RESUMO
The aging-associated secretory phenotype (SASP) is a heterogeneous phenotype of cells secreting pro-inflammatory cytokines, growth factors, apoptosis' regulatory molecules, and proteases. SASP is one of the three main hallmarks of senescent cells. Dysregulation of the synthesis of SASP-forming molecules leads to the development of age-associated diseases, including cardiovascular pathology. The aim of this study is to characterize the SASP of human endotheliocytes during replicative and induced aging. Isolated human umbilical vein endothelial cells HUVEC were used to model replicative and inflammation-induced aging. It has been established that the molecules that form SASP during replicative and inflammation-induced aging of HUVEC are molecules that control apoptosis (p16, p21, p53), adhesion (E-selectin, VCAM-1) and some cytokines (IL-1ß, IL-6). With replicative aging of endotheliocytes, the synthesis of apoptosis' regulatory molecules increases to a greater extent. Inflammation-induced aging of HUVEC is characterized by a multiple increase in the synthesis of adhesion molecules and pro-inflammatory cytokines.
Assuntos
Senescência Celular , Células Endoteliais , Humanos , Células Endoteliais/metabolismo , Senescência Celular/fisiologia , Envelhecimento/fisiologia , Fenótipo , Inflamação/metabolismo , CitocinasRESUMO
OBJECTIVE: To develop a method for early (24 hrs after intervention) prognosis of functional outcome at discharge in patients after endovascular thrombectomy (EVT) in anterior cerebral circulation based on NIHSS. MATERIAL AND METHODS: A retrospective analysis of endovascular treatment in 362 acute stroke patients (189 men, 173 women, median age 69 years) with anterior circulation large vessel occlusion was performed in the regional vascular centers of St. Petersburg. RESULTS: The original scale (S10-10) developed for prognosis of functional outcome at discharge is based on total scores on 3 patterns: NIHSS 24 hrs after EVT (10 and less - 1, greater than 10 - 2), NIHSS improvement 24 hrs (greater than 10 - 0, 1-10 - 1, 0 and less - 2), older than 78 yr - 1. According to the total score, 5 grades are determined: 1 (good, mRs 0-2 75%, mRs 3-5 25%, mRs 6 0%), 2 (favorable, mRs 0-2 66%, mRs 3-5 26%, mRs 6 8%), 3 (unfavorable, mRs 0-2 14%, mRs 3-5 68%, mRs 6 18%), 4 (unfavorable with high mortality, mRs 0-2 1%, mRs 3-5 52%, mRs 6 47%), 5 (highly negative, mRs 0-2 0%, mRs 3-5 16%, mRs 6 84%). S10-10 greater than 2 indicates unfavorable prognosis. The scale allows accurate prognosis of functional outcome at discharge (AUC 0.89; AUC 0.84 in a validation cohort) and length of in-patient staying and time to death for S10-10 greater than 2. CONCLUSION: Accurate prognosis of functional outcome at discharge can be done 24 hrs after EVT in anterior cerebral circulation based on the widely used neurological scale (NIHSS) taking into account patient age.
Assuntos
Isquemia Encefálica , Procedimentos Endovasculares , Acidente Vascular Cerebral , Idoso , Artéria Carótida Primitiva , Feminino , Humanos , Masculino , Alta do Paciente , Prognóstico , Estudos Retrospectivos , Acidente Vascular Cerebral/cirurgia , Trombectomia , Resultado do TratamentoRESUMO
OBJECTIVE: Based on a retrospective analysis, to evaluate technical results and functional outcomes at discharge after endovascular thrombectomy (EVT) in anterior circulation out of 6-hours «therapeutic window¼ in patients with stroke. MATERIAL AND METHODS: The retrospective analysis of EVT in 594 acute stroke patients (303 male, 291 female, median age 69 years) with the anterior circulation large vessel occlusion was performed. EVT was carried out before 6 hrs in 550, later in 44 patients. Time to artery puncture was defined as a cut point. Patients were included in the study if they met the criterion for 0-6 hours «therapeutic window¼. RESULTS: No significant differences in functional outcomes at discharge assessed with the Rankin scale (mRs 0-2 29.8% and 20.5% p<0.19; mRs 3-5 38.7% and 38.6% p<0.99; mRs 6 31.5% and 40.9% p<0.2) and the rates of intracranial haemorrhage, haemorrhagic transformation and symptomatic haemorrhagic transformation (4% and 0% p<0.17; 20.9% and 29.5% p<0.49; 10.1% and 11.4% p<0.78) were observed in patients exposed to EVT before 6 hrs and later. CONCLUSION: EVT in anterior circulation stroke over 6 hrs «therapeutic window¼ based on the criterion for 0-6 hrs provides comparable functional outcomes at discharge without the increase in the frequency of intracranial haemorrhages, haemorrhagic and symptomatic haemorrhagic transformations.
Assuntos
Isquemia Encefálica , Procedimentos Endovasculares , Acidente Vascular Cerebral , Idoso , Circulação Cerebrovascular , Feminino , Humanos , Masculino , Estudos Retrospectivos , Federação Russa , Trombectomia , Resultado do TratamentoRESUMO
Among the diseases of the cardiovascular system in elderly people, ischemic heart disease and myocardial infarction (MI) occupy the first place in the structure of mortality. One of the main causes of disability and death from MI is late diagnosis. In this regard, the search for new, highly informative and non-invasive methods for diagnosing MI is an important task of molecular gerontology. An enzyme immunoassay showed that the concentration of TNF-α, IL-8 cytokines and p16 aging marker in saliva in elderly people without cardiovascular pathologies (CP) increases in 2,1-4,8 times as compared with middle-aged people. At the same time, in elderly people without CP the concentration in the saliva of the hormone irisin (FNDC5) decreases by 1,8 times as compared with middle-aged people. In middle-aged patients with MI the concentration of IL-8, TNF-α, MMP8, MMP9 in saliva increases 4,3-15,3 times, and FNDC5 decreases 1,8 times compared with those parameters without CP in this age group. In elderly people with MI the concentration of IL-8, TNF-α, MMP8 and MMP9 in saliva increases 4,3-7,1 times as compared with elderly people without CP. Thus, the study of the concentration of signaling molecules IL-8, TNF-α, MMP8, MMP9 in saliva can be used as a non-invasive method for diagnosing MI in people of middle and elderly age. To assess the rate of aging of the organism in middle-aged and elderly people without CP, a study of the concentration of p16 and FNDC5 molecules in saliva is recommended.
Assuntos
Envelhecimento , Infarto do Miocárdio , Saliva , Idoso , Envelhecimento/metabolismo , Biomarcadores/metabolismo , Citocinas/metabolismo , Humanos , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Saliva/química , Fator de Necrose Tumoral alfa/metabolismoRESUMO
The authors have analyzed an experience with treatment of 16 patients. All the patients had renovascular hypertension (RVH) and 3 of them had renal dysfunction. Revascularization of the kidneys (RK) was fulfilled in 11 patients by shunting (9) or prosthesis (2) of the renal arteries. In 7 patients percutaneous endovascular angioplasty (PEA) was used. There were neither complications nor lethal outcomes. Arterial pressure normalized in 7 patients and in 9 RVH was better. In the long-term period (at the average within 21 months) 14 patients were followed-up. In 3 patients having perimedial and intimal fibroplasty of RA after PEA restenoses were diagnosed. They had repeated RK. Renal function became better in 1 patient, in 2 patients there was no substantial dynamics. All shunts were passable. The analysis of the data has shown that liquidation of RVH in patients with FMD of RA has inverse dependence on its duration, and decision on the method of RK depends on the type of RA, experience of the specialists, the patients desire included.
Assuntos
Displasia Fibromuscular/cirurgia , Obstrução da Artéria Renal/cirurgia , Artéria Renal/cirurgia , Adolescente , Adulto , Angiografia , Feminino , Displasia Fibromuscular/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Renal/diagnóstico por imagem , Obstrução da Artéria Renal/diagnóstico por imagem , Resultado do Tratamento , Adulto JovemRESUMO
The article presents results of examination and treatment of 14 patients aged from 46 through 79 years with chronic occlusion of one of the renal arteries in each of them and subocclusion of the contralateral renal artery in 13 patients due to atherosclerosis. At first percutaneous intraluminal angioplasty and stenting were performed in 13 out of 14 patients with stenosis of the renal artery. Then at once only percutaneous intraluminal angioplasty of the occlused renal artery was performed in 10 out of 14 patients and within 36 hours on average the implantation of stents in case of patency of the renal artery proper and its branches, according to the findings of control angiography, in these arteries with the optimal result. The percutaneous intraluminal angioplasty and stenting are relatively safe and effective methods of reestablishment of patency of the renal arteries after their chronic occlusion.