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Mesquita T, Lin YN, Chen S, Lee Y, Miguel-dos-Santos R, Atici AE, Fishbein MC, Rivas MN, Arditi M, Cingolani E. Inhibition of IL-1 Ameliorates Cardiac Dysfunction and Arrhythmias in a Murine Model of Kawasaki Disease. Arterioscler Thromb Vasc Biol 2024; 44:e117-e130. [PMID: 38385289 PMCID: PMC10978283 DOI: 10.1161/atvbaha.123.320382] [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] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/09/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Kawasaki disease (KD) is an acute febrile illness and systemic vasculitis often associated with cardiac sequelae, including arrhythmias. Abundant evidence indicates a central role for IL (interleukin)-1 and TNFα (tumor necrosis factor-alpha) signaling in the formation of arterial lesions in KD. We aimed to investigate the mechanisms underlying the development of electrophysiological abnormalities in a murine model of KD vasculitis. METHODS Lactobacillus casei cell wall extract-induced KD vasculitis model was used to investigate the therapeutic efficacy of clinically relevant IL-1Ra (IL-1 receptor antagonist) and TNFα neutralization. Echocardiography, in vivo electrophysiology, whole-heart optical mapping, and imaging were performed. RESULTS KD vasculitis was associated with impaired ejection fraction, increased ventricular tachycardia, prolonged repolarization, and slowed conduction velocity. Since our transcriptomic analysis of human patients showed elevated levels of both IL-1β and TNFα, we asked whether either cytokine was linked to the development of myocardial dysfunction. Remarkably, only inhibition of IL-1 signaling by IL-1Ra but not TNFα neutralization was able to prevent changes in ejection fraction and arrhythmias, whereas both IL-1Ra and TNFα neutralization significantly improved vasculitis and heart vessel inflammation. The treatment of L casei cell wall extract-injected mice with IL-1Ra also restored conduction velocity and improved the organization of Cx43 (connexin 43) at the intercalated disk. In contrast, in mice with gain of function of the IL-1 signaling pathway, L casei cell wall extract induced spontaneous ventricular tachycardia and premature deaths. CONCLUSIONS Our results characterize the electrophysiological abnormalities associated with L casei cell wall extract-induced KD and show that IL-1Ra is more effective in preventing KD-induced myocardial dysfunction and arrhythmias than anti-TNFα therapy. These findings support the advancement of clinical trials using IL-1Ra in patients with KD.
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Affiliation(s)
- Thassio Mesquita
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Yen-Nien Lin
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Shuang Chen
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Guerin Children’s at Cedars-Sinai Medical Center, Los Angeles, California, USA
- Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Youngho Lee
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Guerin Children’s at Cedars-Sinai Medical Center, Los Angeles, California, USA
- Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | | | - Asli E. Atici
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Guerin Children’s at Cedars-Sinai Medical Center, Los Angeles, California, USA
- Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Michael C. Fishbein
- Department of Pathology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Magali Noval Rivas
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Guerin Children’s at Cedars-Sinai Medical Center, Los Angeles, California, USA
- Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Moshe Arditi
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Guerin Children’s at Cedars-Sinai Medical Center, Los Angeles, California, USA
- Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Eugenio Cingolani
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Wu MY, Lee AS, Lin YN, Chung WH, Chen KW, Lu CR, Chen YF, Chang CM, Tsai WC, Shiao YT, Chen CH, Chang KC. Role of low-density lipoprotein electronegativity and sexual dimorphism in contributing early ventricular tachyarrhythmias following ST-elevation myocardial infarction. Front Cardiovasc Med 2024; 11:1285068. [PMID: 38500756 PMCID: PMC10944913 DOI: 10.3389/fcvm.2024.1285068] [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: 08/29/2023] [Accepted: 02/09/2024] [Indexed: 03/20/2024] Open
Abstract
Background Early ventricular tachycardia/fibrillation (VT/VF) in patients with ST-elevation myocardial infarction (STEMI) has higher morbidity and mortality. This study examines gender-differentiated risk factors and underlying mechanisms for early onset VT/VF in STEMI. Methods We analyzed data from 2,964 consecutive STEMI patients between January 1, 2008 and December 31, 2021. Early VT/VF was defined as occurrence of spontaneous VT/VF of ≥30 s or requirement of immediate cardioversion/defibrillation within the first 48 h after symptoms. An ex vivo ischemic-reperfusion experiments were conducted in 8-week-old ApoE-/- mice fed a high-fat diet to explore the underlying mechanisms of early VT/VF. Results In 255 of out 2,964 STEMI patients who experienced early VT/VF, the age was younger (58.6 ± 13.8 vs. 61.0 ± 13.0 years old, P = 0.008) with a male predominance. The plasma levels of L5, the most electronegative subclass of low-density lipoprotein, was higher in early VT/VF patients compared to those without early VT/VF (n = 21, L5: 14.1 ± 22.6% vs. n = 46, L5: 4.3 ± 9.9%, P = 0.016). In the experimental setup, all male mice (n = 4) developed VT/VF post sham operation, whereas no such incidence was observed in the female mice (n = 3). Significantly, male mice exhibited considerably slower cardiac conduction velocity as compared to their female counterparts in whole heart preparations (25.01 ± 0.93 cm/s vs.42.32 ± 5.70 cm/s, P < 0.001), despite analogous action potential durations. Furthermore, isolated ventricular myocytes from male mice showed a distinctly lower sodium current density (-29.20 ± 3.04 pA/pF, n = 6) in comparison to female mice (-114.05 ± 6.41 pA/pF, n = 6, P < 0.001). This decreased sodium current density was paralleled by a reduced membrane expression of Nav1.5 protein (0.38 ± 0.06 vs. 0.89 ± 0.09 A.U., P < 0.001) and increased cytosolic Nav1.5 levels (0.59 ± 0.06 vs. 0.29 ± 0.04 A.U., P = 0.001) in male mice. Furthermore, it was observed that the overall expressions of sorting nexin 27 (SNX27) and vacuolar protein sorting 26 (VPS26) were significantly diminished in male mice as compared to female littermates (0.91 ± 0.15 vs. 1.70 ± 0.28, P = 0.02 and 0.74 ± 0.09 vs. 1.57 ± 0.13, P < 0.01, respectively). Conclusions Our findings reveal that male STEMI patients with early VT/VF are associated with elevated L5 levels. The gender-based discrepancy in early VT/VF predisposition might be due to compromised sodium channel trafficking, possibly linked with increased LDL electronegativity.
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Affiliation(s)
- Mei-Yao Wu
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - An-Sheng Lee
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Yen-Nien Lin
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Wei-Hsin Chung
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Ke-Wei Chen
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Chiung-Ray Lu
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yun-Fang Chen
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Chia-Ming Chang
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wei-Chung Tsai
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
- College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Tzone Shiao
- Center of Institutional Research and Development, Asia University, Taichung, Taiwan
| | - Chu-Huang Chen
- Vascular and Medicinal Research, Texas Heart Institute, Houston, TX, United States
- Institute for Biomedical Sciences, Shinshu University, Nagano, Japan
| | - Kuan-Cheng Chang
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
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Lin YK, Hsiao LC, Wu MY, Chen YF, Lin YN, Chang CM, Chung WH, Chen KW, Lu CR, Chen WY, Chang SS, Shyu WC, Lee AS, Chen CH, Jeng LB, Chang KC. PD-L1 and AKT Overexpressing Adipose-Derived Mesenchymal Stem Cells Enhance Myocardial Protection by Upregulating CD25 + T Cells in Acute Myocardial Infarction Rat Model. Int J Mol Sci 2023; 25:134. [PMID: 38203304 PMCID: PMC10779305 DOI: 10.3390/ijms25010134] [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] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
This study explores the synergistic impact of Programmed Death Ligand 1 (PD-L1) and Protein Kinase B (Akt) overexpression in adipose-derived mesenchymal stem cells (AdMSCs) for ameliorating cardiac dysfunction after myocardial infarction (MI). Post-MI adult Wistar rats were allocated into four groups: sham, MI, ADMSC treatment, and ADMSCs overexpressed with PD-L1 and Akt (AdMSC-PDL1-Akt) treatment. MI was induced via left anterior descending coronary artery ligation, followed by intramyocardial AdMSC injections. Over four weeks, cardiac functionality and structural integrity were assessed using pressure-volume analysis, infarct size measurement, and immunohistochemistry. AdMSC-PDL1-Akt exhibited enhanced resistance to reactive oxygen species (ROS) in vitro and ameliorated MI-induced contractile dysfunction in vivo by improving the end-systolic pressure-volume relationship and preload-recruitable stroke work, together with attenuating infarct size. Molecular analyses revealed substantial mitigation in caspase3 and nuclear factor-κB upregulation in MI hearts within the AdMSC-PDL1-Akt group. Mechanistically, AdMSC-PDL1-Akt fostered the differentiation of normal T cells into CD25+ regulatory T cells in vitro, aligning with in vivo upregulation of CD25 in AdMSC-PDL1-Akt-treated rats. Collectively, PD-L1 and Akt overexpression in AdMSCs bolsters resistance to ROS-mediated apoptosis in vitro and enhances myocardial protective efficacy against MI-induced dysfunction, potentially via T-cell modulation, underscoring a promising therapeutic strategy for myocardial ischemic injuries.
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Affiliation(s)
- Yu-Kai Lin
- Division of Cardiovascular Medicine, China Medical University Hospital, Taichung 404327, Taiwan (Y.-N.L.); (W.-H.C.); (K.-W.C.)
- Cardiovascular Research Laboratory, China Medical University Hospital, Taichung 404327, Taiwan; (C.-M.C.); (A.-S.L.)
- School of Medicine, China Medical University, Taichung 404328, Taiwan
| | - Lien-Cheng Hsiao
- Division of Cardiovascular Medicine, China Medical University Hospital, Taichung 404327, Taiwan (Y.-N.L.); (W.-H.C.); (K.-W.C.)
- Cardiovascular Research Laboratory, China Medical University Hospital, Taichung 404327, Taiwan; (C.-M.C.); (A.-S.L.)
- School of Medicine, China Medical University, Taichung 404328, Taiwan
| | - Mei-Yao Wu
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung 404328, Taiwan;
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404327, Taiwan
| | - Yun-Fang Chen
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan; (Y.-F.C.); (W.-Y.C.)
| | - Yen-Nien Lin
- Division of Cardiovascular Medicine, China Medical University Hospital, Taichung 404327, Taiwan (Y.-N.L.); (W.-H.C.); (K.-W.C.)
- School of Medicine, China Medical University, Taichung 404328, Taiwan
| | - Chia-Ming Chang
- Cardiovascular Research Laboratory, China Medical University Hospital, Taichung 404327, Taiwan; (C.-M.C.); (A.-S.L.)
| | - Wei-Hsin Chung
- Division of Cardiovascular Medicine, China Medical University Hospital, Taichung 404327, Taiwan (Y.-N.L.); (W.-H.C.); (K.-W.C.)
| | - Ke-Wei Chen
- Division of Cardiovascular Medicine, China Medical University Hospital, Taichung 404327, Taiwan (Y.-N.L.); (W.-H.C.); (K.-W.C.)
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404328, Taiwan;
| | - Chiung-Ray Lu
- Division of Cardiovascular Medicine, China Medical University Hospital, Taichung 404327, Taiwan (Y.-N.L.); (W.-H.C.); (K.-W.C.)
| | - Wei-Yu Chen
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan; (Y.-F.C.); (W.-Y.C.)
| | - Shih-Sheng Chang
- Division of Cardiovascular Medicine, China Medical University Hospital, Taichung 404327, Taiwan (Y.-N.L.); (W.-H.C.); (K.-W.C.)
- School of Medicine, China Medical University, Taichung 404328, Taiwan
| | - Woei-Cheang Shyu
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404328, Taiwan;
- Translational Medicine Research Center, China Medical University Hospital, Taichung 404327, Taiwan
- Neuroscience and Brain Disease Center, New Drug Development Center, China Medical University, Taichung 404328, Taiwan
- Department of Neurology, China Medical University, Taichung 404328, Taiwan
- Department of Occupational Therapy, Asia University, Taichung 413305, Taiwan
| | - An-Sheng Lee
- Cardiovascular Research Laboratory, China Medical University Hospital, Taichung 404327, Taiwan; (C.-M.C.); (A.-S.L.)
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan; (Y.-F.C.); (W.-Y.C.)
| | - Chu-Huang Chen
- Vascular and Medicinal Research, Texas Heart Institute, Houston, TX 77030, USA;
- New York Heart Research Foundation, Mineola, NY 11514, USA
| | - Long-Bin Jeng
- Cell Therapy Center, China Medical University Hospital, Taichung 404327, Taiwan;
- Organ Transplantation Center, China Medical University Hospital, Taichung 404327, Taiwan
| | - Kuan-Cheng Chang
- Division of Cardiovascular Medicine, China Medical University Hospital, Taichung 404327, Taiwan (Y.-N.L.); (W.-H.C.); (K.-W.C.)
- Cardiovascular Research Laboratory, China Medical University Hospital, Taichung 404327, Taiwan; (C.-M.C.); (A.-S.L.)
- School of Medicine, China Medical University, Taichung 404328, Taiwan
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Chung WH, Wu HP, Wu MY, Lin YN, Chen JY, Lin KH, Chang KC. Correlations between myocardial injury current and lead performance in His bundle pacing compared with left bundle branch area pacing and right ventricular septum pacing. J Interv Card Electrophysiol 2023; 66:1349-1358. [PMID: 36198845 DOI: 10.1007/s10840-022-01385-9] [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: 06/11/2022] [Accepted: 09/25/2022] [Indexed: 10/10/2022]
Abstract
BACKGROUND Conduction system pacing by implanting the lead in the His bundle (HBP) region or in the left bundle branch area (LBBAP) has gained popularity. Myocardial injury current (IC) is useful for predicting adequate lead fixation in right ventricular septal pacing (RVSP). OBJECTIVES AND METHODS We compared the correlations between IC and lead performance among patients receiving HBP (n = 41), LBBAP (n = 53), and historical RVSP (n = 88). LBBAP was an alternative if optimal HBP was not achieved. A positive IC (STpost-screw-in - STpre-screw-in) was defined as > 0.2 mV or a > 25% ST elevation and prolongation of the ventricular electrograms > 10 ms from baseline. RESULTS HBP patients with a positive IC (48%, 0.84 ± 0.4 V/0.4 ms) exhibited a similar pacing threshold to their LBBAP counterparts (76%, 0.75 ± 0.3 V/0.4 ms, p = 0.329), but a higher pacing threshold than their RVSP counterparts (67%, 0.50 ± 0.1 V/0.4 ms, p < 0.001) at implantation. The R-wave (5.70 ± 3.4 mV) and impedance (660.91 ± 140.8 Ω) were both lower than those of LBBAP (10.35 ± 6.0 mV, p = 0.002; 822.36 ± 235.8 Ω, p = 0.005) and RVSP (11.24 ± 4.9 mV, p < 0.001; 754.27 ± 126.4 Ω, p = 0.006) patients respectively at implantation. The trend of electrical parameter comparisons remained unchanged during follow-up (3.56 ± 1.4 months). Notably, HBP patients without ICs had a higher pacing threshold (1.24 ± 0.6 V/0.4 ms) compared to their LBBAP (0.73 ± 0.3 V/0.4 ms, p = 0.009) and RVSP (0.53 ± 0.1 V/0.4 ms, p < 0.001) counterparts at implantation and during follow-up. CONCLUSIONS The detection of positive changes of myocardial ICs during HBP was associated with a better capture threshold equivalent to the LBBAP counterpart both at implantation and during short-term follow-up. Further large-scale studies with longer follow-up are necessary to confirm these findings.
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Affiliation(s)
- Wei-Hsin Chung
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yude Road, Taichung, 40447, Taiwan
| | - Hung-Pin Wu
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yude Road, Taichung, 40447, Taiwan
| | - Mei-Yao Wu
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yen-Nien Lin
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yude Road, Taichung, 40447, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
- Cardiovascular Research Laboratory, China Medical University Hospital, Taichung, Taiwan
| | - Jan-Yow Chen
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yude Road, Taichung, 40447, Taiwan
| | - Kuo-Hung Lin
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yude Road, Taichung, 40447, Taiwan
| | - Kuan-Cheng Chang
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yude Road, Taichung, 40447, Taiwan.
- School of Medicine, China Medical University, Taichung, Taiwan.
- Cardiovascular Research Laboratory, China Medical University Hospital, Taichung, Taiwan.
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Chen TE, Wang CC, Ho HC, Lai YC, Wu HB, Lin YN, Pai PY. Impact of Premature Ventricular Complex (PVC) Burden on the Left Ventricle in the Structurally Normal Heart: Hemodynamic Alterations of Idiopathic PVC on Echocardiography. Acta Cardiol Sin 2023; 39:687-694. [PMID: 37720406 PMCID: PMC10499960 DOI: 10.6515/acs.202309_39(5).20230119a] [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] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 01/19/2023] [Indexed: 09/19/2023]
Abstract
Background Premature ventricular complex (PVC) without structural heart disease is mostly viewed as a benign arrhythmia. However, the high burden of PVC causes cardiomyopathy due to intraventricular dyssynchrony. The effects of ectopic contraction on left ventricular (LV) hemodynamics in the structurally normal heart are unclear. Objectives To examine the effect of PVC burden on LV dimension, LV systolic function, and intraventricular blood flow, and to determine whether ectopic ventricular contraction affects LV hemodynamics. Methods Patients aged ≥ 18 years with PVC ≥ 5% on Holter recording were enrolled and divided into groups G1 (5-10%), G2 (10-20%), and G3 (≥ 20%). We excluded patients with structural heart diseases, pacemakers, and LV systolic dysfunction [LV ejection fraction (LVEF) < 50%]. Clinical characteristics and routine transthoracic echocardiography parameters were compared. Results The end-systolic LV internal dimension increased according to the PVC burden from G1 to G3 (p = 0.001). LVEF was inversely associated with PVC burden from G1 to G3 (p = 0.002). The same pattern was seen for LV outflow tract (LVOT) maximal velocity (p = 0.005) and maximal pressure gradient (PG) (p = 0.005), LVOT velocity time integral (VTI) (p = 0.03) and LV stroke volume index (LVSI) (p = 0.008). Conclusions Systolic function and LV end-systolic dimension were inversely associated with PVC burden. Decreased LVOT flow velocity and PG were related to increased PVC burden. LVOT VTI and LVSI were smaller when the PVC burden exceeded 20%. These negative hemodynamic manifestations of idiopathic PVC were considerable even in structure normal hearts, hence the early elimination of PVC is strongly advised.
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Affiliation(s)
- Tien-En Chen
- Department of Cardiology, China Medical University Hospital
- Medical College, China Medical University, Taichung, Taiwan
| | - Chun-Cheng Wang
- Department of Cardiology, China Medical University Hospital
- Medical College, China Medical University, Taichung, Taiwan
| | - Hong-Chi Ho
- Department of Cardiology, China Medical University Hospital
- Medical College, China Medical University, Taichung, Taiwan
| | - Yi-Ching Lai
- Department of Cardiology, China Medical University Hospital
- Medical College, China Medical University, Taichung, Taiwan
| | - Hung-Bin Wu
- Department of Cardiology, China Medical University Hospital
- Medical College, China Medical University, Taichung, Taiwan
| | - Yen-Nien Lin
- Department of Cardiology, China Medical University Hospital
- Medical College, China Medical University, Taichung, Taiwan
| | - Pei-Ying Pai
- Department of Cardiology, China Medical University Hospital
- Medical College, China Medical University, Taichung, Taiwan
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Yuan JW, Zhang Y, Liu EB, Tian X, Chen XJ, Li HL, Sun LD, Li FL, Wang C, Zhang YQ, Lin YN, Ru K, Yang SB. [Philadelphia chromosome positive myelodysplastic neoplasms: report of a case]. Zhonghua Bing Li Xue Za Zhi 2023; 52:754-756. [PMID: 37408416 DOI: 10.3760/cma.j.cn112151-20221109-00938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Affiliation(s)
- J W Yuan
- Department of Hematology, Luohe Central Hospital, Luohe 462000, China
| | - Y Zhang
- SINO-US Diagnostics, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300382, China
| | - E B Liu
- SINO-US Diagnostics, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300382, China
| | - X Tian
- SINO-US Diagnostics, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300382, China
| | - X J Chen
- SINO-US Diagnostics, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300382, China
| | - H L Li
- SINO-US Diagnostics, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300382, China
| | - L D Sun
- SINO-US Diagnostics, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300382, China
| | - F L Li
- SINO-US Diagnostics, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300382, China
| | - C Wang
- SINO-US Diagnostics, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300382, China
| | - Y Q Zhang
- Department of Hematology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Y N Lin
- SINO-US Diagnostics, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300382, China
| | - K Ru
- Department of Pathology, Shandong Cancer Hospital, Jinan 250014, China
| | - S B Yang
- SINO-US Diagnostics, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300382, China
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Lin YN, Miguel-Dos-Santos R, Cingolani E. Biological Modification of Arrhythmogenic Substrates by Cell-Free Therapeutics. Heart Lung Circ 2023; 32:844-851. [PMID: 37353457 PMCID: PMC10526725 DOI: 10.1016/j.hlc.2023.05.016] [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] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/21/2023] [Accepted: 05/02/2023] [Indexed: 06/25/2023]
Abstract
Ventricular arrhythmias (VAs) represent a major cause of sudden cardiac death and afflict patients with heart failure from both ischaemic and non-ischaemic origins, and inherited cardiomyopathies. Current VA management, including anti-arrhythmic medications, autonomic modulation, implantable cardioverter-defibrillator implantation, and catheter ablation, remains suboptimal. Catheter ablation may even cause significant cardiomyocyte loss. Cell-based therapies and exosome treatment have been proposed as promising strategies to lessen cardiomyocyte death, modulate immune reaction, and reduce myocardial scarring, and, therefore, are potentially beneficial in treating VAs. In this review, we summarise the current cornerstones of VA management. We also discuss recent advances and ongoing evidence regarding cell-based and exosome therapy, with special attention to VA treatment.
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Affiliation(s)
- Yen-Nien Lin
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Division of Cardiovascular Medicine, Department of Medicine, China Medical University and Hospital, Taipei, Taiwan
| | | | - Eugenio Cingolani
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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Chung WH, Lin YN, Wu MY, Chang KC. Sympathetic Modulation in Cardiac Arrhythmias: Where We Stand and Where We Go. J Pers Med 2023; 13:jpm13050786. [PMID: 37240956 DOI: 10.3390/jpm13050786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 04/27/2023] [Accepted: 04/29/2023] [Indexed: 05/28/2023] Open
Abstract
The nuance of autonomic cardiac control has been studied for more than 400 years, yet little is understood. This review aimed to provide a comprehensive overview of the current understanding, clinical implications, and ongoing studies of cardiac sympathetic modulation and its anti-ventricular arrhythmias' therapeutic potential. Molecular-level studies and clinical studies were reviewed to elucidate the gaps in knowledge and the possible future directions for these strategies to be translated into the clinical setting. Imbalanced sympathoexcitation and parasympathetic withdrawal destabilize cardiac electrophysiology and confer the development of ventricular arrhythmias. Therefore, the current strategy for rebalancing the autonomic system includes attenuating sympathoexcitation and increasing vagal tone. Multilevel targets of the cardiac neuraxis exist, and some have emerged as promising antiarrhythmic strategies. These interventions include pharmacological blockade, permanent cardiac sympathetic denervation, temporal cardiac sympathetic denervation, etc. The gold standard approach, however, has not been known. Although neuromodulatory strategies have been shown to be highly effective in several acute animal studies with very promising results, the individual and interspecies variation between human autonomic systems limits the progress in this young field. There is, however, still much room to refine the current neuromodulation therapy to meet the unmet need for life-threatening ventricular arrhythmias.
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Affiliation(s)
- Wei-Hsin Chung
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan
- UCLA Cardiac Arrhythmia Center, Ronald Reagan UCLA Medical Center, Los Angeles, CA 90024, USA
| | - Yen-Nien Lin
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan
- School of Medicine, China Medical University, Taichung 404333, Taiwan
| | - Mei-Yao Wu
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung 404333, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan
| | - Kuan-Cheng Chang
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan
- School of Medicine, China Medical University, Taichung 404333, Taiwan
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9
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Sanchez L, Mesquita T, Zhang R, Liao K, Rogers R, Lin YN, Miguel-dos-Santos R, Akhmerov A, Li L, Nawaz A, Holm K, Marbán E, Cingolani E. MicroRNA-dependent suppression of biological pacemaker activity induced by TBX18. Cell Rep Med 2022; 3:100871. [PMID: 36543116 PMCID: PMC9798022 DOI: 10.1016/j.xcrm.2022.100871] [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: 03/01/2022] [Revised: 08/18/2022] [Accepted: 11/19/2022] [Indexed: 12/24/2022]
Abstract
Chemically modified mRNA (CMmRNA) with selectively altered nucleotides are used to deliver transgenes, but translation efficiency is variable. We have transfected CMmRNA encoding human T-box transcription factor 18 (CMmTBX18) into heart cells or the left ventricle of rats with atrioventricular block. TBX18 protein expression from CMmTBX18 is weak and transient, but Acriflavine, an Argonaute 2 inhibitor, boosts TBX18 levels. Small RNA sequencing identified two upregulated microRNAs (miRs) in CMmTBX18-transfected cells. Co-administration of miR-1-3p and miR-1b antagomiRs with CMmTBX18 prolongs TBX18 expression in vitro and in vivo and is sufficient to generate electrical stimuli capable of pacing the heart. Different suppressive miRs likewise limit the expression of VEGF-A CMmRNA. Cells therefore resist translation of CMmRNA therapeutic transgenes by upregulating suppressive miRs. Blockade of suppressive miRs enhances CMmRNA expression of genes driving biological pacing or angiogenesis. Such counterstrategies constitute an approach to boost the efficacy and efficiency of CMmRNA therapies.
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Affiliation(s)
- Lizbeth Sanchez
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, Los Angeles, CA 90048, USA
| | - Thassio Mesquita
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, Los Angeles, CA 90048, USA
| | - Rui Zhang
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, Los Angeles, CA 90048, USA
| | - Ke Liao
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, Los Angeles, CA 90048, USA
| | - Russell Rogers
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, Los Angeles, CA 90048, USA
| | - Yen-Nien Lin
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, Los Angeles, CA 90048, USA
| | - Rodrigo Miguel-dos-Santos
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, Los Angeles, CA 90048, USA
| | - Akbarshakh Akhmerov
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, Los Angeles, CA 90048, USA
| | - Liang Li
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, Los Angeles, CA 90048, USA
| | - Asma Nawaz
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, Los Angeles, CA 90048, USA
| | - Kevin Holm
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, Los Angeles, CA 90048, USA
| | - Eduardo Marbán
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, Los Angeles, CA 90048, USA
| | - Eugenio Cingolani
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S San Vicente Blvd, Los Angeles, CA 90048, USA,Corresponding author
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10
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Li YH, Huang XQ, Lin YN, Chen XJ, Chen L, Liu EB, Mi YC, Ru K. [Mutational features of immunoglobulin heavy chain variable region gene in patients with chronic lymphocytic leukemia]. Zhonghua Bing Li Xue Za Zhi 2022; 51:1135-1140. [PMID: 36323543 DOI: 10.3760/cma.j.cn112151-20220309-00159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To investigate the mutational features of the immunoglobulin heavy chain variable region (IgHV) gene in patients with chronic lymphocytic leukemia (CLL) using immunophenotypic and molecular genetic methods. Methods: The laboratory results of 266 CLL patients who underwent IgHV gene examination at Sino-US diagnostics laboratory from February 2020 to February 2021 were analyzed for the IgVH mutational status and presence of specific IgVH fragments. In addition, their immunophenotypic, molecular, chromosomal karyotypic, and FISH profiles were investigated and correlated with the IgVH mutational status. Results: Among 266 patients, 172 were male and 94 were female, with a media age of 67 years (20-82 years).There were more patients with mutated IgHV (m-IgHV) than unmutated IgHV (un-IgHV) (69.2%∶30.8%). There was association of VH family and the presence of gene fragments: the overall incidence of VH families including VH3 family (142/266, 53.4%), VH4 family (75/266, 28.2%), and VH1 family (34/266, 12.8%) was about 95%, among which the proportion of VH4-34 (26/266, 9.8%), VH3-23 (25/266, 9.4%), VH3-7 (24/266, 9.0%), and VH4-39 (16/266, 6.0%) was about 35%. VH3-20 and VH3-49 only occurred in un-IgHV (P<0.05). In addition, the expression rates of CD38 (26.3% vs. 3.0%), CD79b (71.1%∶45.5%) and 11q deletion (25.5%∶5.3%) were higher in un-IgHV, and single trisomy 12 (37.9%∶5.6%) were more commonly found in m-IgHV (P<0.05). MYD88 was one of the major mutation genes in m-IgHV, while ATM had the highest mutation rate in un-IgHV. Conclusion: CLL patients have differential expression in terms of IgHV gene mutations, correlating to their immunophenotype and genetics characteristics.
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Affiliation(s)
- Y H Li
- Tianjin Sino-US Diagnostics Laboratory, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - X Q Huang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China
| | - Y N Lin
- Tianjin Sino-US Diagnostics Laboratory, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - X J Chen
- Tianjin Sino-US Diagnostics Laboratory, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - L Chen
- Tianjin Sino-US Diagnostics Laboratory, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - E B Liu
- Tianjin Sino-US Diagnostics Laboratory, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - Y C Mi
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China
| | - K Ru
- Tianjin Sino-US Diagnostics Laboratory, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
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Chen CH, Chang KC, Lin YN, Ho MW, Cheng MY, Shih WH, Chou CH, Lin PC, Chi CY, Lu MC, Tien N, Wu MY, Chang SS, Hsu WH, Shyu WC, Cho DY, Jeng LB. Mesenchymal stem cell therapy on top of triple therapy with remdesivir, dexamethasone, and tocilizumab improves PaO2/FiO2 in severe COVID-19 pneumonia. Front Med (Lausanne) 2022; 9:1001979. [PMID: 36213639 PMCID: PMC9537613 DOI: 10.3389/fmed.2022.1001979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background Despite patients with severe coronavirus disease (COVID-19) receiving standard triple therapy, including steroids, antiviral agents, and anticytokine therapy, health condition of certain patients continue to deteriorate. In Taiwan, the COVID-19 mortality has been high since the emergence of previous variants of this disease (such as alpha, beta, or delta). We aimed to evaluate whether adjunctive infusion of human umbilical cord mesenchymal stem cells (MSCs) (hUC-MSCs) on top of dexamethasone, remdesivir, and tocilizumab improves pulmonary oxygenation and suppresses inflammatory cytokines in patients with severe COVID-19. Methods Hospitalized patients with severe or critical COVID-19 pneumonia under standard triple therapy were separated into adjuvant hUC-MSC and non-hUC-MSC groups to compare the changes in the arterial partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FiO2) ratio and biological variables. Results Four out of eight patients with severe or critical COVID-19 received either one (n = 2) or two (n = 2) doses of intravenous infusions of hUC-MSCs using a uniform cell dose of 1.0 × 108. Both high-sensitivity C-reactive protein (hs-CRP) level and monocyte distribution width (MDW) were significantly reduced, with a reduction in the levels of interleukin (IL)-6, IL-13, IL-12p70 and vascular endothelial growth factor following hUC-MSC transplantation. The PaO2/FiO2 ratio increased from 83.68 (64.34–126.75) to 227.50 (185.25–237.50) and then 349.56 (293.03–367.92) within 7 days after hUC-MSC infusion (P < 0.001), while the change of PaO2/FiO2 ratio was insignificant in non-hUC-MSC patients (admission day: 165.00 [102.50–237.61]; day 3: 100.00 [72.00–232.68]; day 7: 250.00 [71.00–251.43], P = 0.923). Conclusion Transplantation of hUC-MSCs as adjunctive therapy improves pulmonary oxygenation in patients with severe or critical COVID-19. The beneficial effects of hUC-MSCs were presumably mediated by the mitigation of inflammatory cytokines, characterized by the reduction in both hs-CRP and MDW.
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Affiliation(s)
- Chih-Hao Chen
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Cheng Chang
- Division of Cardiovascular Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
- *Correspondence: Kuan-Cheng Chang,
| | - Yen-Nien Lin
- Division of Cardiovascular Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Mao-Wang Ho
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Meng-Yu Cheng
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Hsin Shih
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Huei Chou
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Po-Chang Lin
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Yu Chi
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Min-Chi Lu
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Microbiology and Immunology, School of Medicine, China Medical University, Taichung, Taiwan
| | - Ni Tien
- Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Mei-Yao Wu
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Shih-Sheng Chang
- Division of Cardiovascular Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wu-Huei Hsu
- School of Medicine, China Medical University, Taichung, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Woei-Cheang Shyu
- School of Medicine, China Medical University, Taichung, Taiwan
- Translational Medicine Research Center, China Medical University Hospital, Taichung, Taiwan
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
- Woei-Cheang Shyu,
| | - Der-Yang Cho
- School of Medicine, China Medical University, Taichung, Taiwan
- Stroke Center, China Medical University Hospital, Taichung, Taiwan
- Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan
| | - Long-Bin Jeng
- School of Medicine, China Medical University, Taichung, Taiwan
- Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan
- Long-Bin Jeng,
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12
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Hsiao LC, Lin YN, Shyu WC, Ho M, Lu CR, Chang SS, Wang YC, Chen JY, Lu SY, Wu MY, Li KY, Lin YK, Tseng WYI, Su MY, Hsu CT, Tsai CK, Chiu LT, Chen CL, Lin CL, Hu KC, Cho DY, Tsai CH, Chang KC, Jeng LB. First-in-human pilot trial of combined intracoronary and intravenous mesenchymal stem cell therapy in acute myocardial infarction. Front Cardiovasc Med 2022; 9:961920. [PMID: 36017096 PMCID: PMC9395611 DOI: 10.3389/fcvm.2022.961920] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 07/13/2022] [Indexed: 12/17/2022] Open
Abstract
BackgroundAcute ST-elevation myocardial infarction (STEMI) elicits a robust cardiomyocyte death and inflammatory responses despite timely revascularization.ObjectivesThis phase 1, open-label, single-arm, first-in-human study aimed to assess the safety and efficacy of combined intracoronary (IC) and intravenous (IV) transplantation of umbilical cord-derived mesenchymal stem cells (UMSC01) for heart repair in STEMI patients with impaired left ventricular ejection fraction (LVEF 30-49%) following successful reperfusion by percutaneous coronary intervention.MethodsConsenting patients received the first dose of UMSC01 through IC injection 4-5 days after STEMI followed by the second dose of UMSC01 via IV infusion 2 days later. The primary endpoint was occurrence of any treatment-related adverse events and the secondary endpoint was changes of serum biomarkers and heart function by cardiac magnetic resonance imaging during a 12-month follow-up period.ResultsEight patients gave informed consents, of whom six completed the study. None of the subjects experienced treatment-related serious adverse events or major adverse cardiovascular events during IC or IV infusion of UMSC01 and during the follow-up period. The NT-proBNP level decreased (1362 ± 1801 vs. 109 ± 115 pg/mL, p = 0.0313), the LVEF increased (52.67 ± 12.75% vs. 62.47 ± 17.35%, p = 0.0246), and the wall motion score decreased (26.33 ± 5.57 vs. 22.33 ± 5.85, p = 0.0180) at the 12-month follow-up compared to the baseline values. The serial changes of LVEF were 0.67 ± 3.98, 8.09 ± 6.18, 9.04 ± 10.91, and 9.80 ± 7.56 at 1, 3, 6, and 12 months, respectively as compared to the baseline.ConclusionThis pilot study shows that combined IC and IV transplantation of UMSC01 in STEMI patients with impaired LVEF appears to be safe, feasible, and potentially beneficial in improving heart function. Further phase 2 studies are required to explore the effectiveness of dual-route transplantation of UMSC01 in STEMI patients.
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Affiliation(s)
- Lien-Cheng Hsiao
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Yen-Nien Lin
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Woei-Cherng Shyu
- Department of Neurology and Translational Medicine Research Center, China Medical University Hospital, Taichung, Taiwan
- Ever Supreme Bio Technology Co., Ltd, Taichung, Taiwan
| | - Ming Ho
- Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan
| | - Chiung-Ray Lu
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Shih-Sheng Chang
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Chen Wang
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Jan-Yow Chen
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Shang-Yeh Lu
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Mei-Yao Wu
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Keng-Yuan Li
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Kai Lin
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Yih I. Tseng
- Molecular Imaging Center, National Taiwan University, Taipei, Taiwan
| | - Mao-Yuan Su
- Molecular Imaging Center, National Taiwan University, Taipei, Taiwan
| | - Chin-Ting Hsu
- Ever Supreme Bio Technology Co., Ltd, Taichung, Taiwan
| | | | - Lu-Ting Chiu
- Ever Supreme Bio Technology Co., Ltd, Taichung, Taiwan
| | | | - Cheng-Li Lin
- School of Medicine, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Kai-Chieh Hu
- School of Medicine, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Der-Yang Cho
- School of Medicine, China Medical University, Taichung, Taiwan
- Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan
| | - Chang-Hai Tsai
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Kuan-Cheng Chang
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
- *Correspondence: Kuan-Cheng Chang,
| | - Long-Bin Jeng
- School of Medicine, China Medical University, Taichung, Taiwan
- Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan
- Long-Bin Jeng,
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13
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Chang KC, Chen KW, Huang CL, Liao WL, Wu MY, Lin YK, Shiao YT, Chung WH, Lin YN, Lane HY. Association of a Common NOS1AP Variant with Attenuation of QTc Prolongation in Men with Heroin Dependence Undergoing Methadone Treatment. J Pers Med 2022; 12:jpm12050835. [PMID: 35629257 PMCID: PMC9143734 DOI: 10.3390/jpm12050835] [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: 03/13/2022] [Revised: 04/20/2022] [Accepted: 05/19/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The effects of methadone-induced severe prolongation of the corrected QT interval (QTc) and sudden cardiac death appear unpredictable and sex-dependent. Genetic polymorphisms in the nitric oxide synthase 1 adaptor protein (NOS1AP) have been implicated in QTc prolongation in general populations. We investigated whether common NOS1AP variants interact with methadone in relation to QTc prolongation in patients with heroin dependence. Methods: We genotyped 17 NOS1AP variants spanning the entire gene in heroin-dependent patients who received a 12-lead electrocardiography (ECG) examination both at baseline and during maintenance methadone treatment in Cohort 1 and only during maintenance methadone treatment in Cohort 2. The QT interval was measured automatically by the Marquette 12SL program, and was corrected for heart rate using Bazett’s formula. Results: Cohort 1 consisted of 122 patients (age: 37.65 ± 8.05 years, 84% male, methadone dosage: 42.54 ± 22.17 mg/day), and Cohort 2 comprised of 319 patients (age: 36.9 ± 7.86 years, 82% male, methadone dosage: 26.08 ± 15.84 mg/day), with complete genotyping data for analyses. Before methadone, the QTc intervals increased with increasing age (r = 0.3541, p < 0.001); the age-adjusted QTc showed dose-dependent prolongation in men (r = 0.6320, p < 0.001), but abbreviation in women (r = −0.5348, p = 0.018) in Cohort 1. The pooled genotype-specific analysis of the two cohorts revealed that the QTc interval was significantly shorter in male carriers of the rs164148 AA variant than in male carriers of the reference GG genotype (GG: n = 262, QTc = 423 ± 1.4 ms; AA: n = 10, QTc = 404.1 ± 7 ms, p = 0.009), according to univariate analysis. The QTc remained shorter in male carriers of the rs164148 AA variant compared to GG genotype (423 ± 1.4 ms vs. 405.9 ± 6.9 ms, p = 0.016) in multivariate analysis after adjusting for age and methadone dosage. A cut-off QTc interval of <410 ms identifies 100% of AA carriers compared to none of GG carriers when receiving a daily methadone dosage of 30.6 ± 19.3 mg. There was no significant gene-drug interaction in contributing to the adjusted QTc (p = 0.2164) in male carriers of the rs164148 variants. Conclusions: Carriers of a common NOS1AP rs164148 AA genotype variant were associated with a shorter QTc interval in men receiving maintenance methadone treatment. This genetic polymorphism attenuates the QTc-prolonging effect by methadone, and thus may explain at least in part the unpredictable and heterogeneous risks for severe QTc prolongation and sudden cardiac death in patients on methadone.
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Affiliation(s)
- Kuan-Cheng Chang
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 404332, Taiwan; (K.-W.C.); (Y.-K.L.); (W.-H.C.); (Y.-N.L.)
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404333, Taiwan;
- Correspondence: ; Tel.: +886-4-22052121 (ext. 2626); Fax: +886-4-22065593
| | - Ke-Wei Chen
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 404332, Taiwan; (K.-W.C.); (Y.-K.L.); (W.-H.C.); (Y.-N.L.)
| | - Chieh-Liang Huang
- Department of Addiction Treatment, Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nan-Tou County 54249, Taiwan;
| | - Wen-Ling Liao
- Center for Personalized Medicine, China Medical University Hospital, Taichung 404332, Taiwan;
- Graduate Institute of Integrated Medicine, China Medical University, Taichung 404333, Taiwan
| | - Mei-Yao Wu
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung 40402, Taiwan;
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404332, Taiwan
| | - Yu-Kai Lin
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 404332, Taiwan; (K.-W.C.); (Y.-K.L.); (W.-H.C.); (Y.-N.L.)
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404333, Taiwan;
| | - Yi-Tzone Shiao
- Center of Institutional Research and Development, Asia University, Taichung 413305, Taiwan;
| | - Wei-Hsin Chung
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 404332, Taiwan; (K.-W.C.); (Y.-K.L.); (W.-H.C.); (Y.-N.L.)
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404333, Taiwan;
| | - Yen-Nien Lin
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 404332, Taiwan; (K.-W.C.); (Y.-K.L.); (W.-H.C.); (Y.-N.L.)
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404333, Taiwan;
| | - Hsien-Yuan Lane
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404333, Taiwan;
- Department of Psychiatry, China Medical University Hospital, Taichung 404332, Taiwan
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Chang KC, chung W, Wu HP, Wu MY, Lin YN, Chen JY, Lin KH. PO-708-03 CORRELATIONS BETWEEN INJURY CURRENT AND LEAD PERFORMANCE IN HIS BUNDLE PACING COMPARED WITH LEFT BUNDLE BRANCH AREA PACING AND RIGHT VENTRICULAR SEPTUM PACING. Heart Rhythm 2022. [DOI: 10.1016/j.hrthm.2022.03.1101] [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: 11/15/2022]
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15
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Liu EB, Sun LD, Zhang JF, Tian X, Chen XJ, Wang C, Yang SB, Chen L, Lin YN, Ru K. [Leukemic manifestation of high grade B cell lymphoma]. Zhonghua Bing Li Xue Za Zhi 2022; 51:389-392. [PMID: 35359061 DOI: 10.3760/cma.j.cn112151-20211112-00819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- E B Liu
- SINO-US Diagnostics Laboratory, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - L D Sun
- SINO-US Diagnostics Laboratory, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - J F Zhang
- SINO-US Diagnostics Laboratory, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - X Tian
- SINO-US Diagnostics Laboratory, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - X J Chen
- SINO-US Diagnostics Laboratory, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - C Wang
- SINO-US Diagnostics Laboratory, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - S B Yang
- SINO-US Diagnostics Laboratory, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - L Chen
- SINO-US Diagnostics Laboratory, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - Y N Lin
- SINO-US Diagnostics Laboratory, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - K Ru
- SINO-US Diagnostics Laboratory, Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
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Huang XQ, Lin YN, Liu EB, Xing F, Wang Z, Chen XJ, Chen L, Ma JT, Mi YC, Ru K. [Characteristics of fusion gene expression in acute lymphoblastic leukemia]. Zhonghua Bing Li Xue Za Zhi 2022; 51:307-313. [PMID: 35359041 DOI: 10.3760/cma.j.cn112151-20211028-00781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To analyze the genetic landscape of 52 fusion genes in patients with de novo acute lymphoblastic leukemia (ALL) and to investigate the characteristics of other laboratory results. Methods: The fusion gene expression was retrospectively analyzed in the 1 994 patients with de novo ALL diagnosed from September 2016 to December 2020. In addition, their mutational, immunophenotypical and karyotypical profiles were investigated. Results: In the 1 994 patients with ALL, the median age was 12 years (from 15 days to 89 years). In the panel of targeted genes, 15 different types of fusion genes were detected in 884 patients (44.33%) and demonstrated a Power law distribution. The frequency of detectable fusion genes in B-cell ALL was significantly higher than that in T-cell ALL (48.48% vs 18.71%), and fusion genes were almost exclusively expressed in B-cell ALL or T-cell ALL. The number of fusion genes showed peaks at<1 year, 3-5 years and 35-44 years, respectively. More fusion genes were identified in children than in adults. MLL-FG was most frequently seen in infants and TEL-AML1 was most commonly seen in children, while BCR-ABL1 was dominant in adults. The majority of fusion gene mutations involved signaling pathway and the most frequent mutations were observed in NRAS and KRAS genes. The expression of early-stage B-cell antigens varied in B-cell ALL patients. The complex karyotypes were more common in BCR-ABL1 positive patients than others. Conclusion: The distribution of fusion genes in ALL patients differs by ages and cell lineages. It also corresponds to various gene mutations, immunophenotypes, and karyotypes.
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Affiliation(s)
- X Q Huang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China SINO-US Diagnostics Lab Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - Y N Lin
- SINO-US Diagnostics Lab Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - E B Liu
- SINO-US Diagnostics Lab Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - F Xing
- SINO-US Diagnostics Lab Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - Z Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - X J Chen
- SINO-US Diagnostics Lab Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - L Chen
- SINO-US Diagnostics Lab Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - J T Ma
- SINO-US Diagnostics Lab Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
| | - Y C Mi
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Kun Ru
- SINO-US Diagnostics Lab Tianjin Enterprise Key Laboratory of AI-aided Hematopathology Diagnosis, Tianjin 300385, China
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Mesquita T, Zhang R, Cho JH, Zhang R, Lin YN, Sanchez L, Goldhaber J, Yu JK, Liang JA, Liu W, Trayanova NA, Cingolani E. Mechanisms of Sinoatrial Node Dysfunction in Heart Failure With Preserved Ejection Fraction. Circulation 2022; 145:45-60. [PMID: 34905696 PMCID: PMC9083886 DOI: 10.1161/circulationaha.121.054976] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [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] [Indexed: 01/14/2023]
Abstract
BACKGROUND The ability to increase heart rate during exercise and other stressors is a key homeostatic feature of the sinoatrial node (SAN). When the physiological heart rate response is blunted, chronotropic incompetence limits exercise capacity, a common problem in patients with heart failure with preserved ejection fraction (HFpEF). Despite its clinical relevance, the mechanisms of chronotropic incompetence remain unknown. METHODS Dahl salt-sensitive rats fed a high-salt diet and C57Bl6 mice fed a high-fat diet and an inhibitor of constitutive nitric oxide synthase (Nω-nitro-L-arginine methyl ester [L-NAME]; 2-hit) were used as models of HFpEF. Myocardial infarction was created to induce HF with reduced ejection fraction. Rats and mice fed with a normal diet or those that had a sham surgery served as respective controls. A comprehensive characterization of SAN function and chronotropic response was conducted by in vivo, ex vivo, and single-cell electrophysiologic studies. RNA sequencing of SAN was performed to identify transcriptomic changes. Computational modeling of biophysically-detailed human HFpEF SAN was created. RESULTS Rats with phenotypically-verified HFpEF exhibited limited chronotropic response associated with intrinsic SAN dysfunction, including impaired β-adrenergic responsiveness and an alternating leading pacemaker within the SAN. Prolonged SAN recovery time and reduced SAN sensitivity to isoproterenol were confirmed in the 2-hit mouse model. Adenosine challenge unmasked conduction blocks within the SAN, which were associated with structural remodeling. Chronotropic incompetence and SAN dysfunction were also found in rats with HF with reduced ejection fraction. Single-cell studies and transcriptomic profiling revealed HFpEF-related alterations in both the "membrane clock" (ion channels) and the "Ca2+ clock" (spontaneous Ca2+ release events). The physiologic impairments were reproduced in silico by empirically-constrained quantitative modeling of human SAN function. CONCLUSIONS Chronotropic incompetence and SAN dysfunction were seen in both models of HF. We identified that intrinsic abnormalities of SAN structure and function underlie the chronotropic response in HFpEF.
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Affiliation(s)
- Thassio Mesquita
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Rui Zhang
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jae Hyung Cho
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Rui Zhang
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Yen-Nien Lin
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Lizbeth Sanchez
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Joshua Goldhaber
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Joseph K. Yu
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Jialiu A. Liang
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Weixin Liu
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Natalia A. Trayanova
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland
- Alliance for Cardiovascular and Diagnostic and treatment Innovation (ADVANCE), Johns Hopkins University, Baltimore, Maryland
| | - Eugenio Cingolani
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Lin YN, Mesquita T, Sanchez L, Chen YH, Liu W, Li C, Rogers R, Wang Y, Li X, Wu D, Zhang R, Ibrahim A, Marbán E, Cingolani E. Extracellular vesicles from immortalized cardiosphere-derived cells attenuate arrhythmogenic cardiomyopathy in desmoglein-2 mutant mice. Eur Heart J 2021; 42:3558-3571. [PMID: 34345905 PMCID: PMC8442111 DOI: 10.1093/eurheartj/ehab419] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [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: 10/27/2020] [Revised: 04/28/2021] [Accepted: 06/25/2021] [Indexed: 01/19/2023] Open
Abstract
AIMS Arrhythmogenic cardiomyopathy (ACM) is characterized by progressive loss of cardiomyocytes, and fibrofatty tissue replacement. Extracellular vesicles (EVs) secreted by cardiosphere-derived cells, immortalized, and engineered to express high levels of β-catenin, exert anti-inflammatory, and anti-fibrotic effects. The aim of the current study was to assess efficacy of EVs in an ACM murine model. METHODS AND RESULTS Four-week-old homozygous knock-in mutant desmoglein-2 (Dsg2mt/mt) were randomized to receive weekly EVs or vehicle for 4 weeks. After 4 weeks, DSG2mt/mt mice receiving EVs showed improved biventricular function (left, P < 0.0001; right, P = 0.0037) and less left ventricular dilation (P < 0.0179). Electrocardiography revealed abbreviated QRS duration (P = 0.0003) and QTc interval (P = 0.0006) in EV-treated DSG2mt/mt mice. Further electrophysiology testing in the EV group showed decreased burden (P = 0.0042) and inducibility of ventricular arrhythmias (P = 0.0037). Optical mapping demonstrated accelerated repolarization (P = 0.0290) and faster conduction (P = 0.0274) in Dsg2mt/mt mice receiving EVs. DSG2mt/mt hearts exhibited reduced fibrosis, less cell death, and preserved connexin 43 expression after EV treatment. Hearts of Dsg2mt/mt mice expressed markedly increased levels of inflammatory cytokines that were, in part, attenuated by EV therapy. The pan-inflammatory transcription factor nuclear factor-κB (NF-κB), the inflammasome sensor NLRP3, and the macrophage marker CD68 were all reduced in EV-treated animals. Blocking EV hsa-miR-4488 in vitro and in vivo reactivates NF-κB and blunts the beneficial effects of EVs. CONCLUSIONS Extracellular vesicle treatment improved cardiac function, reduced cardiac inflammation, and suppressed arrhythmogenesis in ACM. Further studies are needed prior to translating the present findings to human forms of this heterogenous disease.
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Affiliation(s)
- Yen-Nien Lin
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Boulevard, Los Angeles, CA 90048, USA
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University and Hospital, 2, Yu-Der Road, North District, Taichung 40447, Taiwan; and
| | - Thassio Mesquita
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Boulevard, Los Angeles, CA 90048, USA
| | - Lizbeth Sanchez
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Boulevard, Los Angeles, CA 90048, USA
| | - Yin-Huei Chen
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Boulevard, Los Angeles, CA 90048, USA
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University and Hospital, 2, Yu-Der Road, North District, Taichung 40447, Taiwan; and
| | - Weixin Liu
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Boulevard, Los Angeles, CA 90048, USA
| | - Chang Li
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Boulevard, Los Angeles, CA 90048, USA
| | - Russell Rogers
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Boulevard, Los Angeles, CA 90048, USA
| | - Yizhou Wang
- Genomics Core, Cedars-Sinai Medical Center, 8700 Beverly Blvd. Los Angeles, CA 90048, USA
| | - Xinling Li
- Genomics Core, Cedars-Sinai Medical Center, 8700 Beverly Blvd. Los Angeles, CA 90048, USA
| | - Di Wu
- Genomics Core, Cedars-Sinai Medical Center, 8700 Beverly Blvd. Los Angeles, CA 90048, USA
| | - Rui Zhang
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Boulevard, Los Angeles, CA 90048, USA
| | - Ahmed Ibrahim
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Boulevard, Los Angeles, CA 90048, USA
| | - Eduardo Marbán
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Boulevard, Los Angeles, CA 90048, USA
| | - Eugenio Cingolani
- Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Boulevard, Los Angeles, CA 90048, USA
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Akhmerov A, Rogers R, de Couto G, Valle J, Li L, Ibrahim A, Sanchez L, Zhang R, Lin YN, Liu W, Marbán E. Regulatory T cell activation, proliferation, and reprogramming induced by extracellular vesicles. J Heart Lung Transplant 2021; 40:1387-1395. [PMID: 34281778 DOI: 10.1016/j.healun.2021.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 11/04/2020] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Extracellular vesicles (EVs) from heart stromal/progenitor cells modulate innate immunity, with salutary effects in a variety of cardiac disease models. Little is known, however, about the effects of these EVs on adaptive immunity. METHODS Ex vivo differentiation of naïve CD4+ T cells was conducted to assess the effect of EVs on cytokine production and proliferation of Th1, Th2, Th17, and regulatory T (Treg) cells. These effects were further tested in vivo using the experimental autoimmune myocarditis (EAM) model. RESULTS Using differentiated CD4+ T cells, we show that EVs secreted by human-derived heart stromal/progenitor cells selectively influence the phenotype, activity, and proliferation of regulatory T (Treg) cells. Exposure of Treg cells to EVs results in faster proliferation, augmented production of IL-10, and polarization toward an intermediate FOXP3+RORγt+ phenotype. In experimental autoimmune myocarditis, EVs attenuate cardiac inflammation and functional decline, in association with increased numbers of splenic IL10+-Treg cells. CONCLUSIONS T cell modulation by EVs represents a novel therapeutic approach to inflammation, harnessing endogenous immunosuppressive mechanisms that may be applied in solid organ transplantation, graft-versus-host disease, and autoimmune disorders.
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Affiliation(s)
| | - Russell Rogers
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Geoffrey de Couto
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Jackelyn Valle
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Liang Li
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Ahmed Ibrahim
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Lizbeth Sanchez
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Rui Zhang
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Yen-Nien Lin
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Weixin Liu
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Eduardo Marbán
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
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Yan Q, Lin YN, Huang XQ, Qian LZ, Ma JT, Zhang H, Chen L, Chen XJ, Mi YC, Ru K. [Analysis of fusion gene expression in acute myeloid leukemia]. Zhonghua Xue Ye Xue Za Zhi 2021; 42:480-486. [PMID: 34384154 PMCID: PMC8295623 DOI: 10.3760/cma.j.issn.0253-2727.2021.06.007] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To analyze the genetic landscape of multiple fusion genes in patients with de novo acute myeloid leukemia (AML) and investigate the characteristics of immunophenotypes and mutations. Methods: The results of multiple fusion genes from 4192 patients with de novo AML were retrospectively analyzed from 2016 to 2020. In addition, the immunophenotypical data and the mutational results from high-through put method were statistically investigated and correlated as well. Results: ①Among the 52 targets, 29 different types of fusion genes were detected in 1948 patients (46.47%) with AML, which demonstrated an "exponential distribution" . ② As the age increased, the number of patients with fusion gene increased first and then decreased gradually. The total incidence rate of fusion genes and MLL rearrangment in children were significantly higher than those in adults (69.18% vs 44.76%, 15.35% vs 8.36%) . ③The mutations involving FLT3 and RAS signaling pathway contributed most in patients with MLL rearrangment. ④No specific immunophenotypic characteristics were found in AML patients with MLL or NUP98 rearrangements. Conclusion: Nearly half of AML patients were accompanied by specific fusion gene expression, the proportions of different fusion genes in pediatric and adults patients were different by multiple PCR. The gene mutations and immunophenotype of these AML patients have certain rules.
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Affiliation(s)
- Q Yan
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Y N Lin
- SINO-US Diagnostics Lab, Tianjin 300385, China
| | - X Q Huang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - L Z Qian
- SINO-US Diagnostics Lab, Tianjin 300385, China
| | - J T Ma
- SINO-US Diagnostics Lab, Tianjin 300385, China
| | - H Zhang
- SINO-US Diagnostics Lab, Tianjin 300385, China
| | - L Chen
- SINO-US Diagnostics Lab, Tianjin 300385, China
| | - X J Chen
- SINO-US Diagnostics Lab, Tianjin 300385, China
| | - Y C Mi
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - K Ru
- SINO-US Diagnostics Lab, Tianjin 300385, China
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Abstract
Arrhythmogenic cardiomyopathy (AC) is an inherited disease characterized by progressive breakdown of heart muscle, myocardial tissue death, and fibrofatty replacement. In most cases of AC, the primary lesion occurs in one of the genes encoding desmosomal proteins, disruption of which increases membrane fragility at the intercalated disc. Disrupted, exposed desmosomal proteins also serve as epitopes that can trigger an autoimmune reaction. Damage to cell membranes and autoimmunity provoke myocardial inflammation, a key feature in early stages of the disease. In several preclinical models, targeting inflammation has been shown to blunt disease progression, but translation to the clinic has been sparse. Here we review current understanding of inflammatory pathways and how they interact with injured tissue and the immune system in AC. We further discuss the potential role of immunomodulatory therapies in AC.
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Affiliation(s)
- Yen-Nien Lin
- Cedars-Sinai Medical Center, Smidt Heart Institute, 127 S. San Vicente Blvd., Los Angeles, CA, 90048, USA.,Division of Cardiovascular Medicine, Department of Medicine, China Medical University and Hospital, Taichung, Taiwan
| | - Ahmed Ibrahim
- Cedars-Sinai Medical Center, Smidt Heart Institute, 127 S. San Vicente Blvd., Los Angeles, CA, 90048, USA
| | - Eduardo Marbán
- Cedars-Sinai Medical Center, Smidt Heart Institute, 127 S. San Vicente Blvd., Los Angeles, CA, 90048, USA
| | - Eugenio Cingolani
- Cedars-Sinai Medical Center, Smidt Heart Institute, 127 S. San Vicente Blvd., Los Angeles, CA, 90048, USA.
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Akhmerov A, de Couto G, Rogers R, Valle J, Sanchez L, Ibrahim A, Lin YN, Zhang R, Marban E. Exosomes Isolated from Cardiosphere‐Derived Cells Attenuate Disease Severity in Experimental Autoimmune Myocarditis. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.03716] [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: 11/11/2022]
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Chen YH, Yang YC, Chen W, Lin YN, Hung YC. Risk of macrovascular complications in statin-treated patients developing diabetes. Diabetes Res Clin Pract 2019; 157:107870. [PMID: 31560961 DOI: 10.1016/j.diabres.2019.107870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/11/2019] [Accepted: 09/23/2019] [Indexed: 10/26/2022]
Abstract
AIMS To assess the risk of macrovascular complications in patients developing diabetes from statin treatment. METHODS In this population-based cohort study, 40,409 participants who began to receive statin therapy between 2000 and 2012 were enrolled in to the study group, and another 1:1 matched adults without statin treatment during the same period served as the control group. Both groups were followed up to identify individuals who later developed diabetes. After a follow-up identification of diabetes, diabetes and non-diabetes cohorts were subjected to an analysis for the risk of macrovascular events between diagnosis of diabetes and December 31, 2013. RESULTS Compared with individuals without statin therapy, statin-treated patients had a higher risk of developing diabetes (adjusted hazard ratio: 2.46; 95% confidence interval: 2.37-2.57). Compared with statin-treated patients without diabetes, statin-treated participants developing diabetes had a higher overall incidence of macrovascular complications (adjusted hazard ratio: 1.74; 95% confidence interval: 1.62-1.88). Moreover, compared with that of other diabetogenic statins, patients taking pravastatin had a lower risk of developing diabetes (adjusted hazard ratio: 0.63; 95% confidence interval: 0.55-0.73) and macrovascular events (adjusted hazard ratio: 0.64; 95% confidence interval: 0.42-0.98). CONCLUSIONS According to these findings, prescribing statins that have a neutral effect on glucose homeostasis may be advisable for Asian populations.
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Affiliation(s)
- Yin-Huei Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Cih Yang
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan
| | - Weishan Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan
| | - Yen-Nien Lin
- Division of Cardiovascular Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Cardiovascular Research Laboratory, China Medical University Hospital, Taichung, Taiwan
| | - Yi-Chih Hung
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
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Wang JY, Ma J, Lin YN, Wang J, Shen H, Gui FM, Han C, Li QH, Song Z, Wang XJ. [Mutational analysis of RNA splicing machinery genes SF3B1, U2AF1 and SRSF2 in 118 patients with myelodysplastic syndromes and related diseases]. Zhonghua Xue Ye Xue Za Zhi 2018; 38:192-197. [PMID: 28395441 PMCID: PMC7348387 DOI: 10.3760/cma.j.issn.0253-2727.2017.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
目的 探讨RNA剪接体复合物编码基因SF3B1、U2AF1和SRSF2突变在MDS及相关疾病中的突变率、突变特点及临床意义。 方法 以118例MDS及相关疾病患者为研究对象,采用PCR扩增产物直接测序法分别检测SF3B1(K700E)、U2AF1(S34、Q157P)和SRSF2(P95)突变情况。 结果 118例MDS患者中,男76例,女42例,中位年龄53.5(13~84)岁。对全部患者均进行SF3B1(K700E)基因突变分析,SF3B1(K700E)的突变率为19.49%(118例中23例)。在突变的22例MDS患者中,14例环形铁粒幼红细胞(RS)比例≥15%,其中难治性贫血伴环状铁粒幼红细胞(RARS)7例、难治性血细胞减少伴有多系发育异常(RCMD)6例、难治性贫血(RA)1例。与未突变组相比,突变组患者的年龄偏大[58(32~78)岁对51(13~84)岁,z=−1.981,P=0.048]、PLT偏高[121(22~888)×109/L对59(6~1 561)× 109/L,z=−3.305,P=0.001]、骨髓原始细胞比例偏低[0.007(0~0.122)对0.017(0~0.268),z=−2.885,P=0.004]、RS比例偏高[0(0~64%)对0(0~58%),z=−4.664,P<0.001],HGB偏低[63(40~95)g/L对77(34~144)g/L,z=−3.192,P=0.001]。对105例患者进行U2AF1(S34、Q157P)基因突变分析,突变率为21.90%(105例中23例)。突变组患者各临床特征与未突变组相比差异均无统计学意义。107例患者有SRSF2(P95)突变结果,8例突变,突变率为7.48%,突变组患者初诊时年龄偏高,中位年龄63(50~84)岁,其中难治性贫血伴有原始细胞增多-1(RAEB-1)4例,突变率为14.29%(28例中4例);MDS转化的急性髓系白血病3例。1例患者同时出现SF3B1(K700E)和SRSF2(P95H)突变,2例患者同时出现SF3B1(K700E)和U2AF1(S34Y)突变。 结论 SF3B1、U2AF1和SRSF2剪接体复合物蛋白编码基因中,仅SF3B1基因突变与环状铁粒幼红细胞增多性贫血密切相关,是该亚型的主要致病基因。
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Affiliation(s)
- J Y Wang
- Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences, Tianjin 300020, China
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Lin YN, Chen YH, Chang KC. P3514Revisit stroke prevention in atrial fibrillation with end-stage renal disease: a retrospective population-based time-dependent cohort study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Y N Lin
- China Medical University Hospital, Cardiovascular Medicine, Taichung, Taiwan ROC
| | - Y H Chen
- China Medical University Hospital, Taichung, Taiwan ROC
| | - K C Chang
- China Medical University Hospital, Cardiovascular Medicine, Taichung, Taiwan ROC
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Yan YR, Lin YN, Li QY. [Heterogeneity and individualized treatment of OSAHS: current status and prospects]. Zhonghua Jie He He Hu Xi Za Zhi 2018; 41:494-496. [PMID: 29886626 DOI: 10.3760/cma.j.issn.1001-0939.2018.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Wang HJ, Lin JJ, Lo WY, Chang CP, Hsu CH, Hsieh LC, Chen YP, Lin YN, Chang KC, Lo PH. Clinical Outcomes of Polytetrafluoroethylene-Covered Stents for Coronary Artery Perforation in Elderly Patients Undergoing Percutaneous Coronary Interventions. Acta Cardiol Sin 2017; 33:605-613. [PMID: 29167613 DOI: 10.6515/acs20170625a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Coronary artery perforation (CAP) during percutaneous coronary intervention (PCI) is associated with increased mortality. Polytetrafluoroethylene covered stents (CS) are an effective approach to treat CAP, but data regarding elderly patients requiring CS implantation for CAP are limited. The aim of this study is to report clinical data for elderly CAP patients undergoing CS implantation during PCI. Methods Nineteen consecutive elderly patients (≥ 65 years) undergoing CS implantation due to PCI-induced CAP in a tertiary referral center from July 2003 to April 2016 were retrospectively examined. Results There were 13 men and six women, with a mean age of 75.3 ± 5.6 years (range: 65-86 years). Perforation grade was Ellis type II in five patients (26.3%), and Ellis type III in 14 patients (73.7%). Cardiac tamponade developed in six patients (31.6%), and intra-aortic balloon pumping was needed in four patients (21.1%). The overall success rate for CS implantation rate was 94.7%. The overall in-hospital mortality rate was 15.8%; the in-hospital myocardial infarction rate was 63.2%. Among 16 survival-to-discharge cases, dual antiplatelet therapy (DAPT) was prescribed in 14 cases (87.5%) for a mean duration of 14 months. Overall, there were five angiogram- proven CS failures among 18 patients receiving successful CS implantation. The 1, 2 and 4 years of actuarial freedom from the CS failure were 78%, 65%, and 43% in the angiogram follow-up patients. Conclusions CS implantation for CAP is feasible and effective in elderly patients, while CS failure remains a major concern that encourages regular angiographic follow-up in these case.
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Affiliation(s)
- Huang-Joe Wang
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University and Hospital.,School of Medicine, China Medical University.,Cardiovascular Research Laboratory, China Medical University and Hospital
| | - Jen-Jyh Lin
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University and Hospital
| | - Wan-Yu Lo
- Cardiovascular & Translational Medicine Laboratory, Department of Biotechnology, Hungkuang University, Taichung, Taiwan
| | - Chih-Ping Chang
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University and Hospital.,School of Medicine, China Medical University
| | - Chung-Ho Hsu
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University and Hospital
| | - Li-Chuan Hsieh
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University and Hospital
| | - Yeh-Peng Chen
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University and Hospital
| | - Yen-Nien Lin
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University and Hospital
| | - Kuan-Cheng Chang
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University and Hospital.,School of Medicine, China Medical University.,Cardiovascular Research Laboratory, China Medical University and Hospital
| | - Ping-Han Lo
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University and Hospital
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Xie N, Chen DH, Lin YN, Wu SZ, Gu YY, Zeng QS, Zhai YY, Yang LY, Xu JX. [Pulmonary surfactant protein adenosine triphosphate-binding-cassette-A3 gene composite mutations in infant congenital interstitial lung disease: report of a case and review of literature]. Zhonghua Er Ke Za Zhi 2017; 54:761-766. [PMID: 27784479 DOI: 10.3760/cma.j.issn.0578-1310.2016.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To report a case of the pulmonary surfactant protein(SP) adenosine triphosphate-binding-cassette-A3 (ABCA3) gene mutations in infant congenital interstitial lung disease(ILD), and review the related literature, to investigate the relationships of ABCA3 gene mutation associated with ILD in infants. Method: A 6-months-old boy was hospitalized in the department of Pediatrics of the First Affiliated Hospital of Guangzhou Medical University. The clinical, radiological, histological information from transbronchial lung biopsy (TBLB) and genetic testing in this case was analyzed; 12 reports retrieved on literature search at Pubmed, OVID databases from 2004 to 2015 by using the ABCA3 as keyword were reviewed and analyzed. Result: (1)The patient, a 6-months-old boy, had progressive tachypnea and dyspnea since 4 months old. Physical examination on admission revealed respiratory rate of 78 times/min , heart rate of 187 times/min, SpO2 0.93(mask oxygen-inspiration with 6 L/min), scattered fine moist crackles could be heard over the both lungs, clubbing fingers were found. High-resolution computed tomography(HRCT) revealed diffuse ground-glass opacity, interlobular and intralobular septal thickening. Lung biopsies showed evidences of the alveolar cavity atelectatic changes and interstitial fibrosis. SP-A and SP-B were negative in immunohistochemical stainting. SP-related gene sequence analysis found that there was compound heterozygous missense mutation of ABCA3 gene in c. 1942A>G, c.2701-33G>C and c. 991-105C>A. (2)The review of related literature found that totally 12 cases were reported. The main manifestations were progressive tachypnea and dyspnea, age of onset was between birth and 4 years of age. The imaging characteristics of chest HRCT revealed diffuse infiltration or diffuse ground-glass pattern in the lung. PROGNOSIS 6 cases died, and 6 cases survived, including 4 cases with pulmonary function disturbance to different degrees; 12 cases had ABCA3 gene mutations, 9 cases had composite ABCA3 gene mutations, in 11 cases the mutation occured in the exon of coding region, in 1 case in the intron, 9 cases had heterozygous mutations, 3 cases had homozygous mutations. Conclusion: The main phenotypes of ABCA3 mutation associated with ILD were full term neonatal respiratory distress syndrome or progressive tachypnea or dyspnea unexplained in infants. The chest HRCT showed two diffuse pulmonary interstitial changes. ABCA3 mutation mainly was multi-site composite mutations and heterozygous mutations in the exon of coding region.
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Affiliation(s)
- N Xie
- *Department of Pediatrics, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
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Lin YN, Chang SS, Wang LM, Chi HT, Ueng KC, Tsai CF, Phan CS, Lu LH, Hii CH, Chung YT, Chugh SS, Chen MF, Wu TJ, Chang KC. Prehospital Predictors of Initial Shockable Rhythm in Out-of-Hospital Cardiac Arrest: Findings From the Taichung Sudden Unexpected Death Registry (THUNDER). Mayo Clin Proc 2017; 92:347-359. [PMID: 28259227 DOI: 10.1016/j.mayocp.2016.10.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 06/24/2016] [Revised: 09/25/2016] [Accepted: 10/28/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To identify the incidence and prehospital predictors of ventricular tachycardia/ventricular fibrillation (VT/VF) as the initial arrhythmia in patients with out-of-hospital cardiac arrest (OHCA) in central Taiwan. PATIENTS AND METHODS The Taichung Sudden Unexpected Death Registry program encompasses the Taichung metropolitan area in central Taiwan, with a population of 2.7 million and 17 destination hospitals for patients with OHCA. We performed a detailed analysis of demographic characteristics, circumstances of cardiac arrest, and emergency medical service records using the Utstein Style. RESULTS From May 1, 2013, through April 30, 2014, resuscitation was attempted in 2013 individuals with OHCA, of which 384 were excluded due to trauma and noncardiac etiologies. Of the 1629 patients with presumed cardiogenic OHCA, 7.9% (n=129) had initial shockable rhythm; this proportion increased to 18.8% (61 of 325) in the witnessed arrest subgroup. Male sex (odds ratio [OR], 2.45; 95% CI, 1.46-4.12; P<.001), age younger than 65 years (OR, 2.39, 95% CI, 1.58-3.62; P<.001), public location of arrest (OR, 4.61; 95% CI, 2.86-7.44; P<.001), and witnessed status (OR, 3.98; 95% CI, 2.62-6.05; P<.001) were independent predictors of VT/VF rhythm. CONCLUSION The proportion of patients with OHCA presenting with VT/VF was generally low in this East Asian population. Of the prehospital factors associated with VT/VF, public location of OHCA was the strongest predictor of VT/VF in this population, which may affect planning and deployment of emergency medical services in central Taiwan.
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Affiliation(s)
- Yen-Nien Lin
- Division of Cardiovascular Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Cardiovascular Research Laboratory, China Medical University Hospital, Taichung, Taiwan
| | - Shih-Sheng Chang
- Division of Cardiovascular Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Cardiovascular Research Laboratory, China Medical University Hospital, Taichung, Taiwan
| | - Lee-Min Wang
- Department of Emergency, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Hwan-Ting Chi
- Department of Emergency, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Kwo-Chang Ueng
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chin-Feng Tsai
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chee-Seong Phan
- Department of Emergency, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Li-Hua Lu
- Department of Emergency, Tung's Taichung MetroHabor Hospital, Taichung, Taiwan
| | - Choon-Hoon Hii
- Department of Emergency, Kuang Tien General Hospital, Taichung, Taiwan
| | - Yu-Ting Chung
- Department of Emergency, China Medical University Hospital, Taichung, Taiwan
| | | | - Ming-Fong Chen
- Division of Cardiovascular Medicine, China Medical University, Taichung, Taiwan; Cardiovascular Research Laboratory, China Medical University Hospital, Taichung, Taiwan
| | - Tsu-Juey Wu
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan.
| | - Kuan-Cheng Chang
- Division of Cardiovascular Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Cardiovascular Research Laboratory, China Medical University Hospital, Taichung, Taiwan.
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Peng L, Guo Y, Wang Y, Lin YN, Zhang CH, Wang HY, Yu RM, Sun XP. [Efficacy of intravenous thrombolysis in acute ischemic stroke with hyperdense middle cerebral artery sign]. Zhonghua Yi Xue Za Zhi 2017; 97:193-197. [PMID: 28162169 DOI: 10.3760/cma.j.issn.0376-2491.2017.03.007] [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: 06/06/2023]
Abstract
Objective: To observe the efficacy and safety of recombinant tissue-type plasminogen activator (rtPA) intravenous thrombolysis (IVT) in the treatment of acute cerebral infarction with hyperdense middle cerebral artery sign (HMCAS). Methods: Acute cerebral infarction patients with HMCAS from July 2010 to November 2015 at the First Affiliated Hospital of Dalian Medical University were collected.These patients were divided into two groups depending on whether they received IVT or not.The Nation Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to evaluate early and long-time therapeutic effects.Efficacy and safety were compared between the two groups. Results: A total of 93 patients were eligible for the analysis, with 45 cases in IVT group and 48 cases in non-IVT group.As time went by, NIHSS score in IVT group showed significant downward trend than the non-IVT group.The rate of patients with good outcome in IVT group was higher than that in non-IVT group (P<0.05). The rate of hemorrhage transformation (HT) in IVT group and non-IVT group was 35.6% (16/45) and 10.4% (11/48), respectively, and the difference was statistically significant (P<0.05). While no statistically significant difference was found about the rate of symptomatic intracranial hemorrhage (sICH) (8.9% vs 2.1%, P>0.05) and mortality (33.3% vs 27.1%, P>0.05) between these two groups.Logistic regression analysis identified relativity between IVT treatment and good outcome (P<0.05), hemorrhage transformation (P<0.05), rather than mortality (P>0.05). Conclusions: Intravenous thrombolysis with rt-PA is an effective and safe treatment for most acute ischemic stroke patients with HMCAS and can promote early neurologic improvement and significantly improve long-term functional prognosis.Although Ⅳ thrombolysis can increase the risk of overall HT, it does not add risk in sICH and mortality.
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Affiliation(s)
- L Peng
- Department of Neurology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
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Lin YN, Chen YH, Wang HJ, Hung JS, Chang KC, Lo PH. Atrial Septostomy for Left Atrial Decompression During Extracorporeal Membrane Oxygenation by Inoue Balloon Catheter. Circ J 2017; 81:1419-1423. [PMID: 28496031 DOI: 10.1253/circj.cj-16-1308] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yen-Nien Lin
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital
- Cardiovascular Research Laboratory, China Medical University Hospital
- Graduate Institute of Clinical Medical Science, China Medical University
| | - Yin-Huei Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital
| | - Huang-Joe Wang
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital
- Cardiovascular Research Laboratory, China Medical University Hospital
| | - Jui-Sung Hung
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital
| | - Kuan-Cheng Chang
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital
- Cardiovascular Research Laboratory, China Medical University Hospital
- Graduate Institute of Clinical Medical Science, China Medical University
| | - Ping-Han Lo
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital
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Xing F, Lin YN, Sun Q, Qin L, Jia YJ, Zhang DL, Ru K. [Characterization of mutational pattern in patients with Ph negative myeloproliferative neoplasms]. Zhonghua Bing Li Xue Za Zhi 2016; 45:626-30. [PMID: 27646892 DOI: 10.3760/cma.j.issn.0529-5807.2016.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To characterize the molecular profile in patients with Ph negative myeloproliferative neoplasms (MPN) by exploring 49 gene mutations. METHODS Targeted gene sequencing were performed to analyze 49 MPN-associated genes in 51 patients with Ph negative MPN, of which CARL (exon 9), NPM1 (exon 12) and CEBPA (TAD, BZIP domains) were investigated by using Sanger sequencing simultaneously, while FLT3-ITD was assessed by PCR method. RESULTS Mutations were detected in 73.5% (36/49) of genes, and the mutational rates of JAK2-V617F, CALR (exon 9) and MPL were 60.8%(31/51), 7.8%(4/51) and 7.8%(4/51) respectively, whereas the mutational rates of ASXL1, SETBP1, and SF3B1 were around 10%. In addition, 96.1% (49/51) of patients harbored at least one mutation, and more than half of the patients (52.9%, 27/51) possessed 3 or 4 gene mutations. The amount of gene mutations was significantly higher in patients with JAK2-V617F mutation than those without JAK2-V617F or CALR (exon 9) mutation (P<0.05). The last finding was that there was no statistically significant difference in the amount of mutations among four MPN subtypes (PV, ET, PMF, and MPN-U). CONCLUSION Most patients with Ph negative MPN possesses three or more gene mutations, with various mutational profiles.
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Affiliation(s)
- F Xing
- Department of Pathology and Lab Medicine, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Tianjin 300020, China
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Li QY, Lin YN. [Assessment of factors that influence CPAP adherence: a biopsychosocial perspective]. Zhonghua Yi Xue Za Zhi 2016; 96:2369-2371. [PMID: 27545025 DOI: 10.3760/cma.j.issn.0376-2491.2016.30.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Guo Y, Zhang CH, Wang HY, Lin YN, Wang Y, Sun XP. [Effect of intravenous thrombolysis with recombinant tissue type plasminogen activator (rt-PA) in different time windows on acute cerebral infarction patients with atrial fibrillation]. Zhonghua Yi Xue Za Zhi 2016; 96:2054-8. [PMID: 27468616 DOI: 10.3760/cma.j.issn.0376-2491.2016.26.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To observe the intravenous thrombolysis effect of rt-PA in different time windows of acute cerebral infarction with atrial fibrillation(AF). METHODS Acute cerebral infarction patients who accepted the intravenous thrombolysis treatment with AF from January 2012 to December 2015 were included.According to the time from onset to intravenous thrombolysis, patients were divided into two groups: thrombolysis within 3 h and thrombolysis between 3-4.5 h. The Nation Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to evaluate early and long-time therapeutic effects. The incidence of hemorrhagic infarction(HI), parenchymal hemorrhage(PH) and symptomatic intracranial hemorrhage(sICH) after thrombolysis within 24 hours were observed in the two groups. RESULTS A total of 103 patients were included in the study, with 48 cases in thrombolysis within 3 h group and 55 cases in thrombolysis between 3-4.5 h group. After thrombolysis treatment, the 24-hour and 7-day NIHSS score of the two groups were significant lower than before treatment, and the difference was statistically significant(P<0.05). Compared between groups, 24-hour clinical efficacy of thrombolysis within 3 h group was better than that of thrombolysis between 3-4.5 h group, and the difference was statistically significant(P<0.05). There were no statistically significant differences between these two groups about 7-day and 90-day prognosis(P<0.05). The rate of PH in thrombolysis within 3 h group and thrombolysis between 3-4.5 h group is 6.3%(3/48) and 21.8%(12/55) individually, and the difference was statistically significant(P<0.05). While no statistically significant differences was found about the rate of HI(18.8% vs 32.7%, P>0.05) and sICH(8.3% vs 14.5%, P>0.05) between these two groups. CONCLUSIONS For patients of acute cerebral infarction with AF, intravenous thrombolytic therapy by rt-PA within 3 h may contribute to a greatly improvement in a short time. Thrombolysis between 3-4.5 h increase the incidence of PH, but do not increase the incidence of sICH. There are no statistically significant differences between these two groups about 90-day favorable prognosis, indicating that thrombolysis between 3-4.5 h is safe and effective for acute cerebral infarction patients with AF.
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Affiliation(s)
- Y Guo
- Department of Neurology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
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Lin YN, Jia R, Liu YH, Gao Y, Wang LL, Kou JP, Yu BY. Ruscogenin suppresses mouse neutrophil activation: Involvement of protein kinase A pathway. J Steroid Biochem Mol Biol 2015; 154:85-93. [PMID: 26134424 DOI: 10.1016/j.jsbmb.2015.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 05/26/2015] [Accepted: 06/22/2015] [Indexed: 11/20/2022]
Abstract
Ruscogenin, a natural steroidal sapogenin, presents in both food and medicinal plants. It has been found to exert significant anti-inflammatory activities. Considering that activation of neutrophil is a key feature of inflammatory diseases, this study was performed to investigate the inhibitory effect of ruscogenin and its underlying mechanisms responsible for neutrophil activation. Ruscogenin displayed potent antioxidative effects against Formyl-Met-Leu-Phe (FMLP)-induced extra- and intracellular superoxide generation in mouse bone marrow neutrophils, with IC50 values of 1.07±0.32 μM and 1.77±0.46 μM, respectively. Phorbol myristate acetate (PMA)-elicited extra- and intracellular superoxide generation were also suppressed by ruscogenin, with IC50 values of 1.56±0.46 μM and 1.29±0.49 μM, respectively. However, ruscogenin showed weak inhibition in NaF-induced response. Inhibition of superoxide generation was mediated neither by a superoxide-scavenging ability nor by a cytotoxic effect. Furthermore, ruscogenin inhibited the membrane translocation of p47phox and p67phox. It reduced FMLP-induced phosphorylation of cytosolic phospholipase A2 (cPLA2) and p21-activated kinase (PAK). The cellular cyclic adenosine monophosphate (cAMP) levels and protein kinase A (PKA) expression were increased by ruscogenin. Moreover, ruscogenin inhibited phosphorylation of protein kinase B (Akt), p38 mitogen-activated protein kinase (p38MAPK), extracellular signal-regulated kinase 1 and 2 (ERK1/2), and c-Jun N-terminal kinase (JNK). In addition, the inhibitory effects of ruscogenin on superoxide production and the phosphorylation of Akt, p38MAPK, and ERK1/2 were reversed by PKA inhibitor (H89), suggesting a PKA-dependent mechanism. In summary, our data suggest that ruscogenin inhibits activation of neutrophil through cPLA2, PAK, Akt, MAPKs, cAMP, and PKA signaling pathways. Increased PKA activity is associated with suppression of the phosphorylation of Akt, p38MAPK, and ERK1/2 pathways.
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Affiliation(s)
- Y N Lin
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, PR China
| | - R Jia
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, PR China
| | - Y H Liu
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, PR China
| | - Y Gao
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, PR China
| | - L L Wang
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, PR China
| | - J P Kou
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Department of Complex Prescription of TCM, China Pharmaceutical University, Nanjing, PR China.
| | - B Y Yu
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Department of Complex Prescription of TCM, China Pharmaceutical University, Nanjing, PR China.
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Chen J, Chee D, Wang Y, Lim GY, Chong SM, Lin YN, Huangfu T. Identification of a novel cyprinid herpesvirus 3 genotype detected in koi from the East Asian and South-East Asian Regions. J Fish Dis 2015; 38:915-923. [PMID: 25297376 DOI: 10.1111/jfd.12305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 07/29/2014] [Accepted: 07/29/2014] [Indexed: 06/04/2023]
Abstract
Cyprinid herpesvirus 3 (CyHV-3) is a highly contagious virus that causes significant morbidity and mortality in common carp Cyprinus carpio L. and considered to be one of the most important pathogens of koi and common carp worldwide. Cyprinid herpesvirus 3 infected consignments imported from East Asian and South-East Asian regions were identified during quarantine period in Singapore, and virus from a 2005 consignment was successfully isolated in koi fin cells. A combination of sequence analyses and duplex PCR were used to characterize 15 CyHV-3 isolates detected in koi consignments between 2005 and 2011. Sequence analyses of the enlarged 9/5, SphI-5 and TK gene regions identified both the Asian 1 (n = 11) and European 4 (n = 4) genotypes. Duplex PCR analysis of two variable marker regions between ORF29 and ORF30 (marker I) as well as ORF133 and its upstream region (marker II) revealed viruses of genotypes J (I++ II+ ), U/I (I-- II- ), an intermediate genotype (I++ II- ) and a novel genotype, I++ II+Δ , which was identified in viruses from seven different consignments. This novel genotype has a 13-bp deletion in marker II, while maintaining the I++ allele of marker I. The I++ II+Δ genotype may have emerged from East Asian and South-East Asian regions in recent years.
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Affiliation(s)
- J Chen
- Virology Section, Animal Health Laboratory Department, Laboratories Group, Agri-Food and Veterinary Authority of Singapore, Singapore
| | - D Chee
- Aquatic Animal Health Section, Animal Health Laboratory Department, Laboratories Group, Agri-Food and Veterinary Authority of Singapore, Singapore
| | - Y Wang
- Virology Section, Animal Health Laboratory Department, Laboratories Group, Agri-Food and Veterinary Authority of Singapore, Singapore
| | - G Y Lim
- Virology Section, Animal Health Laboratory Department, Laboratories Group, Agri-Food and Veterinary Authority of Singapore, Singapore
| | - S M Chong
- Aquatic Animal Health Section, Animal Health Laboratory Department, Laboratories Group, Agri-Food and Veterinary Authority of Singapore, Singapore
| | - Y N Lin
- Virology Section, Animal Health Laboratory Department, Laboratories Group, Agri-Food and Veterinary Authority of Singapore, Singapore
| | - T Huangfu
- Virology Section, Animal Health Laboratory Department, Laboratories Group, Agri-Food and Veterinary Authority of Singapore, Singapore
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Chang KC, Lee AS, Chen WY, Lin YN, Hsu JF, Chan HC, Chang CM, Chang SS, Pan CC, Sawamura T, Chang CT, Su MJ, Chen CH. Increased LDL electronegativity in chronic kidney disease disrupts calcium homeostasis resulting in cardiac dysfunction. J Mol Cell Cardiol 2015; 84:36-44. [PMID: 25871829 DOI: 10.1016/j.yjmcc.2015.03.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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: 11/18/2014] [Revised: 03/27/2015] [Accepted: 03/28/2015] [Indexed: 11/27/2022]
Abstract
Chronic kidney disease (CKD), an independent risk factor for cardiovascular disease, is associated with abnormal lipoprotein metabolism. We examined whether electronegative low-density lipoprotein (LDL) is mechanistically linked to cardiac dysfunction in patients with early CKD. We compared echocardiographic parameters between patients with stage 2 CKD (n = 88) and normal controls (n = 89) and found that impaired relaxation was more common in CKD patients. Reduction in estimated glomerular filtration rate was an independent predictor of left ventricular relaxation dysfunction. We then examined cardiac function in a rat model of early CKD induced by unilateral nephrectomy (UNx) by analyzing pressure-volume loop data. The time constant of isovolumic pressure decay was longer and the maximal velocity of pressure fall was slower in UNx rats than in controls. When we investigated the mechanisms underlying relaxation dysfunction, we found that LDL from CKD patients and UNx rats was more electronegative than LDL from their respective controls and that LDL from UNx rats induced intracellular calcium overload in H9c2 cardiomyocytes in vitro. Furthermore, chronic administration of electronegative LDL, which signals through lectin-like oxidized LDL receptor-1 (LOX-1), induced relaxation dysfunction in wild-type but not LOX-1(-/-) mice. In in vitro and in vivo experiments, impaired cardiac relaxation was associated with increased calcium transient resulting from nitric oxide (NO)-dependent nitrosylation of SERCA2a due to increases in inducible NO synthase expression and endothelial NO synthase uncoupling. In conclusion, LDL becomes more electronegative in early CKD. This change disrupts SERCA2a-regulated calcium homeostasis, which may be the mechanism underlying cardiorenal syndrome.
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Affiliation(s)
- Kuan-Cheng Chang
- Division of Cardiology, China Medical University (CMU) Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, CMU, Taichung, Taiwan
| | - An-Sheng Lee
- Department of Medicine, Mackay Medical College, New Taipei, Taiwan; L5 Research Center, CMU Hospital, CMU, Taichung, Taiwan
| | - Wei-Yu Chen
- L5 Research Center, CMU Hospital, CMU, Taichung, Taiwan
| | - Yen-Nien Lin
- Division of Cardiology, China Medical University (CMU) Hospital, Taichung, Taiwan
| | - Jing-Fang Hsu
- L5 Research Center, CMU Hospital, CMU, Taichung, Taiwan
| | - Hua-Chen Chan
- L5 Research Center, CMU Hospital, CMU, Taichung, Taiwan; Center for Lipid Biosciences, Kaohsiung Medical University (KMU) Hospital, KMU, Kaohsiung, Taiwan
| | | | - Shih-Sheng Chang
- Division of Cardiology, China Medical University (CMU) Hospital, Taichung, Taiwan
| | - Chia-Chi Pan
- L5 Research Center, CMU Hospital, CMU, Taichung, Taiwan
| | - Tatsuya Sawamura
- Department of Physiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | | | - Ming-Jai Su
- Graduate Institute of Pharmacology, National Taiwan University, Taipei, Taiwan.
| | - Chu-Huang Chen
- L5 Research Center, CMU Hospital, CMU, Taichung, Taiwan; Vascular and Medicinal Research, Texas Heart Institute, Houston, TX, USA; Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Center for Lipid and Glycomedicine Research, KMU Hospital, KMU, Kaohsiung, Taiwan.
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Hsiao P, Hsu WY, Liou TH, Lin YN, Lin Y, Chang KH. Association between body composition and median neuropathy in patients with physical disabilities. Eur J Phys Rehabil Med 2015; 51:5-13. [PMID: 25311882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Patients with physical disabilities more often have median neuropathies of the wrist and more than 70% of wheelchair users are overweight or obese. AIM To explore the effects of body composition on the occurrence of distal median neuropathy and to search for the best probabilistic cutoff value of indicators to predict the likelihood of developing distal median neuropathy in patients with physical disabilities. DESIGN A prospective study. SETTING A 1-day annual physical checkup program for employees of a social welfare organization. POPULATION In total, 72 patients with a physical disability (mean age ± SD, 40.0 ± 8.8 years; 40 women). METHODS Using electrophysiologic testing to assess distal median nerve function and using a dual-energy X-ray absorptiometry examination to assess body composition. The formula for leg exercise burden index (EBI) was: leg EBI = body fat mass of both legs/lean tissue mass of both legs. RESULTS The risk of developing a low median sensory nerve conduction velocity in the wrist-to-palm segment (< 43 m/s) was greater for patients with a higher leg EBI, yielding an adjusted odds ratio of 6.88 (P < 0.005). The body mass index (BMI) and being a wheelchair user were predictors of developing long median distal motor latency (> 4 ms). Using receiver operating characteristic analyses, we determined that patients with a physical disability were likely to develop distal median sensory neuropathy if they had a leg EBI of ≥ 0.943 and were likely to develop distal median motor neuropathy if they had a BMI of ≥ 24.5 kg/m2. CONCLUSION The leg EBI is a predictor of having distal median sensory neuropathy among patients with a physical disability. CLINICAL REHABILITATION IMPACT The value of the leg EBI can be useful information for identifying risk of distal median sensory neuropathy in patients with a physical disability.
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Affiliation(s)
- P Hsiao
- Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, (Hsiao, Hsu, YN Lin, Yu Lin, Chang), Taipei, Taiwan -
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Affiliation(s)
- Yin-Huie Chen
- Department of Internal Medicine, China Medical University Hospital, China Medical University, Taiwan
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Chang YS, Yang YW, Lin YN, Lin KH, Chang KC, Chang JG. Mutation Analysis of KCNQ1, KCNH2 and SCN5A Genes in Taiwanese Long QT Syndrome Patients. Int Heart J 2015; 56:450-3. [PMID: 26118593 DOI: 10.1536/ihj.14-428] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Ya-Sian Chang
- Epigenome Research Center, China Medical University Hospital
- Department of Laboratory Medicine, China Medical University Hospital
| | - Yi-Wen Yang
- Department of Laboratory Medicine, China Medical University Hospital
| | - Yen-Nien Lin
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital
| | - Kuo-Hung Lin
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital
| | - Kuan-Cheng Chang
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital
- School of Medicine, China Medical University
| | - Jan-Gowth Chang
- Epigenome Research Center, China Medical University Hospital
- Department of Laboratory Medicine, China Medical University Hospital
- School of Medicine, China Medical University
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Lin YN, Liang HY, Lo PH, Chang KC, Chen YP. Precordial ST-Segment Elevation Caused by Proximal Occlusion of a Non-Dominant Right Coronary Artery. Acta Cardiol Sin 2014; 30:497-500. [PMID: 27122826 PMCID: PMC4834965] [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] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 12/20/2013] [Indexed: 06/05/2023]
Abstract
UNLABELLED For patients with ST-segment elevation myocardial infarction, primary percutaneous coronary intervention to the culprit lesion via electrocardiographic guidance is essential. We herein report the rare case of a 49-year-old man who presented with ST-segment elevation in the precordial leads, while coronary angiography results indicated total occlusion of the proximal non-dominant right coronary artery. We evaluated its possible pathophysiologic mechanisms and thoroughly discussed isolated right ventricular infarction and its electrocardiography findings. KEY WORDS Coronary angiography; Myocardial infarction; Total occlusions.
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Affiliation(s)
- Yen-Nien Lin
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, China Medical University
| | - Hsin-Yueh Liang
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, China Medical University
| | - Ping-Han Lo
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, China Medical University
| | - Kuan-Cheng Chang
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, China Medical University
- Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Yeh-Peng Chen
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, China Medical University
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Lin YN, Chang YJ, Chen YH, Ko PY, Lin CL, Sung FC, Chang KC, Kao CH. Nationwide population-based cohort study on the association of acute coronary syndrome in patients with malignancies. Support Care Cancer 2014; 22:2707-13. [DOI: 10.1007/s00520-014-2262-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 04/22/2014] [Indexed: 10/25/2022]
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Lin YN, Lin CL, Chang YJ, Peng CL, Sung FC, Chang KC, Kao CH. Increased subsequent risk of acute coronary syndrome for patients with depressive disorder: a nationwide population-based retrospective cohort study. Psychiatry Clin Neurosci 2014; 68:263-9. [PMID: 24313756 DOI: 10.1111/pcn.12125] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 09/18/2013] [Accepted: 09/21/2013] [Indexed: 12/29/2022]
Abstract
AIM The purpose of this study was to explore the possible association between subsequent acute coronary syndrome (ACS) risk and depressive disorder. METHODS We used data from the National Health Insurance system of Taiwan to address the research topic. The exposure cohort contained 10 871 patients with new diagnoses of depressive disorders. Each patient was randomly frequency-matched for sex and age with four participants from the general population who did not have any ACS history before the index date (control group). Cox's proportion hazard regression analyses were conducted to estimate the relation between depressive disorders and subsequent ACS risk. RESULTS Among patients with depressive disorders, the overall risk for developing subsequent ACS was significantly higher than that of the control group (adjusted hazard ratio: 1.88, 95% confidence interval: 1.63-2.17). Further analysis revealed that the higher risk was observed in patients who were male, were of older age, or whose diagnosis was combined with other comorbidities. CONCLUSIONS The findings from this population-based retrospective cohort study suggest that depressive disorder is associated with an increased subsequent ACS risk.
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Affiliation(s)
- Yen-Nien Lin
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
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Huang TL, Lin YN, Chen CH, Tseng YJ. A rare complication of contraceptives: hematoma formation and thrombosis. Intern Med 2014; 53:1447. [PMID: 24990338 DOI: 10.2169/internalmedicine.53.2408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Tai-Lin Huang
- Division of Toxicology, China Medical University Hospital, Taiwan
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46
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Affiliation(s)
- Yen-Nien Lin
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, Taiwan
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Lin YN, Chou JW, Cheng KS, Peng CY, Jeng LB, Chiang IP. Treatment of Fulminant Autoimmune Hepatitis: Corticosteroid Therapy or Liver Transplantation? A Case Report and Literature Review. Gastroenterology Res 2011; 4:231-235. [PMID: 27957021 PMCID: PMC5139849 DOI: 10.4021/gr323w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2011] [Indexed: 11/22/2022] Open
Abstract
Autoimmune hepatitis initially presenting as fulminant hepatic failure is rare in clinical practice. Although corticosteroid is considered as a good therapeutic agent in treating autoimmune hepatitis in the literature, the effect of corticosteroid in treating fulminant autoimmune hepatitis is still controversial. Because corticosteroid therapy for fulminant autoimmune hepatitis can sometimes overlook any future treatment such as delay the timing of liver transplantation and precipitate postoperative complications. We report a case of a 41-year-old female who was admitted to our hosptal because of acute hepatitis with severe jaundice. Type 1 autoimmune hepatitis complicated by fulminant hepatic failure was diagnosed on the basis of her clinical course and laboratory findings. Although we prescribed aggressive medical treatment, plasma transfusion, and plasma exchange therapy, her liver function deteriorated progressively and she developed hepatic coma later. Finally, her fulminant hepatic fuilure gained dramatic improvement after receiving an orthotopic liver transplant from her younger brother. High MELD score and poor treatment response of corticosteroid therapy are indicators of poor prognosis and need of prompt OLT. Moreover, the preoperative interventions should be applied carefully ensuring that they do not delay OLT or precipitate postoperative complications such as infection, bleeding, or poor wound healing.
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Affiliation(s)
- Yen-Nien Lin
- Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Jen-Wei Chou
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; These authors contribute equally to this article
| | - Ken-Sheng Cheng
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; These authors contribute equally to this article
| | - Cheng-Yuan Peng
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Long-Bin Jeng
- Organ transplantation center, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - I-Ping Chiang
- Department of Pathology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
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Affiliation(s)
- Po-Heng Chuang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taiwan
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Lin YN, Yeh HC, Huang CP, Chiang IP. Wicked benign tumor in a young woman. Intern Med 2011; 50:2069-70. [PMID: 21921406 DOI: 10.2169/internalmedicine.50.5817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yen-Nien Lin
- Department of Internal Medicine, China Medical University Hospital, Taiwan
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Lin YN, Chou JW, Chuang PH, Cheng KS, Peng CY, Chiang IP. Primary small intestinal natural killer/T cell lymphoma mimicking tuberculous peritonitis: report of a case and review of the literature. Intern Med 2011; 50:515-8. [PMID: 21372470 DOI: 10.2169/internalmedicine.50.4435] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Extranodal natural killer/T cell lymphoma is very rarely encountered in clinical practice. It has a high mortality rate and very short median survival. Early diagnosis of these rare tumors, especially those originating from the small intestine, is usually difficult because of its nonspecific symptoms. Herein, we describe a case of a primary small intestinal natural killer/T cell lymphoma in a 52-year-old man who presented with abdominal fullness and weight loss. The clinical symptoms, elevation of serum levels of cancer antigen-125, and presence of ascites initially led to the suspicion of tuberculous peritonitis. Abdominal computed tomography scan demonstrated a hypodense tumor in the jejunum. Finally, the tumor was surgically confirmed to be a natural killer/T-cell lymphoma. Although aggressive chemotherapy was prescribed, the patient subsequently died of disease progression. In addition, we also review the English literature on this rare disease.
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Affiliation(s)
- Yen-Nien Lin
- Department of Internal Medicine, China Medical University Hospital, China Medical University, Taiwan
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