Clinical Hemorheology and Microcirculation - Volume 73, issue 4

Authors: Biran, Roni | Hadayer, Noa | Ramot, Yuval | Zlotogorski, Abraham | Yedgar, Saul | Barshtein, Gregory

Article Type: Research Article

Abstract: BACKGROUND: Alternations in erythrocyte deformability (ED), namley, the ability of erythrocytes to change shape under flow in the microcirculation, can contribute to cardiovascular diseases. Psoriasis, a systemic inflammatory skin disorder, is associated with an increased cardiovascular risk. The effect of psoriasis and psoriasis treatment on ED was only scarcely evaluated. OBJECTIVE: To evaluate ED changes in psoriasis patients following narrow band-ultraviolet B (NB-UVB) treatment. METHODS: Erythrocyte deformability was determined using a computerized cell flow properties analyzer in 9 patients with psoriasis before and after a course of Goeckerman regimen. ED was quantified using two parameters: average …elongation ratio (AER) in the cell population, and the fraction of low deformable cells (% LDFC). RESULTS: All 9 patients showed decreased ED (i.e. impaired deformability) following NB-UVB treatment. There was a significant (p  = 0.003) decrease in AER after treatment (AER±SD; 1.58±0.06) compared to the starting values (1.69±0.1). Additionally, there was a significant (p  = 0.002) increase in the fraction of low deformable cells (% LDFC±SD; 60.00±9.05) compared to their fraction before treatment (34.86±11.44). CONCLUSIONS: The decreased ED observed following phototherapy could have clinical influences on psoriasis patients, and may partially explain why phototherapy does not decrease the cardiovascular risk in psoriasis compared to other treatments. Show more

Keywords: Psoriasis, phototherapy, erythrocytes, deformability, comorbidities, cardiovascular disease

DOI: 10.3233/CH-180424

Citation: Clinical Hemorheology and Microcirculation, vol. 73, no. 4, pp. 489-496, 2019

Authors: Rohm, Ilonka | Grün, Katja | Müller, Linda Marleen | Bäz, Laura | Förster, Martin | Schrepper, Andrea | Kretzschmar, Daniel | Pistulli, Rudin | Yilmaz, Atilla | Bauer, Reinhard | Jung, Christian | Berndt, Alexander | Schulze, P. Christian | Franz, Marcus

Article Type: Research Article

Abstract: Growing evidence suggests that inflammation is crucially involved in the pathogenesis of pulmonary hypertension (PH) and consecutive right heart failure. The present study analyzed the inflammatory response in lung and right ventricle in a rat model of PH and evaluated the effects of the dual endothelin receptor antagonist (ERA) Macitentan. PH was induced by monocrotalin (60 mg/kg body weight s.c.) in Sprague-Dawley rats (PH, n  = 10) and compared to healthy controls (CON, n  = 10) as well as monocrotalin-induced, macitentan-treated rats (THER, n  = 10). Detection of Dendritic cells (DCs), regulatory T cells (Tregs) and others as well as RT-PCR based inflammatory gene …expression analysis were performed. Circulating DCs and Tregs were quantified by flow cytometry in the rat model and in PH patients (n  = 70) compared to controls (n  = 52). Inflammatory cells were increased in lung and right ventricular tissue, whereas DCs and Tregs were decreased in blood. Expression of 17 genes in the lung and 20 genes in the right ventricle were relevantly (>2.0 fold) regulated in the PH group. These effects were, at least in part, attenuated in response to Macitentan treatment. In humans as well as rats, immune cells showed significant correlations to clinical, echocardiographic, and haemodynamic parameters. PH is accompanied by a distinct inflammatory response in lung and right but not left ventricular tissue attenuated by Macitentan. Correlations of circulating DCs as well as tissue resident immune cells with parameters reflecting right ventricular function raise the idea of both, promising biomarkers and novel treatment strategies. Show more

Keywords: pulmonary hypertension, right heart failure, inflammation, biomarker, dual endothelin receptor antagonist

DOI: 10.3233/CH-180529

Citation: Clinical Hemorheology and Microcirculation, vol. 73, no. 4, pp. 497-522, 2019

Authors: Caimi, G. | Raso, S. | Napolitano, M. | Hopps, E. | Lo Presti, R. | Siragusa, S.

Article Type: Research Article

Abstract: Although the inherited quantitative and qualitative disorders of fibrinogen are rare, in the course of time patients may develop complications including episodes of arterial and venous thrombosis. It can be useful to complete the laboratory assessment of these clinical conditions with the evaluation of the haemorheological profile. The data obtained from this study showed that congenital afibrinogenemia was characterized by a primary plasma hypoviscosity, whereas congenital dysfibrinogenemia by a primary plasma hyperviscosity. Both these haemorheological alterations may concur, with different mechanisms, to the pathogenesis of thrombotic vascular complications.

DOI: 10.3233/CH-180542

Citation: Clinical Hemorheology and Microcirculation, vol. 73, no. 4, pp. 523-530, 2019

Authors: Ugurel, Elif | Connes, Philippe | Yavas, Gokce | Eglenen, Buse | Turkay, Mine | Aksu, Ali Cenk | Renoux, Celine | Joly, Philippe | Gauthier, Alexandra | Hot, Arnaud | Bertrand, Yves | Cannas, Giovanna | Yalcin, Ozlem

Article Type: Research Article

Abstract: BACKGROUND: Erythrocyte deformability is impaired in sickle cell disease (SCD). The regulation of cytoskeletal protein organization plays a key role in erythrocyte deformability. The activation of adenylyl cyclase (AC)/cAMP/Protein kinase A (PKA) signaling pathway was associated with increased deformability in healthy erythrocytes, however the role of this pathway in SCD is unknown. OBJECTIVE: We evaluated mechanical responses of sickle red blood cells under physiological levels of shear stress and the possible link between their deformability and AC/cAMP/PKA signaling pathway. METHODS: The shearing of sickle red blood cells at physiological level (5 Pa) and the measurement of …deformability were performed by a laser assisted optical rotational cell analyzer (LORRCA). RESULTS: Red blood cell deformability increased of 2.5–6.5% by blocking the activity of phosphodiesterase with Pentoxifylline (10μ M) (p  < 0.05). The inhibition of AC with SQ22536 (100μ M) produced more significant rise in deformability (+4.8–12%, p  < 0.01). No significant change was observed by the inhibition of PKA with H89 (10μ M). CONCLUSION: Pentoxifylline and SQ22536 increased the deformability of sickle red blood cells under fluid shear stress. Modulation of the AC/cAMP/PKA pathway could have the potential to be an effective therapeutic approach for SCD through shear-induced improvements of RBC deformability. Show more

Keywords: Protein kinase a, adenylyl cyclase, phosphodiesterase, red blood cell deformability, sickle cell disease

DOI: 10.3233/CH-190563

Citation: Clinical Hemorheology and Microcirculation, vol. 73, no. 4, pp. 531-543, 2019

Authors: Chen, Baoding | Zhang, Zheng | Wang, Keke | Shang, Mengyuan | Zhao, Shuangshuang | Ding, Wenbo | Du, Rui | Yu, Zhuan | Xu, Ximing

Article Type: Research Article

Abstract: OBJECTIVE: To analyze the association of BRAFV600E mutation with ultrasonographic (US) features and clinicopathologic characteristics in Chinese patients with papillary thyroid microcarcinoma (PTMC). METHODS AND MATERIALS: We retrospectively reviewed 116 consecutive Chinese patients with PTMC diagnosed by postoperative pathology. The incidence of the BRAFV600E mutation was calculated. The US features and clinicopathologic characteristics were compared between BRAF-positive and BRAF-negative patients. RESULTS: The BRAFV600E mutation was detected in 60.3% of patients (70 of 116). Multifocality (OR: 3.681, P  = 0.031), non-parallel orientation (OR: 3.181, P  = 0.041) and lymph node metastasis (OR: 4.615, P  = 0.009) were …significantly associated with BRAFV600E mutation. Other US and clinicopathologic characteristics were not significantly related to the presence of BRAF mutation. CONCLUSION: Multifocality, non-parallel orientation and cervical lymph node metastasis are risk factors for BRAFV600E mutation in PTMC. These factors potentially guide treatment planning or prognosis evaluation. Show more

Keywords: BRAFV600E mutation, ultrasonographic features, clinicopathologic characteristics, papillary thyroid microcarcinoma

DOI: 10.3233/CH-190568

Citation: Clinical Hemorheology and Microcirculation, vol. 73, no. 4, pp. 545-552, 2019

Authors: Chen, Chao-Tsung | Hsu, Chung-Hua | Liu, Jyh-Rou | Wu, Hung-Bo | Chou, Yi-Sheng | Hsiu, Hsin

Article Type: Research Article

Abstract: This study tested the hypothesis that measuring and analyzing skin-surface blood flow dynamics can be used to noninvasively discriminate the different microcirculatory and physiological function states of breast-cancer patients with chemotherapy between receiving and not receiving Kuan-Sin-Yin (KSY) treatment. The 17 included patients were assigned randomly to 2 comparison groups: Group K (n  = 10) received KSY treatment, while Group NK (n  = 7) did not receive KSY treatment. Beat-to-beat, spectral, and approximate-entropy (ApEn) analyses were applied to the 20-minute laser-Doppler sequences. The self-reported quality of life and cancer-related symptoms of patients were also investigated. In posttests, Group NK had a significantly …larger ApEn ratio than that in Group K, significantly smaller values of laser-Doppler-flowmetry variability indices, and a slightly higher relative energy contribution of the neural-related frequency band compared to those in the pretests. Almost all cancer-related symptoms showed improvements in Group K compared to in Group NK. The present findings indicated that the present analysis can be used to detect the significantly different responses in the laser-Doppler indices between taking and not taking KSY. The KSY effect was also noted to be accompanied with improvement of EORTC QLQ-C30 scores. These could lead to a rapid, inexpensive, and objective technique for enhancing clinical applications in quality-of-life monitoring of breast cancer therapy. Show more

Keywords: Breast cancer, blood flow, laser Doppler, approximate entropy, spectral analysis

DOI: 10.3233/CH-190569

Citation: Clinical Hemorheology and Microcirculation, vol. 73, no. 4, pp. 553-563, 2019

Authors: Veres, T.Gy. | Petrovics, L. | Sárvári, K. | Vereczkei, A. | Jancsó, G. | Farkas, K. Borbásné | Takács, I.

Article Type: Research Article

Abstract: INTRODUCTION: Pneumoperitoneum, widely used in laparoscopic surgery increases the intraabdominal pressure, leading to hypoperfusion of the abdominal organs, and promoting the buildup of reactive oxygen species(ROS) and inflammatory cytokines which in turn impairs the body postoperatively. Aim of our investigation was to evaluate the potential protective effects of short ischemic episodes on ischemic damages. METHODS: 70 Wistar rats were used, divided into 7 groups: 1st group sham, 2nd group pneumoperitoneum with 5 mmHg, 3rd group preconditioning with 5 mmHg, 4th group: postconditioning with 5 mmHg, 5th group pneumoperitoneum with 10 mmHg, 6th group: preconditioning with 10 mmHg, 7th group postconditioning with 10 mmHg. Pneumoperitoneum …was created by Veres needle. Oxidative stress parameters: malondialdehyde (MDA) concentration, reduced glutathione (GSH), sulfhydril (SH-), myeloperoxidase (MPO) levels and superoxide-dismutase (SOD) activity were measured. We measured TNF-α and IL-6 concentrations. We monitored the activation of anti- and proapoptotic common signaling pathways (bax, bcl-2, p53) during the early phase of reperfusion. Histology was made from kidney samples. RESULTS: GSH concentrations were significantly reduced, MDA concentrations were significantly higher in each group compared to the Sham. SOD enzyme: a pressure of 10 mmHg elicited significantly greater damage than 5 mmHg. There was a significantly higher SOD activity in group 10 mmHg IPC compared to 10 mmHg. We found that the expression of bax was considerably higher in the none conditioned groups. Noticeably higher expression of anti-apoptotic bcl-2 level was measured in 10 mmHg IPC and 10 mmHg IPoC groups. In case of p53 expression: significant decrease could be seen in groups 10 mmHg IPC and 10 mmHg IPoC compared to the 10 mmHg group. CONCLUSION: Based on our results, the elevated intraabdominal pressure due to pneumoperitoneum induces oxidative stress, which is dependent on the applied pressure. Mostly precondiotioning – but also postconditioning – reduces surgical stress following laparoscopic procedures. In order to explore its mechanism it requires further investigations. Show more

Keywords: Laparoscopy, preconditioning, postconditioning, oxidative stress

DOI: 10.3233/CH-190572

Citation: Clinical Hemorheology and Microcirculation, vol. 73, no. 4, pp. 565-577, 2019

Authors: Gilicze, Orsolya | Simon, Diana | Farkas, Nelli | Lantos, Mate | Jancso, Gabor | Berki, Timea | Lenard, Laszlo

Article Type: Research Article

Abstract: BACKGROUND: Composition of pericardial fluid (PF) may reveal immunological processes influencing oxidative stress and microcirculation of different tissues of the heart and may play a role in the course of myocardial infarction, atherosclerosis, and aortic stenosis. PATIENTS AND METHODS: We investigated lymphocyte populations, cardiovascular markers and immunoglobulin composition in PF and blood samples of patients undergoing CABG operation and compared them to those who had aortic valve surgery. RESULTS: The amount of CD8 + T, NK, memoT and activated T-cytotoxic cells were elevated in PF compared to blood, but naiveT and activated T-helper cell ratio were lower in …PF. Amount of activated T-helper cells and regulatory T-lymphocytes were elevated in CABG participants in both PF and blood. INKT cells represented the only regulatory lymphocyte population reaching significantly higher concentration in PF than in blood. IL-6 and MCP1 level were elevated in PF compared to blood and MCP1 plasma level was markedly elevated in CABG group. CONCLUSIONS: Our study describes a comprehensive immunological analysis of PF in humans for the first time. We showed that the investigated lymphocyte populations and cardiovascular markers in PF have significantly different distribution compared to blood, and lymphocyte populations show different compartmentization in coronary disease and aortic stenosis. Show more

Keywords: Lymphocyte populations, cardiovascular markers, immunoglobulin, pericardial fluid, ischemic heart disease, calcific aortic stenosis

DOI: 10.3233/CH-190594

Citation: Clinical Hemorheology and Microcirculation, vol. 73, no. 4, pp. 579-590, 2019

Authors: Lin, Lirong | Zhang, Yaxuan | Zeng, Qingxin | Lin, Ligong | Geng, Xiaoli | Wang, Shaobin

Article Type: Research Article

Abstract: OBJECTIVE: To study the atherosclerosis (AS), inflammatory factor level, cognitive disorder and vascular endothelial functions in patients with different grades of leukoaraiosis (LA), and to explore the correlations of different grades of LA with cognitive disorder. METHODS: A total of 180 patients with cerebral infarction admitted and treated in the Department of Neurology of our hospital were selected, and they were graded according to the Tarvonen-shcolder standard, with 45 patients in each group. The atherosclerotic plaques of the patients were detected via a color Doppler ultrasound system and magnetic resonance imaging (MRI). Their inflammatory factor levels were determined …using enzyme-linked immunosorbent assay (ELISA). The cognitive function was scored based on the mini-mental state examination (MMSE), and the levels of malondialdehyde (MDA), superoxide dismutase (SOD), endothelin (ET) and nitric oxide (NO) were measured to evaluate vascular endothelial functions. RESULTS: According to the comparisons among four groups of the patients, the incidence rate of AS was gradually increased among patients with different grades of LA (p  < 0.05). With the aggravation of LA, the levels of inflammatory factors in patients were obviously increased (p  < 0.05). LA patients had evidently lowered MMSE scores and levels of SOD and NO, but notably raised inflammatory factors C-reactive protein (CRP) and matrix metalloproteinase-9 (MMP-9) and vascular endothelial function indices MDA and ET (p  < 0.05). CONCLUSION: The occurrence of LA is implicated with the increasing levels of inflammatory factors in the patients, aggregation of cognitive dysfunction and impairment vascular endothelial functions. Show more

Keywords: Leukoaraiosis, atherosclerosis, inflammatory factors, cognitive function, vascular endothelial functions

DOI: 10.3233/CH-190597

Citation: Clinical Hemorheology and Microcirculation, vol. 73, no. 4, pp. 591-597, 2019

Authors: Islam, Sufia | Ahmed, Najneen | Rivu, Sanzana Fareen | Khalil, Marjana | Tanjia, Nafisa | Lehmann, Christian

Article Type: Research Article

Abstract: BACKGROUND: Microvascular dysfunction is a main contributor to morbidity and mortality worldwide. Sophisticated technical tools (e.g. miniaturized hardware, automated software), along with skilled personnel are the prerequisite for quantitative observations of the microvasculature. OBJECTIVE: This review aimed to get an overview about on-going microcirculatory research in developing countries, particularly of the South-East Asia region for the last five years and to project the challenges faced in microcirculation research in developing countries. METHODS: Original research articles originating from 194 countries were searched in PubMed database on the field of microcirculation research for the last five years. …RESULTS: Our findings showed that around 1800 articles have been published from developing countries compared to more than 5000 from developed countries on different aspects of microcirculation. The overall publication per million populations for developing countries was found to be 0.37 where for developed countries it was 3.62. CONCLUSIONS: Initiation and execution of sophisticated research in microcirculation is a demand of the time. Such research, initially, may seem unmanageable in developing countries with limited resources and infrastructure settings. Collaborative scientific projects may aid in establishing networks for microvascular research in developing countries. Show more

Keywords: Microcirculation, infrastructure, developed countries, developing countries

DOI: 10.3233/CH-190611

Citation: Clinical Hemorheology and Microcirculation, vol. 73, no. 4, pp. 599-607, 2019