgium
| | - Dirk Drasdo
- Interdisciplinary Centre for Bioinformatics (IZBI)University of LeipzigLeipzigGermany
- LJLLINRIA Paris & Sorbonne Universités UPMC Univ Paris 6ParisFrance
- Leibniz Research Centre for Working Environment and Human Factors at the Technical University DortmundDortmundGermany
| | - Stefan Hoehme
- Interdisciplinary Centre for Bioinformatics (IZBI)University of LeipzigLeipzigGermany
- Institute of Computer ScienceUniversity of LeipzigLeipzigGermany
| | - Wim Laleman
- Department of Clinical and Experimental MedicineKU LeuvenLeuvenBelgium
- Department of Gastroenterology and HepatologyUniversity Hospitals LeuvenLeuvenBelgium
| | - Patrick Segers
- IBiTech – bioMMedaDepartment of Electronics and Information SystemsGhent UniversityGentBelgium
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15
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Peeters G, Debbaut C, Laleman W, Monbaliu D, Vander Elst I, Detrez JR, Vandecasteele T, De Schryver T, Van Hoorebeke L, Favere K, Verbeke J, Segers P, Cornillie P, De Vos WH. A multilevel framework to reconstruct anatomical 3D models of the hepatic vasculature in rat livers. J Anat 2016; 230:471-483. [PMID: 27995631 DOI: 10.1111/joa.12567] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 12/21/2022] Open
Abstract
The intricate (micro)vascular architecture of the liver has not yet been fully unravelled. Although current models are often idealized simplifications of the complex anatomical reality, correct morphological information is instrumental for scientific and clinical purposes. Previously, both vascular corrosion casting (VCC) and immunohistochemistry (IHC) have been separately used to study the hepatic vasculature. Nevertheless, these techniques still face a number of challenges such as dual casting in VCC and limited imaging depths for IHC. We have optimized both techniques and combined their complementary strengths to develop a framework for multilevel reconstruction of the hepatic circulation in the rat. The VCC and micro-CT scanning protocol was improved by enabling dual casting, optimizing the contrast agent concentration, and adjusting the viscosity of the resin (PU4ii). IHC was improved with an optimized clearing technique (CUBIC) that extended the imaging depth for confocal microscopy more than five-fold. Using in-house developed software (DeLiver), the vascular network - in both VCC and IHC datasets - was automatically segmented and/or morphologically analysed. Our methodological framework allows 3D reconstruction and quantification of the hepatic circulation, ranging from the major blood vessels down to the intertwined and interconnected sinusoids. We believe that the presented framework will have value beyond studies of the liver, and will facilitate a better understanding of various parenchymal organs in general, in physiological and pathological circumstances.
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Affiliation(s)
- Geert Peeters
- IBiTech - bioMMeda, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Charlotte Debbaut
- IBiTech - bioMMeda, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Wim Laleman
- Gastroenterology & Hepatology, University Hospitals Leuven, Leuven, Belgium.,Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
| | - Diethard Monbaliu
- Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Ingrid Vander Elst
- Gastroenterology & Hepatology, University Hospitals Leuven, Leuven, Belgium.,Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
| | - Jan R Detrez
- Laboratory of Cell Biology and Histology, Department of Veterinary Sciences, University of Antwerp, Antwerp, Belgium
| | - Tim Vandecasteele
- Department of Morphology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Thomas De Schryver
- Center for X-Ray Tomography, Department of Physics and Astronomy, Ghent University, Ghent, Belgium
| | - Luc Van Hoorebeke
- Center for X-Ray Tomography, Department of Physics and Astronomy, Ghent University, Ghent, Belgium
| | - Kasper Favere
- IBiTech - bioMMeda, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Jonas Verbeke
- IBiTech - bioMMeda, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Patrick Segers
- IBiTech - bioMMeda, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Pieter Cornillie
- Department of Morphology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Winnok H De Vos
- Laboratory of Cell Biology and Histology, Department of Veterinary Sciences, University of Antwerp, Antwerp, Belgium.,Cell Systems and Imaging, Department of Molecular Biotechnology, University of Ghent, Ghent, Belgium
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