Blood Vessels In Lesions Research Articles

#2699 Rare glomerular microangiopathy: clinicopathological characteristics and prognosis

Abstract Background and Aims Different from the typical histologic changes of thrombotic microangiopathy (TMA), we identified a group of patients whose pathology with glomerular involvement without blood vessel lesions, which was rare and known as glomerular microangiopathy (GMA). Method In Peking Union Medical College Hospital, a total of 33 patients were diagnosed as GMA with proliferation and swelling of glomerular endothelial cells, fragmented red blood cells, fibrin or platelet thrombi in the capillary lumen, thickening of the basement membrane, stenosis or occlusion of capillary lumen, but no abnormalities in the endothelium of renal small vessels. The pathology and clinical data were from the medical records and analyzed. Results The patients were 66.7% male with a mean of 45 years (14 to 74 years). The primary diseases were Castleman's disease (CD, 30.3%), POEMS syndrome (21.2%), cancer patients receiving agents targeting vascular endothelial growth factor (21.2%), and others. All the patients showed various degrees of proteinuria, with an average 24-hour urinary protein of 2.66 g/d, hematuria (63.6%), and acute kidney injury (AKI, 39.4%). The median serum creatinine (SCr) was 142 (107.5, 169) μmol/L. The AKI patients had lower Alb (P < 0.0001), PLT (P = 0.0192), higher high-sensitivity C-reactive protein (hs-CRP) (P = 0.0199), and reduction of IgA (P = 0.0021). There is no significant difference in SCr and proteinuria among patients with different etiologies. The CD patients exhibited higher hs-CRP and D-Dimer. Treatment included targeting therapy of underlying hematological disorders, glucocorticoid combination with or without immunosuppressant, and supportive treatment. After treatment, we observed proteinuria remission (66.7%), partial improvement (27.3%), or complete recovery (45.5%) of renal function. Conclusion In Castleman's disease, POEMS syndrome, and patients receiving agents targeting VEGF, initial attention to GMA might improve the prognosis and shed light on the study of the mechanisms.

Iatrogenic gas embolism in a juvenile loggerhead sea turtle (Caretta caretta)

A mild pneumocoelom was diagnosed by computed tomography in a stranded juvenile loggerhead sea turtle (Caretta caretta). After gas extraction by ultrasound-guided puncture, the animal did not improve and was subjected to hyperbaric oxygen therapy (HBOT). After HBOT, the turtle developed marked subcutaneous emphysema and was found dead the following morning. Gross lesions included a distended right atrium with numerous gas bubbles within the epicardium, gas bubbles in the hepatic, gastric and mesenteric veins, a small gas-filled bulla in the left lung and diffuse haemorrhages in the encephalon. Histological lesions included gas-like emboli in the lumen of the right atrium with myocardial necrosis, gas-like emboli in the lumina of intestinal, pulmonary and renal blood vessels and severe meningeal haemorrhages. From a forensic pathology perspective, the subcutaneous emphysema of immediate onset after HBOT and the greater severity of the histological lesions in blood vessels, heart, lung and brain differentiate this case from other cases of gas embolism in turtles due to incidental capture. Two factors contributed to this outcome: the existence of a probably unresolved pneumocoelom and the application of HBOT without an initial diagnosis that accurately indicated its use. Therefore, as in human medicine, the use of HBOT in sea turtles with lung lesions and pneumocoelom is discouraged. This is the first description of an iatrogenic gas embolism in a sea turtle.

Masson’s tumor of the thoracic spine: A rare cause of slowly progressive paraplegia

Introduction. Intravascular papillary endothelial hyperplasia is an unusual reactive proliferation of endothelial cells around an organized thrombus, which occurs either in a dilated blood vessel, hematoma, or preexisting vascular lesion. These tumors rarely affect the central nervous system. Symptoms depend on the localization of the process itself. Localization in the central nervous system is limited to the intracranial space. Localization in the spinal canal is extremely rare, and only a few clinical cases have been described so far in the literature. Case report. A 67- year-old female patient was examined neurologically initially due to bilateral weakness of the lower extremities, accompanied by a feeling of pain and muscle tension, dominantly in the upper legs, more to the right. The complaints were present a year ago, and before that period, the patient was in a stable state of health. Due to a severe neurological deficit and the need for detailed exploration, the patient was hospitalized. A diagnosis was performed, which showed the localization of the pathological process in the thoracic 5?6 region of the spinal column. Decompression surgery was performed, and with the ex tempore findings metastasis was ruled out. Definitive pathohistological findings proved Masson?s tumor. After the operation, the neurological weakness recovered. Conclusion. Masson?s tumor, although rarely localized in spinal canal, is curable if it is correctly diagnosed and if an adequate therapeutic approach is applied. The initially presented symptoms may resemble numerous neurological or systemic diseases, which requires the clinician to be continuously aware of such rare pathological processes.

Protective effect of novel angiotensin receptor neprilysin inhibitor S086 on target organ injury in spontaneously hypertensive rats

BackgroundHypertension is a clinical syndrome characterized by elevated systemic arterial blood pressure associated with injury to the heart, kidney, brain, and other organs. Angiotensin receptor neprilysin inhibitors (ARNi), including angiotensin receptor blockers (ARBs) and neprilysin inhibitors (NEPi), have been shown to be safe and effective at reducing blood pressure and alleviating development of target organ injury. This study was used to develop S086 as a novel ARNi and conducted preclinical studies in animal models to evaluate the protective effects of S086 on target organs. MethodsThis study used a 14-month-old spontaneously hypertensive rat (SHR) model to evaluate the protective effects of S086 on the cardiovascular system and organs such as heart and kidney by blood pressure monitoring, urine and blood examination, pathological examination, and immunological index detection. ResultsAfter administering S086 orally to the SHR, their blood pressure and levels of renal injury indicators such as serum creatinine and urinary microalbumin were reduced, and myocardial cell necrosis and cardiac fibrosis of the heart were significantly improved. In addition, there were also significantly improvements in the histological lesions of blood vessels and the kidneys. ConclusionsThe findings showed that S086 effectively reduced the blood pressure of SHR and had effects on alleviating development of heart, blood vessels and kidney.

TREATMENT OF PURULENT-NECROTIC COMPLICATIONS OF SOFT TISSUES IN DIABETES MELLITUS

One of the frequent complications of diabetes mellitus (DM) is the lesion of human blood vessels, leading to the development of diabetic foot. Literature and daily practical observation show an increase of the rate of diabetic foot (30-70%), which raises the actuality of the problem of diabetic foot treatment. This article contains data concerning the results of surgical treatment of 151 patients with diabetes mellitus complicated by diabetic foot and purulent-necrotic soft tissue inflammation. Our work presents the basic principles of treatment of purulent-necrotic complications of diabetes mellitus. The effectiveness of local application of Acerbin solution and two-stage surgical tactics in the complex surgical treatment of purulent-necrotic complications of diabetes mellitus has been proved.

Dosiahnennia kardiolohii u vyvchenni kryteriiv diahnostyky ta predyktoriv prohnozuvannia uskladnen systemy krovoobihu pid chas ishemichnoi khvoroby sertsia u poiednanni z arterialnoiu hipertenziieiu (ohliad literatury; rezultaty vlasnykh doslidzhen)

Introduction. It is generally accepted, that activation of renin-angiotensin-aldosterone system is the first step in the development of hypertension, subsequently leading to the formation of atherosclerotic lesions in blood vessels of heart, brain, kidneys, aorta, and further alteration of peripheral vessels. Some time after the onset of hypertension, left ventricle hypertension develops, inducing various forms of coronary heart disease, strokes, etc. Currently the above circumstances turned to be a global problem of cardiology and medicine. However, data on diagnostic criteria and the evaluation of these combined diseases prognostic predictors are far from complete. The aim of the study. To reflect achievements of modern cardiology in the investigation of criteria predicting complications in the blood circulatory system. Materials and methods. A review of 51 articles is supplemented with author`s own results. Results. It is estimated that arterial hypertension induce hypertrophy of the left ventricle with further cardiac remodeling, which contributes to myocardial infarction, strokes, and cardiac arrhythmias. In patients with coronary heart disease combined with hypertension, structural reorganization of myocardium is supplemented with remodeling of cardiac conducting system resulting with ventricular extrasystoles, atrial fibrillation, etc. Predictors of acute left ventricular failure and chronic heart failure have been published in the literature. Due to our observations, coronary heart disease in patients with hypertension correlates with disturbances in central hemodynamics, decreased contractile function of the left ventricle, changes in blood supply of different pulmonary zones, significant disturbances in tissue metabolism, these pathological signs leading to the development of chronic heart failure, arrhythmias and heart blockage, disorders of cerebral blood circulation. Conclusion. The obtained results make it possible the identification of diagnostic criteria and predictors of various circulatory complications in patients with the diagnosed coronary heart disease combined with hypertension. However, more observations are needed to get new insight into the pathogenic mechanisms of complications development, further specification of their predictors and creating more effective methods of their prevention. Keywords: prediction of malignant arrhythmias, atrial fibrillation, left ventricular hypertrophy.

Impact of focal segmental glomerulosclerosis over the past decade.

This is a study on the demographics and clinical outcomes including the response to therapy of patients with focal segmental glomerulosclerosis (FSGS) over the past decade. All histologically proven FSGS cases diagnosed between 2008 and 2018 were analyzed for their clinical, laboratory, and histological characteristics including treatment that could influence the disease progression and renal outcome of these patients. We used the Columbia Classification for FSGS for the renal biopsy. There were two subgroups of FSGS patients; those with nephrotic syndrome and those without nephrotic syndrome. Patients with FSGS with non-nephrotic syndrome had poorer survival rates compared to the nephrotic group. For those without nephrotic syndrome, the indices responsible for progression involved more tubular and blood vessel lesions in addition to glomerular pathology compared to those with nephrotic syndrome. Patients with FSGS with nephrotic syndrome responded to immunosuppressants more favorably compared to the non-nephrotic group, though both groups responded with decreasing proteinuria. The nephrotic group had a better 10-year long-term survival rate of 92 vs. 72% for the non-nephrotic group (log-rank 0.002). The 10-year survival for the whole group of FSGS patients was 64%. Our data suggest that in FSGS, one of the significant components of the disease is the vascular and tubular damage, apart from the underlying glomerular pathology, resulting in varying responses to therapy, and the difference is reflected in inherently poorer response to immunosuppressant therapy in those without nephrotic syndrome as opposed to those with nephrotic syndrome, who responded to immunosuppressant therapy (IST) with stabilization of renal function and had less blood vessel and tubular lesions.

Biomarkers of interstitial lung disease in systemic scleroderma and their significance

Systemic scleroderma (SSD) is a rare immune-inflammatory systemic disease of connective tissue with a typical lesion of skin, blood vessels, musculoskeletal system and internal organs (lungs, heart, digestive tract, kidneys). The SSD pathogenesis is based on activation of a cascade of complex immune interactions that lead to vasculopathy. The presence of many pathophysiological links in the progression of the disease causes a variety of clinical manifestations in various patients with SSD. A full assessment of all stages of SSD development is still being carried out and every newly open element of the interaction of immunological subjects completes the overall picture of the disease. A number of studies show a correlation between level of several biomarkers and both disease prognosis and estimated therapy effectiveness. Recent data confirm importance of the biomarkers for formation of patterns of a particular disease phenotype in a specific patient. Depending on relation of the biomarkers to various biological processes, several of their categories are distinguished: biomarkers expressed in lung tissue, cellular units of immunity, nucleic acids, acute phase indicators, connective tissue growth factors, matrix proteinases and their inhibitors, chemokines and cytokines, as well as biomarkers of endothelial activation. Discovery of a novel set of the indicators can be decisive in determining the management tactics and forecasting the response to therapy of some groups of patients with SSD. By combining the most recent data on significant markers obtained in the framework of extensive studies, we have described the most significant biomarkers of SSD and their link to interstitial lung disease (ILD) that is formed in SSD.

Relation between thyroid hormonal status, neutrophillymphocyte ratio and left ventricular systolic function in patients with acute coronary syndrome.

Aim To examine a relation of thyroid function, neutrophil-lymphocyte ratio (NLR) with left ventricular function measured through the left ventricular ejection fraction (LVEF) in patients with acute myocardial infarction treated with percutaneous coronary intervention (PCI). Methods This prospective research involved 160 consecutive patients with acute myocardial infarction. Patients were divided into those with normal thyroid hormone status (n=80) and those with hypothyroidism (newly diagnosed) (n=80). Inflammatory parameters and parameters of hormonal status were taken for analysis: thyroid-stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free thyroxine (FT4), and free triiodothyronine (FT3). All patients underwent transthoracic echocardiographic examination (TTE) five days upon admission, and left ventricular ejection fraction (LVEF) was analysed. Results Significant difference between the two groups was verified in values of T3, T4, erythrocytes, haemoglobin, haematocrit, neutrophil, lymphocytes, NLR, C-reactive protein (CRP) and sedimentation rate. Patients with euthyroidism had a higher frequency of coronary single-vessel disease (p=0.035) and a significantly lower frequency of triple vessel disease (p=0.046), as well as a higher median value of LVEF (p=0.003). There was a significant correlation between LVEF with haemoglobin values (p=0.002), NLR (p=0.001), and CRP (p=001). Conclusion The altered status of the thyroid gland in acute myocardial infarction is associated with the severity of the coronary blood vessel lesion, LVEF and correlates with inflammatory response.

Kliničke i patohistološke karakteristike lupus nefritisa u pedijatrijskoj i adultnoj populaciji

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease, characterized by abundant production of antibodies, deposits of immune complexes, and activation of the complement system, which disrupts the integrity and function of many organs, including the kidney. Although the frequency of SLE is less common in children, affected children develop lupus nephritis (LN) significantly more often, while in adults with SLE, LN occurs in 23% of cases, more often in males. Aim: The aim of this study was to analyze clinical parameters (gender, frequency of LN as the first manifestation of SLE, proteinuria, and serum creatinine values) and pathohistological parameters (frequency of LN classes, activity and chronicity index values, immunoglobulin deposit intensity and complement components at immunofluorescence, and blood vessel lesions) in the pediatric and adult populations of LN patients. Material and methods: The study included 218 biopsy samples of kidney tissue. Patients were divided into two groups: patients under 18 years of age (n=35) and those over 18 years of age (n =183). Results: Mean values of serum creatinine in pediatric population (71.6±16.4 µmol/l) were statistically significantly lower (p<0.001) than in adults (115.5 ±64 µmol/l). Leukocyte interstitial infiltration was statistically significantly higher in the adult group (p=0.003). The average value of the chronicity index (p=0.002), as well as the tubulointerstitial parameters that determine it (tubular atrophy (p <0.001) and interstitial fibrosis (p=0.011)) were significantly higher in adults with LN. Leukocyte infiltration (p=0.003) and myoelastofibrosis (p<0.001) of blood vessels were statistically significantly more common in the adult population. Conclusions: Serum creatinine values are significantly higher in the adult population of LN. Pathohistological findings indicate that glomerular LN lesions do not differ significantly with regard to activity and chronicity index in pediatric and adult populations, but the degrees of tubulointerstitial lesions are significantly higher, both in terms of activity and in terms of chronicity within the adult groups. Myoelastofibrosis and hyalinization of blood vessels as well as leukocyte infiltration of blood vessels, are statistically significantly more common in the adult population.

Complications and risk factors after digital subtraction angiography: 1-year single-center study.

Digital subtraction angiography (DSA) is an imaging technique used to diagnose and confirm abnormal lesions of cerebral blood vessels in various situations. Several complications such as cerebral infarction, contrast-induced allergy, and angio-site hematoma or infection can occur after DSA. We investigated complication rates and risk factors related to DSA. All patients who underwent DSA at Incheon St. Mary's Hospital from January to December 2021 were included. Those who underwent emergency DSA due to stroke or who underwent endovascular surgery within 1 week after DSA were excluded. Complications that occurred within 1 week after DSA were included in the study and was classified into three categories (neurologic complications, contrast-induced allergy, and wound complications). The mean age was 57.7±13.2 years old and the female was dominant at 63.9%. The overall complication rate was 5% (n=20/407). Regarding neurologic complications, the presence of malignancy (p<0.01), and a longer procedure time (>15 minutes, p=0.04) were statistically significant factors. Contrast-induced allergy did not show any statistically significant difference in any parameter. The wound complication rate was higher in men (p=0.02), trans-femoral approach (p=0.02), frequent alcohol drinkers (p=0.04), those taking anticoagulants (p=0.03), and longer procedure time (>15 minutes, p<0.01). DSA is an invasive diagnostic modality and can cause several complications. Patients with cancer should be more careful about the occurrence of cerebral infarction, and men taking anticoagulants or drinking frequently should be more careful about the occurrence of angio-site hematomas.

Angiosarcomas of the head and neck: Impact of large data analysis on clinical management.

Angiosarcoma is a rare but often fatal malignancy from blood and lymphatic vessels that can arise anywhere in the body and often affects the head and neck region. Although its dismal prognosis is predominantly explained by its aggressive biology, several secondary factors contribute to poor outcomes. These include a phenotypic resemblance to innocuous blood vessel lesions, which contributes to a significant degree of late diagnosis. Another important factor is the rarity of angiosarcoma, which has impaired scientific determination of its optimal treatment significantly. As a result, treatment of angiosarcomas has largely been guided by information derived from the study of sarcomas at large, themselves a highly heterogeneous group of mesenchymal cancers both from a diagnostic as well as therapeutical perspective. The Digital Revolution and resultant Information Age promise to transform the clinical management of rare cancers from a generic to a more customized approach. In this paper, we review the current understanding of head and neck angiosarcomas within the context of this process.

SCLEROTHERAPY FOR EXTENSIVE VASCULAR MALFORMATION IN THE TONGUE: A REPORT OF TWO CASES

Vascular anomalies such as hemangioma, vascular malformations, and varix are common in the head and neck. Vascular malformations (VMs) are benign lesions of blood vessels originating from an error in vascular morphogenesis during the embryologic phase. Treatment depends on the location and extent of the lesion; sclerotherapy, surgical excision, and laser therapy are the most frequently performed. The objective of this work is to report 2 cases of extensive vascular malformation in the oral cavity treated with sclerotherapy. After diagnosis and shared decision making, the treatment consisted of 12 applications of monoethanolamine oleate (Ethamolin) in a 1:1 proportion with lidocaine anesthetic in the amount of 1.0 mL. Total regression of both lesions was achieved and the patients have been followed up with satisfactory results. This report shows that sclerotherapy is an effective and practical form of treatment for VMs, even in cases of extensive lesions.

Current approaches to the treatment of purulent-necrotic soft tissue complications in diabetic foot

One of the frequent complications of diabetes mellitus is the lesion of human blood vessels, leading to the development of diabetic foot. Literature and daily practical observation show an increase of the rate of diabetic foot (30-70%), which raises the actuality of the problem of diabetic foot treatment. This article contains data concerning the results of surgical treatment of 151 patients with diabetes mellitus complicated by diabetic foot and purulent-necrotic soft tissue inflammation. Our work presents the basic principles of treatment of purulent-necrotic complications of diabetes mellitus. The effectiveness of local application of Acerbin solution and two-stage surgical tactics in the complex surgical treatment of purulent-necrotic complications of diabetes mellitus has been proved.

DEVELOPMENT OF PERORAL HYPOLIPIDEMIC FORMULATION BASED ON SULFATED ARABINOGALACTAN IN THE FORM OF POTASSIUM SALT

An original heparinoid, sulfated arabinogalactan in the form of potassium salt, possessing anticoagulant and hypolipidemic activities, has been developed at the A.E. Favorsky Irkutsk Institute of Chemistry Siberian Branch of the Russian Academy of Sciences.The aim was to develop solid peroral dose forms (capsules and film-coated tablets) for the prevention and treatment of atherosclerotic lesion of blood vessels on the basis of potassium salt of sulfated arabinogalactan which would be suitable for further clinical trials of these forms.Materials and methods. The following materials were used in the work: sulfated arabinogalactan in the form of potassium salt, obtained at the A.E. Favorsky Irkutsk Institute of Chemistry Siberian Branch of the Russian Academy of Sciences; Ludipress®; AEROSIL® 200 Pharma; calcium stearate; Aquacoat ECD. The powder mixtures were briquetted followed by tableting and application of the finished film coating Aquacoat ECD, and encapsulation in hard gelatin capsules.Results. Composition and technological characteristics of capsules and film-coated tablets were determined using physico-chemical and technological properties of sulfated arabinogalactan in the form of potassium salt. Technological parameters and quality indicators were determined for the solid pharmaceutical dose forms in accordance with the requirements of the State Pharmacopoeia of the Russian Federation of the XIVth edition. Conclusion. The optimum compositions and technology for the preparation of capsules and film-coated tablets based on potassium salt of sulfated arabinogalactan for the prevention and treatment of atherosclerotic lesion of blood vessels, were developed. The data obtained were used for the regulatory documentation design.

Noise-optimized virtual monoenergetic imaging technology of the third-generation dual-source computed tomography and its clinical applications.

The third-generation dual-source computed tomography (DSCT) is among the most advanced imaging methods. It employs noise-optimized virtual monoenergetic imaging (VMI+) technology. It uses the frequency-split method to extract high-contrast image information from low-energy images and low-noise information from images reconstructed at an optimal energy level, combining them to obtain the final image with improved quality. This review is the first to summarize the results of clinical studies that primarily and recently evaluated the VMI+ technique based on tumor, blood vessel, and other lesion classification. We aim to assist radiologists in quickly selecting the appropriate energy level when performing image reconstruction for superior image quality in clinical work and providing several ideas for future scientific research of the VMI+ technique. Presently, VMI+ reconstruction is mostly used for images of various tumors or blood vessels, including coronary plaques, coronary stents, deep vein thromboses, pulmonary embolisms (PEs), active arterial hemorrhages, and endoleaks after endovascular aneurysm repair. In addition, VMI+ has been used for imaging children's heads, liver lesions, pancreatic lacerations, and reducing metal artifacts. Regarding the reconstruction at the optimal energy level, the VMI+ technique yielded a higher image quality than the pre-optimized virtual monoenergetic imaging (VMI) technique and single-energy CT. Moreover, either low concentrations of contrast medium or low iodine injection rates can be applied before VMI+ reconstruction at a low-energy level to reduce contrast agent-related kidney injury risk. After reconstructing an image at the optimal energy level, both the image's window width and level can also be adjusted to improve the image effect's reach and diagnosis suitability. To improve image quality and lesion-imaging clarity and reduce the use of contrast agents, VMI+ reconstruction technology has been applied clinically, in which the selection of energy level is the key to the whole reconstruction process. Our review summarizes these optimal levels for radiologists' reference and suggests new ideas for the direction of future VMI+ research.

Red-lesion extraction in retinal fundus images by directional intensity changes\u2019 analysis

Diabetic retinopathy (DR) is an important retinal disease threatening people with the long diabetic history. Blood leakage in retina leads to the formation of red lesions in retina the analysis of which is helpful in the determination of severity of disease. In this paper, a novel red-lesion extraction method is proposed. The new method firstly determines the boundary pixels of blood vessel and red lesions. Then, it determines the distinguishing features of boundary pixels of red-lesions to discriminate them from other boundary pixels. The main point utilized here is that a red lesion can be observed as significant intensity changes in almost all directions in the fundus image. This can be feasible through considering special neighborhood windows around the extracted boundary pixels. The performance of the proposed method has been evaluated for three different datasets including Diaretdb0, Diaretdb1 and Kaggle datasets. It is shown that the method is capable of providing the values of 0.87 and 0.88 for sensitivity and specificity of Diaretdb1, 0.89 and 0.9 for sensitivity and specificity of Diaretdb0, 0.82 and 0.9 for sensitivity and specificity of Kaggle. Also, the proposed method has a time-efficient performance in the red-lesion extraction process.

Роль аутоиммунных нарушений в патогенезе цереброваскулярной недостаточности у детей, больных бронхиальной астмой

It has been shown that the main spectrum of immunopathological reactions in bronchial asthma in children has a clear antigenic dependence not only on the inflammatory-activated intermediate stroma of the bronchopulmonary system, but also on the effects of autoantibodies on cerebral vessels and cell tissue. insufficiency of this contingent of children, which is currently insufficiently studied. The aim is to study autoimmune disorders in the pathogenesis of cerebrovascular insufficiency in children with bronchial asthma. 121 patients with asthma aged 5 to 15 years in the period of exacerbation were examined. To study the role of the autoimmune component in the development of cerebrovascular insufficiency and its connection with the autoimmune process in the bronchopulmonary system in asthma in children, we used the method of quantitative determination of autoantibodies to lipopolysaccharide antigens of cerebral vessels and topographic structures of the brain and brain, trachea, bronchi and lung tissue. The results showed that the levels of autoantibodies to lipopolysaccharide antigens vessels and cell tissue structures of the brain and bronchopulmonary system in children with asthma significantly increased from mild to severe. The rank correlation showed that there is a direct reliable connection between the autoimmune process in the bronchopulmonary system and the level of autoantibodies to the lipopolysaccharide antigens of cerebral vessels and cell tissue structures of the brain. Thus, it is shown that the level of autoantibodies to lipopolysaccharide antigens arteries, venous vessels and cell tissue structures of the brain, allows to detect lesions of blood vessels and tissue areas of the brain in cerebrovascular insufficiency in children with asthma.

Acidosis induces synovial fibroblasts to release vascular endothelial growth factor via acid-sensitive ion channel 1a

AbstractAcid-sensitive ion channel 1a (ASIC1a) is a member of the extracellular H+ activated cation channel family. Studies have shown that tissue acidification contributes to the formation of microvessels in rheumatoid arthritis (RA) synovial tissue, but its underlying mechanisms remain unclear. The purpose of this study was to investigate the role of tissue acidification in microvascular formation of arthritic synovial tissue and the effect of ASIC1a on vascular endothelial growth factor (VEGF) release from arthritic synovial tissue. Our results indicate that ASIC1a expression, VEGF expression, and microvessel density (MVD) are elevated in RA synovial tissue and adjuvant arthritis (AA) rat synovial tissue. When AA rats were treated with ASIC1a-specific blocker psalmotoxin-1 (PcTx-1), the expression of ASIC1a, VEGF expression, and MVD were all reduced. Acidification of RA synovial fibroblasts (RASF) can promote the release of VEGF. PcTx-1 and ASIC1a-short hairpin RNA can inhibit acid-induced release of VEGF. In addition, the ASIC1a overexpression vector can promote acid-induced VEGF release. This indicates that extracellular acidification induces the release of VEGF by RASF via ASIC1a. These findings suggest that blocking ASIC1a mediates the release of VEGF from synoviocytes may provide a potential therapeutic strategy for RA therapy.Both ASIC1a and VEGF are highly expressed in rheumatoid arthritis synovial tissue and are associated with vascular disease. Interfering with ASIC1a in vitro using silencing, blocking, and overexpression interferes with the release of VEGF under acid stimulation. Blocking ASIC1a in the articular cavity of rats with adjuvant arthritis not only reduces the expression of VEGF in the synovium, but also reduces the proliferation and lesions of blood vessels and interferes with the development of the disease.

Factors of Progression and Occurrence of Atherosclerosis in Rheumatoid Arthritis.

Aim To determine in a prospective study factors of progressive atherosclerotic lesion of blood vessels in patients with rheumatoid arthritis (RA).Material and methods This prospective study included 124 patients with RA and suspected ischemic heart disease (IHD) and 30 patients with IHD (comparison group) aged 58 [52; 63] years. On enrollment to the study and at 3 years of follow-up, all patients underwent clinical and instrumental examination according to European and Russian guidelines for diagnosis and treatment of stable IHD (2013), including coronography as indicated. For all RA patients of the comparison group, risk factors (RF) were evaluated, including arterial hypertension, smoking, excessive body weight, family history of cardiovascular diseases (CVD), diabetes mellitus, and dyslipidemia. The following laboratory data were evaluated: blood count; biochemistry, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), rheumatoid factor (RhF), cyclic citrullinated peptide antibodies, and high-sensitivity C-reactive protein (hsCRP). Proinflammatory cytokines, including interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF- α), were measured in RA patients once, at 3 years of follow-up.Results Incidence of FRs for CVD was similar in RA patients and in the comparison group. Median RA duration before inclusion into the study was 11 years, and median DAS28 index score was 3.8. Incidence of dyslipidemia due to increased TC, LDL-C, and HDL-C was higher for RA patients at baseline. The LDL-C goal (&lt;1.8 mmol/l) was achieved only in 3 (10 %) patients of the comparison group and 10 (8 %) RA patients. RA patients had higher levels of the inflammation indexes, hsCRP (0.75 mg/dl vs. 0.16 mg/dl; p&lt;0.05) and erythrocyte sedimentation rate (ESR) (15 mm/h vs. 11.5 mm/h; p&lt;0.05). In the RA group at baseline, atherosclerotic plaques with carotid artery (CTA) stenosis of 20% or more were found in 94 (77 %) patients; in 3 of them, CA stenosis was &gt;50%. Patients with RA frequently had unchanged or slightly changed coronary arteries (CA) (47% of patients), and less frequently they had hemodynamically significant multi-arterial coronary atherosclerotic lesions (7 % vs. 57 % of patients in comparison group). At 37.5 months, 21 (23 %) of 94 RA patients had progressive atherosclerosis in CA and/or CTA; 12 (13 %) RA patients had only progressive CA atherosclerosis; 7 (8 %) had only progressive CTA atherosclerosis; and 2 (2 %) had simultaneous progression of CA and CTA atherosclerosis. Two groups of RA patients were formed, with the progression of atherosclerosis (n=21) and without the progression of atherosclerosis (n=69). RFs for the development/progression of atherosclerosis in RA patients included smoking, family history of CVD, and duration of the disease. Levels of lipids did not differ. Levels of proinflammatory cytokines (IL-1β, IL-6, TNF-α) were higher in RA patients with progressive atherosclerosis. No effects of the anti-rheumatic therapy on the progression of atherosclerosis were observed.Conclusion Progression of atherosclerosis in RA remains in disease with low and moderate activity during the anti-rheumatic and hypolipidemic treatment. The development of atherosclerosis in RA is determined by lipid, inflammatory, and immune disorders.