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Eildermann K, Durashov M, Kuschnerus K, Poppe A, Weixler V, Photiadis J, Sigler M, Murin P. Tissue-engineered and autologous pericardium in congenital heart surgery: comparative histopathological study of human vascular explants. Eur J Cardiothorac Surg 2024; 65:ezae027. [PMID: 38290761 PMCID: PMC10924714 DOI: 10.1093/ejcts/ezae027] [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: 09/20/2023] [Revised: 01/06/2024] [Accepted: 01/26/2024] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVES The goal of this histological study was to assess the biocompatibility of vascular patches used in the repair of congenital heart defects. METHODS We examined tissue-engineered bovine (n = 7) and equine (n = 7) patches and autologous human pericardium (n = 7), all explanted due to functional issues or follow-up procedures. Techniques like Movat-Verhoeff, von Kossa and immunohistochemical staining were used to analyse tissue composition, detect calcifications and identify immune cells. A semi-quantitative scoring system was implemented to evaluate the biocompatibility aspects, thrombus formation, extent of pannus, inflammation of pannus, cellular response to patch material, patch degradation, calcification and neoadventitial inflammation. RESULTS We observed distinct material degradation patterns among types of patches. Bovine patches showed collagen disintegration and exudate accumulation, whereas equine patches displayed edematous swelling and material dissolution. Biocompatibility scores were lower in terms of cellular response, degradation and overall score for human autologous pericardial patches compared to tissue-engineered types. The extent of pannus formation was not influenced by the type of patch. Bovine patches had notable calcifications causing tissue hardening, and foreign body giant cells were more frequently seen in equine patches. Plasma cells were frequently detected in the neointimal tissue of engineered patches. CONCLUSIONS Our results confirm the superior biocompatibility of human autologous patches and highlight discernible variations in the changes of patch material and the cellular response to patch material between bovine and equine patches. Our approach implements the semi-quantitative scoring of various aspects of biocompatibility, facilitating a comparative quantitative analysis across all types of patches, despite their inherent differences.
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Affiliation(s)
- Katja Eildermann
- Department of Pediatric Cardiology and Intensive Care Medicine, Georg-August University Göttingen, Göttingen, Germany
| | - Maksim Durashov
- Department of Pediatric Cardiology and Intensive Care Medicine, Georg-August University Göttingen, Göttingen, Germany
| | - Kira Kuschnerus
- Department of Congenital Heart Surgery—Pediatric Heart Surgery, Deutsches Herzzentrum der Charité, Berlin, Germany
| | - Andrea Poppe
- Department of Pediatric Cardiology and Intensive Care Medicine, Georg-August University Göttingen, Göttingen, Germany
| | - Viktoria Weixler
- Department of Congenital Heart Surgery—Pediatric Heart Surgery, Deutsches Herzzentrum der Charité, Berlin, Germany
| | - Joachim Photiadis
- Department of Congenital Heart Surgery—Pediatric Heart Surgery, Deutsches Herzzentrum der Charité, Berlin, Germany
| | - Matthias Sigler
- Department of Pediatric Cardiology and Intensive Care Medicine, Georg-August University Göttingen, Göttingen, Germany
| | - Peter Murin
- Department of Congenital Heart Surgery—Pediatric Heart Surgery, Deutsches Herzzentrum der Charité, Berlin, Germany
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Kuschnerus K, Starck C, Potapov E, Cho MY. Bridge to recovery using an Impella 2.5 device in a 3-year-old child. Eur J Cardiothorac Surg 2023; 63:7142556. [PMID: 37097902 DOI: 10.1093/ejcts/ezad157] [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] [Received: 01/02/2023] [Revised: 04/03/2023] [Accepted: 04/24/2023] [Indexed: 04/26/2023] Open
Abstract
Mechanical support options for children and small adolescents with acute left ventricular failure are often limited to ECLS and subsequent left ventricular assist device (LVAD) implantation. We report a case of a 3-year-old child weighing 12 kg with acute humoral rejection after cardiac transplantation not adequately responding to medical therapy who presented in persistent low cardiac output syndrome. We successfully stabilized the patient by implanting a Impella 2.5 device via a 6 mm Hemashield prosthesis on the right axillary artery. The patient was bridged to recovery.
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Affiliation(s)
- Kira Kuschnerus
- Department of Congenital Heart Surgery-Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Christoph Starck
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| | - Evgenij Potapov
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| | - Mi-Young Cho
- Department of Congenital Heart Surgery-Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany
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Weixler VHM, Kuschnerus K, Romanchenko O, Ovroutski S, Cho MY, Berger F, Sigler M, Sinzobahamvya N, Photiadis J, Murin P. Mid-term performance of decellularized equine pericardium in congenital heart surgery. Interact Cardiovasc Thorac Surg 2022:ivac269. [PMID: 36342192 DOI: 10.1093/icvts/ivac269] [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: 09/19/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE The aim was to report mid-term performance of decellularized equine pericardium used for repair of various congenital heart defects in the pediatric population. METHODS A retrospective review of all patients undergoing patch implantation between 2016 - 2020 was performed. Patch quality, surgical handling, hemostasis and early patch-related complications were studied on all patients. Mid-term performance was observed in patients with ≥12 months follow-up and intact patch at discharge (without reoperation/stent implantation). RESULTS A total of 201 patients with median age of 2.5 years [interquartile range (IQR): 0.6-6.5] underwent 207 procedures at 314 implant locations. The patch was used in following numbers/locations: 171 for pulmonary artery (PA) augmentation, 36 for aortic repair, 35 for septal defect closure, 22 for valvular repair and 50 at other locations. Early/30-day mortality was 6.5%. Early patch-related reoperations/stent implantations occurred in 28 locations (8.9%). No patch-related complications were noted except for bleeding from implant site in three locations (1%). Follow-up ≥ 12 months was available for 132 patients/200 locations. During a median follow-up of 29.7 months [IQR: 20.7-38.3], 53 patch-related reoperations/catheter reinterventions occurred (26.5%) with the majority in PA position (88.7%, 47/53). Overall 12- and 24-months freedom from patch-related reoperation/catheter reintervention per location was 91.5% (95% CI: 86.7%-94.6%) and 85.2% (95% CI: 78.9%-89.6%) respectively. CONCLUSION Decellularized equine pericardium used for repair of various congenital heart defects showed acceptable mid-term performance. Reoperation/reintervention rates were in a range as observed with other xenogeneic materials previously reported articles, occurring most frequently after PA augmentation.
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Affiliation(s)
- Viktoria H M Weixler
- Department of Congenital Heart Surgery - Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany
| | - Kira Kuschnerus
- Department of Congenital Heart Surgery - Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany
| | - Olga Romanchenko
- Department of Congenital Heart Surgery - Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany
| | - Stanislav Ovroutski
- Department of Congenital Heart Disease - Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany
| | - Mi-Young Cho
- Department of Congenital Heart Surgery - Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany
| | - Felix Berger
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany
- Department of Congenital Heart Disease - Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany
| | - Matthias Sigler
- Department of Pediatric Cardiology and Intensive Care Medicine, Georg-August University Göttingen, Göttingen, Germany
| | - Nicodème Sinzobahamvya
- Department of Congenital Heart Surgery - Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany
| | - Joachim Photiadis
- Department of Congenital Heart Surgery - Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany
| | - Peter Murin
- Department of Congenital Heart Surgery - Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany
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Giral H, Franke V, Moobed M, Müller MF, Lübking L, James DM, Hartung J, Kuschnerus K, Meteva D, Seppelt C, Jakob P, Klingenberg R, Kränkel N, Leistner D, Zeller T, Blankenberg S, Zimmermann F, Haghikia A, Lüscher TF, Akalin A, Landmesser U, Kratzer A. Rapid Inflammasome Activation Is Attenuated in Post-Myocardial Infarction Monocytes. Front Immunol 2022; 13:857455. [PMID: 35558073 PMCID: PMC9090500 DOI: 10.3389/fimmu.2022.857455] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/28/2022] [Indexed: 12/02/2022] Open
Abstract
Inflammasomes are crucial gatekeepers of the immune response, but their maladaptive activation associates with inflammatory pathologies. Besides canonical activation, monocytes can trigger non-transcriptional or rapid inflammasome activation that has not been well defined in the context of acute myocardial infarction (AMI). Rapid transcription-independent inflammasome activation induced by simultaneous TLR priming and triggering stimulus was measured by caspase-1 (CASP1) activity and interleukin release. Both classical and intermediate monocytes from healthy donors exhibited robust CASP1 activation, but only classical monocytes produced high mature interleukin-18 (IL18) release. We also recruited a limited number of coronary artery disease (CAD, n=31) and AMI (n=29) patients to evaluate their inflammasome function and expression profiles. Surprisingly, monocyte subpopulations isolated from blood collected during percutaneous coronary intervention (PCI) from AMI patients presented diminished CASP1 activity and abrogated IL18 release despite increased NLRP3 gene expression. This unexpected attenuated rapid inflammasome activation was accompanied by a significant increase of TNFAIP3 and IRAKM expression. Moreover, TNFAIP3 protein levels of circulating monocytes showed positive correlation with high sensitive troponin T (hsTnT), implying an association between TNFAIP3 upregulation and the severity of tissue injury. We suggest this monocyte attenuation to be a protective phenotype aftermath following a very early inflammatory wave in the ischemic area. Damage-associated molecular patterns (DAMPs) or other signals trigger a transitory negative feedback loop within newly recruited circulating monocytes as a mechanism to reduce post-injury tissue damage.
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Affiliation(s)
- Hector Giral
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Vedran Franke
- Max Delbrück Center, The Berlin Institute for Medical Systems Biology, Berlin, Germany
| | - Minoo Moobed
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Maja F Müller
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Laura Lübking
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Divya Maria James
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Johannes Hartung
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Kira Kuschnerus
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Denitsa Meteva
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Claudio Seppelt
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Philipp Jakob
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.,Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Roland Klingenberg
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Nicolle Kränkel
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - David Leistner
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tanja Zeller
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg, Lübeck, Kiel, Hamburg, Germany
| | - Stefan Blankenberg
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg, Lübeck, Kiel, Hamburg, Germany
| | - Friederike Zimmermann
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Arash Haghikia
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Thomas F Lüscher
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Altuna Akalin
- Max Delbrück Center, The Berlin Institute for Medical Systems Biology, Berlin, Germany
| | - Ulf Landmesser
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Adelheid Kratzer
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
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Murin P, Kuschnerus K, Eildermann K, Nordmeyer S, Weixler V, Mi-Young C, Photiadis J, Sigler M. Histological Analysis of Decellularized Equine Pericardium after Repair of Congenital Heart Defects. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742899] [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] [Indexed: 10/19/2022]
Affiliation(s)
- P. Murin
- Deutsches Herzzentrum Berlin, Klinik für Chirurgie Angeborener Herzfehler - Kinderherzchirurgie, Berlin, Deutschland
| | - K. Kuschnerus
- Deutsches Herzzentrum Berlin Klinik für Chirurgie Angeborener Herzfehler - Kinderherzchirurgie, Berlin, Deutschland
| | - K. Eildermann
- Pediatric Cardiology and Intensive Care Medicine, Georg-August University Göttingen, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - S. Nordmeyer
- Institute for Cardiovascular Computer-assisted Medicine, Berlin, Deutschland
| | - V. Weixler
- Deutsches Herzzentrum Berlin, Klinik für Chirurgie Angeborener Herzfehler - Kinderherzchirurgie, Berlin, Deutschland
| | - C. Mi-Young
- Deutsches Herzzentrum Berlin, Klinik für Chirurgie Angeborener Herzfehler - Kinderherzchirurgie, Berlin, Deutschland
| | - J. Photiadis
- Deutsches Herzzentrum Berlin, Klinik für Chirurgie Angeborener Herzfehler - Kinderherzchirurgie, Berlin, Deutschland
| | - M. Sigler
- Pediatric Cardiology and Intensive Care Medicine, Georg-August University Göttingen, Göttingen, Deutschland
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Weixler V, Kuschnerus K, Romanchenko O, Schleiger A, Nordmeyer J, Mi-Young C, Photiadis J, Murin P. Decellularized Equine Pericardium in Congenital Heart Surgery: Midterm Results. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742864] [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] [Indexed: 10/19/2022]
Affiliation(s)
- V. Weixler
- German Heart Institute Berlin, Berlin, Deutschland
| | | | - O. Romanchenko
- Congenital Heart Surgery, German Heart Institute Berlin, Berlin, Deutschland
| | | | - J. Nordmeyer
- German Heart Institute Berlin, Berlin, Deutschland
| | - C. Mi-Young
- German Heart Institute Berlin, Berlin, Deutschland
| | | | - P. Murin
- Augustenburger Platz 1, Berlin, Deutschland
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Murin P, Kuschnerus K, Mi-Young C, Photiadis J. Decellularized Fresh Pulmonary Homografts for Pulmonary Valve Replacement in Ross Patients: A Promising Solution for the Double-Valve Problem in Adolescents and Young Adults. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742862] [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] [Indexed: 10/19/2022]
Affiliation(s)
- P. Murin
- Augustenburger Platz 1, Berlin, Deutschland
| | - K. Kuschnerus
- Deutsches Herzzentrum Berlin Klinik für Chirurgie Angeborener Herzfehler - Kinderherzchirurgie, Berlin, Deutschland
| | - C. Mi-Young
- Deutsches Herzzentrum Berlin, Klinik für Chirurgie Angeborener Herzfehler - Kinderherzchirurgie, Berlin, Deutschland
| | - J. Photiadis
- Deutsches Herzzentrum Berlin, Klinik für Chirurgie Angeborener Herzfehler - Kinderherzchirurgie, Berlin, Deutschland
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Murin P, Weixler VHM, Kuschnerus K, Romanchenko O, Lorenzen V, Nordmeyer J, Cho MY, Sigler M, Photiadis J. Pulmonary artery augmentation using decellularized equine pericardium (Matrix Patch™): initial single-centre experience. Eur J Cardiothorac Surg 2021; 60:1094-1101. [PMID: 34270732 DOI: 10.1093/ejcts/ezab183] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/31/2021] [Accepted: 03/09/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The aim of this study was to report our initial experience when using Matrix Patch™ a cell-free equine-derived pericardium for the augmentation of branch pulmonary arteries (PAs) in children. METHODS Between September 2016 and September 2019, Matrix Patch was used for the augmentation of branch PAs in 96 patients and implanted in 147 separate locations. The median age at implantation was 3.2 years (interquartile range: 0.9-8.4), and 33% of patients were infants. The patch was used mainly in redo surgeries (89.6%). Intra-procedural feasibility and reinterventions were analysed. Primary end points were death or patch-related reoperation/stent implantation. Explanted patches were stained for recellularization/calcification, or to reveal proliferation/inflammation. RESULTS A total of 81 patients, who received patches in 119 separate locations, were followed within a median of 20 months (interquartile range: 10.2-30.2). Patients with early reoperation/stent implantation were excluded from follow-up. No patch-related death was noted. Survival at last follow-up was 88% (95% CI: 78.8-93.7%). Overall probability of freedom from reoperation/stent implantation per location, 12 and 24 months after initial surgery was 85.8% (95% CI: 76.2-91.7%) and 78.7 (95% CI: 65.9-87.2%), respectively. At 20 months, superficial proliferation with discrete macrophage activity was seen in explants; however, no signs of calcification are observed. CONCLUSIONS The initial experience with the Matrix Patch in PAs showed comparable results to other xenogeneic patch materials. Long-term follow-up data are needed to prove the desired durability of the patch in different locations.
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Affiliation(s)
- Peter Murin
- Department of Congenital Heart Surgery-Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany
| | - Viktoria H M Weixler
- Department of Congenital Heart Surgery-Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany
| | - Kira Kuschnerus
- Department of Congenital Heart Surgery-Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany
| | - Olga Romanchenko
- Department of Congenital Heart Surgery-Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany
| | - Victoria Lorenzen
- Department of Congenital Heart Disease-Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany
| | - Johannes Nordmeyer
- Department of Congenital Heart Disease-Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany
| | - Mi-Young Cho
- Department of Congenital Heart Surgery-Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany
| | - Matthias Sigler
- Department of Pediatric Cardiology and Intensive Care Medicine, Georg-August University Göttingen, Göttingen, Germany
| | - Joachim Photiadis
- Department of Congenital Heart Surgery-Pediatric Heart Surgery, German Heart Center Berlin, Berlin, Germany
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Kuschnerus K, Straessler ET, Müller MF, Lüscher TF, Landmesser U, Kränkel N. Increased Expression of miR-483-3p Impairs the Vascular Response to Injury in Type 2 Diabetes. Diabetes 2019; 68:349-360. [PMID: 30257976 DOI: 10.2337/db18-0084] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 09/13/2018] [Indexed: 11/13/2022]
Abstract
Aggravated endothelial injury and impaired endothelial repair capacity contribute to the high cardiovascular risk in patients with type 2 diabetes (T2D), but the underlying mechanisms are still incompletely understood. Here we describe the functional role of a mature form of miRNA (miR) 483-3p, which limits endothelial repair capacity in patients with T2D. Expression of human (hsa)-miR-483-3p was higher in endothelial-supportive M2-type macrophages (M2MΦs) and in the aortic wall of patients with T2D than in control subjects without diabetes. Likewise, the murine (mmu)-miR-483* was higher in T2D than in nondiabetic murine carotid samples. Overexpression of miR-483-3p increased endothelial and macrophage apoptosis and impaired reendothelialization in vitro. The inhibition of hsa-miR-483-3p in human T2D M2MΦs transplanted to athymic nude mice (NMRI-Foxn1ν/Foxn1ν ) or systemic inhibition of mmu-miR-483* in B6.BKS(D)-Leprdb /J diabetic mice rescued diabetes-associated impairment of reendothelialization in the murine carotid-injury model. We identified the endothelial transcription factor vascular endothelial zinc finger 1 (VEZF1) as a direct target of miR-483-3p. VEZF1 expression was reduced in aortae of diabetic mice and upregulated in diabetic murine aortae upon systemic inhibition of mmu-483*. The miRNA miR-483-3p is a critical regulator of endothelial integrity in patients with T2D and may represent a therapeutic target to rescue endothelial regeneration after injury in patients with T2D.
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Affiliation(s)
- Kira Kuschnerus
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Elisabeth T Straessler
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Maja F Müller
- University Hospital Zurich, Department of Cardiology, Zürich, Switzerland
| | - Thomas F Lüscher
- University Hospital Zurich, Department of Cardiology, Zürich, Switzerland
- Center of Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Ulf Landmesser
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- University Hospital Zurich, Department of Cardiology, Zürich, Switzerland
- Center of Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Nicolle Kränkel
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Center of Molecular Cardiology, University of Zurich, Zurich, Switzerland
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Kratzer A, Giral H, Franke V, Kraenkel N, Mueller M, Moobed M, Kuschnerus K, Jakob P, Luescher T, Akalin A, Landmesser U. P6269Next-generation-sequencing reveals diverse inflammasome components within monocyte subpopulations: differential activation in healthy subjects and patients with acute coronary syndrome. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lupieri A, Brenner C, Garcia R, Smirnova NF, Malet NF, Arnal JF, Martinez LO, Wymann M, Hirsch E, Gayral S, Laffargue M, Remm F, Kuschnerus K, Kraenkel N, Landmesser U, Franz WM, Tascon V, Villar AV, Ruiz L, Hurle MA, Nistal JF. Vascular Remodeling in Cardiovascular Disease231Absence of PI3Kg leads to increased reendothelialization in mice through modulation of IP-10 secretion.232DPP4 inhibition mediates vascular protection in acute and chronic vascular injury233Effects of transforming growth factor beta signalling on smooth muscle cell phenotype in the angiotensin II-induced abdominal aortic aneurysm model. Cardiovasc Res 2016. [DOI: 10.1093/cvr/cvw137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
Impaired functions of vascular cells are responsible for the majority of complications in patients with type 2 diabetes (T2D). Recently a better understanding of mechanisms contributing to development of vascular dysfunction and the role of systemic inflammatory activation and functional alterations of several secretory organs, of which adipose tissue has more recently been investigated, has been achieved. Notably, the progression of vascular disease within the context of T2D appears to be driven by a multitude of incremental signaling shifts. Hence, successful therapies need to target several mechanisms in parallel, and over a long time period. This review will summarize the latest molecular strategies and translational developments of cardiovascular therapy in patients with T2D.
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Affiliation(s)
- Kira Kuschnerus
- Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Medizinische Klinik für Kardiologie, Berlin, Germany
| | - Ulf Landmesser
- Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Medizinische Klinik für Kardiologie, Berlin, Germany
| | - Nicolle Kränkel
- Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Medizinische Klinik für Kardiologie, Berlin, Germany
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Brenner C, Franz WM, Kühlenthal S, Kuschnerus K, Remm F, Gross L, Theiss HD, Landmesser U, Kränkel N. DPP-4 inhibition ameliorates atherosclerosis by priming monocytes into M2 macrophages. Int J Cardiol 2015. [PMID: 26197403 DOI: 10.1016/j.ijcard.2015.07.044] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Glipitins are widely used for the treatment of type 2 diabetic patients. In addition to their improvement of glycemic control, animal studies have suggested an independent anti-atherosclerotic effect of gliptins. Nevertheless, recent clinical trials regarding long-term effects of gliptin therapy on vascular events have been disappointing. This discrepancy led us to better dissect the functional role of SDF-1/CXCR4 signaling as a potential mechanism underlying gliptin action. The study should give improved understanding of the potential of gliptin therapy in the prevention and treatment of atherosclerosis. METHODS AND RESULTS In an ApoE-/- mouse model on high cholesterol diet, long-term treatment with the DPP-4 inhibitor Sitagliptin significantly reduced atherosclerosic plaque load in the aorta. Flow cytometry analyses showed an enrichment of M2 macrophages in the aortic wall under gliptin therapy. Importantly, the number of recruited CD206+ macrophages was inversely correlated with total plaque area while no correlation was found for the overall macrophage population or M1 macrophages. Blockade of CXCR4/SDF-1 signaling by AMD3100 inhibited aortic M2 accumulation and the therapeutic effect of Sitagliptin. Correspondingly, Sitagliptin shifted the polarization profile of macrophages towards a M2-like phenotype. CONCLUSION Sitagliptin-mediated inhibition of early atherosclerosis is based on M2-polarization during monocyte differentiation via the SDF-1/CXCR4 signaling. In contrast to earlier assumptions gliptin treatment might be especially effective in prevention of atherosclerosis.
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Affiliation(s)
- C Brenner
- Department of Internal Medicine III, Medical University of Innsbruck, Innsbruck, Austria; Department of Internal Medicine I, University of Munich, Munich, Germany.
| | - W M Franz
- Department of Internal Medicine III, Medical University of Innsbruck, Innsbruck, Austria
| | - S Kühlenthal
- Department of Internal Medicine I, University of Munich, Munich, Germany
| | - K Kuschnerus
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland; Department of Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - F Remm
- Department of Internal Medicine III, Medical University of Innsbruck, Innsbruck, Austria; Department of Internal Medicine I, University of Munich, Munich, Germany
| | - L Gross
- Department of Internal Medicine I, University of Munich, Munich, Germany
| | - H D Theiss
- Department of Internal Medicine I, University of Munich, Munich, Germany
| | - U Landmesser
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland; Department of Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - N Kränkel
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland; Department of Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
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Kraenkel N, Kuschnerus K, Briand S, Luescher TF, Landmesser U. miR-483 impairs endothelial homeostasis and response to vascular injury: upregulation by high-glucose and in patients with type-2 diabetes. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Speer T, Rohrer L, Blyszczuk P, Shroff R, Kuschnerus K, Kränkel N, Kania G, Zewinger S, Akhmedov A, Shi Y, Martin T, Perisa D, Winnik S, Müller MF, Sester U, Wernicke G, Jung A, Gutteck U, Eriksson U, Geisel J, Deanfield J, von Eckardstein A, Lüscher TF, Fliser D, Bahlmann FH, Landmesser U. Abnormal high-density lipoprotein induces endothelial dysfunction via activation of Toll-like receptor-2. Immunity 2013; 38:754-68. [PMID: 23477738 DOI: 10.1016/j.immuni.2013.02.009] [Citation(s) in RCA: 230] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 02/11/2013] [Indexed: 01/06/2023]
Abstract
Endothelial injury and dysfunction (ED) represent a link between cardiovascular risk factors promoting hypertension and atherosclerosis, the leading cause of death in Western populations. High-density lipoprotein (HDL) is considered antiatherogenic and known to prevent ED. Using HDL from children and adults with chronic kidney dysfunction (HDL(CKD)), a population with high cardiovascular risk, we have demonstrated that HDL(CKD) in contrast to HDL(Healthy) promoted endothelial superoxide production, substantially reduced nitric oxide (NO) bioavailability, and subsequently increased arterial blood pressure (ABP). We have identified symmetric dimethylarginine (SDMA) in HDL(CKD) that causes transformation from physiological HDL into an abnormal lipoprotein inducing ED. Furthermore, we report that HDL(CKD) reduced endothelial NO availability via toll-like receptor-2 (TLR-2), leading to impaired endothelial repair, increased proinflammatory activation, and ABP. These data demonstrate how SDMA can modify the HDL particle to mimic a damage-associated molecular pattern that activates TLR-2 via a TLR-1- or TLR-6-coreceptor-independent pathway, linking abnormal HDL to innate immunity, ED, and hypertension.
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Affiliation(s)
- Thimoteus Speer
- Cardiovascular Center, Cardiology, University Hospital Zurich and Cardiovascular Research, Institute of Physiology, University of Zurich, Zurich, Switzerland.
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Kränkel N, Kuschnerus K, Müller M, Speer T, Mocharla P, Madeddu P, Bader M, Lüscher TF, Landmesser U. Novel insights into the critical role of bradykinin and the kinin B2 receptor for vascular recruitment of circulating endothelial repair-promoting mononuclear cell subsets: alterations in patients with coronary disease. Circulation 2012; 127:594-603. [PMID: 23275384 DOI: 10.1161/circulationaha.112.118117] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [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: 01/28/2023]
Abstract
BACKGROUND Endothelial injury is considered critical for progression of atherosclerosis and its complications in coronary artery disease (CAD). The endothelial-supportive effects of bradykinin have mainly been attributed to activation of the resident endothelium. Here we newly investigate the role of bradykinin and its B2 receptor for the recruitment and functional activation of circulating mononuclear cell subsets with endothelial-repair promoting capacity, such as CD34(+)CXCR4(+)cells, at sites of arterial injury. METHODS AND RESULTS Bradykinin-B2-receptor (B2R) blockade by icatibant substantially impaired recruitment of circulating CD34(+)CXCR4(+) mononuclear cells (expressing high levels of B2R) to endothelial cells in vitro and to injured arterial wall in vivo, whereas recruitment of CD14(hi) monocytes (expressing low levels of B2R) was unchanged. Moreover, the capacity of genetically B2R-deficient bone marrow cells to promote endothelial repair in vivo was markedly impaired as compared with wild-type bone marrow cells. B2R expression was reduced on CD34(+)CXCR4(+)mononuclear cells and endothelial repair-promoting early outgrowth cells, but not on CD14(hi)monocytes, from CAD patients as compared with healthy subjects. B2R stimulation induced CD18 activation in early outgrowth cells of healthy subjects, but not in early outgrowth cells of CAD patients. Adenoviral B2R overexpression enhanced in vivo vascular recruitment and rescued impaired endothelial repair capacity of early outgrowth cells from CAD patients. CONCLUSIONS We newly report that bradykinin/B2R signaling may promote endothelial repair after arterial injury by selective recruitment and functional activation of B2R-expressing circulating mononuclear cell subsets. In CAD patients, B2R downregulation on endothelial repair-promoting circulating mononuclear cells substantially impairs the bradykinin-dependent endothelial repair, representing a novel mechanism promoting endothelial injury in CAD patients.
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Affiliation(s)
- Nicolle Kränkel
- Department of Cardiology, University Hospital Zürich, Zürich,
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Grzegorzewska AE, Niepolski L, Sikora J, Jagodzinski PP, Pajzderski D, Speer T, Rohrer L, Krankel N, Kuschnerus K, Stephen Z, Akhmedov A, Shi Y, Jung A, Wernicke G, Von Eckardstein A, Luscher TF, Fliser D, Landmesser U, Bahlmann F, Robinson B, Robinson B, Karaboyas A, Combe C, Gallagher M, De Sequera P, Yamamoto H, Morgenstern H, Schaubel D, Goodkin D, Levin N, Saran R, Port F, Goldstein B, Winkelmayer W, Assimes T, Drechsler C, Ritz E, Tomaschitz A, Pilz S, Schonfeld S, Blouin K, Bidlingmaier M, Hammer F, Krane V, Marz W, Allolio B, Fassnacht M, Wanner C, Nishimura M, Okamoto Y, Tokoro T, Nishida M, Sato N, Hashimoto T, Iwamoto N, Ono T. Cardiovascular complications in CKD 5d. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ocak G, van Stralen K, Verduijn M, Dekker F, Jager K, Liabeuf S, Schiffer E, Lacroix C, Temmar M, Renard C, Monsarrat B, Choukroun G, Lemke HD, Vanholder R, Mischak H, Massy Z, Fenske W, Wanner C, Allolio B, Drechsler C, Blouin K, Lilienthal J, Krane V, Usvyat L, Raimann JG, Thijssen S, Kotanko P, Levin NW, Roman-Garcia P, Carrillo-Lopez N, Panizo S, Rodriguez-Garcia I, Fernandez-Martin JL, Naves-Diaz M, Cannata-Andia JB, Speer T, Rohrer L, Krankel N, Shi Y, Akhmedov A, Kuschnerus K, Wernicke G, Jung A, von Eckardstein A, Luscher T, Fliser D, Landmesser U, Bahlmann F. Dialysis / Cardiovascular complications. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kränkel N, Kuschnerus K, Madeddu P, Lüscher TF, Landmesser U. A novel flow cytometry-based assay to study leukocyte-endothelial cell interactions in vitro. Cytometry A 2011; 79:256-62. [DOI: 10.1002/cyto.a.21043] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 02/01/2011] [Accepted: 02/13/2011] [Indexed: 12/26/2022]
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