Clinical Hemorheology and Microcirculation - Volume 40, issue 2

Authors: Vayá, Amparo | Santaolaria, Marisa | Micó, Luisa | Calvo, Javier | Oropesa, Roberto | Villa, Piedad | Todoli, Jose | Simó, María | Corella, Dolores | Ricart, Jose M.

Article Type: Research Article

Abstract: Systemic lupus erythematosus (SLE) is characterised by increased venous and arterial thrombotic risk. Although antiphospholipid antibodies (APAs) have been shown to be related with thrombotic tendency in these patients, in more than 40% of them, thrombosis occurs without the presence of such antibodies. We analysed the association of venous and arterial thrombotic events with acquired (anticardiolipin antibodies (ACAs) and lupus anticoagulant (LA)) and inherited (antithrombin (AT), protein C (PC), protein S (PS) deficiencies, factor V Leiden and the prothrombin G20210A mutation), thrombophilic risk factors in 86 SLE patients and 89 healthy controls. Patients showed a higher significant percentage of ACAs …titres IgG>41 GPL u/ml and LA than controls (P=0.009; P<0.001, respectively), although no differences in AT, PC, PS deficiencies, factor V Leiden and prothrombin G20210A mutation was observed (P>0.05). When patients with and without thrombosis were compared, those with thrombosis showed a statistically higher percentage of ACAs IgG>41 GPL u/ml and LA (P=0.048; P=0.001, respectively), OR 4.33; 95% CI 1.01–18.50 and OR 11.57; 95% CI 3.28–40.75, respectively. When venous and arterial thrombotic events were considered separately, the presence of LA constituted a risk factor for arterial thrombosis (P=0.010), OR 11.33; 95% CI 1.86–68.89, as well as for venous thrombosis (P=0.005), OR 10.15; 95% CI 2.12–48.64, while ACAs IgG>41 GPL u/ml on their own, were not associated with arterial or venous thrombosis (P=0.142, P=0.233, respectively). In addition inherited thrombophilic risk factors AT, PC, PS deficiencies, factor V Leiden and PT G20210A mutation do not seem to increase thrombotic risk in SLE patients. Show more

Keywords: Systemic lupus erythematosus, thrombosis, acquired thrombophilic defects, inherited thrombophilic defects

DOI: 10.3233/CH-2008-1117

Citation: Clinical Hemorheology and Microcirculation, vol. 40, no. 2, pp. 79-87, 2008

Authors: Monchanin, Geraldine | Serpero, Laura D. | Connes, Philippe | Tripette, Julien | Wouassi, Dieudonné | Francina, Alain | Massarelli, Raphael | Gozal, David | Thiriet, Patrice | Martin, Cyril

Article Type: Research Article

Abstract: The aim of the study was to examine the effects of endurance exercise on circulating vascular cell adhesion molecule-1 (sVCAM-1) and intercellular adhesion molecule-1 (sICAM-1) in sickle cell trait (SCT) athletes with or without α-thalassemia. Five athletes with SCT, 7 athletes with both SCT and α-thalassemia (SCTAT) and 8 control athletes (CONT) performed an incremental test on cycloergometer followed 72 hours later by a 60-min endurance exercise with a workload set at 70% Ppeak (peak power). We assessed levels of sICAM-1, sVCAM-1 and TNF-α at rest, immediately after endurance exercise and 1, 2, and 24 hours of recovery. Although, …CONT and SCTAT groups exhibited similar basal plasma levels of adhesion molecules and TNF-α, SCT group had higher sVCAM-1 basal concentrations. No significant variation in sVCAM-1, sICAM-1 and TNF-α was measured following endurance exercise. Consequently, sVCAM-1 remained elevated in the SCT group after exercise and during the recovery period. In conclusion, our findings support the concept that SCT athletes might be at risk for microcirculatory disturbances, but these adhesive processes were not further impaired in response to endurance exercise. In addition, α-thalassemia co existing trait may be protective both at rest and after endurance exercise in SCT subjects. Show more

Keywords: Tumor necrosis factor α, vascular cell adhesion molecule-1, hemoglobinopathy, exercise

DOI: 10.3233/CH-2008-1119

Citation: Clinical Hemorheology and Microcirculation, vol. 40, no. 2, pp. 89-97, 2008

Authors: Almeida, José Pedro | Carvalho, Filomena Almeida | Freitas, Teresa | Saldanha, Carlota

Article Type: Research Article

Abstract: Background: There is growing knowledge about the association between hemorheological blood disorders and compromised microcirculation in erythrocyte abnormalities. Effects of the non-neuronal cholinergic elements, especially acetylcholinesterase, on the erythrocyte hemorheological parameters were characterized in the past. However, alterations of these parameters have not been studied under the influence of the cellular redox thiol status. Methods: Aliquots of venous blood from ten healthy male subjects were incubated in vitro with increasing concentrations of a thiol reducer agent (dithiothreitol 1, 10, 50 μM final concentrations) in the presence and absence of acetylcholinesterase substrate (acetylcholine) or inhibitor (velnacrine maleate). The following parameters …were determined in all blood samples aliquots: erythrocyte aggregation, erythrocyte deformability and lipid membrane fluidity. Blood smears were performed. Results: Dithiothreitol induces no significant changes on the hemorheological behaviour of human red cells. Upon intracellular thiol stimulation, the presence of AChE effectors (either acetylcholine or velnacrine) decreases erythrocyte aggregation and elongation indexes. Conclusion: The addition of DTT to blood samples aliquots, contributing to the redox thiol status, is not directly involved in the modulation of erythrocyte rheological properties. However, upon acetylcholinesterase modulation by its substrate or inhibitor, changes on the hemorheological parameters are triggered by DTT. Associated pharmacological interest is considerable to address the hemorheology–hemostasis–microcirculation triad disorders. Show more

Keywords: Dithiothreitol, hemorheology, red blood cell, redox status

DOI: 10.3233/CH-2008-1120

Citation: Clinical Hemorheology and Microcirculation, vol. 40, no. 2, pp. 99-111, 2008

Authors: Adar, T. | Ben-Ami, R. | Elstein, D. | Zimran, P. | Berliner, S. | Yedgar, S. | Barshtein, G.

Article Type: Research Article

Abstract: Red blood cell (RBC) aggregation is enhanced in the presence of ongoing inflammation, because of plasma protein effects, especially fibrinogen. Large RBC aggregates, in addition to being a marker of systemic inflammation, may hinder tissue perfusion and oxygenation. Gaucher disease, the most common lysosomal storage disorder, evinces many of the hallmarks of chronic inflammation. Manifestations of Gaucher disease which may be related to microvascular occlusion include avascular necrosis (AVN), bone crisis, and pulmonary hypertension. This study aims to determine whether increased RBC aggregation in non-splenectomized patients with Gaucher disease is due to Gaucher-related inflammation. The Cell Flow Properties Analyzer (CFA) …monitors blood under conditions of different shear stress by creating varying pressure gradients. Blood from non-splenectomized patients with Gaucher disease showed only a slight correlation between aggregation parameters and fibrinogen levels, whereas blood from non-splenectomized patients treated with enzyme replacement therapy (ERT) showed marked correlation between aggregation parameters and fibrinogen, as in the control group. These results underscore the hypothesis that RBC aggregation in Gaucher disease is increased by (at least) two mechanisms: a fibrinogen-mediated inflammatory process and another non-inflammatory process that may be induced by elevated glucocerebroside levels in the RBC and/or inhibited by elevated plasma cerebroside levels. Show more

Keywords: Gaucher disease, red blood cells aggregation

DOI: 10.3233/CH-2008-1121

Citation: Clinical Hemorheology and Microcirculation, vol. 40, no. 2, pp. 113-118, 2008

Authors: Yang, Ji-Ying | Sun, Kai | Wang, Chuan-She | Guo, Jun | Xue, Xin | Liu, Yu-Ying | Zheng, Jun | Fan, Jing-Yu | Liao, Fu-Long | Han, Jing-Yan

Article Type: Research Article

Abstract: Panax notoginseng saponin (PNS) is the collective of the major effective components of Panax notoginseng. The present study intended to explore the effect of post-treatment of PNS on rat mesentery microcirculatory disturbance induced by lipopolysaccharide (LPS) continuous challenge. By virtue of a microcirculation observation system, the vascular hemodynamics were determined continuously until 60 min of LPS (2 mg/kg/h) infusion through the left femoral vein. After observation, blood was taken for assessment of the expression of CD11b/CD18 in neutrophils and the concentration of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interferon-gamma (INF-γ) in plasma with flow-cytometry. The number of leukocytes adherent to …venular wall, the intensity of hydrogen peroxide dependent dihydrorhodamine 123 (DHR) fluorescence in the venular walls and albumin leakage from venules were increased impressively after 20 min of LPS infusion, the RBCs velocity diminished after 30 min, and degranulated mast cells increased remarkably after 60 min. Post-treatment with PNS (5 mg/kg/h) through the left jugular vein from 20 min of LPS exposure resulted in significant reduction in the number of adherent leukocytes, degranulation of mast cell, expression of CD11b and the concentration of IL-6, INF-γ, while had no influence on the intensity of DHR fluorescence and albumin leakage. The results suggested that post-treatment with PNS significantly attenuated microcirculatory disturbance induced by LPS. Show more

Keywords: Panax notoginseng saponins, microcirculatory disturbance, leukocyte adhesion molecules, mast cell degranulation, lipopolysaccharide

DOI: 10.3233/CH-2008-1122

Citation: Clinical Hemorheology and Microcirculation, vol. 40, no. 2, pp. 119-131, 2008

Authors: Sínay, L. | Kürthy, M. | Horváth, Sz. | Arató, E. | Shafiei, M. | Lantos, J. | Ferencz, S. | Bátor, A. | Balatonyi, B. | Verzár, Zs. | Sütő, B. | Kollár, L. | Wéber, Gy. | Rőth, E. | Jancsó, G.

Article Type: Research Article

Abstract: Objective: We studied the protective effects of ischaemic postconditioning (PS) on ischemia–reperfusion injury of the lower extremities in a rat model of abdominal aortic intervention. We aimed to examine the evoked oxidative stress, cytokine expression and leukocyte activation after revascularisation surgery. Methods: Anesthetized animals (48 Whistar rats) underwent a 60 min infrarenal aorta cross-clamping. After the ischaemic period, an intermittent 4 times 15 s reperfusion – 15 seconds ischaemic episodes – were applied (ischaemic postconditioning: group PS). Then we started a 120 min reperfusion in the aorta. In untreated group animals underwent a long ischaemia (60 min) and the …following reperfusion (group IR). Peripherial blood samples were collected before operation, and in early (5, 10, 15, 30, 60 and 120 min) reperfusion periods. Serum peroxide level, TNF-alpha concentration, myeloperoxidase (MPO) activity and PMA-induced leukocyte ROS production were measured. Results: In PS group, plasma peroxide level elevation was significantly lower in very early reperfusion (5–30 min) comparing to non-conditioned IR group (10.04±1.9 μM/l vs. 16.91±3.67 μM/l, p<0.05). PS also reduced serum TNF-alpha concentration (167.41±31.26 μg/ml vs. 116.55±12.04 μg/ml, p<0.05), MPO activity (1.759±0.239 μM/ml vs. 1.22±0.126 μM/ml, p<0.05) and leukocyte activation detected by PMA-induced leukocyte ROS production (5.7±0.96 AU/103 cells vs. 4.63±0.69 AU/103 cells). Conclusions: Ischaemic postconditioning could reduce ROI production after IR in early reperfusion period, thus limiting ROI mediated tissue lesion, cytokine–leukocyte activation and inflammatory responses. PS seems to be an effective tool in vascular surgery to reduce reperfusion injuries after revascularization interventions. Show more

Keywords: Postconditioning, reperfusion injury, vascular surgery, reactive oxygen species, TNF-alpha, leukocyte, inflammatory response

DOI: 10.3233/CH-2008-1124

Citation: Clinical Hemorheology and Microcirculation, vol. 40, no. 2, pp. 133-142, 2008

Authors: Schreyer, A.G. | Finkenzeller, T. | Gössmann, H. | Daneschnejad, M. | Müller-Wille, R. | Schacherer, D. | Zuber-Jerger, I. | Strauch, U. | Feuerbach, S. | Jung, E.M.

Article Type: Research Article

Abstract: Aim: To evaluate a newly introduced high resolution linear transducer for vascularization and mural perfusion assessment using contrast harmonic imaging (CHI) with quantitative time intensity curve analysis (TIC) in patients with active Crohn's disease (CD). Material and methods: We prospectively evaluated 14 consecutive patients (7 women, 7 males, age range 19–42 years, median 28 years) with histologically proven CD having an acute episode of the disease applying contrast enhanced MRI and high resolution ultrasound. For the ultrasound we used a newly introduced high resolution linear multi-frequency transducer (6–9 MHz, Logiq 9, GE). Ultrasound was performed by an experienced radiologist …applying color coded Doppler sonography (CCDS), power Doppler (PD) and contrast enhanced CHI using the ‘true agent detection mode’. Additionally, 5 healthy volunteers were examined by ultrasound applying CCDS, PD and CHI. After the injection of 2.4 ml ultrasound contrast agent (SonoVue) the dynamic CHI cine sequences were recorded as digital raw data for 60 seconds. Therefore we were able to perform a quantitative perfusion analysis using TIC retrospectively. CCDS, PD and CHI with TIC were compared and analyzed. Results: In all 14 patients MRI showed inflammatory changes in the terminal or pre-terminal ileum. Using PD and CCDS enlarged vessels surrounding the bowel wall were visualized in all patients. PD as well as CCDS diagnosed just in 9 of 14 patients augmented mural vessels. Having CHI with TIC increased mural contrast enhancement was diagnosed in all 14 patients. Patients with CD showed a maximum enhancement 36 s after injection with 9 dB (range 5.9–13.2 dB), while healthy volunteers reached the maximum level of 2.8 dB (range 2–3.8 dB) after 23 s (p<0.05). Conclusion: Using high resolution linear transducer mural perfusion changes in active Crohn's disease can be appreciated applying CHI with TIC. This technique could be an effective dynamic imaging modality for diagnosis and especially follow-up examination to monitor treatment in CD. Show more

Keywords: Crohn's disease, MRI, ultrasound, contrast enhanced ultrasound

DOI: 10.3233/CH-2008-1125

Citation: Clinical Hemorheology and Microcirculation, vol. 40, no. 2, pp. 143-155, 2008

Authors: Caimi, Gregorio | Montana, Maria | Calandrino, Vincenzo | Caruso, Marco | Carollo, Caterina | Catania, Anna | Lo Presti, Rosalia

Article Type: Research Article

Abstract: Nitric oxide (NO) has a role in the pathophysiology of acute and chronic cardiovascular events. We studied the plasma concentration of NO stable end products (nitrite and nitrate – NOx ) in 43 patients aged <46 years, with recent acute myocardial infarction (AMI). The evaluation was effected at the initial stage, after 3 and 12 months. We subdivided the patients into subgroups according to the number of the main cardiovascular risk factors and to the extent of coronary disease. In the whole group the NOx concentration was initially increased and progressively decreased after 3 and 12 months, remaining at …both times significantly higher than in control subjects. The patients with more risk factors had a significantly higher NOx concentration. In conclusion, the persisting high NOx concentration in AMI patients is the expression of a prolonged inflammatory condition and is significantly influenced by the simultaneous presence of several cardiovascular risk factors. Show more

Keywords: Nitric oxide, nitrite, nitrate, acute myocardial infarction, cardiovascular risk factors

DOI: 10.3233/CH-2008-1126

Citation: Clinical Hemorheology and Microcirculation, vol. 40, no. 2, pp. 157-163, 2008

Authors: Horvath, Beata | Vekasi, Judit | Kesmarky, Gabor | Toth, Kalman

Article Type: Letter

Keywords: Oxygen free radicals, antioxidant effect, red blood cell deformability

DOI: 10.3233/CH-2008-1123

Citation: Clinical Hemorheology and Microcirculation, vol. 40, no. 2, pp. 165-166, 2008