Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 7.124
Filtrar
1.
Medicine (Baltimore) ; 100(6): e24699, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578605

RESUMO

RATIONALE: Pulmonary artery intimal sarcoma is a rare tumor with exceptionally high mortality and easily misdiagnosed as pulmonary thromboembolism pulmonary thromboembolism (PTE) due to the nonspecific clinical presentation and symptom. Misdiagnosis or untimely diagnosis makes the disease progress to an advanced stage and eventually leads to a poor prognosis. PATIENT CONCERNS: A 37-year-old Chinese female presented with chest tightness and dyspnea for 3 months. Echocardiography and chest computed tomography revealed an intraluminal obstruction of the pulmonary arteries. Tests of serum tumor makers showed slight elevation for carbohydrate antigen-125, and α-fetoprotein. PTE was suspected according to the radiological and laboratory findings. DIAGNOSIS: Microscopic findings of the presumed thrombus showed prominent myxoid and edematous background with atypical spindled cells and curvilinear vascularity. Immunohistochemical staining demonstrated that the atypical spindled cells were positive for vimentin but negative for CK, S100, SMA, desmin, CD68, STAT6, CD34, ß-catenin, ALK-p80, p53, and MDM2. According to the radiological and pathological findings, the diagnosis of fibrosarcoma of pulmonary artery was made. INTERVENTIONS: The patient underwent surgical resection and the mass was excised as completely as possible. OUTCOME: Follow-up information showed no evidence of recurrence or metastasis after 3 months postresection. LESSONS: Because of the low incidence rate, nonspecific clinical symptoms, and radiological findings, primary fibrosarcoma of the pulmonary artery is commonly misdiagnosed as PTE. Pathological examination is necessary to confirm the diagnosis.


Assuntos
Fibrossarcoma/diagnóstico , Artéria Pulmonar/diagnóstico por imagem , Embolia Pulmonar/diagnóstico , Túnica Íntima/patologia , Adulto , Assistência ao Convalescente , Grupo com Ancestrais do Continente Asiático/etnologia , Antígeno Ca-125/metabolismo , Erros de Diagnóstico/prevenção & controle , Erros de Diagnóstico/estatística & dados numéricos , Ecocardiografia/métodos , Feminino , Fibrossarcoma/sangue , Fibrossarcoma/patologia , Fibrossarcoma/cirurgia , Humanos , Embolia Pulmonar/patologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Vimentina/metabolismo , alfa-Fetoproteínas/metabolismo
2.
PLoS One ; 15(12): e0244015, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33332434

RESUMO

High-risk coronary plaques have been considered predictive of adverse cardiac events. Both wall shear stress (WSS) in patients with hemodynamically significant lesions and optical coherence tomography (OCT) -verified thin-cap fibroatheroma (TCFA) are associated with plaque rupture, the most common underlying mechanism of acute coronary syndrome. The aim of the study was to test the hypothesis that invasive coronary angiography-based high WSS is associated with the presence of TCFA detected by OCT in obstructive lesions. From a prospective study of patients who underwent OCT examination for angiographically obstructive lesions (Yellow II), we selected patients who had two angiographic projections to create a 3-dimensional reconstruction model to allow assessment of WSS. The patients were divided into 2 groups according to the presence and absence of TCFA. Mean WSS was assessed in the whole lesion and in the proximal, middle and distal segments. Of 70 patients, TCFA was observed in 13 (19%) patients. WSS in the proximal segment (WSSproximal) (10.20 [5.01, 16.93Pa]) and the whole lesion (WSSlesion) (12.37 [6.36, 14.55Pa]) were significantly higher in lesions with TCFA compared to WSSproximal (5.84 [3.74, 8.29Pa], p = 0.02) and WSSlesion (6.95 [4.41, 11.60], p = 0.04) in lesions without TCFA. After multivariate analysis, WSSproximal was independently associated with the presence of TCFA (Odds ratio 1.105; 95%CI 1.007-1.213, p = 0.04). The optimal cutoff value of WSSproximal to predict TCFA was 6.79 Pa (AUC: 0.71; sensitivity: 0.77; specificity: 0.63 p = 0.02). Our results demonstrate that high WSS in the proximal segments of obstructive lesions is an independent predictor of OCT-verified TCFA.


Assuntos
Doença da Artéria Coronariana/diagnóstico por imagem , Hemodinâmica , Placa Aterosclerótica/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Idoso , Angiografia Coronária/métodos , Doença da Artéria Coronariana/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Placa Aterosclerótica/patologia , Túnica Íntima/diagnóstico por imagem , Túnica Íntima/patologia
3.
PLoS One ; 15(8): e0234165, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32866179

RESUMO

Histopathological examination of temporal artery biopsy (TAB) remains the gold standard for the diagnosis of giant cell arteritis (GCA) but is associated with essential limitations that emphasize the need for an upgraded pathological process. This study pioneered the use of full-field optical coherence tomography (FF-OCT) for rapid and automated on-site pathological diagnosis of GCA. Sixteen TABs (12 negative and 4 positive for GCA) were selected according to major histopathological criteria of GCA following hematoxylin-eosin-saffron-staining for subsequent acquisition with FF-OCT to compare structural modifications of the artery cell wall and thickness of each tunica. Gabor filtering of FF-OCT images was then used to compute TAB orientation maps and validate a potential automated analysis of TAB sections. FF-OCT allowed both qualitative and quantitative visualization of the main structures of the temporal artery wall, from the internal elastic lamina to the vasa vasorum and red blood cells, unveiling a significant correlation with conventional histology. FF-OCT imaging of GCA TABs revealed destruction of the media with distinct remodeling of the whole arterial wall into a denser reticular fibrous neo-intima, which is distinctive of GCA pathogenesis and accessible through automated Gabor filtering. Rapid on-site FF-OCT TAB acquisition makes it possible to identify some characteristic pathological lesions of GCA within a few minutes, paving the way for potential machine intelligence-based or even non-invasive diagnosis of GCA.


Assuntos
Arterite de Células Gigantes/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Arterite de Células Gigantes/diagnóstico , Arterite de Células Gigantes/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Artérias Temporais/diagnóstico por imagem , Artérias Temporais/patologia , Túnica Íntima/diagnóstico por imagem , Túnica Íntima/patologia , Túnica Média/diagnóstico por imagem , Túnica Média/patologia
5.
PLoS One ; 15(7): e0235228, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32658909

RESUMO

PURPOSE: To assess specific risk factors and biomarkers associated with intimal arterial calcification (IAC) and medial arterial calcification (MAC). METHODS: We conducted a cross-sectional study in patients with or at risk of vascular disease from the SMART study(n = 520) and the DCS cohort(n = 198). Non-contrast computed tomography scanning of the lower extremities was performed and calcification in the femoral and crural arteries was scored as absent, predominant IAC, predominant MAC or indistinguishable. Multinomial regression models were used to assess the associations between cardiovascular risk factors and calcification patterns. Biomarkers for inflammation, calcification and vitamin K status were measured in a subset of patients with IAC(n = 151) and MAC(n = 151). RESULTS: Femoral calcification was found in 77% of the participants, of whom 38% had IAC, 28% had MAC and 11% were scored as indistinguishable. The absolute agreement between the femoral and crural arteries was high(69%). Higher age, male sex, statin use and history of coronary artery disease were associated with higher prevalences of femoral IAC and MAC compared to absence of calcification. Smoking and low ankle-brachial-index (ABI) were associated with higher prevalence of IAC and high ABI was associated with less IAC. Compared to patients with IAC, patients with MAC more often had diabetes, have a high ABI and were less often smokers. Inactive Matrix-Gla Protein was associated with increased MAC prevalence, while osteonectin was associated with decreased risk of MAC, compared to IAC. CONCLUSIONS: When femoral calcification is present, the majority of the patients have IAC or MAC throughout the lower extremity, which have different associated risk factor profiles.


Assuntos
Artéria Femoral/patologia , Doença Arterial Periférica/epidemiologia , Túnica Íntima/patologia , Túnica Média/patologia , Calcificação Vascular/epidemiologia , Idoso , Biomarcadores/sangue , Estudos Transversais , Feminino , Artéria Femoral/diagnóstico por imagem , Humanos , Extremidade Inferior/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/sangue , Doença Arterial Periférica/diagnóstico , Doença Arterial Periférica/patologia , Prevalência , Medição de Risco , Fatores de Risco , Tomografia Computadorizada por Raios X , Túnica Íntima/diagnóstico por imagem , Túnica Média/diagnóstico por imagem , Calcificação Vascular/sangue , Calcificação Vascular/diagnóstico , Calcificação Vascular/patologia , Vitamina K/sangue
6.
Transl Res ; 224: 40-54, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32522668

RESUMO

The modulation of voltage-gated K+ (Kv) channels, involved in cell proliferation, arises as a potential therapeutic approach for the prevention of intimal hyperplasia present in in-stent restenosis (ISR) and allograft vasculopathy (AV). We studied the effect of PAP-1, a selective blocker of Kv1.3 channels, on development of intimal hyperplasia in vitro and in vivo in 2 porcine models of vascular injury. In vitro phenotypic modulation of VSMCs was associated to an increased functional expression of Kv1.3 channels, and only selective Kv1.3 channel blockers were able to inhibit porcine VSMC proliferation. The therapeutic potential of PAP-1 was then evaluated in vivo in swine models of ISR and AV. At 15-days follow-up, morphometric analysis demonstrated a substantial reduction of luminal stenosis in the allografts treated with PAP-1 (autograft 2.72 ± 1.79 vs allograft 10.32 ± 1.92 vs allograft + polymer 13.54 ± 8.59 vs allograft + polymer + PAP-1 3.06 ± 1.08 % of luminal stenosis; P = 0.006) in the swine model of femoral artery transplant. In the pig model of coronary ISR, using a prototype of PAP-1-eluting stent, no differences were observed regarding % of stenosis compared to control stents (31 ± 13 % vs 37 ± 18%, respectively; P = 0.372) at 28-days follow-up. PAP-1 treatment was safe and did not impair vascular healing in terms of delayed endothelialization, inflammation or thrombosis. However, an incomplete release of PAP-1 from stents was documented. We conclude that the use of selective Kv1.3 blockers represents a promising therapeutic approach for the prevention of intimal hyperplasia in AV, although further studies to improve their delivery method are needed to elucidate its potential in ISR.


Assuntos
Canal de Potássio Kv1.3/antagonistas & inibidores , Músculo Liso Vascular/patologia , Miócitos de Músculo Liso/patologia , Bloqueadores dos Canais de Potássio/farmacologia , Túnica Íntima/patologia , Aloenxertos/efeitos dos fármacos , Animais , Proliferação de Células/efeitos dos fármacos , Reestenose Coronária/patologia , Vasos Coronários/efeitos dos fármacos , Vasos Coronários/lesões , Vasos Coronários/patologia , Modelos Animais de Doenças , Feminino , Artéria Femoral/efeitos dos fármacos , Artéria Femoral/patologia , Regulação da Expressão Gênica/efeitos dos fármacos , Hiperplasia , Canal de Potássio Kv1.3/genética , Canal de Potássio Kv1.3/metabolismo , Canal de Potássio Kv1.5/genética , Canal de Potássio Kv1.5/metabolismo , Modelos Biológicos , Miócitos de Músculo Liso/efeitos dos fármacos , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Stents , Suínos , Túnica Íntima/efeitos dos fármacos
7.
Asian Cardiovasc Thorac Ann ; 28(5): 282-285, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32483975

RESUMO

Primary pulmonary intimal sarcoma is rare. Differentiating it from pulmonary thromboembolism is difficult because of similarities in clinical symptoms and imaging findings. Positron-emission tomography-computed tomography has been useful for diagnosing primary pulmonary intimal sarcoma. We describe a rare case of primary pulmonary intimal sarcoma that showed no abnormal 18F-fluorodeoxyglucose uptake on positron-emission tomography. We resected the mass and performed right ventricular outflow tract reconstruction. Proper diagnosis is necessary to determine appropriate therapy, Clinicians must consider the possibility of primary pulmonary intimal sarcoma even if imaging findings are inconsistent with the disease.


Assuntos
Fluordesoxiglucose F18/administração & dosagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Artéria Pulmonar/diagnóstico por imagem , Compostos Radiofarmacêuticos/administração & dosagem , Sarcoma/diagnóstico por imagem , Túnica Íntima/diagnóstico por imagem , Neoplasias Vasculares/diagnóstico por imagem , Idoso , Feminino , Humanos , Valor Preditivo dos Testes , Artéria Pulmonar/patologia , Artéria Pulmonar/cirurgia , Sarcoma/patologia , Sarcoma/cirurgia , Resultado do Tratamento , Túnica Íntima/patologia , Túnica Íntima/cirurgia , Neoplasias Vasculares/patologia , Neoplasias Vasculares/cirurgia
8.
J Vis Exp ; (159)2020 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-32478716

RESUMO

Although vein grafts have been commonly used as autologous grafts in revascularization surgeries for ischemic diseases, the long-term patency remains poor because of the acceleration of intimal hyperplasia due to the exposure to arterial blood pressure. The present protocol is designed for the establishment of experimental venous intimal hyperplasia by interposing rabbit jugular veins to the ipsilateral carotid arteries. The protocol does not require surgical procedures deep in the body trunk and the extent of the incision is limited, which is less invasive for the animals, allowing long-term observation after implantation. This simple procedure enables researchers to investigate strategies to attenuate the progression of intimal hyperplasia of the implanted vein grafts. Using this protocol, we reported the effects transduction of microRNA-145 (miR-145), which is known to control the phenotype of vascular smooth muscle cells (VSMCs) from the proliferative to the contractile state, into harvested vein grafts. We confirmed the attenuation of intimal hyperplasia of vein grafts by transducing miR-145 before implantation surgery through the phenotype change of the VSMCs. Here we report a less invasive experimental platform to investigate the strategies that can be used to attenuate intimal hyperplasia of vein grafts in revascularization surgeries.


Assuntos
Pressão Arterial/fisiologia , Hiperplasia/patologia , Túnica Íntima/patologia , Túnica Íntima/fisiopatologia , Procedimentos Cirúrgicos Vasculares/métodos , Veias/transplante , Animais , Modelos Animais de Doenças , Coelhos
9.
J Surg Res ; 253: 280-287, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32402853

RESUMO

BACKGROUND: The autologous vein remains the standard conduit for lower extremity and coronary artery bypass grafting despite a 30%-50% 5-y failure rate, primarily attributable to intimal hyperplasia (IH) that develops in the midterm period (3-24 mo) of graft maturation. Our group discovered that externally strengthening vein grafts by cross-linking the adventitial collagen with photochemical tissue passivation (PTP) mitigates IH in an arteriovenous model at 4 wk. We now investigate whether this effect is retained in the midterm period follow-up. METHODS: Six Hanford miniature pigs received bilateral carotid artery interposition vein grafts. In each animal, the external surface of one graft was treated with PTP before grafting, whereas the opposite side served as the untreated control. The grafts were harvested after 3 mo. Ultrasound evaluation of all vein grafts was performed at the time of grafting and harvest. The grafts were also evaluated histomorphometrically and immunohistologically for markers of IH. RESULTS: All vein grafts were patent at 3 mo except one graft in the PTP-treated group because of early technical failure. The control vein grafts had significantly greater IH than PTP-treated grafts at 3 mo, as evidenced by the intimal area (2.6 ± 1.0 mm2versus 1.4 ± 1.5 mm2, respectively, P = 0.045) and medial area (5.1 ± 1.9 mm2versus 2.7 ± 2.4 mm2, respectively, P = 0.048). The control grafts had an increased presence and proliferation of mural myofibroblasts with greater smooth muscle actin and proliferating cell nuclear antigen staining. CONCLUSIONS: PTP treatment to the external surface of the vein grafts decreases IH at 3 mo after arteriovenous grafting and may prevent future graft failure.


Assuntos
Artérias Carótidas/cirurgia , Neointima/prevenção & controle , Fotoquimioterapia/métodos , Veia Safena/transplante , Enxerto Vascular/métodos , Túnica Adventícia/efeitos dos fármacos , Túnica Adventícia/efeitos da radiação , Animais , Colágeno/química , Colágeno/efeitos dos fármacos , Colágeno/efeitos da radiação , Feminino , Corantes Fluorescentes/administração & dosagem , Luz , Neointima/diagnóstico , Neointima/etiologia , Neointima/patologia , Rosa Bengala/administração & dosagem , Veia Safena/diagnóstico por imagem , Veia Safena/patologia , Suínos , Porco Miniatura , Transplante Autólogo/efeitos adversos , Túnica Íntima/diagnóstico por imagem , Túnica Íntima/patologia , Enxerto Vascular/efeitos adversos , Grau de Desobstrução Vascular
10.
Am J Physiol Heart Circ Physiol ; 318(5): H1068-H1079, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32216615

RESUMO

The clinical risks and prognosis of diabetic vascular intimal calcification (VIC) and medial calcification (VMC) are different. This study aims to investigate the mechanism of VIC/VMC translocation. Anterior tibial arteries were collected from patients with diabetic foot amputation. The patients were then divided into VIC and VMC groups. There were plaques in all anterior tibial arteries, while the enrichment of galectin-3 in arterial plaques in the VIC group was significantly higher than that in the VMC group. Furthermore, a macrophage/vascular smooth muscle cell (VSMC) coculture system was constructed. VSMC-derived extracellular vesicles (EVs) was labeled with fluorescent probe. After macrophages were pretreated with recombinant galectin-3 protein, the migration of VSMC-derived EVs and VSMC-derived calcification was more pronounced. And anti-galectin-3 antibody can inhibit this process of EVs and calcification translocation. Then, lentivirus (LV)-treated bone marrow cells (BMCs) were transplanted into apolipoprotein E-deficient (ApoE-/-) mice, and a diabetic atherosclerosis mouse model was constructed. After 15 wk of high-fat diet, ApoE-/- mice transplanted with LV-shgalectin-3 BMCs exhibited medial calcification and a concentrated distribution of EVs in the media. In conclusion, upregulation of galectin-3 in macrophages promotes the migration of VSMC-derived EVs to the intima and induces diabetic vascular intimal calcification.NEW & NOTEWORTHY The clinical risk and prognosis of vascular intimal and medial calcification are different. Macrophage galectin-3 regulates the migration of vascular smooth muscle cell-derived extracellular vesicles and mediates diabetic vascular intimal/medial calcification translocation. This study may provide insights into the early intervention in diabetic vascular calcification.


Assuntos
Angiopatias Diabéticas/metabolismo , Cardiomiopatias Diabéticas/metabolismo , Galectina 3/metabolismo , Macrófagos/metabolismo , Túnica Íntima/metabolismo , Calcificação Vascular/metabolismo , Idoso , Idoso de 80 Anos ou mais , Animais , Apolipoproteínas E/genética , Células Cultivadas , Angiopatias Diabéticas/patologia , Cardiomiopatias Diabéticas/genética , Cardiomiopatias Diabéticas/patologia , Vesículas Extracelulares/metabolismo , Feminino , Humanos , Masculino , Camundongos , Pessoa de Meia-Idade , Miócitos de Músculo Liso/metabolismo , Artérias da Tíbia/metabolismo , Artérias da Tíbia/patologia , Túnica Íntima/patologia , Calcificação Vascular/patologia
11.
Surg Technol Int ; 35: 197-201, 2020 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-32120449

RESUMO

INTRODUCTION: Progressive saphenous vein graft (SVG) failure remains a key limitation to the long-term success of coronary artery bypass grafting (CABG). SVG disease after the first year is dominated by intimal hyperplasia, which predisposes the SVG to thrombosis and accelerated atherosclerosis. The objective of this study was to review and summarize the latest experimental and clinical data on the use of mechanical external stents for vein grafts. METHODS: In January 2020, the PubMed database was searched using the terms "external stent", "CABG", "saphenous vein graft" and "intimal hyperplasia". The results were reviewed and only randomized experimental and clinical studies that analyzed the effect of external stenting on venous intimal hyperplasia were included in the analysis, together with studies that investigated the clinical benefit of external stenting. RESULTS: Eight experimental and four clinical trials met the search criteria. Controlled trials in different large animal models concluded that external stenting significantly reduced intimal hyperplasia 3-6 months post implantation, and reduced both thrombosis rates and the development of lumen irregularities. Data from randomized controlled trials with a follow-up period of 1-4.5 years supported the pre-clinical findings and demonstrated that external stents significantly reduced vein graft disease. CONCLUSION: Strong evidence indicates that supporting the vein with external stents is safe and leads to clear advantages at both the anatomical and cellular levels. With the further accumulation of consistent positive results, external stenting of SVG may become the standard of care in future CABG.


Assuntos
Ponte de Artéria Coronária/métodos , Oclusão de Enxerto Vascular/prevenção & controle , Veia Safena/transplante , Stents , Túnica Íntima/patologia , Animais , Aterosclerose/etiologia , Aterosclerose/prevenção & controle , Implante de Prótese Vascular/métodos , Oclusão de Enxerto Vascular/etiologia , Humanos , Hiperplasia/cirurgia , Ensaios Clínicos Controlados Aleatórios como Assunto , Veia Safena/cirurgia , Trombose/etiologia , Trombose/prevenção & controle , Túnica Íntima/cirurgia , Grau de Desobstrução Vascular
12.
J Cardiothorac Surg ; 15(1): 34, 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32041642

RESUMO

BACKGROUND: This study aims to compare the effects of storage solutions commonly used in coronary artery bypass grafting on the vascular reactivity in vein graft interposed in arterial position in syngeneic rats. METHODS: Twenty-seven male Lewis rats were sacrified to sample a vein graft implanted 6 weeks ago into abdominal aorta position. The vein grafts were inferior venae cavae initially pretreated with heparinized saline solution (HS) or autologous heparinized blood (AHB) or our referent solution, GALA. The endothelial functionality, the in situ Reactive Oxygen Species (ROS) levels and the histological characteristics were conducted from segments of arterialized vein graft. RESULTS: At 6 weeks, graft thrombosis occurred respectively in 22% of AHB group, 62.5% in the HS group and 82.5% in the GALA group. In each group, significative intimal hyperplasia was observed. After 6 weeks, an endothelium-remodeling layer associated with an increase of wall thickness was observed in each group. Endothelium-dependent tone was reduced in the vein graft regardless of the group. No difference was observed concerning the ROS in vein graft between the different groups. In distal aortic sections, ROS levels were increased in HS and GALA groups. CONCLUSIONS: Storage solutions used in this experimental model of vein graft implanted in arterial position cause graft injury and a complete disappearance of vascular reactivity. GALA solution did not reduce intimal risk hyperplasia when the vein graft was exposed to arterial flow in a rat model.


Assuntos
Aorta Abdominal/cirurgia , Ponte de Artéria Coronária , Endotélio Vascular/efeitos dos fármacos , Soluções para Preservação de Órgãos/farmacologia , Túnica Íntima/patologia , Veia Cava Inferior/transplante , Animais , Anticoagulantes/administração & dosagem , Anticoagulantes/uso terapêutico , Sangue , Modelos Animais de Doenças , Endotélio Vascular/patologia , Heparina/administração & dosagem , Heparina/uso terapêutico , Hiperplasia , Masculino , Soluções para Preservação de Órgãos/administração & dosagem , Soluções para Preservação de Órgãos/uso terapêutico , Ratos , Ratos Endogâmicos Lew , Espécies Reativas de Oxigênio/análise , Solução Salina/administração & dosagem , Solução Salina/uso terapêutico , Túnica Íntima/efeitos dos fármacos , Veia Cava Inferior/efeitos dos fármacos
13.
Biomed Res Int ; 2020: 4291327, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32090093

RESUMO

Objectives: Atherosclerosis (AS) is a severe disease in which the inside of an artery narrows because of plaque formation, leading to endothelial injury in the patients. Although it has been found that endothelial nitric oxide synthase (eNOS), which produces a low concentration of NO, is necessary for endothelial function and integrity, the regulatory mechanisms of eNOS expression against the pathogenesis and development of AS are unclear. Evidence has indicated that diet supplementation with L-arginine could reduce the size of the endothelial injury lesions in AS patients. In addition, nonencoding microRNAs (miRNAs) were found to be a promising tool that regulates the expression of eNOS in human endothelial cells. Design: The aim of this research was to explore the role of L-arginine in the development of AS and the mechanisms by which miR-221 influences the possible signaling pathways in endothelial cells during AS. Results: The results suggested that L-arginine could prevent oxidized low-density lipoprotein-induced apoptosis in endothelial cells, which is associated with the downregulation of miR-221. Similar results were also observed in rat AS models. Conclusion: This research could provide potential therapies for the treatment of AS.


Assuntos
Arginina/uso terapêutico , Aterosclerose/tratamento farmacológico , Aterosclerose/genética , Dieta Hiperlipídica , Regulação para Baixo/genética , MicroRNAs/genética , Animais , Antagomirs/farmacologia , Aorta/patologia , Apoptose/efeitos dos fármacos , Arginina/farmacologia , Regulação para Baixo/efeitos dos fármacos , Células Endoteliais/efeitos dos fármacos , Células Endoteliais/metabolismo , Lipoproteínas LDL/farmacologia , Masculino , MicroRNAs/metabolismo , Óxido Nítrico Sintase Tipo III/metabolismo , Ratos Sprague-Dawley , Túnica Íntima/patologia , Túnica Média/patologia
14.
Am J Cardiol ; 125(6): 999-1000, 2020 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-31980140

RESUMO

Described herein is a patient who had a coronary endarterectomy at the time of coronary artery bypass grafting. Histologic study of cross-sections of the endarterectomy specimen disclosed that the layer of separation of the endarterectomy specimen from the underlying native artery was in the media. This layer or plane of excision is virtually always the media irrespective of the artery having the endarterectomy. The procedure might better be called "endomediaectomy?"


Assuntos
Ponte de Artéria Coronária , Vasos Coronários/patologia , Vasos Coronários/cirurgia , Endarterectomia , Túnica Média/patologia , Humanos , Túnica Íntima/patologia , Túnica Íntima/cirurgia , Túnica Média/cirurgia
15.
Biomed Pharmacother ; 124: 109935, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31986407

RESUMO

Intimal hyperplasia, the key event of arterial restenosis, is a result of vascular smooth muscle cell (VSMC) proliferation and migration. Previous studies have demonstrated that total Panax notoginseng saponin (TPNS) represses intimal hyperplasia and inhibits the proliferation of VSMCs following balloon injury. However, the underlying roles of TPNS in intimal hyperplasia remain unclear. In this study, we first found that TPNS inhibited the intimal hyperplasia and reversed the reduced m6A quantity in balloon catheter-injured rat carotid artery. Then, we measured the expression profiles of m6A "writers" (i.e., methyltransferase like 3 (METTL3), methyltransferase like 14 (METTL14), and WT1 associated protein (WTAP)) and "erasers" (i.e., FTO alpha-ketoglutarate dependent dioxygenase (FTO) and alkB homolog 5, RNA demethylase (ALKBH5)) in vivo and found that TPNS up-regulated the reduced the WTAP expression in balloon catheter-injured rat carotid artery. Furthermore, we illustrated that TPNS inhibited the viability, proliferation, and migration potential of VSMCs via promotion of WTAP expression and suppression of WTAP restored the TPNS-induced inhibition of cell viability, proliferation and migration potential of VSMCs. In addition, we found that p16 was up-regulated in VSMCs treated with TPNS and repression of p16 restored the TPNS-induced inhibition of cell viability, proliferation and migration potential of VSMCs. Finally, we elucidated that, mechanistically, WTAP exerted its role by regulating p16 via m6A modification. Collectively, our results reveal the WTAP-p16 signaling axis and highlight the critical roles of m6A modification in intimal hyperplasia. Thus, this study provided a potential biomarker for the assessment of intimal hyperplasia risk following angioplasty as well as a novel therapeutic target for this disease.


Assuntos
Proliferação de Células/efeitos dos fármacos , Músculo Liso Vascular/efeitos dos fármacos , Panax notoginseng/química , Saponinas/farmacologia , Adenosina/análogos & derivados , Adenosina/metabolismo , Animais , Lesões das Artérias Carótidas/tratamento farmacológico , Lesões das Artérias Carótidas/patologia , Movimento Celular/efeitos dos fármacos , Células Cultivadas , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Humanos , Hiperplasia/tratamento farmacológico , Masculino , Músculo Liso Vascular/citologia , Ratos , Ratos Sprague-Dawley , Saponinas/isolamento & purificação , Transdução de Sinais/efeitos dos fármacos , Túnica Íntima/efeitos dos fármacos , Túnica Íntima/patologia , Proteínas WT1/metabolismo
16.
Neurology ; 94(11): e1122-e1125, 2020 03 17.
Artigo em Inglês | MEDLINE | ID: mdl-31949089

RESUMO

OBJECTIVE: To present the clinical, radiologic, and pathologic findings of a patient with carotid intimal sarcoma. METHODS: Detailed medical interview, neurologic examination, and diagnostic evaluation including CT angiography head and neck, MRI brain and neck, digital subtraction angiography, and biopsy of the mass were performed. RESULTS: We report a patient who presented with symptoms of multifocal, bilateral strokes over weeks caused by an enlarging tumor thrombus associated with an intimal sarcoma of the carotid artery. The presence of a carotid space mass encasing the left internal carotid artery was initially not recognized on imaging and was mistakenly attributed to soft atheromatous plaque rather than tumor thrombus. Rapid disease progression resulted in multiple intracranial metastases from tumor embolization. CONCLUSION: Clinical and radiologic findings of intimal sarcoma may be similar to those of thrombotic disease. However, patients with sarcoma may show an associated perivascular soft tissue mass and an unusual distribution of vessel stenosis. Reevaluation of imaging should be considered in patients presenting with initial imaging findings suggestive of rapidly progressive thrombotic disease who have a poor response to antithrombotic therapy and do not follow an expected clinical course.


Assuntos
Doenças das Artérias Carótidas/patologia , Artéria Carótida Interna/patologia , Sarcoma/secundário , Acidente Vascular Cerebral/etiologia , Neoplasias Vasculares/patologia , Neoplasias Encefálicas/secundário , Doenças das Artérias Carótidas/complicações , Doenças das Artérias Carótidas/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Células Neoplásicas Circulantes/patologia , Placa Aterosclerótica/diagnóstico , Sarcoma/diagnóstico , Túnica Íntima/patologia , Neoplasias Vasculares/diagnóstico
17.
Cancer ; 126(1): 98-104, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31536651

RESUMO

BACKGROUND: Intimal sarcoma (InS) is an exceedingly rare neoplasm with an unfavorable prognosis, for which new potentially active treatments are under development. We report on the activity of anthracycline-based regimens, gemcitabine-based regimens, and pazopanib in patients with InS. METHODS: Seventeen sarcoma reference centers in Europe, the United States, and Japan contributed data to this retrospective analysis. Patients with MDM2-positive InS who were treated with anthracycline-based regimens, gemcitabine-based regimens, or pazopanib between October 2001 and January 2018 were selected. Local pathological review was performed to confirm diagnosis. Response was assessed by RECIST1.1. Recurrence-free survival (RFS), progression-free survival (PFS) and overall survival were computed by Kaplan-Meier method. RESULTS: Seventy-two patients were included (66 anthracycline-based regimens; 26 gemcitabine-based regimens; 12 pazopanib). In the anthracycline-based group, 24 (36%) patients were treated for localized disease, and 42 (64%) patients were treated for advanced disease. The real-world overall response rate (rwORR) was 38%. For patients with localized disease, the median RFS was 14.6 months. For patients with advanced disease, the median PFS was 7.7 months. No anthracycline-related cardiac toxicity was reported in patients with cardiac InS (n = 26). For gemcitabine and pazopanib, the rwORR was 8%, and the median PFS was 3.2 and 3.7 months, respectively. CONCLUSION: This retrospective series shows the activity of anthracycline-based regimens in InS. Of note, anthracyclines were used in patients with cardiac InS with no significant cardiac toxicity. The prognosis in patients with InS remains poor, and new active drugs and treatment strategies are needed.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Neoplasias Cardíacas/tratamento farmacológico , Sarcoma/tratamento farmacológico , Túnica Íntima/efeitos dos fármacos , Adulto , Idoso , Antraciclinas/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Cardiotoxicidade , Desoxicitidina/administração & dosagem , Desoxicitidina/análogos & derivados , Feminino , Neoplasias Cardíacas/genética , Neoplasias Cardíacas/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Intervalo Livre de Progressão , Proteínas Proto-Oncogênicas c-mdm2/genética , Pirimidinas/administração & dosagem , Sarcoma/genética , Sarcoma/patologia , Sulfonamidas/administração & dosagem , Resultado do Tratamento , Túnica Íntima/patologia
18.
Angiology ; 71(1): 62-69, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31088126

RESUMO

The prevalence of coronary intimal thickening (IT) was assessed in fetuses and pediatric population. We studied the coronary arteries of 63 hearts obtained from fetuses, infants, children, and adolescents, deceased from noncardiac disease or trauma. Histomorphometric analysis, planimetry, and immunohistochemical studies were conducted. Intimal thickening consisted of proliferation of smooth muscle cells and scarce monocytes embedded in amorphous deposits within the internal elastic membrane (IEM). Intermingled lesions of intimal hyperplasia and parietal nonstenotic plaques were also observed. Intimal thickening was found in 10% of 20 fetuses, in 33.3% of 18 infants, 73.3% of 15 children, and 100% of 10 adolescents. A significant correlation (r = 0.671, P < 0.001) was found between the extent of IT and age. The IEM was duplicated or interrupted in 43% of patients, showing a positive correlation with the degree of IT (P = 0.01). Intimal thickening was predominantly found near bifurcation sites in the left anterior descending coronary artery (55.6%) and in zones free of bifurcation in the right coronary artery (75%). In conclusion, the prevalence and extension of IT lesions are higher at older ages within a young population. Intimal thickening may be regarded as the first event occurring in coronary preatherosclerosis, preceding lipid deposition.


Assuntos
Doença da Artéria Coronariana/patologia , Vasos Coronários/patologia , Coração Fetal/patologia , Neointima , Placa Aterosclerótica , Túnica Íntima/patologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Progressão da Doença , Feminino , Idade Gestacional , Humanos , Hiperplasia , Lactente , Recém-Nascido , Masculino
19.
J Surg Res ; 246: 550-559, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31668608

RESUMO

BACKGROUND: Intimal hyperplasia (IH) is the initial lesion of vein graft failure after coronary artery bypass grafting. The weak venous wall is likely one of the primary reasons for IH after exposure to the arterial environment. We investigate whether adventitial collagen cross-link by glutaraldehyde (GA) reinforces the venous wall and then reduces IH. MATERIALS AND METHODS: Adventitial collagen cross-link by 0.3% GA was performed on the rabbit jugular veins. The degree of cross-link was accessed by tensile test. The jugular vein with or without cross-link was implanted into the carotid artery of rabbit. Vein dilatation at the immediate anastomosis and pathological remodeling of vein graft after 4 wk was assessed. RESULTS: Tensile test indicated that the mechanical property of 3-min cross-linked veins more closely resembled that of the carotid artery. In rabbit arteriovenous graft models, 3-min adventitial collagen cross-link limited overdistension (diameter: 3.24 mm versus 4.65 mm, P < 0.01) at the immediate anastomosis and reduced IH (intima thickness: 78.83 µm versus 140.19 µm, P < 0.01) of vein grafts 4 wk after implantation in the cross-link group as compared with the graft group (without cross-link). Compared with the cross-link group, the expression of proliferating cell nuclear antigen and vascular cell adhesion molecule-1 increased significantly at both the mRNA and protein levels within the graft group (P < 0.01), but the expression of smooth muscle-22α decreased significantly (P < 0.01). CONCLUSIONS: Adventitial collagen cross-link by GA increased the vessel stiffness and remarkably reduced IH in a rabbit arteriovenous graft model.


Assuntos
Túnica Adventícia/efeitos dos fármacos , Colágeno/metabolismo , Reagentes para Ligações Cruzadas/administração & dosagem , Glutaral/administração & dosagem , Túnica Íntima/patologia , Túnica Adventícia/metabolismo , Animais , Artérias Carótidas/transplante , Ponte de Artéria Coronária/efeitos adversos , Modelos Animais de Doenças , Humanos , Hiperplasia/etiologia , Hiperplasia/prevenção & controle , Veias Jugulares/efeitos dos fármacos , Veias Jugulares/transplante , Masculino , Coelhos , Túnica Íntima/efeitos dos fármacos , Túnica Íntima/metabolismo , Rigidez Vascular/efeitos dos fármacos
20.
Prostaglandins Other Lipid Mediat ; 146: 106401, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31841663

RESUMO

Inflammation ensuing from vascular injury promotes intimal hyperplasia (IH) and restenosis. Resolvin D1 (RvD1) is a lipid mediator that attenuates IH in vivo when delivered locally to the vessel wall in animal models. We tested the hypothesis that peri-procedural oral administration of RvD1 could blunt the local inflammatory response to angioplasty, and attenuate downstream IH. Carotid angioplasty was performed on rats fed with either RvD1 or vehicle through oral gavage, starting one day prior to injury until post-operative day (POD) 3 or 14 when arteries were harvested. To study pharmacokinetics and bioactivity of oral RvD1, we measured plasma RvD1 by ELISA, whole blood phagocytosis activity using flow cytometry, and cAMP levels in the thoracic aorta by ELISA. Carotid arteries were harvested on POD3 for staining (anti-CD45, anti-Myeloperoxidase (MPO), anti-Ki67 or dihydroethidium (DHE) for reactive oxygen species), mRNA expression of target genes (quantitative RT-PCR), or on POD14 for morphometry (elastin stain). RvD1 plasma concentration peaked 3 h after gavage in rats, at which point we concurrently observed an increase in circulating monocyte phagocytosis activity and aortic cAMP levels in RvD1-treated rats vs. vehicle. Oral RvD1 attenuated local arterial inflammation after angioplasty by reducing CD45+, MPO+, Ki67+ cells, and DHE staining intensity. Oral RvD1 also reduced the expression of several pro-inflammatory genes within the injured vessels. However, oral RvD1 did not significantly reduce IH. Oral RvD1 attenuated acute inflammation within the arterial wall after angioplasty in rats, but did not significantly affect IH.


Assuntos
Angioplastia , Artérias Carótidas , Ácidos Docosa-Hexaenoicos/farmacologia , Túnica Íntima/metabolismo , Administração Oral , Animais , Artérias Carótidas/metabolismo , Artérias Carótidas/patologia , Artérias Carótidas/cirurgia , Modelos Animais de Doenças , Hiperplasia , Inflamação/metabolismo , Inflamação/patologia , Masculino , Ratos , Ratos Sprague-Dawley , Túnica Íntima/patologia , Túnica Íntima/cirurgia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...