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Collins BEG, Kingsley M, Gordon BA, Zadow EK, Wundersitz DWT. Coagulation activity and thrombotic risk following high-volume endurance exercise in recreationally active cyclists. J Appl Physiol (1985) 2024; 136:1284-1290. [PMID: 38572538 DOI: 10.1152/japplphysiol.00824.2023] [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: 11/17/2023] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/05/2024] Open
Abstract
Despite the prognostic effect of physical activity, acute bouts of high-volume endurance exercise can induce cardiac stress and postexercise hypercoagulation associated with increased thrombotic risk. The aim of this study was to explore the effect of high-volume endurance exercise on coagulation and thrombotic activity in recreational cyclists. Thirty-four recreational cyclists completed 4.8 ± 0.3 h of cycling at 45 ± 5% of maximal power output on a bicycle ergometer. Intravenous blood samples were collected preexercise, immediately postexercise, 24 and 48 h postexercise, and analyzed for brain natriuretic peptide (BNP), cardiac troponin (cTn), C-reactive protein (CRP), D-dimer, thrombin-antithrombin (TAT) complex, tissue factor (TF), tissue factor pathway inhibitor (TFPI), and TF-to-TFPI ratio (TF:TFPI). An increase in cTn was observed postexercise (P < 0.001). CRP concentrations were increased at 24 and 48 h postexercise compared with preexercise concentrations (P ≤ 0.001). TF was elevated at 24 h postexercise (P < 0.031) and TFPI was higher immediately postexercise (P < 0.044) compared with all other time points. TF:TFPI was increased at 24 and 48 h postexercise compared with preexercise (P < 0.025). TAT complex was reduced at 48 h postexercise compared with preexercise (P = 0.015), D-dimer was higher immediately postexercise compared with all other time points (P ≤ 0.013). No significant differences were observed in BNP (P > 0.05). High-volume endurance cycling induced markers of cardiac stress among recreational cyclists. However, plasma coagulation and fibrinolytic activity suggest no increase in thrombotic risk after high-volume endurance exercise.NEW & NOTEWORTHY In this study, a high-volume endurance exercise protocol induced markers of cardiac stress and altered plasma coagulation and fibrinolytic activity for up to 48 h in recreationally active cyclists. However, analysis of coagulation biomarkers indicates no increase in thrombotic risk when appropriate hydration and rest protocols are implemented.
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Affiliation(s)
- Blake E G Collins
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Michael Kingsley
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- Department of Exercise Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand
| | - Brett A Gordon
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Emma K Zadow
- School of Health Science, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Daniel W T Wundersitz
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
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Harjen HJ, Hellum M, Rørtveit R, Oscarson M, Anfinsen KP, Moldal ER, Solbak S, Kanse SM, Henriksson CE. Persistent hypercoagulability in dogs envenomated by the European adder (Vipera berus berus). PLoS One 2022; 17:e0263238. [PMID: 35180240 PMCID: PMC8856559 DOI: 10.1371/journal.pone.0263238] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 01/14/2022] [Indexed: 11/23/2022] Open
Abstract
Background Envenomation by the European adder, Vipera berus berus (Vbb), is a medical emergency. The overall in vivo haemostatic effects of pro- and anticoagulant components in Vbb venom, and the downstream effects of cellular injury and systemic inflammation, are unclear. Objectives To longitudinally describe the global coagulation status of dogs after Vbb envenomation and compare to healthy controls. A secondary aim was to investigate differences between dogs treated with and without antivenom. Methods Citrated plasma was collected at presentation, 12 hours (h), 24 h, 36 h and 15 days after bite from 28 dogs envenomated by Vbb, and from 28 healthy controls at a single timepoint. Thrombin generation (initiated with and without exogenous phospholipids and tissue factor), thrombin-antithrombin (TAT)-complexes and the procoagulant activity of phosphatidylserine (PS)-expressing extracellular vesicles (EVs), expressed as PS-equivalents, were measured. Results At presentation the envenomated dogs were hypercoagulable compared to controls, measured as increased thrombin generation, TAT-complexes and PS-equivalents. The hypercoagulability decreased gradually but compared to controls thrombin generation and PS-equivalents were still increased at day 15. The discrepancy in peak thrombin between envenomated dogs and controls was greater when the measurement was phospholipid-dependent, indicating that PS-positive EVs contribute to hypercoagulability. Lag time was shorter in non-antivenom treated dogs, compared to antivenom treated dogs <24 h after envenomation. Conclusions Hypercoagulability was measured in dogs up to 15 days after Vbb envenomation. Dogs treated with antivenom may be less hypercoagulable than their non-antivenom treated counterparts. Thrombin generation is a promising diagnostic and monitoring tool for Vbb envenomation.
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Affiliation(s)
- Hannah J. Harjen
- Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo, Norway
- * E-mail:
| | - Marit Hellum
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- The Blood Cell Research Group, Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Runa Rørtveit
- Faculty of Veterinary Medicine, Department of Preclinical Sciences and Pathology, Norwegian University of Life Sciences, Oslo, Norway
| | | | - Kristin P. Anfinsen
- Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo, Norway
| | - Elena R. Moldal
- Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo, Norway
| | - Susanna Solbak
- Anicura Dyresykehus Oslo, Oslo, Norway
- Anicura Jeløy Dyresykehus, Moss, Norway
| | - Sandip M. Kanse
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Carola E. Henriksson
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- The Blood Cell Research Group, Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
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Maffioli E, Jiang Z, Nonnis S, Negri A, Romeo V, Lietz CB, Hook V, Ristagno G, Baselli G, Kistler EB, Aletti F, O’Donoghue AJ, Tedeschi G. High-Resolution Mass Spectrometry-Based Approaches for the Detection and Quantification of Peptidase Activity in Plasma. Molecules 2020; 25:molecules25184071. [PMID: 32899982 PMCID: PMC7571063 DOI: 10.3390/molecules25184071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/28/2020] [Accepted: 09/04/2020] [Indexed: 12/16/2022] Open
Abstract
Proteomic technologies have identified 234 peptidases in plasma but little quantitative information about the proteolytic activity has been uncovered. In this study, the substrate profile of plasma proteases was evaluated using two nano-LC-ESI-MS/MS methods. Multiplex substrate profiling by mass spectrometry (MSP-MS) quantifies plasma protease activity in vitro using a global and unbiased library of synthetic peptide reporter substrates, and shotgun peptidomics quantifies protein degradation products that have been generated in vivo by proteases. The two approaches gave complementary results since they both highlight key peptidase activities in plasma including amino- and carboxypeptidases with different substrate specificity profiles. These assays provide a significant advantage over traditional approaches, such as fluorogenic peptide reporter substrates, because they can detect active plasma proteases in a global and unbiased manner, in comparison to detecting select proteases using specific reporter substrates. We discovered that plasma proteins are cleaved by endoproteases and these peptide products are subsequently degraded by amino- and carboxypeptidases. The exopeptidases are more active and stable in plasma and therefore were found to be the most active proteases in the in vitro assay. The protocols presented here set the groundwork for studies to evaluate changes in plasma proteolytic activity in shock.
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Affiliation(s)
- Elisa Maffioli
- Department of Veterinary Medicine, University of Milano, 20133 Milano, Italy; (E.M.); (S.N.); (A.N.); (V.R.)
- Centre for Nanostructured Materials and Interfaces (CIMAINA), University of Milano, 20133 Milano, Italy
| | - Zhenze Jiang
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA 92093, USA; (Z.J.); (C.B.L.); (V.H.)
| | - Simona Nonnis
- Department of Veterinary Medicine, University of Milano, 20133 Milano, Italy; (E.M.); (S.N.); (A.N.); (V.R.)
- Centre for Nanostructured Materials and Interfaces (CIMAINA), University of Milano, 20133 Milano, Italy
| | - Armando Negri
- Department of Veterinary Medicine, University of Milano, 20133 Milano, Italy; (E.M.); (S.N.); (A.N.); (V.R.)
- Centre for Nanostructured Materials and Interfaces (CIMAINA), University of Milano, 20133 Milano, Italy
| | - Valentina Romeo
- Department of Veterinary Medicine, University of Milano, 20133 Milano, Italy; (E.M.); (S.N.); (A.N.); (V.R.)
| | - Christopher B. Lietz
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA 92093, USA; (Z.J.); (C.B.L.); (V.H.)
| | - Vivian Hook
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA 92093, USA; (Z.J.); (C.B.L.); (V.H.)
- Department of Neurosciences, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Giuseppe Ristagno
- Department of Pathophysiology and Transplantation, University of Milan, 20133 Milan, Italy;
| | - Giuseppe Baselli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milan, Italy;
| | - Erik B. Kistler
- Department of Anesthesiology & Critical Care, University of California San Diego, La Jolla, CA 92093, USA;
- Department of Anesthesiology & Critical Care, VA San Diego HealthCare System, San Diego, CA 92161, USA
| | - Federico Aletti
- Department of Bioengineering, University of California San Diego, La Jolla, CA 92093, USA;
| | - Anthony J. O’Donoghue
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA 92093, USA; (Z.J.); (C.B.L.); (V.H.)
- Correspondence: (A.J.O.); (G.T.); Tel.: +1-8585345360 (A.J.O.); +39-02-50318127 (G.T.)
| | - Gabriella Tedeschi
- Department of Veterinary Medicine, University of Milano, 20133 Milano, Italy; (E.M.); (S.N.); (A.N.); (V.R.)
- Centre for Nanostructured Materials and Interfaces (CIMAINA), University of Milano, 20133 Milano, Italy
- Correspondence: (A.J.O.); (G.T.); Tel.: +1-8585345360 (A.J.O.); +39-02-50318127 (G.T.)
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Cui C, Gao J, Li J, Yu M, Zhang H, Cui W. Value of TAT and PIC with D-dimer for cancer patients with metastasis. Int J Lab Hematol 2020; 42:387-393. [PMID: 32250048 DOI: 10.1111/ijlh.13194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The hypercoagulability of blood is related to the development and metastasis of cancer. High levels of D-dimer have been reported to be associated with the metastasis and poor prognoses of cancer. Here, we investigated the performance of biomarkers-TAT, PIC, TM, and tPAI·C by new method-for monitoring cancer patients with metastasis. METHODS A total of 197 cancer patients were enrolled. TM, TAT, PIC, and tPAI·C were detected by the chemiluminescence immunoassay. RESULTS Results showed that the levels of TAT and PIC were higher in the metastasis group than those in the nonmetastasis group (P < .01). In the nonmetastasis group, there were 16 patients with elevated levels of D-dimer. But, TAT and PIC in these 16 patients were all at normal level (<0.55 mg/L FEU). After dilution, D-dimer was also decreased to normal levels in these 16 patients. The ROC was used to show the performance of D-dimer, TAT, and PIC on indicating cancer with metastasis. The AUC of PIC was higher than that of D-dimer (0.825 vs. 0.770). The specificity and PPV of TAT and PIC were higher than those of D-dimer. Serial test of TAT, PIC, and D-dimer improved the specificity and positive predictive value to 90.91% [80.61%, 96.25%] and 89.29% [77.45%, 95.57%], respectively. CONCLUSION Combining TAT and PIC with D-dimer could be useful surveillance biomarkers for cancer with metastasis.
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Affiliation(s)
- Chanjuan Cui
- Department of Laboratory Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jia Gao
- Department of Laboratory Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jia Li
- Department of Laboratory Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mengyao Yu
- Department of Laboratory Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao Zhang
- Department of Laboratory Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Cui
- Department of Laboratory Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Walsh SW, Nugent WH, Al Dulaimi M, Washington SL, Dacha P, Strauss JF. Proteases Activate Pregnancy Neutrophils by a Protease-Activated Receptor 1 Pathway: Epigenetic Implications for Preeclampsia. Reprod Sci 2020; 27:2115-2127. [PMID: 32542542 DOI: 10.1007/s43032-020-00232-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 02/28/2020] [Revised: 05/04/2020] [Accepted: 06/03/2020] [Indexed: 12/14/2022]
Abstract
We tested a novel hypothesis that elevated levels of proteases in the maternal circulation of preeclamptic women activate neutrophils due to their pregnancy-specific expression of protease-activated receptor 1 (PAR-1). Plasma was collected longitudinally from normal pregnant and preeclamptic women and analyzed for MMP-1 and neutrophil elastase. Neutrophils were isolated for culture and confocal microscopy. Omental fat was collected for immunohistochemistry. Circulating proteases were significantly elevated in preeclampsia. Confocal microscopy revealed that tet methylcytosine dioxygenase 2 (TET2), a DNA de-methylase, and p65 subunit of NF-κB were strongly localized to the nucleus of untreated neutrophils of preeclamptic women, but in untreated neutrophils of normal pregnant women they were restricted to the cytosol. Treatment of normal pregnancy neutrophils with proteases activated PAR-1, leading to activation of RhoA kinase (ROCK), which triggered translocation of TET2 and p65 from the cytosol into the nucleus, mimicking the nuclear localization in neutrophils of preeclamptic women. IL-8, an NF-κB-regulated gene, increased in association with TET2 and p65 nuclear localization. Co-treatment with inhibitors of PAR-1 or ROCK prevented nuclear translocation and IL-8 did not increase. Treatment of preeclamptic pregnancy neutrophils with inhibitors emptied the nucleus of TET2 and p65, mimicking the cytosolic localization of normal pregnancy neutrophils. Expression of PAR-1 and TET2 were markedly increased in omental fat vessels and neutrophils of preeclamptic women. We conclude that elevated levels of circulating proteases in preeclamptic women activate neutrophils due to their pregnancy-specific expression of PAR-1 and speculate that TET2 DNA de-methylation plays a role in the inflammatory response.
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Affiliation(s)
- Scott W Walsh
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23298-0034, USA.
- Department of Physiology and Biophysics, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23298-0034, USA.
| | - William H Nugent
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23298-0034, USA
| | - Marwah Al Dulaimi
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23298-0034, USA
| | - Sonya L Washington
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23298-0034, USA
| | - Phoebe Dacha
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23298-0034, USA
| | - Jerome F Strauss
- Department of Obstetrics and Gynecology, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23298-0034, USA
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Nahab F, Sharashidze V, Liu M, Rathakrishnan P, El Jamal S, Duncan A, Hoskins M, Marmarchi F, Belagaje S, Bianchi N, Belair T, Henriquez L, Monah K, Rangaraju S. Markers of coagulation and hemostatic activation aid in identifying causes of cryptogenic stroke. Neurology 2020; 94:e1892-e1899. [PMID: 32291293 PMCID: PMC7274921 DOI: 10.1212/wnl.0000000000009365] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 11/27/2019] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To test the hypothesis that markers of coagulation and hemostatic activation (MOCHA) help identify causes of cryptogenic stroke, we obtained serum measurements on 132 patients and followed them up to identify causes of stroke. METHODS Consecutive patients with cryptogenic stroke who met embolic stroke of undetermined source (ESUS) criteria from January 1, 2017, to October 31, 2018, underwent outpatient cardiac monitoring and the MOCHA profile (serum D-dimer, prothrombin fragment 1.2, thrombin-antithrombin complex, and fibrin monomer) obtained ≥2 weeks after the index stroke; abnormal MOCHA profile was defined as ≥2 elevated markers. Prespecified endpoints monitored during routine clinical visits included new atrial fibrillation (AF), malignancy, venous thromboembolism (VTE), or other defined hypercoagulable states (HS). RESULTS Overall, 132 patients with ESUS (mean age 64 ± 15 years, 61% female, 51% nonwhite) met study criteria. During a median follow-up of 10 (interquartile range 7-14) months, AF, malignancy, VTE, or HS was identified in 31 (23%) patients; the 53 (40%) patients with ESUS with abnormal MOCHA were significantly more likely than patients with normal levels to have subsequent new diagnoses of malignancy (21% vs 0%, p < 0.001), VTE (9% vs 0%, p = 0.009), or HS (11% vs 0%, p = 0.004) but not AF (8% vs 9%, p = 0.79). The combination of 4 normal MOCHA and normal left atrial size (n = 30) had 100% sensitivity for ruling out the prespecified endpoints. CONCLUSION The MOCHA profile identified patients with cryptogenic stroke more likely to have new malignancy, VTE, or HS during short-term follow-up and may be useful in direct evaluation for underlying causes of cryptogenic stroke.
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Affiliation(s)
- Fadi Nahab
- From the Departments of Neurology (F.N., V.S., M.L., P.R., S.E.J., F.M., S.B., N.B., T.B., L.H., K.M., S.R.), Pediatrics (F.N.), Pathology (A.D.), and Cardiology (M.H.), Emory University, Atlanta, GA
| | - Vera Sharashidze
- From the Departments of Neurology (F.N., V.S., M.L., P.R., S.E.J., F.M., S.B., N.B., T.B., L.H., K.M., S.R.), Pediatrics (F.N.), Pathology (A.D.), and Cardiology (M.H.), Emory University, Atlanta, GA
| | - Michael Liu
- From the Departments of Neurology (F.N., V.S., M.L., P.R., S.E.J., F.M., S.B., N.B., T.B., L.H., K.M., S.R.), Pediatrics (F.N.), Pathology (A.D.), and Cardiology (M.H.), Emory University, Atlanta, GA
| | - Priyadharshi Rathakrishnan
- From the Departments of Neurology (F.N., V.S., M.L., P.R., S.E.J., F.M., S.B., N.B., T.B., L.H., K.M., S.R.), Pediatrics (F.N.), Pathology (A.D.), and Cardiology (M.H.), Emory University, Atlanta, GA
| | - Sleiman El Jamal
- From the Departments of Neurology (F.N., V.S., M.L., P.R., S.E.J., F.M., S.B., N.B., T.B., L.H., K.M., S.R.), Pediatrics (F.N.), Pathology (A.D.), and Cardiology (M.H.), Emory University, Atlanta, GA
| | - Alexander Duncan
- From the Departments of Neurology (F.N., V.S., M.L., P.R., S.E.J., F.M., S.B., N.B., T.B., L.H., K.M., S.R.), Pediatrics (F.N.), Pathology (A.D.), and Cardiology (M.H.), Emory University, Atlanta, GA
| | - Michael Hoskins
- From the Departments of Neurology (F.N., V.S., M.L., P.R., S.E.J., F.M., S.B., N.B., T.B., L.H., K.M., S.R.), Pediatrics (F.N.), Pathology (A.D.), and Cardiology (M.H.), Emory University, Atlanta, GA
| | - Fahad Marmarchi
- From the Departments of Neurology (F.N., V.S., M.L., P.R., S.E.J., F.M., S.B., N.B., T.B., L.H., K.M., S.R.), Pediatrics (F.N.), Pathology (A.D.), and Cardiology (M.H.), Emory University, Atlanta, GA
| | - Samir Belagaje
- From the Departments of Neurology (F.N., V.S., M.L., P.R., S.E.J., F.M., S.B., N.B., T.B., L.H., K.M., S.R.), Pediatrics (F.N.), Pathology (A.D.), and Cardiology (M.H.), Emory University, Atlanta, GA
| | - Nicolas Bianchi
- From the Departments of Neurology (F.N., V.S., M.L., P.R., S.E.J., F.M., S.B., N.B., T.B., L.H., K.M., S.R.), Pediatrics (F.N.), Pathology (A.D.), and Cardiology (M.H.), Emory University, Atlanta, GA
| | - Trina Belair
- From the Departments of Neurology (F.N., V.S., M.L., P.R., S.E.J., F.M., S.B., N.B., T.B., L.H., K.M., S.R.), Pediatrics (F.N.), Pathology (A.D.), and Cardiology (M.H.), Emory University, Atlanta, GA
| | - Laura Henriquez
- From the Departments of Neurology (F.N., V.S., M.L., P.R., S.E.J., F.M., S.B., N.B., T.B., L.H., K.M., S.R.), Pediatrics (F.N.), Pathology (A.D.), and Cardiology (M.H.), Emory University, Atlanta, GA
| | - Kaslyn Monah
- From the Departments of Neurology (F.N., V.S., M.L., P.R., S.E.J., F.M., S.B., N.B., T.B., L.H., K.M., S.R.), Pediatrics (F.N.), Pathology (A.D.), and Cardiology (M.H.), Emory University, Atlanta, GA
| | - Srikant Rangaraju
- From the Departments of Neurology (F.N., V.S., M.L., P.R., S.E.J., F.M., S.B., N.B., T.B., L.H., K.M., S.R.), Pediatrics (F.N.), Pathology (A.D.), and Cardiology (M.H.), Emory University, Atlanta, GA
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Qi Y, Hu X, Chen J, Ying X, Shi Y. The Risk Factors of VTE and Survival Prognosis of Patients With Malignant Cancer: Implication for Nursing and Treatment. Clin Appl Thromb Hemost 2020; 26:1076029620971053. [PMID: 33119403 PMCID: PMC7607791 DOI: 10.1177/1076029620971053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/22/2020] [Accepted: 10/14/2020] [Indexed: 12/21/2022] Open
Abstract
Venous thromboembolism (VTE) is very common in patients with malignant cancer. We aimed to conduct a retrospective analysis on the risk factors of VTE and its survival prognosis of patients with malignant cancer, to provide evidence into the management of VTE. Patients with malignant cancer treated in our hospital were selected. The characteristic of patients and related lab detection results including activated partial thromboplastin time (APTT), plasma prothrombin time (PT) and thrombin coagulation time (TT), fibrinogen (FIB), thrombin AT-Ⅲ complex (TAT) and D-dimer (D-D) were collected and analyzed. And logistic regression analyses were performed to identify the potential risk factors. And ROC curves were established to evaluate their predictive ability of VTE for patients with malignant cancers. A total of 286 patients were included, of which 63 patients had VTE, the incidence of VTE in patients with malignant cancers was 22.03%. There were significant differences on the D-D, TAT level between VTE and no VTE patients (all P < 0.05). The survival condition of VTE patients was significantly worse than that of no VTE patients(P = 0.017). D-D (RR7.895, 3.228∼19.286) and TAT (6.122, 2.244∼16.695) were risk factors of VTE for patients with cancers (all P < 0.05). The area under the curve (AUC) of D-D, TAT and combined use was 0.764, 0.698, 0.794 respectively, and the cutoff value for D-D, TAT was 1.835mg/L and 4.58μg/L respectively. For cancer patients with D-D >1.835 mg/L and TAT >4.58 μg/L, early interventions are needed for the prophylaxis of VTE.
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Affiliation(s)
- Yan Qi
- School of Medicine, Jinggangshan University, Ji An, China
- Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xin Hu
- Ji An Central Hospital, Ji An, China
| | - Jing Chen
- Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiaobin Ying
- Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yan Shi
- Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
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Zhou K, Zhang J, Zheng ZR, Zhou YZ, Zhou X, Wang LD, Suo B, Jiang XF, Liu PJ, Wang DH. Diagnostic and Prognostic Value of TAT, PIC, TM, and t-PAIC in Malignant Tumor Patients With Venous Thrombosis. Clin Appl Thromb Hemost 2020; 26:1076029620971041. [PMID: 33141604 PMCID: PMC7649926 DOI: 10.1177/1076029620971041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/05/2020] [Accepted: 10/13/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Venous thromboembolism (VTE) is an important complication in patients with malignant tumors. Its exact diagnosis and treatment are still lacking. We used a high-sensitive chemiluminescence method to detect thrombin-antithrombin III complex (TAT), plasmin-α2-plasmininhibitor complex (PIC), thrombomodulin (TM), and tissue plasminogen activator-inhibitor complex(t-PAIC) in combination with D-dimer and fibrin degradation product (FDP) to analyze their diagnostic and prognostic value in patients with malignant tumors. METHODS In total, 870 patients with confirmed malignant tumors were included, 82 of whom had diagnosed VTE; 200 healthy individuals were classified as the control group. The TAT, PIC, TM, and t-PAIC were detected using Sysmex HISCL5000 automated analyzers, whereas FDP and D-dimer were detected using Sysmex CS5100 coagulation analyzer. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficiency. Survival probabilities were determined using Kaplan-Meier analysis, and multivariate analyses were performed using a Cox regression model. RESULTS Compared with healthy controls, patients with malignant tumors showed significantly elevated TAT, PIC, TM, t-PAIC, D-dimer, and FDP. Similarly, compared with patients in the non-thrombosis group, those in the thrombosis group showed significantly elevated levels of the above mentioned markers. Logistic regression analysis showed that TAT, PIC, TM, t-PAIC, D-Dimer, and FDP were all associated with VTE. ROC analysis showed that "TAT+PIC+TM+t-PAIC+D-dimer+FDP"showed the highest sensitivity and specificity. Patients with elevated TAT, PIC, TM, and t-PAIC had a significantly shorter survival. Multivariate Cox survival analysis showed that TM and t-PAIC were significantly associated with poor prognosis. In addition, the incidence of VTE was significantly lower in patients with malignant tumors who were treated with low-molecular-weight heparin (LMWH), and their survival period was significantly longer than that of patients with malignant tumors who were not treated with LMWH. CONCLUSION TAT, PIC, TM, and t-PAIC combined with D-dimer and FDP were better than the application of a single marker in the diagnosis of VTE in patients with malignant tumors. TAT and PIC can be used as sensitive markers in the diagnosis of VTE but not as prognostic markers. TM and t-PAIC might be independent prognostic indicators in patients with malignant tumors, regardless of the state of thrombus.
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Affiliation(s)
- Kun Zhou
- Department of Clinical Laboratory, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, Heilongjiang, People’s Republic of China
- Kun Zhou, Department of Clinical Laboratory, General Hospital of Heilongjiang Province Land Reclamation Bureau, 235 Hashuang Road, Nangang District, Harbin, Heilongjiang 150088, People’s Republic of China.
| | - Jun Zhang
- Rehabilitation Department, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, Heilongjiang, People’s Republic of China
| | - Zun-Rong Zheng
- Department of Clinical Laboratory, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, Heilongjiang, People’s Republic of China
| | - Yu-Zhen Zhou
- Department of Clinical Laboratory, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, Heilongjiang, People’s Republic of China
| | - Xun Zhou
- Department of Clinical Laboratory, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, Heilongjiang, People’s Republic of China
| | - Li-Da Wang
- Department of Medical Record, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, Heilongjiang, People’s Republic of China
| | - Bing Suo
- Department of Medical Record, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, Heilongjiang, People’s Republic of China
| | - Xiao-Feng Jiang
- Department of Molecular Diagnosis Laboratory, The 4th Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People’s Republic of China
| | - Pei-Jia Liu
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, People’s Republic of China
| | - Dong-Hua Wang
- Department of Gastrointestinal Surgery, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, Heilongjiang, People’s Republic of China
- Dong-Hua Wang, Department of Gastrointestinal Surgery, General Hospital of Heilongjiang Province Land Reclamation Bureau, 235 Hashuang Road, Nangang District, Harbin, Heilongjiang 150088, People’s Republic of China.
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Adineh H, Naderi M, Khademi Hamidi M, Harsij M. Biofloc technology improves growth, innate immune responses, oxidative status, and resistance to acute stress in common carp (Cyprinus carpio) under high stocking density. Fish Shellfish Immunol 2019; 95:440-448. [PMID: 31678186 DOI: 10.1016/j.fsi.2019.10.057] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 10/11/2019] [Accepted: 10/28/2019] [Indexed: 06/10/2023]
Abstract
This study aimed to evaluate the effects of biofloc technology (BFT) on the performance of common carp under high stocking density. Fish (8.41 ± 0.44 g) were stocked into 12 tanks (70 L) in a 2 × 2 factorial design consisting of clear water (CW) and BFT systems at two stocking densities. Fish were divided into four groups according to culture system and stocking density: CW6 (clear water, 6 kg m-3), CW12 (clear water, 12 kg m-3), BFT6 (biofloc, 6 kg m-3), and BFT12 (biofloc, 12 kg m-3). After 49 days, the fish were exposed to acute crowding stress (40 kg m-3) for 7 days to evaluate the fish performance to additional stressors. Total ammonia nitrogen (TAN) concentration was significantly lower in BFT groups at the end of the trial. The growth of fish was significantly higher and the feed conversion ratio was lower in BFT groups. The final density of fish was highest in BFT12 group (25.41 ± 0.48 kg m-3). The amylase and protease activities in BFT groups were significantly higher than the CW12 group. The highest serum catalase, superoxide dismutase, and glutathione peroxidase activities, and malondialdehyde content (3.07 ± 0.16 nmol mg-1 protein) were observed in CW12 group. Serum LDL, cholesterol, triglyceride, total protein, and albumin levels were significantly higher in CW6 and BFT6 groups, followed by BFT12 group, and lowest in CW12 group. Serum globulin level was lowest in CW12 group (0.68 ± 0.06 g dL-1). After 49 days, serum lysozyme, alternative complement (ACH50) and ALP activities were significantly higher and serum cortisol and glucose levels and ALT and AST activities were lower in BFT groups than the CW12 group. After 7 days of acute stress, serum lysozyme activities were significantly lower and ACH50 and ALP activities were higher in BFT groups than the CW12 group. Also, fish in CW12 group were more sensitive to the acute stressor, showing higher cortisol and lower glucose levels. Overall, biofloc had the anti-stress effect, and the culture of common carp in the biofloc system at a stocking density of 12 kg m-3 could be recommended. BFT can also exert beneficial effects on the welfare of fish subjected to acute stress.
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Affiliation(s)
- Hossein Adineh
- Department of Fisheries, Faculty of Agriculture and Natural Resources, Gonbad Kavous University, Gonbad Kavous, Golestan, Iran.
| | - Mahdi Naderi
- Department of Fisheries, Faculty of Marine Natural Resources, Khorramshahr University of Marine Science and Technology, Khorramshahr, Khouzestan, Iran
| | - Mohammad Khademi Hamidi
- Department of Fisheries, Faculty of Agriculture and Natural Resources, Gonbad Kavous University, Gonbad Kavous, Golestan, Iran
| | - Mohammad Harsij
- Department of Fisheries, Faculty of Agriculture and Natural Resources, Gonbad Kavous University, Gonbad Kavous, Golestan, Iran
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Affiliation(s)
- Megan A. Slack
- Saha Cardiovascular Research Center and Department of Physiology, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Scott M. Gordon
- Saha Cardiovascular Research Center and Department of Physiology, University of Kentucky College of Medicine, Lexington, KY, USA
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Wu C, Yan X, Liao Y, Liao L, Huang S, Zuo Q, Zhou L, Gao L, Wang Y, Lin J, Li S, Wang K, Ge X, Song H, Yang R, Lu F. Increased perihematomal neuron autophagy and plasma thrombin-antithrombin levels in patients with intracerebral hemorrhage: An observational study. Medicine (Baltimore) 2019; 98:e17130. [PMID: 31574813 PMCID: PMC6775380 DOI: 10.1097/md.0000000000017130] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Animal studies have demonstrated that autophagy was involved in neuronal damage after intracerebral hemorrhage (ICH). Several studies showed thrombin-antithrombin (TAT) plasma levels were elevated in patients with ICH. In this study, we aimed to evaluate if autophagy occurred in patients with ICH; and the relationship between the severity of brain injury and plasma TAT levels.A novel tissue harvesting device was used during hematoma removal surgery to collect loose fragments of tissue surrounding the affected brain area in 27 ICH patients with hematoma volumes of >30 mL in the basal ganglia. Control tissues were obtained from patients who underwent surgery for arteriovenous malformation (n = 25). Transmission electron microscopy (TEM) and immunohistochemistry for autophagy-related proteins were used to evaluate the ultrastructural and morphologic cellular characteristics; and the extent of autophagy in the recovered tissue specimens. Stroke severity was assessed by using the Glasgow Coma Scale (GCS) and the National Institutes of Health Stroke Scale (NIHSS). An enzyme-linked immunosorbent assay (ELISA) was used to measure plasma TAT levels.Transmission electron microscopy showed autophagosomes and autolysosomes exist in neurons surrounding the hematoma, but not in the control tissues. The number of cells containing autophagic vacuoles correlated with the severity of brain injury. Immunohistochemistry showed strong LC3, beclin 1, and cathepsin D staining in ICH tissue specimens. Plasma TAT levels correlated positively with autophagic cells and ICH severity (P < .01).Autophagy was induced in perihematomal neurons after ICH. Autophagy and plasma TAT levels correlated positively with severity of brain injury. These results suggest that autophagy and increased plasma TAT levels may contribute to the secondary damage in ICH patients.
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Affiliation(s)
- Chenghan Wu
- Department of Neurology, Second Affiliated Clinical College of Fujian University of Traditional Chinese Medicine
| | - Xiaohua Yan
- Department of Neurosurgery and TCM, Fujian Provincial Hospital
| | - Yuansheng Liao
- Department of Neurology, Second Affiliated Clinical College of Fujian University of Traditional Chinese Medicine
| | - Lianming Liao
- Central Laboratory, Union Hospital of Fujian Medical University
| | - Shengyue Huang
- Department of Neurosurgery and TCM, Fujian Provincial Hospital
| | - Quanting Zuo
- Department of Neurology, Second Affiliated Clinical College of Fujian University of Traditional Chinese Medicine
| | - Linying Zhou
- Laboratory of Electron Microscopy, Department of Pathology, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Lili Gao
- Department of Neurology, Second Affiliated Clinical College of Fujian University of Traditional Chinese Medicine
| | - Yinzhou Wang
- Department of Neurosurgery and TCM, Fujian Provincial Hospital
| | - Jushan Lin
- Department of Neurology, Second Affiliated Clinical College of Fujian University of Traditional Chinese Medicine
| | - Shiju Li
- Department of Neurology, Second Affiliated Clinical College of Fujian University of Traditional Chinese Medicine
| | - Kaiyu Wang
- Department of Neurosurgery and TCM, Fujian Provincial Hospital
| | - Xiuming Ge
- Department of Neurology, Second Affiliated Clinical College of Fujian University of Traditional Chinese Medicine
| | - Hailong Song
- Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, MO
| | - Ruiling Yang
- Department of Neurology, Second Affiliated Clinical College of Fujian University of Traditional Chinese Medicine
| | - Feng Lu
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Innocenti F, Gori AM, Giusti B, Tozzi C, Donnini C, Meo F, Giacomelli I, Ralli ML, Sereni A, Sticchi E, Zari M, Caldi F, Tassinari I, Zanobetti M, Marcucci R, Pini R. Prognostic value of sepsis-induced coagulation abnormalities: an early assessment in the emergency department. Intern Emerg Med 2019; 14:459-466. [PMID: 30535649 DOI: 10.1007/s11739-018-1990-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 11/20/2018] [Indexed: 02/07/2023]
Abstract
To evaluate if the assessment of coagulation abnormalities at ED admission could improve prognostic assessment of septic patients. This report utilizes a portion of the data collected in a prospective study, with the aim to identify reliable biomarkers for an early sepsis diagnosis. In the period November 2011-December 2016, we enrolled 268 patients, admitted to our High-Dependency Unit with a diagnosis severe sepsis/septic shock. Study-related blood samplings were performed at ED-HDU admission (T0), after 6 h (T6) and 24 h (T24): D-dimer, thrombin-antithrombin complex (TAT) and prothrombin fragment F1 + 2 levels were analyzed. The primary end-points were day-7 and in-hospital mortality. Day-7 mortality rate was 16%. D-dimer (T0: 4661 ± 4562 µg/ml vs 3190 ± 7188 µg/ml; T6: 4498 ± 4931 µg/ml vs 2822 ± 5623 µg/ml; T24 2905 ± 2823 µg/ml vs 2465 ± 4988 µg/ml, all p < 0.05) and TAT levels (T0 29 ± 45 vs 22 ± 83; T6 21 ± 22 vs 15 ± 35; T24 16 ± 19 vs 13 ± 30, all p < 0.05) were higher among non-survivors compared to survivors. We defined an abnormal coagulation activation (COAG+) as D-dimer > 500 µg/ml and TAT > 8 ng/ml (for both, twice the upper normal value). Compared to COAG-, COAG+ patients showed higher lactate levels at the earliest evaluations (T0: 3.3 ± 2.7 vs 2.5 ± 2.3, p = 0.041; T6: 2.8 ± 3.4 vs 1.8 ± 1.6, p = 0.015); SOFA score was higher after 24 h (T24: 6.7 ± 3.1 vs 5.4 ± 2.9, p = 0.008). At T0, COAG+ patients showed a higher day-7 mortality rate (HR 2.64; 95% CI 1.14-6.11, p = 0.023), after adjustment for SOFA score and lactate level. Presence of abnormal coagulation at ED admission shows an independent association with an increased short-term mortality rate.
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Affiliation(s)
- Francesca Innocenti
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy.
| | - Anna Maria Gori
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Betti Giusti
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Camilla Tozzi
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Chiara Donnini
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Federico Meo
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Irene Giacomelli
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Maria Luisa Ralli
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Alice Sereni
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Elena Sticchi
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Michela Zari
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Francesca Caldi
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Irene Tassinari
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Maurizio Zanobetti
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
| | - Rossella Marcucci
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Riccardo Pini
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy
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Dahms SO, Demir F, Huesgen PF, Thorn K, Brandstetter H. Sirtilins - the new old members of the vitamin K-dependent coagulation factor family. J Thromb Haemost 2019; 17:470-481. [PMID: 30644641 PMCID: PMC6850207 DOI: 10.1111/jth.14384] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Indexed: 12/04/2022]
Abstract
Essentials Blood coagulation is driven by vitamin K (VK)-dependent proteases. We have identified and characterized 'sirtilin' as an additional VK-dependent protease. Sirtilins emerged early in the evolution of the coagulation system of vertebrates. Ubiquitous occurrence might indicate an important functional role of sirtilins. SUMMARY: Background Vitamin K (VK)-dependent proteases are major players in blood coagulation, including both the initiation and the regulation of the cascade. Five different members of this protease family have been described, comprising the following coagulation factors: factor VII, FIX, FX, protein C (PC), and prothrombin (FII). FVII, FIX, FX and PC share a typical domain architecture, with an N-terminal γ-carboxyglutamate (Gla) domain, two epidermal growth factor-like (EGF) domains, and a C-terminal trypsin-like serine protease (SP) domain. Objectives We have identified uncharacterized proteins in snake genomes showing the typical Gla-EGF1-EGF2-SP domain architecture but relatively low sequence conservation compared to known VK-dependent proteases. On the basis of sequence analysis, we hypothesized that these proteins are functional members of the VK-dependent protease family. Methods/results Using phylogenetic analyses, we confirmed the so-called 'sirtilins' as an additional VK-dependent protease class. These proteases were found in several vertebrates, including jawless fish, cartilaginous fish, bony fish, reptiles, birds, and marsupials, but not in other mammals. The recombinant zymogen form of Thamnophis sirtalis sirtilin was produced by in vitro renaturation, and was activated with human activated FXI. The activated form of sirtilin proteolytically cleaved peptide and protein substrates, including prothrombin. Mass spectrometry-based substrate profiling of sirtilin revealed a narrower sequence specificity than those of FIX and FX. Conclusions The ubiquitous occurrence of sirtilins in many vertebrate classes might indicate an important functional role. Understanding the detailed functions of sirtilins might contribute to a deeper understanding of the evolution and function of the vertebrate coagulation system.
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Affiliation(s)
- Sven O. Dahms
- Department of BiosciencesUniversity of SalzburgSalzburgAustria
| | - Fatih Demir
- ZEA‐3 AnalyticsCentral Institute for Engineering, Electronics and AnalyticsForschungszentrum JülichJülichGermany
| | - Pitter F. Huesgen
- ZEA‐3 AnalyticsCentral Institute for Engineering, Electronics and AnalyticsForschungszentrum JülichJülichGermany
| | - Karina Thorn
- Haemophilia ResearchNovo Nordisk A/SMåløvDenmark
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Ellis D, Rangaraju S, Duncan A, Hoskins M, Raza SA, Rahman H, Winningham M, Belagaje S, Bianchi N, Mohamed GA, Obideen M, Sharashidze V, Belair T, Henriquez L, Nahab F. Coagulation markers and echocardiography predict atrial fibrillation, malignancy or recurrent stroke after cryptogenic stroke. Medicine (Baltimore) 2018; 97:e13830. [PMID: 30572550 PMCID: PMC6320212 DOI: 10.1097/md.0000000000013830] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 10/01/2018] [Accepted: 11/26/2018] [Indexed: 11/25/2022] Open
Abstract
We evaluated the utility of left atrial volume index (LAVI) and markers of coagulation and hemostatic activation (MOCHA) in cryptogenic stroke (CS) patients to identify those more likely to have subsequent diagnosis of atrial fibrillation (AF), malignancy or recurrent stroke during follow-up.Consecutive CS patients who met embolic stroke of undetermined source (ESUS) who underwent transthoracic echocardiography and outpatient cardiac monitoring following stroke were identified from the Emory cardiac registry. In a subset of consecutive patients, d-dimer, prothrombin fragment 1.2, thrombin-antithrombin complex and fibrin monomer (MOCHA panel) were obtained ≥2 weeks post-stroke and repeated ≥4 weeks later if abnormal; abnormal MOCHA panel was defined as ≥2 elevated markers which did not normalize when repeated. We assessed the predictive abilities of LAVI and the MOCHA panel to identify patients with subsequent diagnosis of AF, malignancy, recurrent stroke or the composite outcome during follow-up.Of 94 CS patients (mean age 64 ± 15 years, 54% female, 63% non-white, mean follow-up 1.4 ± 0.8 years) who underwent prolonged cardiac monitoring, 15 (16%) had new AF. Severe LA enlargement (vs normal) was associated with AF (P < .06). In 42 CS patients with MOCHA panel testing (mean follow-up 1.1 ± 0.6 years), 14 (33%) had the composite outcome and all had abnormal MOCHA. ROC analysis showed LAVI and abnormal MOCHA together outperformed either test alone with good predictive ability for the composite outcome (AUC 0.84).We report the novel use of the MOCHA panel in CS patients to identify a subgroup of patients more likely to have occult AF, occult malignancy or recurrent stroke during follow-up. A normal MOCHA panel identified a subgroup of CS patients at low risk for recurrent stroke on antiplatelet therapy. Further study is warranted to evaluate whether the combination of an elevated LAVI and abnormal MOCHA panel identifies a subgroup of CS patients who may benefit from early anticoagulation for secondary stroke prevention.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Fadi Nahab
- Department of Neurology & Pediatrics, Emory University, United States
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Rimpo K, Tanaka A, Ukai M, Ishikawa Y, Hirabayashi M, Shoyama T. Thrombin-antithrombin complex measurement using a point-of-care testing device for diagnosis of disseminated intravascular coagulation in dogs. PLoS One 2018; 13:e0205511. [PMID: 30304025 PMCID: PMC6179255 DOI: 10.1371/journal.pone.0205511] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 09/26/2018] [Indexed: 11/24/2022] Open
Abstract
Reference interval for thrombin-antithrombin complex (TAT) level was determined using an in-house TAT measurement device, and its validity for diagnosis of disseminated intravascular coagulation (DIC) was evaluated in dogs. One hundred and two clinically healthy dogs and 247 diseased dogs with conditions that potentially caused DIC were recruited in the study. Six diagnostic testing for DIC were evaluated in diseased dogs and the diseased dogs were categorized into five groups depending on abnormal findings. TAT was measured in all study animals and between-group differences were evaluated. TAT level was positively associated with severity of DIC. There were no significant differences in TAT levels among clinically healthy dogs, diseased dogs without any abnormal finding and diseased dogs with one abnormal finding in the DIC diagnostic testing. TAT levels in groups with two or more abnormal findings were significantly higher than clinically healthy dogs. Reference interval of TAT level for clinically healthy dogs was ≤ 0.25 ng/ml. Validity of using TAT for early detection of DIC was evaluated. In-house TAT measurement was suggested to be a clinically relevant and useful tool for early detection of canine DIC.
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Affiliation(s)
- Kenji Rimpo
- Saitama Animal Medical Center, Iruma-shi, Saitama, Japan
- * E-mail:
| | - Aki Tanaka
- Department of Wildlife Medicine, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, Japan
| | - Masayasu Ukai
- Saitama Animal Medical Center, Iruma-shi, Saitama, Japan
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Schafer PH, Ye Y, Wu L, Kosek J, Ringheim G, Yang Z, Liu L, Thomas M, Palmisano M, Chopra R. Cereblon modulator iberdomide induces degradation of the transcription factors Ikaros and Aiolos: immunomodulation in healthy volunteers and relevance to systemic lupus erythematosus. Ann Rheum Dis 2018; 77:1516-1523. [PMID: 29945920 PMCID: PMC6161670 DOI: 10.1136/annrheumdis-2017-212916] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 05/31/2018] [Accepted: 06/11/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVES IKZF1 and IKZF3 (encoding transcription factors Ikaros and Aiolos) are susceptibility loci for systemic lupus erythematosus (SLE). The pharmacology of iberdomide (CC-220), a cereblon (CRBN) modulator targeting Ikaros and Aiolos, was studied in SLE patient cells and in a phase 1 healthy volunteer study. METHODS CRBN, IKZF1 and IKZF3 gene expression was measured in peripheral blood mononuclear cells (PBMC) from patients with SLE and healthy volunteers. Ikaros and Aiolos protein levels were measured by Western blot and flow cytometry. Anti-dsDNA and anti-phospholipid autoantibodies were measured in SLE PBMC cultures treated for 7 days with iberdomide. Fifty-six healthy volunteers were randomised to a single dose of iberdomide (0.03-6 mg, n=6 across seven cohorts) or placebo (n=2/cohort). CD19+ B cells, CD3+ T cells and intracellular Aiolos were measured by flow cytometry. Interleukin (IL)-2 and IL-1β production was stimulated with anti-CD3 and lipopolysaccharide, respectively, in an ex vivo whole blood assay. RESULTS SLE patient PBMCs expressed significantly higher CRBN (1.5-fold), IKZF1 (2.1-fold) and IKZF3 (4.1-fold) mRNA levels compared with healthy volunteers. Iberdomide significantly reduced Ikaros and Aiolos protein levels in B cells, T cells and monocytes. In SLE PBMC cultures, iberdomide inhibited anti-dsDNA and anti-phospholipid autoantibody production (IC50 ≈10 nM). Single doses of iberdomide (0.3-6 mg) in healthy volunteers decreased intracellular Aiolos (minimum mean per cent of baseline: ≈12%-28% (B cells); ≈0%-33% (T cells)), decreased absolute CD19+ B cells, increased IL-2 and decreased IL-1β production ex vivo. CONCLUSIONS These findings demonstrate pharmacodynamic activity of iberdomide and support its further clinical development for the treatment of SLE. TRIAL REGISTRATION NUMBER NCT01733875; Results.
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Affiliation(s)
- Peter H Schafer
- Department of Translational Development, Celgene Corporation, Summit, New Jersey, USA
| | - Ying Ye
- Department of Clinical Pharmacology, Celgene Corporation, Summit, New Jersey, USA
| | - Lei Wu
- Department of Translational Development, Celgene Corporation, Summit, New Jersey, USA
| | - Jolanta Kosek
- Department of Translational Development, Celgene Corporation, Summit, New Jersey, USA
| | - Garth Ringheim
- Department of Translational Development, Celgene Corporation, Summit, New Jersey, USA
| | - Zhihong Yang
- Department of Biostatistics, Celgene Corporation, Summit, New Jersey, USA
| | - Liangang Liu
- Department of Biostatistics, Celgene Corporation, Summit, New Jersey, USA
| | - Michael Thomas
- Department of Clinical Pharmacology, Celgene Corporation, Summit, New Jersey, USA
| | - Maria Palmisano
- Department of Clinical Pharmacology, Celgene Corporation, Summit, New Jersey, USA
| | - Rajesh Chopra
- Department of Translational Development, Celgene Corporation, Summit, New Jersey, USA
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
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Chennakrishnaiah S, Meehan B, D'Asti E, Montermini L, Lee TH, Karatzas N, Buchanan M, Tawil N, Choi D, Divangahi M, Basik M, Rak J. Leukocytes as a reservoir of circulating oncogenic DNA and regulatory targets of tumor-derived extracellular vesicles. J Thromb Haemost 2018; 16:1800-1813. [PMID: 29971917 DOI: 10.1111/jth.14222] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [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: 12/13/2017] [Indexed: 12/11/2022]
Abstract
Essentials Tumor-bearing mice were employed to follow oncogenic HRAS sequences in plasma, and blood cells. Cancer DNA accumulated in leukocytes above levels detected in exosomes, platelets and plasma. Extracellular vesicles and nucleosomes are required for uptake of tumor DNA by leukocytes. Uptake of tumor-derived extracellular vesicles by leukocytes triggers coagulant phenotype. SUMMARY Background Tumor-derived extracellular vesicles (EVs) and free nucleosomes (NSs) carry into the circulation a wealth of cancer-specific, bioactive and poorly understood molecular cargoes, including genomic DNA (gDNA). Objective Here we investigated the distribution of extracellular oncogenic gDNA sequences (HRAS and HER2) in the circulation of tumor-bearing mice. Methods and Results Surprisingly, circulating leukocytes (WBCs), especially neutrophils, contained the highest levels of mutant gDNA, which exceeded the amount of this material recovered from soluble fractions of plasma, circulating EVs, platelets, red blood cells (RBCs) and peripheral organs, as quantified by digital droplet PCR (ddPCR). Tumor excision resulted in disappearance of the WBC-associated gDNA signal within 2-9 days, which is in line with the expected half-life of these cells. EVs and nucleosomes were essential for the uptake of tumor-derived extracellular DNA by neutrophil-like cells and impacted their phenotype. Indeed, the exposure of granulocytic HL-60 cells to EVs from HRAS-driven cancer cells resulted in a selective increase in tissue factor (TF) procoagulant activity and interleukin 8 (IL-8) production. The levels of circulating thrombin-antithrombin complexes (TAT) were markedly elevated in mice harboring HRAS-driven xenografts. Conclusions Myeloid cells may represent a hitherto unrecognized reservoir of cancer-derived, EV/NS-associated oncogenic gDNA in the circulation, and a possible novel platform for liquid biopsy in cancer. In addition, uptake of this material alters the phenotype of myeloid cells, induces procoagulant and proinflammatory activity and may contribute to systemic effects associated with cancer.
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Affiliation(s)
- S Chennakrishnaiah
- Research Institute of the McGill University Health Centre, Glen Site, McGill University, Montreal, QC, Canada
| | - B Meehan
- Research Institute of the McGill University Health Centre, Glen Site, McGill University, Montreal, QC, Canada
| | - E D'Asti
- Research Institute of the McGill University Health Centre, Glen Site, McGill University, Montreal, QC, Canada
| | - L Montermini
- Research Institute of the McGill University Health Centre, Glen Site, McGill University, Montreal, QC, Canada
| | - T-H Lee
- Research Institute of the McGill University Health Centre, Glen Site, McGill University, Montreal, QC, Canada
| | - N Karatzas
- Research Institute of the McGill University Health Centre, Glen Site, McGill University, Montreal, QC, Canada
| | - M Buchanan
- Department of Oncology and Surgery, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - N Tawil
- Research Institute of the McGill University Health Centre, Glen Site, McGill University, Montreal, QC, Canada
| | - D Choi
- Research Institute of the McGill University Health Centre, Glen Site, McGill University, Montreal, QC, Canada
| | - M Divangahi
- Department of Medicine, Department of Microbiology and Immunology, Department of Pathology, McGill International TB Centre, McGill University Health Centre, Meakins-Christie Laboratories, Montreal, QC, Canada
| | - M Basik
- Department of Oncology and Surgery, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - J Rak
- Research Institute of the McGill University Health Centre, Glen Site, McGill University, Montreal, QC, Canada
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18
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Reda RM, El-Hady MA, Selim KM, El-Sayed HM. Comparative study of three predominant gut Bacillus strains and a commercial B. amyloliquefaciens as probiotics on the performance of Clarias gariepinus. Fish Shellfish Immunol 2018; 80:416-425. [PMID: 29920384 DOI: 10.1016/j.fsi.2018.06.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/03/2018] [Accepted: 06/14/2018] [Indexed: 06/08/2023]
Abstract
The present study was conducted to evaluate the supplementation of three autochthonous Bacillus strains (B. subtilis, B. amyloliquefaciens and B. cereus) and a commercial B. amyloliquefaciensin doses of 1 × 1010 CFU/kg on the growth performance, hematology, antioxidant activities, digestive enzyme levels, immune status and disease resistance of Clarias gariepinus. A total of 300 fish (75.23 ± 1.6 g) were randomly divided into 5 groups (each group was subdivided into 2 subgroups, 30 fish/each). The control group was fed basal diet (D0). Diets D1, D2, D3 and D4were supplemented with B. subtilis, B. amyloliquefaciens, B. cereus and a commercial B. amyloliquefaciens, respectively. During the course of the experiment, D3 showed the best body weight, weight gain, specific growth rate and food conversion ratio. The measured hemogram blood parameters had the highest significant increase in D3. WBCs and monocyte counts had no significant differences among the experimental groups. The serum antioxidant and digestive enzymes were the highest in D3 and were the lowest in D0. After 15 d, the non-specific immune parameters were markedly increased in fish fed probiotic-containing diet compared with the control. After 30 d, the highest significant immune parameters were observed in D3; D1 and D2 had no significant differences in serum lysozyme activity, nitric oxide and IgM compared with D0. Myostatin cDNA levels were adversely affected by probiotic supplements compare with the control. The PACAP expression showed the highest significant value in D3 followed by D1and D4then D2. The relative survival percentages of the Aeromonas sobria challenged C. gariepinus were the highest in D3, D2, D4 and then D1. Among the three isolated Bacillus species, dietary supplementation with the B. cereus had the highest performance in C. gariepinus compared with the commercial B. amyloliquefaciens and the control group.
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Affiliation(s)
- Rasha M Reda
- Department of Fish Diseases and Management, Faculty of Veterinary Medicine, Zagazig University, 44511, Zagazig, Sharkia, Egypt.
| | - M A El-Hady
- Department of Fish Diseases and Management, Faculty of Veterinary Medicine, Zagazig University, 44511, Zagazig, Sharkia, Egypt
| | | | - Hassanin M El-Sayed
- Department of Fish Diseases and Management, Faculty of Veterinary Medicine, Zagazig University, 44511, Zagazig, Sharkia, Egypt
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Wang X, Luo H, Zhang R. Innate immune responses in the Chinese oak silkworm, Antheraea pernyi. Dev Comp Immunol 2018; 83:22-33. [PMID: 29241953 DOI: 10.1016/j.dci.2017.12.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 12/10/2017] [Accepted: 12/11/2017] [Indexed: 06/07/2023]
Abstract
Innate immunity, the evolutionarily conserved defense system, has been extensively analyzed in insect models over recent decades. The significant progress in this area has formed our dominant conceptual framework of the innate immune system, but critical advances in other insects have had a profound impact on our insights into the mystery of innate immunity. In recent years, we focused on the immune responses in Antheraea pernyi, an important commercial silkworm species reared in China. Here, we review the immune responses of A. pernyi based on immune-related gene-encoded proteins that are divided into five categories, namely pattern recognition receptors, hemolymph proteinases and their inhibitors, prophenoloxidase, Toll pathway factors and antimicrobial peptides, and others. Although the summarized information is limited since the research on A. pernyi immunity is in its infancy, we hope to provide evidence for further exploration of innate immune mechanisms.
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Affiliation(s)
- Xialu Wang
- School of Medical Devices, Shenyang Pharmaceutical University, Shenyang, 110016, Liaoning, China
| | - Hao Luo
- School of Life Science and Bio-pharmaceutics, Shenyang Pharmaceutical University, Shenyang, 110016, Liaoning, China
| | - Rong Zhang
- School of Life Science and Bio-pharmaceutics, Shenyang Pharmaceutical University, Shenyang, 110016, Liaoning, China.
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20
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Ramírez-Santana M, Farías-Gómez C, Zúñiga-Venegas L, Sandoval R, Roeleveld N, Van der Velden K, Scheepers PTJ, Pancetti F. Biomonitoring of blood cholinesterases and acylpeptide hydrolase activities in rural inhabitants exposed to pesticides in the Coquimbo Region of Chile. PLoS One 2018; 13:e0196084. [PMID: 29718943 PMCID: PMC5931667 DOI: 10.1371/journal.pone.0196084] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/05/2018] [Indexed: 11/18/2022] Open
Abstract
In Chile, agriculture is a relevant economic activity and is concomitant with the use of pesticides to improve the yields. Acute intoxications of agricultural workers occur with some frequency and they must be reported to the surveillance system of the Ministry of Health. However the impacts of chronic and environmental pesticide exposure have been less studied. Among pesticides frequently used in Chile for insects control are organophosphates (OP) and carbamates (CB). They are inhibitors of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). In this study we determined the pattern of both biomarkers activity in three populations with different type of chronic exposure to OP/CB: environmentally exposed (EE), occupationally exposed (OE) and a reference group (RG) without exposure. Besides this, we also measured the activity of acylpeptide hydrolase (APEH), an enzyme involved in relevant functions in the central synapses that is also expressed in erythrocytes and previously reported to be highly inhibited by some OP. A baseline measurement was done in both exposure groups and then a second measurement was done during the spraying season. The RG was measured only once at any time of the year. Our results indicate that people under chronic OP/CB exposure showed an adaptive response through an increase of basal BChE activity. During the spray season only BChE activity was decreased in the EE and OE groups (p<0.05 and p<0.01, respectively) and the higher magnitude of BChE inhibition was observed in the EE group. The analysis of the frequencies of inhibition above 30% (biological tolerance limit declared by Chilean legislation) indicated that BChE was most frequently inhibited in the EE group (53% of the individuals displayed inhibition) and AChE in the OE group (55% of the individuals displayed AChE inhibition). APEH activity showed the highest frequency of inhibition in the EE group independent of its magnitude (64%). Our results demonstrate that the rural population living nearby agricultural settings displays high levels of environmental exposure. APEH activity seems to be a sensitive biomarker for acute low-level exposure and its usefulness as a routine biomarker must to be explored in future studies. Systematic biomonitoring and health outcomes studies are necessary as well as obtaining the baseline for BChE and AChE activity levels with the aim to improve environmental and occupational health policies in Chile.
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Affiliation(s)
- Muriel Ramírez-Santana
- Department of Public Health, Faculty of Medicine, Universidad Católica del Norte, Coquimbo, Chile
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands
| | - Cristián Farías-Gómez
- Laboratory of Environmental Neurotoxicology, Faculty of Medicine, Universidad Católica del Norte, Coquimbo, Chile
| | - Liliana Zúñiga-Venegas
- Laboratory of Biomedical Research, Faculty of Medicine, Universidad Católica del Maule, Talca, Chile
| | - Rodrigo Sandoval
- Laboratory of Environmental Neurotoxicology, Faculty of Medicine, Universidad Católica del Norte, Coquimbo, Chile
| | - Nel Roeleveld
- Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Koos Van der Velden
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands
| | - Paul T. J. Scheepers
- Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Floria Pancetti
- Laboratory of Environmental Neurotoxicology, Faculty of Medicine, Universidad Católica del Norte, Coquimbo, Chile
- * E-mail:
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21
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Pusateri AE, Ryan KL, Delgado AV, Martinez RS, Uscilowicz JM, Cortez DS, Martinowitz U. Effects of increasing doses of activated recombinant factor VII on haemostatic parameters in swine. Thromb Haemost 2017; 93:275-83. [PMID: 15711743 DOI: 10.1160/th04-03-0200] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SummaryThis study examined dose-response relationships between activated recombinant factorVII (rFVIIa) and (1) in vivo haemostasis and (2) in vitro measures of coagulation and platelet function. Anesthetized swine were used. Ear bleeding time (BT) was measured and blood was sampled following increasing doses of rFVIIa (0, 90, 180, 360 and 720 μg/kg; n = 6) or saline (n = 6). BT was not altered by rFVIIa. Prothrombin time (PT) using standard or pig-specific methods was decreased by rFVIIa. Activated clotting time (ACT) was decreased by rFVIIa. Thromboelastography using collagen (COLL) or pig thromboplastin (p-ThP) as agonist demonstrated shorter reaction times, shortened time to reach maximum velocity of clot formation, and increased α -angle in the presence of rFVIIa. rFVIIa dosing increased maximum velocity of clot formation when p-ThP was used to initiate the reaction but not when COLL was used. rFVIIa at the highest concentration increased maximum amplitude when COLL was used to initiate the reaction. Platelet aggregation was not altered by rFVIIa. Following completion of the dose escalation phase, a severe liver injury was produced. rFVIIa altered neither blood loss nor survival time following injury but improved mean arterial pressure. A small increase in systemic thrombin-antithrombin III complex occurred after administration of rFVIIa at doses of 180 μg/kg and above. However, there was no histological evidence of intravascular coagulation after rFVIIa administration. In summary, rFVIIa activity was detectable in vitro but did not change haemostasis in normal swine.
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Affiliation(s)
- Anthony E Pusateri
- U.S. Army Institute of Surgical Research, 3400 Rawley E. Chambers Avenue, Ft. Sam Houston, TX 78234-6315, USA.
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22
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Marcucci R, Gori AM, Bertuccioli M, Gensini GF, Abbate R. In vivo effect of Chianti red wine on Tissue Factor, Tissue Factor Pathway Inhibitor and Homocysteine levels. Thromb Haemost 2017; 94:689-90. [PMID: 16268496 DOI: 10.1160/th05-03-0689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Payling L, Kim IH, Walsh MC, Kiarie E. Effects of a multi-strain Bacillus spp. direct-fed microbial and a protease enzyme on growth performance, nutrient digestibility, blood characteristics, fecal microbiota, and noxious gas emissions of grower pigs fed corn-soybean-meal-based diets-A meta-analysis. J Anim Sci 2017; 95:4018-4029. [PMID: 28992032 DOI: 10.2527/jas2017.1522] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Three studies involving 352 grower pigs were conducted to determine the effects of dietary supplementation with multistrain spp. direct-fed microbial (DFM) and protease, alone or in combination, on growth performance, nutrient digestibility, blood characteristics, fecal microbiota, and noxious gas emissions, and to use a meta-analysis to increase the reliability of the findings. Treatments ( = 4) were set up as a 2 × 2 factorial design with 2 levels of protease (0 and 5.000/6.000 units/kilogram of feed [U/KG]) and 2 levels of DFM (0 and 1.5 × 10 colony forming units/gram of feed [CFU/G]), plus a protease + DFM combination. Pigs were housed in groups of 3 or 4/pen with 8 replicate pens/treatment. Experimental diets were fed for 42 d and feed intake and BW were measured weekly. Fecal samples were collected at d 42 and analyzed to determine apparent total tract digestibility (ATTD). Fecal counts of and coliforms, and noxious gas emissions were measured. Blood samples were taken by anterior vena cava puncture to measure blood urea nitrogen (BUN) and creatinine. Data from the 3 studies were pooled and analyzed as a 2 × 2 factorial using the Fit Model platform of JMP 11 (SAS Inst. Inc., Cary, NC). Means separation was determined using Tukey's honest significant difference test. The main effect of protease and DFM increased: BW at 42 d, overall ADG, and overall G:F compared to the control ( < 0.04). There were no interactions between protease and DFM ( > 0.05); however, the protease + DFM combination was the only treatment to improve ADG and G:F in all phases compared to the control. The main effect of protease increased ATTD of DM, nitrogen (N), and ADF ( < 0.04). The main effect of DFM increased ATTD of DM, N, GE, DE, ADF, and fat ( < 0.02). There was a trend for an interaction between protease and DFM for ATTD of GE and DE ( < 0.08) because the protease + DFM combination increased energy digestibility more than the additive effects of the protease and DFM alone. The main effects of protease and DFM decreased fecal ammonia emissions ( < 0.01), but the protease + DFM combination was the only treatment to decrease ammonia emissions compared to the control. In conclusion, the main effects of protease and DFM improved growth performance and nutrient digestibility compared to the control, but there was a greater additive effect of the protease + DFM combination on energy and N digestibility.
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Kitayama H, Kondo T, Sugiyama J, Kurimoto K, Nishino Y, Hirayama M, Tsuji Y. Venous thromboembolism in hospitalized patients receiving chemotherapy for malignancies at Japanese community hospital: prospective observational study. BMC Cancer 2017; 17:351. [PMID: 28525975 PMCID: PMC5438527 DOI: 10.1186/s12885-017-3326-1] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 05/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although Asian population was recognized to have a lower risk of venous thromboembolism (VTE), its increasing prevalence and incidence remain unclear in patients with malignancies. We attempted to predict VTE development using activation markers of coagulation and fibrinolysis. METHODS We enrolled patients with malignancy admitted to Tonan Hospital between April and December 2014 to receive a new-for-them chemotherapy regimen. All patients were examined for VTE by computed tomography and whole-leg compression ultrasonography before chemotherapy and three months later. We also examined plasma levels of thrombin-antithrombin complex (TAT) and plasmin α2-plasmin inhibitor complex (PIC) before chemotherapy. The cut off values of TAT and PIC were set at 2.1 ng/mL and 1.8 μg/mL, respectively. RESULTS Of 97 patients, the majority (67%) had distant metastases. The most common malignancies were colorectal (26%), breast (23%), and stomach (19%) cancer. VTE was detected in 29 patients (31%); all were asymptomatic. VTE was newly developed in 12 patients in the three-month observation period, which means the incidence was 49 per 1000 person-years. Non-increased PIC with increased TAT was the only significant risk factor for both VTE prevalence and incidence in multivariate analysis, and the odds ratios were 3.0 (95% confidence interval, 1.1-8.2; P = 0.034) and 9.4 (95% confidence interval, 1.7-51.9; P = 0.011), respectively. CONCLUSIONS The prevalence and incidence of VTE were high in hospitalized Japanese patients receiving chemotherapy for malignancies. Non-increased PIC with increased levels of TAT may be an independent risk factor for VTE development.
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Affiliation(s)
- Hiromitsu Kitayama
- Department of Medical Oncology, Tonan Hospital, Kita 4 Nishi 7 3-8, Chuo-ku, Sapporo, Hokkaido 060-0004 Japan
| | - Tomohiro Kondo
- Department of Medical Oncology, Tonan Hospital, Kita 4 Nishi 7 3-8, Chuo-ku, Sapporo, Hokkaido 060-0004 Japan
| | - Junko Sugiyama
- Department of Medical Oncology, Tonan Hospital, Kita 4 Nishi 7 3-8, Chuo-ku, Sapporo, Hokkaido 060-0004 Japan
| | - Kazutomo Kurimoto
- Department of Clinical Laboratory, Tonan Hospital, Kita 4 Nishi 7 3-8, Chuo-ku, Sapporo, Hokkaido 060-0004 Japan
| | - Yasuhiro Nishino
- Department of Cardiovascular Medicine, Tonan Hospital, Kita 4 Nishi 7 3-8, Chuo-ku, Sapporo, Hokkaido 060-0004 Japan
| | - Michiaki Hirayama
- Department of Gastroenterology, Tonan Hospital, Kita 4 Nishi 7 3-8, Chuo-ku, Sapporo, Hokkaido 060-0004 Japan
| | - Yasushi Tsuji
- Department of Medical Oncology, Tonan Hospital, Kita 4 Nishi 7 3-8, Chuo-ku, Sapporo, Hokkaido 060-0004 Japan
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Parsons-Rich D, Hua F, Li G, Kantaridis C, Pittman DD, Arkin S. Phase 1 dose-escalating study to evaluate the safety, pharmacokinetics, and pharmacodynamics of a recombinant factor Xa variant (FXa I16L ). J Thromb Haemost 2017; 15:931-937. [PMID: 28294526 DOI: 10.1111/jth.13673] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Indexed: 11/28/2022]
Abstract
Essentials FXaI16L is a recombinant zymogen-like variant of activated coagulation factor X (FXa). A phase 1 dose escalation clinical trial of FXaI16L was conducted in healthy adults. FXaI16L was safe and tolerated at doses up to 5 μg/kg; no dose-limiting toxicity was observed. Data support further development of FXaI16L for patients with acute hemorrhagic conditions. SUMMARY Background FXaI16L (PF-05230907) is a zymogen-like variant of activated factor X (FXa). It shows enhanced resistance to inactivation by endogenous inhibitors as compared with wild-type FXa, and restores hemostatic activity in non-clinical models of various bleeding conditions. Objectives To evaluate the safety, pharmacokinetics and pharmacodynamics of FXaI16L by performing a phase 1, first-in-human, dose-escalation clinical trial in healthy adult volunteers. Methods Participants were assigned to one of six ascending single-dose cohorts (0.1, 0.3, 1, 2, 3 or 5 μg kg-1 ), each planned to comprise six volunteers treated with FXaI16L and two treated with placebo. Assessments included safety monitoring, pharmacokinetic and pharmacodynamic (PD) analyses, and immunogenicity testing. Results The trial enrolled 49 male volunteers. Administration of a single intravenous bolus dose of FXaI16L was safe and tolerated at all dose levels tested, with no dose-limiting toxicity or serious adverse events. FXaI16L plasma levels appeared to increase dose-proportionally, with a half-life of ~ 4 min. Treatment-related PD changes were observed for activated partial thromboplastin time, thrombin generation assay, thrombin-antithrombin complexes, prothrombin fragment 1 + 2, and D-dimer. One volunteer had a weak and transient non-neutralizing antidrug antibody response, which did not cross-react with native FX or native FXa. Conclusions FXaI16L was safe and tolerated, and showed a pharmacologic effect in healthy adults when administered at doses up to 5 μg kg-1 . The safety profile, pharmacokinetics and pharmacodynamics observed in this clinical trial support the further development of FXaI16L for hemostatic treatment in individuals with acute hemorrhagic conditions.
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Affiliation(s)
- D Parsons-Rich
- PharmaTherapeutics Clinical Research, Pfizer Inc., Cambridge, MA, USA
| | - F Hua
- PharmaTherapeutics Clinical Research, Pfizer Inc., Cambridge, MA, USA
| | - G Li
- PharmaTherapeutics Clinical Research, Pfizer Inc., Collegeville, PA, USA
| | - C Kantaridis
- Pfizer Clinical Research Unit, Pfizer Inc., Brussels, Belgium
| | - D D Pittman
- Rare Disease Research, Pfizer Inc., Cambridge, MA, USA
| | - S Arkin
- Rare Disease Research, Pfizer Inc., Cambridge, MA, USA
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Liu Y, Wu XH. [Effect of ulinastatin on serum levels of tumor necrosis factor-α, P-selectin, and thrombin-antithrombin complex in young rats with sepsis]. Zhongguo Dang Dai Er Ke Za Zhi 2017; 19:237-241. [PMID: 28202126 PMCID: PMC7389459] [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] [Received: 08/16/2016] [Accepted: 11/04/2016] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To investigate the effect of ulinastatin (UTI) for early drug intervention on the serum levels of tumor necrosis factor-α (TNF-α), P-selectin, and thrombin-antithrombin complex (TAT) in young rats with sepsis. METHODS A total of 120 male rats aged 4 weeks were randomly divided into normal control group, sham-operation group, sepsis group, low-dose UTI group (50 000 U/kg), and high-dose UTI group (200 000 U/kg), with 24 rats in each group. Modified cecal ligation and puncture was performed to establish a rat model of sepsis, and the rats in the low- and high-dose UTI groups were given caudal vein injection of UTI after model establishment. ELISA was used to measure the serum levels of TNF-α, P-selectin, and TAT at 6, 12, and 24 hours after model establishment. RESULTS The sepsis group had significant increases in the serum levels of TNF-α, P-selectin, and TAT at 6 hours, and the serum levels of TNF-α and TAT continued to increase by 24 hours (P<0.05); P-selectin reached the peak at 12 hours and decreased slightly at 24 hours (P<0.05). The UTI groups had similar change patterns in the levels of P-selectin and TAT as the sepsis group. The UTI groups had significant increases in the level of TNF-α at 6 hours, but gradually decreased over time. The changes in serum levels of TNF-α, P-selectin, and TAT in the UTI groups were significantly smaller than in the sepsis group (P<0.05). The high-dose UTI group had significantly smaller changes in serum levels of TNF-α, P-selectin, and TAT than the low-dose UTI group (P<0.05). CONCLUSIONS Early intervention with UTI can significantly improve coagulation function and inhibit the production of TNF-α, P-selectin, and TAT in young rats with sepsis. High-dose UTI has a significantly greater effect than low-dose UTI.
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Affiliation(s)
- Yun Liu
- Department of Pediatrics, First Affiliated Hospital of Nanchang University, Nanchang 330006, China.
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27
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Liu Y, Wu XH. [Effect of ulinastatin on serum levels of tumor necrosis factor-α, P-selectin, and thrombin-antithrombin complex in young rats with sepsis]. Zhongguo Dang Dai Er Ke Za Zhi 2017; 19:237-241. [PMID: 28202126 PMCID: PMC7389459 DOI: 10.7499/j.issn.1008-8830.2017.02.020] [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] [Received: 08/16/2016] [Accepted: 11/04/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To investigate the effect of ulinastatin (UTI) for early drug intervention on the serum levels of tumor necrosis factor-α (TNF-α), P-selectin, and thrombin-antithrombin complex (TAT) in young rats with sepsis. METHODS A total of 120 male rats aged 4 weeks were randomly divided into normal control group, sham-operation group, sepsis group, low-dose UTI group (50 000 U/kg), and high-dose UTI group (200 000 U/kg), with 24 rats in each group. Modified cecal ligation and puncture was performed to establish a rat model of sepsis, and the rats in the low- and high-dose UTI groups were given caudal vein injection of UTI after model establishment. ELISA was used to measure the serum levels of TNF-α, P-selectin, and TAT at 6, 12, and 24 hours after model establishment. RESULTS The sepsis group had significant increases in the serum levels of TNF-α, P-selectin, and TAT at 6 hours, and the serum levels of TNF-α and TAT continued to increase by 24 hours (P<0.05); P-selectin reached the peak at 12 hours and decreased slightly at 24 hours (P<0.05). The UTI groups had similar change patterns in the levels of P-selectin and TAT as the sepsis group. The UTI groups had significant increases in the level of TNF-α at 6 hours, but gradually decreased over time. The changes in serum levels of TNF-α, P-selectin, and TAT in the UTI groups were significantly smaller than in the sepsis group (P<0.05). The high-dose UTI group had significantly smaller changes in serum levels of TNF-α, P-selectin, and TAT than the low-dose UTI group (P<0.05). CONCLUSIONS Early intervention with UTI can significantly improve coagulation function and inhibit the production of TNF-α, P-selectin, and TAT in young rats with sepsis. High-dose UTI has a significantly greater effect than low-dose UTI.
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Affiliation(s)
- Yun Liu
- Department of Pediatrics, First Affiliated Hospital of Nanchang University, Nanchang 330006, China.
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Handa T, Watanabe K, Tanizawa K, Oga T, Aihara K, Ikezoe K, Sokai A, Nakatsuka Y, Hirai T, Nagai S, Chin K, Horiuchi H, Mishima M. Platelet aggregability in patients with interstitial pneumonias. Sarcoidosis Vasc Diffuse Lung Dis 2016; 33:143-150. [PMID: 27537717] [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] [Received: 01/24/2015] [Accepted: 07/23/2015] [Indexed: 06/06/2023]
Abstract
BACKGROUND Recent epidemiological studies have shown that patients with interstitial pneumonia have an increased risk of cardiovascular events. Although the presence of a coagulation/fibrinolysis abnormality in idiopathic pulmonary fibrosis (IPF) has been reported, platelet aggregability has not been evaluated in interstitial pneumonias. This study aimed to investigate platelet aggregability in patients with interstitial pneumonias. METHODS This observational cohort study included 59 patients with interstitial pneumonias [19 with IPF, 23 with other idiopathic interstitial pneumonias (IIPs), and 17 with connective tissue disease-associated interstitial pneumonias (CTD-IPs)] and 23 healthy control subjects. ADP- and collagen-induced platelet aggregability was measured together with coagulation/fibrinolysis markers. Whole blood (WB) and platelet rich plasma platelet aggregation were measured using the screen filtration pressure and optical aggregometer techniques, respectively. The platelet aggregation threshold index (PATI) was calculated; a lower PATI indicated enhanced platelet aggregability. RESULTS ADP-induced WB-PATI was significantly decreased in CTD-IPs [log WB-PATI median 0.31 (inter-quartile range, 0.07-0.34) μM, n = 17] compared with that in controls [0.35 (0.32-0.45) μM, n = 23] (p < 0.05). However, there was no significant difference in platelet aggregability between the other patient groups and controls. In contrast, d-dimer, thrombin-antithrombin complex, and von Willebrand factor levels were significantly higher in all patient groups compared with those in controls (p < 0.001). Platelet aggregability was not associated with either disease severity or survival. CONCLUSIONS Serum coagulation and fibrinolysis markers significantly increased in IIPs and CTD-IPs. In contrast, platelet aggregability was only weakly enhanced in CTDs, but not in IIPs.
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Affiliation(s)
- Tomohiro Handa
- Assistant professor Department of respiratory medicine Kyoto university hospital.
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Abstract
Various improvements have been made in cardiopulmonary bypass (CPB) in the past few decades. We designed a new type of CPB to reduce the secretion of systemic inflammatory markers. We used a low prime volume pump (LPVP), completely closed CPB circuit and examined coagulant factors and inflammatory cytokines. In this study, we demonstrate the efficacy of LPVP using molecular biological data. Fourteen patients were randomized prospectively into two groups: Group L patients underwent LPVP ( n = 8) and Group N patients underwent normal prime volume CPB ( n = 6). We measured thrombin-antithrombin III complex (TAT), complement factor (C3a), and interleukin (IL)-10 levels at four time points. TAT (66.1 ± 15.1 ng·mL−1), C3a (1895 ± 282 ng·mL−1) and IL-10 (486 ± 114 pg·mL−1) levels in Group N were significantly higher than in Group L (TAT, 19.5 ± 4.4 ng·mL−1; IL-10, 105 ± 24.6 pg·mL−1; C3a, 1349 ± 369 ng·mL−1) immediately following CPB. LPVP demonstrated a lower systemic inflammatory response compared to normal prime volume CPB, as assessed using a molecular biological approach.
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Affiliation(s)
- Hideaki Takai
- Department of Cardiovascular Surgery, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
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Metochis C, Crampton VO, Ruohonen K, Bell JG, Adams A, Thompson KD. The effects of increasing dietary levels of amino acid-supplemented soy protein concentrate and constant dietary supplementation of phosphorus on growth, composition and immune responses of juvenile Atlantic salmon (Salmo salar L.). Fish Physiol Biochem 2016; 42:807-829. [PMID: 26781956 DOI: 10.1007/s10695-015-0177-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 12/07/2015] [Indexed: 06/05/2023]
Abstract
Diets with 50 (SPC50), 65 (SPC65) and 80 % (SPC80) substitution of prime fish meal (FM) with soy protein concentrate (SPC) were evaluated against a commercial type control feed with 35 % FM replacement with SPC. Increases in dietary SPC were combined with appropriate increases in methionine, lysine and threonine supplementation, whereas added phosphorus was constant among treatments. Diets were administered to quadruplicate groups of 29 g juvenile Atlantic salmon were exposed to constant light, for 97 days. On Day 63 salmon were subjected to vaccination. Significant weight reductions in SPC65 and SPC80 compared with SPC35 salmon were observed by Day 97. Linear reductions in body cross-sectional ash, Ca/P ratios, and Ca, P, Mn and Zn were observed at Days 63 (prior vaccination) and 97 (34 days post-vaccination), while Mg presented a decrease at Day 63, in salmon fed increasing dietary SPC. Significant reductions in Zn, Ca, P and Ca/P ratios persisted in SPC65 and SPC80 compared with SPC35 salmon at Day 97. Significant haematocrit reductions in SPC50, SPC65 and SPC80 salmon were observed at Days 63, 70 and 97. Enhanced plasma haemolytic activity, increased total IgM, and a rise in thrombocytes were demonstrated in SPC50 and SPC65 salmon on Day 97, while increased lysozyme activity was demonstrated for these groups on Days 63, 70 and 97. Leucocyte and lymphocyte counts revealed enhanced immunostimulation in salmon fed with increasing dietary SPC at Day 97. High SPC inclusion diets did not compromise the immune responses of salmon, while SPC50 diet also supported good growth without compromising elemental concentrations.
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Affiliation(s)
- C Metochis
- Institute of Aquaculture, School of Natural Sciences, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
| | | | | | - J G Bell
- Institute of Aquaculture, School of Natural Sciences, University of Stirling, Stirling, FK9 4LA, Scotland, UK
| | - A Adams
- Institute of Aquaculture, School of Natural Sciences, University of Stirling, Stirling, FK9 4LA, Scotland, UK
| | - K D Thompson
- Moredun Research Institute, Pentlands Science Park, Bush Loan, Penicuik, UK
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Horn P, Erkilet G, Veulemans V, Kröpil P, Schurgers L, Zeus T, Heiss C, Kelm M, Westenfeld R. Microparticle-Induced Coagulation Relates to Coronary Artery Atherosclerosis in Severe Aortic Valve Stenosis. PLoS One 2016; 11:e0151499. [PMID: 27010400 PMCID: PMC4807100 DOI: 10.1371/journal.pone.0151499] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/29/2016] [Indexed: 12/02/2022] Open
Abstract
Background Circulating microparticles (MPs) derived from endothelial cells and blood cells bear procoagulant activity and promote thrombin generation. Thrombin exerts proinflammatory effects mediating the progression of atherosclerosis. Aortic valve stenosis may represent an atherosclerosis-like process involving both the aortic valve and the vascular system. The aim of this study was to investigate whether MP-induced thrombin generation is related to coronary atherosclerosis and aortic valve calcification. Methods In a cross-sectional study of 55 patients with severe aortic valve stenosis, we assessed the coronary calcification score (CAC) as indicator of total coronary atherosclerosis burden, and aortic valve calcification (AVC) by computed tomography. Thrombin-antithrombin complex (TATc) levels were measured as a marker for thrombin formation. Circulating MPs were characterized by flow cytometry according to the expression of established surface antigens and by measuring MP-induced thrombin generation. Results Patients with CAC score below the median were classified as patients with low CAC, patients with CAC Score above the median as high CAC. In patients with high CAC compared to patients with low CAC we detected higher levels of TATc, platelet-derived MPs (PMPs), endothelial-derived MPs (EMPs) and MP-induced thrombin generation. Increased level of PMPs and MP-induced thrombin generation were independent predictors for the severity of CAC. In contrast, AVC Score did not differ between patients with high and low CAC and did neither correlate with MPs levels nor with MP-induced thrombin generation. Conclusion In patients with severe aortic valve stenosis MP-induced thrombin generation was independently associated with the severity of CAC but not AVC indicating different pathomechanisms involved in coronary artery and aortic valve calcification.
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Affiliation(s)
- Patrick Horn
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
- * E-mail:
| | - Gülsüm Erkilet
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
| | - Verena Veulemans
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
| | - Patric Kröpil
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
| | - Leon Schurgers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Tobias Zeus
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
| | - Christian Heiss
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
| | - Malte Kelm
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
- Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty, University Düsseldorf, Düsseldorf, Germany
| | - Ralf Westenfeld
- Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
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van Bijnen STA, Wouters D, van Mierlo GJ, Muus P, Zeerleder S. Neutrophil activation and nucleosomes as markers of systemic inflammation in paroxysmal nocturnal hemoglobinuria: effects of eculizumab. J Thromb Haemost 2015; 13:2004-11. [PMID: 26333021 DOI: 10.1111/jth.13125] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 08/14/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Paroxysmal nocturnal hemoglobinuria (PNH) is characterized by complement-mediated hemolysis and a high risk of life-threatening venous and arterial thrombosis. Uncontrolled complement activation and the release of cell-free heme may result in systemic inflammation, neutrophil activation, and the release of procoagulant neutrophilic proteases. Eculizumab, an antibody to complement factor C5, inhibits hemolysis and reduces thrombotic risk. OBJECTIVES To study neutrophil activation and nucleosome levels in relation to thrombosis in PNH patients before and during treatment with eculizumab. PATIENTS/METHODS In 51 untreated PNH patients, including 20 patients before and after commencing eculizumab treatment, we have assessed neutrophil activation by measuring elastase-α1 -antitrypsin (EA) complexes and circulating nucleosomes, as established markers for systemic inflammation and cell death. RESULTS Nucleosomes (median; range; 95% confidence interval [CI]), but not EA complexes, were higher in PNH patients with a history of thrombosis (16; 7-264; 0.3-94 U mL(-1) , n = 12) than in those without (6; 6-35; 7-11 U mL(-1) , n = 39) or controls (8; 6-23; 7-12 U mL(-1) , n = 17). EA complexes, but not nucleosomes, decreased promptly and markedly upon eculizumab treatment. EA complexes (estimated marginal means; 95% CI) remained low at ≥ 12 weeks (50; 34-67) compared with baseline (12; -6 to 29). CONCLUSIONS The increased nucleosome levels in PNH patients with a history of thrombosis suggest systemic inflammation and/or cell death. Neutrophil activation markers did not differ between patients with and without a history of thrombosis and healthy controls. Interestingly, basal neutrophil activation in PNH patients significantly decreases on treatment with eculizumab, indicating that neutrophil activation is C5a driven.
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Affiliation(s)
| | - D Wouters
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - G J van Mierlo
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - P Muus
- Department of Hematology, RadboudUMC, Nijmegen, the Netherlands
| | - S Zeerleder
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory AMC, University of Amsterdam, Amsterdam, the Netherlands
- Department of Hematology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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Xiang J, Fangchao Y, Bing W, Yongqiang W, Shuhua C, Yuliang W. [Thrombocytopenia induced by lipopolysaccharide may be not related to coagulation and inflammatory response]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2015; 27:754-758. [PMID: 26955703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To explore the relationship between thrombocytopenia (TCP) induced by lipopolysaccharide (LPS) and coagulation or inflammatory response in mouse. METHODS Forty-eight C57BL/6 mice were divided into control group, low-dose, and high-dose LPS treatment groups by random number table method, and each group was subdivided into 4-hour and 24-hour subgroups randomly, with 8 mice in each subgroup. 0.5 mg/kg or 50 mg/kg LPS was injected intraperitoneally in low-dose or high-does group respectively, and equal amount of normal saline was injected in control group. Blood was collected from endocanthal vein at the specified time point, platelet count (PLT) was counted, and the levels of thrombin antithrombin complex (TAT), D-dimer, fibrinogen degradation product (FDP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were determined by enzyme linked immunosorbent assay (ELISA). RESULTS Compared with control group, PLT ( x 10(9)/L) at 4 hours and 24 hours in low-dose and high-dose LPS groups was significantly decreased (4 hours: 660.65 ± 180.48, 568.55 ± 117.99 vs. 1 199.13 ± 110.54; 24 hours: 505.63 ± 218.92, 256.33 ± 72.86 vs. 1 229.13 ± 1 189.37, all P < 0.05), and the changes were more obvious in high-dose LPS group compared with those of the low-dose LPS group (all P < 0.05). Factorial analysis showed that the changes in PLT were related with LPS dosage and time (F1 = 135.660, P = 0.000; F2 = 12.120, P2 = 0.001). It was also found that there was an interactive effect of the dose of LPS and time on PLT (F = 5.580, P = 0.007). Compared with control group, TAT, TNF-α, and IL-6 at 4 hours and 24 hours in low-dose and high-dose LPS groups were significantly decreased [TAT (ng/L) at 4 hours: 1.10 ± 0.59, 0.22 ± 0.13 vs. 3.47 ± 1.73; 24 hours: 1.18 ± 0.68, 0.39 ± 0.29 vs. 3.19 ± 1.27; TNF-α (nmol/L) at 4 hours: 87.35 ± 12.29, 93.70 ± 5.25 vs. 101.59 ± 10.96, 24 hours: 81.94 ± 8.26, 93.23 ± 4.71 vs. 102.84 ± 10.56; IL-6 (ng/L) at 4 hours: 81.78 ± 7.82, 78.59 ± 9.06 vs. 110.88 ± 9.66, 24 hours: 76.03 ± 9.85, 71.34 ± 3.69 vs. 110.88 ± 10.35, all P < 0.05]. TAT at 4 hours and 24 hours in high-dose LPS group was further decreased, and TNF-α at 24 hours was increased as compared with those of low-dose LPS group (all P < 0.05). TAT, TNF-α and IL-6 were influenced only by different dosage of LPS (TAT: F = 42.350, P = 0.000; TNF-α: F = 14.8 10, P = 0.000; IL-6: F = 81.910, P = 0.000), not time (TAT: F = 0.002, P = 0.967; TNF-α: F = 0.342, P = 0.562; IL-6: F = 2.973, P = 0.092). Changes in TAT was not found to be related with the dose of LPS and its time of action, or levels of TNF-α and IL-6 (TAT: F = 0.236, P = 0.791; TNF-α: F = 0.572, P = 0.569; IL-6: F = 0.774, P = 0.468). The dosage of LPS and time of admission showed no influence on D-dimer (F1 = 2.448, P = 0.099; F2 = 0.024; P2 = 0.877). The effect of different doses of LPS and time of administration showed no influence on FDP (F1 = 0.106, P = 0.900; F2 = 0.013, P2 = 0.908), and no interactive effects were found (D- dimer: F = 0.002, P = 0.998; FDP: F = 0.582, P = 0.563). CONCLUSION LPS can induce TCP in mouse, but this effect may not related to the activation of coagulation system and excessive inflammatory response.
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Pan YN, Liang XX, Niu LY, Wang YN, Tong X, Hua HM, Zheng J, Meng DY, Liu XQ. Comparative studies of pharmacokinetics and anticoagulatory effect in rats after oral administration of Frankincense and its processed products. J Ethnopharmacol 2015; 172:118-123. [PMID: 26117531 DOI: 10.1016/j.jep.2015.06.029] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 05/21/2015] [Accepted: 06/16/2015] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Frankincense (FRA), Ruxiang, is the resin of Boswellia carterii Birdw and Boswellia bhaw-dajiana Birdw which has been used for centuries as formulas to improve the circulation and to relieve pain against carbuncles. Stir-fried Frankincense (SFF) and vinegar processed Frankincense (VPF) are two major processed Frankincense, and the processing procedures reportedly enhance the curative efficacy or reduce the side effects of FRA. This paper describes the comparisons in plasma pharmacokinetic behaviors of 11-keto-β-boswellic acid (KBA) and 3-acetyl-11-keto-β-boswellic acid (AKBA) in FRA and its processed products, and their effects on coagulation factors and blood clotting tetrachoric, using an acute cold blood-stasis animal model after oral administration of FRA, SFF, and VPF. MATERIALS AND METHODS For pharmacokinetic study, Sprague-Dawley (SD) rats were randomly divided into three groups, including group FRA, group SFF and group VPF. And the plasma samples were analyzed by HPLC. For study of anticoagulatory effect, SD rats were randomly divided into six groups, including control, acute cold blood-stasis model, Fu-fang-dan-shen tablet- (0.75g/kg), FRA-, SFF-, and VPF-treated (2.7g/kg) groups, respectively. The serum contents of thrombin-antithrombin complex (TAT), D-dimer (D-D), and prostacyclin (PGI2) of each group were measured by ELISA. The values of prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) were also assessed by hematology analyzer. RESULTS Significantly increased levels of Cmax, AUC, T1/2, and MRT were found in rats treated with the processed products. In addition, decreased levels of D-D and TAT and increased contents of PGI2 were observed in rats given FRA and its processed products, compared with that of the model group. Moreover, VPF improved anticoagulation more than SFF in the animals. CONCLUSIONS The observed improvement of anticoagulation by processed FRA may result from the increased absorption and bioavailability of triterpenoids.
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Affiliation(s)
- Ying-Ni Pan
- School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, No. 103, Wenhua Road, Shenyang, China
| | - Xiao-Xu Liang
- School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, No. 103, Wenhua Road, Shenyang, China
| | - Li-Ying Niu
- School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, No. 103, Wenhua Road, Shenyang, China
| | - Yan-Nian Wang
- School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, No. 103, Wenhua Road, Shenyang, China
| | - Xin Tong
- School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, No. 103, Wenhua Road, Shenyang, China
| | - Hui-Ming Hua
- School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, No. 103, Wenhua Road, Shenyang, China
| | - Jiang Zheng
- School of Pharmacy, Shenyang Pharmaceutical University, No. 103, Wenhua Road, Shenyang, China; Center for Developmental Therapeutics, Seattle Children's Research Institute, Division of Gastroenterology and Hepatology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA 98102, USA
| | - Dong-Ya Meng
- Clinical Laboratory, Shenyang Military Region General Hospital, No. 83, Wenhua Road, Shenyang, China
| | - Xiao-Qiu Liu
- School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, No. 103, Wenhua Road, Shenyang, China.
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Spronk HMH, Braunschweig T, Rossaint R, Wüst DC, van Oerle R, Lauritzen B, Tolba R, Grottke O. Recombinant Factor VIIa Reduces Bleeding after Blunt Liver Injury in a Pig Model of Dilutional Coagulopathy under Severe Hypothermia. PLoS One 2015; 10:e0113979. [PMID: 26098426 PMCID: PMC4476676 DOI: 10.1371/journal.pone.0113979] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 10/31/2014] [Indexed: 11/29/2022] Open
Abstract
Background Recombinant factor VIIa (rFVIIa) is registered for use in haemophilia with inhibitors and other rare bleeding disorders, but has also been used in various other clinical conditions to terminate life-threatening bleeding. Underlying conditions (e.g. coagulopathy) and dosing may affect treatment efficacy. The objective of the present study was to evaluate the impact of increasing doses of rFVIIa on blood loss and coagulation assays in haemodiluted and hypothermic pigs undergoing blunt liver injury. Methods A grade III blunt liver injury was induced in 28 pigs after 70% haemodilution and cooling to 32.6–33.4°C. Ten minutes after trauma, animals randomly received placebo or 90, 180 or 360 μg/kg rFVIIa. Global coagulation parameters, thromboelastometry (TEM) and plasma thrombin generation (TG) were determined at different time points during the observation period of 120 minutes. Results Total blood loss was significantly lower following 90 μg/kg rFVIIa (1206 [1138–1470] mL) relative to placebo (2677 [2337–3068] mL; p<0.05), with no increased effect with higher dose levels of rFVIIa. Following trauma and haemodilution, coagulation was impaired relative to baseline in both TEM and TG analysis. At 60 and 120 minutes after trauma, TEM variables improved in the rFVIIa-treated animals compared with the placebo group. Similarly, rFVIIa improved coagulation kinetics in TG. As was observed with blood loss, no significant effect between different rFVIIa dose levels was found in TEM or TG. Macro- and microscopic post-mortem examination did not reveal any signs of thromboembolic events. Conclusion Early administration of 90 μg/kg rFVIIa reduced blood loss in pigs undergoing blunt liver injury even after severe haemodilution and hypothermia, with no further effect of higher dose levels. Coagulation assays showed impaired coagulation in coagulopathic animals, with a dose-independent improvement in animals treated with rFVIIa.
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Affiliation(s)
- Henri M. H. Spronk
- Laboratory for Clinical Thrombosis and Haemostasis, Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Till Braunschweig
- Department of Pathology, RWTH Aachen University Hospital, Aachen, Germany
| | - Rolf Rossaint
- Department of Anaesthesiology, RWTH Aachen University Hospital, Aachen, Germany
| | - Dirk C. Wüst
- Department of Anaesthesiology, RWTH Aachen University Hospital, Aachen, Germany
| | - Rene van Oerle
- Laboratory for Clinical Thrombosis and Haemostasis, Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | | | - Rene Tolba
- Institute for Laboratory Animal Science, RWTH Aachen University Hospital, Aachen, Germany
| | - Oliver Grottke
- Department of Anaesthesiology, RWTH Aachen University Hospital, Aachen, Germany
- * E-mail:
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Gogia S, Lo CY, Neelamegham S. Detection of Plasma Protease Activity Using Microsphere-Cytometry Assays with E. coli Derived Substrates: VWF Proteolysis by ADAMTS13. PLoS One 2015; 10:e0126556. [PMID: 25992814 PMCID: PMC4436310 DOI: 10.1371/journal.pone.0126556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 04/03/2015] [Indexed: 11/19/2022] Open
Abstract
Protease levels in human blood are often prognostic indicators of inflammatory, thrombotic or oncogenic disorders. The measurement of such enzyme activities in substrate-based assays is complicated due to the low prevalence of these enzymes and steric hindrance of the substrates by the more abundant blood proteins. To address these limitations, we developed a molecular construct that is suitable for microsphere-cytometer based assays in the milieu of human blood plasma. In this proof of principle study, we demonstrate the utility of this substrate to measure metalloprotease ADAMTS13 activity. The substrate, expressed in E. coli as a fusion protein, contains the partial A2-domain of von Willebrand factor (VWF amino acids 1594-1670) that is mutated to include a single primary amine at the N-terminus and free cysteines at the C-terminus. N-terminus fluorescence conjugation was possible using NHS (N-hydroxysuccinimide) chemistry. Maleimide-PEG(Polyethylene glycol)n-biotin coupling at the C-terminus allowed biotinylation with variable PEG spacer lengths. Once bound to streptavidin-bearing microspheres, the substrate fluorescence signal decreased in proportion with ADAMTS13 concentration. Whereas recombinant ADAMTS13 activity could be quantified using substrates with all PEG repeat-lengths, only the construct with the longer 77 PEG-unit could quantify proteolysis in blood plasma. Using this longer substrate, plasma ADAMTS13 down to 5% of normal levels could be detected within 30 min. Such measurements could also be readily performed under conditions resembling hyperbilirubinemia. Enzyme catalytic activity was tuned by varying buffer calcium, with lower divalent ion concentrations enhancing cleavage. Overall, the study highlights the substrate design features important for the creation of efficient proteolysis assays in the setting of human plasma. In particular, it emphasizes the need to introduce PEG spacers in plasma-based experiments, a design attribute commonly ignored in immobilized peptide-substrate assays.
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Affiliation(s)
- Shobhit Gogia
- Department of Chemical and Biological Engineering and NY State Center for Excellence in Bioinformatics and Life Sciences, State University of New York, Buffalo, New York, United States of America
| | - Chi Y. Lo
- Department of Chemical and Biological Engineering and NY State Center for Excellence in Bioinformatics and Life Sciences, State University of New York, Buffalo, New York, United States of America
| | - Sriram Neelamegham
- Department of Chemical and Biological Engineering and NY State Center for Excellence in Bioinformatics and Life Sciences, State University of New York, Buffalo, New York, United States of America
- * E-mail:
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Howard JW, Kay RG, Tan T, Minnion J, Creaser CS. Identification of plasma protease derived metabolites of glucagon and their formation under typical laboratory sample handling conditions. Rapid Commun Mass Spectrom 2015; 29:171-181. [PMID: 25641492 DOI: 10.1002/rcm.7090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 10/29/2014] [Accepted: 10/31/2014] [Indexed: 06/04/2023]
Abstract
RATIONALE Glucagon modulates glucose production, and it is also a biomarker for several pathologies. It is known to be unstable in human plasma, and consequently stabilisers are often added to samples, although these are not particularly effective. Despite this, there have not been any studies to identify in vitro plasma protease derived metabolites; such a study is described here. Knowledge of metabolism should allow the development of more effective sample stabilisation strategies. METHODS Several novel metabolites resulting from the incubation of glucagon in human plasma were identified using high-resolution mass spectrometry with positive electrospray ionisation. Tandem mass spectrometric (MS/MS) scans were acquired for additional confirmation using a QTRAP. Separation was performed using reversed-phase ultra-high-performance liquid chromatography. The formation of these metabolites was investigated during a time-course experiment and under specific stress conditions representative of typical laboratory handling conditions. Clinical samples were also screened for metabolites. RESULTS Glucagon(3-29) and [pGlu](3) glucagon(3-29) were the major metabolites detected, both of which were also present in clinical samples. We also identified two oxidised forms of [pGlu](3) glucagon(3-29) as well as glucagon(19-29), or 'miniglucagon', along with the novel metabolites glucagon(20-29) and glucagon(21-29). The relative levels of these metabolites varied throughout the time-course experiment, and under the application of the different sample handling conditions. Aprotinin stabilisation of samples had negligible effect on metabolite formation. CONCLUSIONS Novel plasma protease metabolites of glucagon have been confirmed, and their formation characterised over a time-course experiment and under typical laboratory handling conditions. These metabolites could be monitored to assess the effectiveness of new sample stabilisation strategies, and further investigations into their formation could suggest specific enzyme inhibitors to use to increase sample stability. In addition the potential of the metabolites to affect immunochemistry-based assays as a result of cross-reactivity could be investigated.
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Affiliation(s)
- James W Howard
- LGC, Newmarket Road, Fordham, CB7 5WW, UK; Centre for Analytical Science, Department of Chemistry, Loughborough University, Loughborough, LE11 3TU, UK
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Chuchalin AG, Tseimakh IY, Momot AR, Mamaev AN, Karbyshev IA, Strozenko LA. [THROMBOGENIC RISK FACTORS IN PATIENTS WITH EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE]. Klin Med (Mosk) 2015; 93:18-23. [PMID: 27149808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We studied activation of hemostatic reactions together with mechanisms of systemic inflammation and genetic factors responsible for thrombogenic risk in 65 patients suffering exacerbation of chronic obstructive pulmonary disease with 2 or 3 positive criteria proposed by N.Anthonisen at al. (1987). The levels of indicators of systemic inflammation, such as C-reactive protein and tumour necrosis factor-alpha, increased concurrently with those of homocysteine, endothelin-1, Willebrand factor plasminogen activator inhibitor type 1, and thrombin-antithrombin complex (marker of thrombinemia). The prevalence of pathological alleles ofprotein genes involved in the hemostasis system and folate cycle remained as in the control group. A relationship between plasma levels of thrombin-antithrombin complex and Willebrand factor and the activity of indicators of systemic inflammation was documented. Treatment of exacerbation resulted in the decrease in the levels of the thrombin- antithrombin complex, inhibitor of the extrinsic pathway of coagulation, and plasminogen activator inhibitor type 1. The treatment failed to normalize parameters of thrombinemia and blood fibrinolytic potential.
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Kotschy D, Kotschy M, Socha P, Masłowski L, Kwapisz J, Żuk N, Dubis J, Karczewski M, Witkiewicz W. Tissue factor and other hemostatic parameters in patients with advanced peripheral artery disease after endovascular revascularization - search for hemostatic factors which indicate restenosis. ADV CLIN EXP MED 2015; 24:93-8. [PMID: 25923092 DOI: 10.17219/acem/38160] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND In patients with peripheral artery disease (PAD) a hypercoagulable state and thromboembolic complications occur. Revascularization procedures increase this state, sometimes leading to restenosis. Restenosis following balloon angioplasty (PTA)and stent implantation is ≥ 50% of artery stenosis. OBJECTIVES To determine the concentration of tissue factor (TF), tissue factor pathway inhibitor (TFPI), thrombin-antithrombin (TAT) complexes, fibrinogen and D-dimers in the blood of patients with PAD after peripheral endovascular revascularization of the lower legs and in PAD patients with restenosis. MATERIAL AND METHODS The study included 150 patients with PAD, 90 men and 60 women, aged 44-88 (mean 65.5) years, after successful peripheral angioplasty (PTA) and/or with stenting. During the 6 months after the revascularization procedures, restenosis occurred in 27 patients. The reference group consisted of 53 healthy persons (44 men and 9 women, aged 20-56 years). Blood was drawn in the morning into 3.2% natrium citrate at a ratio of 9 : 1. The concentration of TF, TFPI, TAT complexes and D-dimers were measured in plasma with commercial tests using an enzyme immunoassay. Fibrinogen was determined with coagulometer. RESULTS In the plasma of patients with PAD after endovascular revascularization, the concentrations of TF, TAT complexes, fibrinogen and D-dimers were significantly higher compared to the reference group. During the six months of observation, 27 patients developed restenosis. The results of hemostatic factors in patients with restenosis were compared with the same patients before restenosis and the group of 123 PAD patients after endovascular revascularization. TF and fibrinogen levels in the 27 patients with restenosis were significantly higher than in the group of PAD patients before restenosis. CONCLUSIONS Statistically significantly higher levels of tissue factor (TF) and fibrinogen in PAD patients with new restenosis, compared to those without restenosis after endovascular revascularization, indicate they can participate in the formation of restenosis.
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Affiliation(s)
- Daniel Kotschy
- WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland
| | - Maria Kotschy
- WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland
| | - Paweł Socha
- WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland
| | - Leszek Masłowski
- WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland
| | - Justyna Kwapisz
- WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland
| | - Natalia Żuk
- WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland
| | - Joanna Dubis
- WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland
| | - Maciej Karczewski
- WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland
| | - Wojciech Witkiewicz
- WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland
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Joshi N, Kopec AK, O'Brien KM, Towery KL, Cline-Fedewa H, Williams KJ, Copple BL, Flick MJ, Luyendyk JP. Coagulation-driven platelet activation reduces cholestatic liver injury and fibrosis in mice. J Thromb Haemost 2015; 13:57-71. [PMID: 25353084 PMCID: PMC4487795 DOI: 10.1111/jth.12770] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 10/17/2014] [Indexed: 01/14/2023]
Abstract
BACKGROUND The coagulation cascade has been shown to participate in chronic liver injury and fibrosis, but the contribution of various thrombin targets, such as protease activated receptors (PARs) and fibrin(ogen), has not been fully described. Emerging evidence suggests that in some experimental settings of chronic liver injury, platelets can promote liver repair and inhibit liver fibrosis. However, the precise mechanisms linking coagulation and platelet function to hepatic tissue changes following injury remain poorly defined. OBJECTIVES To determine the role of PAR-4, a key thrombin receptor on mouse platelets, and fibrin(ogen) engagement of the platelet αII b β3 integrin (αIIb β3 ) in a model of cholestatic liver injury and fibrosis. METHODS Biliary and hepatic injury was characterized following 4 week administration of the bile duct toxicant α-naphthylisothiocyanate (ANIT) (0.025%) in PAR-4-deficient mice, mice expressing a mutant form of fibrin(ogen) incapable of binding integrin αII b β3 (Fibγ(Δ5) ), and wild-type mice. RESULTS Elevated plasma thrombin-antithrombin and serotonin levels, hepatic fibrin deposition, and platelet accumulation in liver accompanied hepatocellular injury and fibrosis in ANIT-treated wild-type mice. PAR-4 deficiency reduced plasma serotonin levels, increased serum bile acid concentration, and exacerbated ANIT-induced hepatocellular injury and peribiliary fibrosis. Compared with PAR-4-deficient mice, ANIT-treated Fibγ(Δ5) mice displayed more widespread hepatocellular necrosis accompanied by marked inflammation, robust fibroblast activation, and extensive liver fibrosis. CONCLUSIONS Collectively, the results indicate that PAR-4 and fibrin-αII b β3 integrin engagement, pathways coupling coagulation to platelet activation, each exert hepatoprotective effects during chronic cholestasis.
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MESH Headings
- 1-Naphthylisothiocyanate
- Animals
- Antithrombin III
- Bile Acids and Salts/blood
- Blood Coagulation/genetics
- Blood Platelets/metabolism
- Chemical and Drug Induced Liver Injury/blood
- Chemical and Drug Induced Liver Injury/genetics
- Chemical and Drug Induced Liver Injury/pathology
- Chemical and Drug Induced Liver Injury/prevention & control
- Cholestasis/blood
- Cholestasis/chemically induced
- Cholestasis/genetics
- Cholestasis/pathology
- Cholestasis/prevention & control
- Fibrinogens, Abnormal/genetics
- Fibrinogens, Abnormal/metabolism
- Genotype
- Liver/metabolism
- Liver/pathology
- Liver Cirrhosis, Experimental/blood
- Liver Cirrhosis, Experimental/chemically induced
- Liver Cirrhosis, Experimental/genetics
- Liver Cirrhosis, Experimental/pathology
- Liver Cirrhosis, Experimental/prevention & control
- Male
- Mice, Inbred C57BL
- Mice, Knockout
- Mutation
- Necrosis
- Peptide Hydrolases/blood
- Phenotype
- Platelet Activation/genetics
- Platelet Glycoprotein GPIIb-IIIa Complex/metabolism
- Receptors, Thrombin/deficiency
- Receptors, Thrombin/genetics
- Serotonin/blood
- Signal Transduction
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Affiliation(s)
- N Joshi
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI, USA; Center for Integrative Toxicology, Michigan State University, East Lansing, MI, USA
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42
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Weisshaar S, Litschauer B, Gouya G, Mayer P, Smerda L, Kapiotis S, Kyrle PA, Eichinger S, Wolzt M. Antithrombotic triple therapy and coagulation activation at the site of thrombus formation: a randomized trial in healthy subjects. J Thromb Haemost 2014; 12:1850-60. [PMID: 25211369 DOI: 10.1111/jth.12726] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 09/07/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Patients with acute coronary syndrome and concomitant atrial fibrillation may require antithrombotic triple therapy but clinical evidence of safety and efficacy is poor. We have therefore studied the combination of different antithrombotic medicines for coagulation activation in an in vivo model in the skin microvasculature. METHODS AND RESULTS Platelet activation (β-thromboglobulin [β-TG]) and thrombin generation (prothrombin fragment 1 + 2 [F1+2 ], thrombin-antithrombin complex [TAT]) were studied in an open-label, randomized, parallel group trial in 60 healthy male subjects (n = 20 per group) who received ticagrelor and acetylsalicylic acid (ASA) in combination with dabigatran (150 mg bid), rivaroxaban (20 mg od) or phenprocoumon (INR 2.0-3.0). Coagulation biomarkers in shed blood were assessed at 3 h after monotherapy with the medicines under study, at 3 h after triple therapy dosing and at steady state trough conditions. Single doses of ticagrelor, dabigatran or rivaroxaban caused comparable decreases in shed blood β-TG and were more pronounced than phenprocoumon at an INR of 2.0-3.0. In contrast, thrombin generation was more affected by rivaroxaban and phenprocoumon than by dabigatran. During triple therapy a similarly sustained inhibition of platelet activation and thrombin generation with a maximum decrease of β-TG, F1+2 and TAT at 3 h post-dosing was noted, which remained below pre-dose levels at trough steady state. CONCLUSION A triple therapy at steady state with ticagrelor plus ASA in combination with dabigatran or rivaroxaban is as effective as a combination with phenprocoumon for platelet activation and thrombin generation in vivo.
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Affiliation(s)
- S Weisshaar
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
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43
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Tempst P. [The coding according molecular mass of synthetic biomarkers under comprehensive testing of urine components: horizons of disease monitoring]. Klin Lab Diagn 2014; 59:4-5. [PMID: 25850235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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44
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Jakobsche-Policht U, Bednarska-Chabowska D, Sadakierska-Chudy A, Adamiec-Mroczek J. Expression of the PAR-1 protein on the surface of platelets in patients with chronic peripheral arterial insufficiency - preliminary report. ADV CLIN EXP MED 2014; 23:159-67. [PMID: 24913105 DOI: 10.17219/acem/37042] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The activation of pro-coagulation mechanisms associated with the vascular wall's immune and inflammatory responses wall to injury plays a crucial role in the mechanisms of the induction and progression of atherosclerosis. OBJECTIVES The aim of this study was to determine the role of protease activated receptors (PAR-1) expressed on the surface of blood platelets in the pathogenesis of chronic peripheral arterial obliterative disease (PAOD) in patients with obliterative atherosclerosis (n = 24) and diabetic macroangiopathy (n = 16), as well as in the controls (n = 12). MATERIAL AND METHODS In addition to the expression of PAR-1, serum/plasma concentrations of thrombin-antithrombin complex (TAT), the von Willebrand factor (vWF), the platelet-derived growth factor, monocyte chemotactic protein, the soluble form of the platelet endothelial cell adhesion molecule, thrombin activatable fibrinolysis inhibitor and interleukin 6 (IL-6) were determined. RESULTS Compared to the controls, PAOD patients were characterized by significantly higher levels of PAR-1 expression, vWF, TAT and IL-6. Individuals with diabetic macroangiopathy did not differ significantly from individuals with obliterative atherosclerosis in terms of PAR-1 expression. Upon activation with thrombin receptor antagonist peptide (TRAP), the levels of PAR-1 were comparable in all analyzed groups. In patients with diabetic macroangiopathy, a significant association was observed between the expression of PAR-1 on the surface of the platelet and the serum TAT concentration, as well as between TAT and serum IL-6 concentration. CONCLUSIONS Enhanced expression of PAR-1 on the thrombocyte surface in chronic PAOD patients occurs equally in cases of diabetic macroangiopathy and in individuals free from this endocrine pathology.
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Affiliation(s)
- Urszula Jakobsche-Policht
- Department and Clinic of Angiology, Hypertension and Diabetology, Wroclaw Medical University, Poland
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Atichartakarn V, Chuncharunee S, Archararit N, Udomsubpayakul U, Aryurachai K. Intravascular hemolysis, vascular endothelial cell activation and thrombophilia in splenectomized patients with hemoglobin E/β-thalassemia disease. Acta Haematol 2014; 132:100-7. [PMID: 24525823 DOI: 10.1159/000355719] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 09/18/2013] [Indexed: 01/27/2023]
Abstract
The relationship between asplenia and thrombophilia in β-thalassemia disease patients is not yet completely understood. One hundred and ten adult hemoglobin (Hb) E/β-thalassemia (E/β-Thal) disease outpatients, dichotomized according to the presence or absence of the spleen, were prospectively studied for evidence of intravascular hemolysis (IVH) and vascular endothelial cell (EC) activation. Biomarkers of IVH (serum cell-free Hb), EC [soluble E-selectin (sE-selectin) and soluble vascular cell adhesion molecule 1 (sVCAM-1)], platelet and EC [soluble P-selectin (sP-selectin)], inflammation [high-sensitivity C-reactive protein (hs-CRP)], and coagulation [thrombin-antithrombin complexes (TAT)] activation, as well as other selected blood tests were determined. The 61 splenectomized patients had a more severe hemolytic disease and higher levels of cell-free Hb and ferritin (p = 0.003), sE-selectin, sP-selectin, hs-CRP, and TAT (p < 0.05). However, serum levels of sVCAM-1 were not different between the two groups. The findings suggested IVH and EC activation. Together with chronic iron overload and chronic low-grade inflammation activation, the findings extend our understanding of the mechanism of thrombophilia in splenectomized E/β-Thal disease patients.
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Affiliation(s)
- Vichai Atichartakarn
- Division of Hematology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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46
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Korshunov GV, BYchkov EN, Borodulin VB, Arsent'eva LA, Serkova SA, Bel'skaia NA. [About the biochemical criteria of heroin (narcotic) intoxication]. Klin Lab Diagn 2013:18-20. [PMID: 24340942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The article deals with the data of study of biochemical indicators and activity of particular proteolytic enzymes in blood serum of patients with heroin drug addiction. The results can be applied to detect the typical laboratory changes intrinsic to this kind of intoxication.
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Yae M, Sueishi M, Mikami Y, Kinoshita M, Hirano S, Nakamura K, Futata Y, Kawashima H, Ohkubo K, Ishikura H, Matsunaga A. [Influence of pre-analytical storage conditions on four plasma coagulation molecular markers measured using a STACIA automatic coagulation analyzer]. Rinsho Byori 2012; 60:1139-1144. [PMID: 23427695] [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: 06/01/2023]
Abstract
We investigated the effects of specimen storage conditions on the analysis of the coagulation molecular markers, soluble fibrin (SF), thrombin-antithrombin complex (TAT), thrombomodulin (TM) and tissue plasminogen activator inhibitor-1 complex (total PAI-1: tPAI). Marker levels were measured using a STACIA automatic coagulation analyzer. Among these four markers in blood from healthy subjects, only tPAI increased gradually with time, and the differences were especially marked when blood samples were stored at room temperature. Patient blood samples were stored for 4 hours under three different conditions: whole blood storage on ice, storage on ice after centrifugation, and refrigerated storage after centrifugation. Analytical results were compared between the three sets of samples. There were no significant differences in TAT or TM after 4 hours' storage under the different conditions. However, SF was decreased in several samples. In 11 of 14 samples with >20 microg/ml SF, SF levels were reduced by >10 microg/ml when whole blood without centrifugation was stored on ice. tPAI levels increased slightly after storage for 4 hours under all three conditions. These results suggest that centrifugation followed by refrigeration is the optimal storage method for blood samples when all four markers are to be measured simultaneously in the same sample.
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Affiliation(s)
- Masataka Yae
- Department of Clinical Laboratory, Fukuoka University Hospital, Fukuoka 814-0180, Japan.
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Pinelli A, Trivulzio S, Rossoni G, Redaelli R, Brenna S. Factors involved in sudden coagulation observed in patients with acute myocardial infarction. In Vivo 2012; 26:1021-1025. [PMID: 23160687] [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: 06/01/2023]
Abstract
Coronary artery diseases (CAD) evolving into acute myocardial infarction (AMI) is associated with coagulation and thrombotic occlusion of coronary vessels in the presence of unstable atheroma. The atheromatous plaque becomes unstable when it is infiltrated by monocytes, macrophages and neutrophils capable of secreting proteases that induce plaque erosion, rupture and initialize the coagulation process. The aim of this study was (a) to analyse the plasma of patients with AMI for the presence of proteases that may activate rapid coagulation, (b) to evaluate coagulation markers as prothrombin fragment (F1+2) and antithrombin III and (c) to find an interrelation between proteases and coagulation markers. The examined plasma showed high values of prothrombin fragment (F1+2) and low levels of antithrombin III. These markers showed a highly significant negative-correlation. The plasma also exhibited increased levels of matrix metalloproteinase-9 (MMP-9) which were positively-correlated with the prothrombin fragment (F1+2). MMP-9 seems to cause the coagulation activity by increasing the level of prothrombin fragment (F1+2) and the consumption of antithrombin III. The examined plasma also exhibited high levels of neutrophil gelatinase-associated lipocalin (NGAL), which is known to modulate MMP-9 activity. The high plasma levels of MMP-9 and NGAL can be attributed to plaque instability and appear to activate sudden coagulation. MMP-9 and NGAL, in the presence of altered values of prothrombin fragment (F1+2) and antithrombin III in AMI patients, seem to be suitable markers to be studied in unstable plaque patients, for the prediction and prevention of acute coronary syndrome.
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Affiliation(s)
- Arnaldo Pinelli
- Department of Medical Biotechnology and Translational Medicine, Research Unit Iraklis Galatoulas, University of Milan, Italy.
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Stogov MV, Luneva SN, Mitrofanov AI, Tkachuk EA. [The characteristics of chemical composition of content of unicameral bone cysts depending on their growth stage]. Klin Lab Diagn 2012:21-22. [PMID: 23305011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The article deals with the results of study of chemical composition of solitary cysts and blood serum of 27 patients. The results demonstrated that qualitative composition of f content of unicameral bone cysts is identical to chemical composition of blood serum. The results of analysis of total proteolysis activity and acid phosphatase activity in content of cysts can be used as criteria to determine the stage of cyst growth and to evaluate the effectiveness of applied treatment.
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Caseiro A, Ferreira R, Quintaneiro C, Pereira A, Marinheiro R, Vitorino R, Amado F. Protease profiling of different biofluids in type 1 diabetes mellitus. Clin Biochem 2012; 45:1613-9. [PMID: 22975642 DOI: 10.1016/j.clinbiochem.2012.08.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 08/20/2012] [Accepted: 08/26/2012] [Indexed: 12/11/2022]
Abstract
OBJECTIVES We aimed to disclose the proteolytic events underlying type 1 diabetes and related complication through protease profiling in the bodily fluids serum, urine and saliva. DESIGN AND METHODS Zymography followed by LC-MS/MS was performed for protease identification and quantitative comparison of proteolytic activity between healthy, type 1 diabetic patients with no complications and with retinopathy and nephropathy. Western blotting was also accomplished for MMP-9 and MMP-2 identification and expression analysis. RESULTS Only MMP-2 and MMP-9 were observed in serum with significantly increased levels and activity observed in diabetic patients. In urine and saliva other proteases besides MMPs were identified by MS and presented disease-dependent activity variations. Among these are complex MMP-9/Neutrophil gelatinase-associated lipocalin, aminopeptidase N, azurocidin and kallikrein 1 with more activity noticed in type 1 diabetes patients with nephropathy and/or retinopathy. CONCLUSION Our data highlight the usefulness of urine and saliva for the monitoring of type-1 diabetes-related proteolytic events, where aminopeptidase N, azurocidin and kallikrein 1 appear as promising screening targets for type 1 diabetes-related complications.
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Affiliation(s)
- Armando Caseiro
- QOPNA, Mass Spectrometry Center, Department of Chemistry, University of Aveiro, Aveiro, Portugal
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