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Post-occlusive reactive hyperemia variables can be used to diagnose vascular dysfunction in hemorrhagic shock 闭塞后反应性充血变量可用于诊断失血性休克的血管功能障碍
IF 3.1 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-12-11 DOI: 10.1016/j.mvr.2023.104647
Aleksey Dubensky, Ivan Ryzhkov, Zoya Tsokolaeva, Konstantin Lapin, Sergey Kalabushev, Lidia Varnakova, Vladimir Dolgikh

Introduction

Laser doppler flowmetry (LDF) allows non-invasive assessment of microvascular functions. The combination of LDF with an occlusion functional test enables study of post-occlusive reactive hyperemia (PORH), providing additional information about vasomotor function, capillary blood flow reserve, and the overall reactivity of the microvascular system.

Aim

To identify early alterations of PORH variables in the skin of a rat in hemorrhagic shock (HS).

Material and methods

Male Wistar rats (n = 14) weighing 400–450 g were anesthetized with a combination of tiletamine/zolazepam (20 mg/kg) and xylazine (5 mg/kg). The animals breathed on their own, and were placed on a heated platform in the supine position. A PE-50 catheter was inserted into the carotid artery to measure the mean arterial pressure (MAP). The optical probe of the Laser Doppler device was installed on the plantar surface of the hind limb of a rat; a pneumatic cuff was applied proximal to the same limb. The occlusion time was 3 min. The following physiological variables were measured at baseline and 30 min after blood loss: MAP, mmHg; mean cutaneous blood flow (M, PU); cutaneous vascular conductance (CVC = M/MAP); peak hyperemia (Mmax, PU) and maximum cutaneous vascular conductance (CVCmax) during PORH. In the HS group (n = 7), 30 % of the estimated blood volume was taken within 5 min. There was no blood loss in the group of sham-operated animals (Sham, n = 7). The results are presented as Me [25 %;75 %]. The U-Mann-Whitney criterion was used to evaluate intergroup differences. Differences were considered statistically significant at p < 0.05.

Results

The groups did not differ at baseline. Blood loss led to a significant decrease in MAP (43 [31;46] vs. 94 [84;104] mmHg), M (11.5 [16.9;7.8] vs 16.7 [20.2;13.9]) and Mmax (18.1 [16.4;21.8] vs. 25.0 [23.0;26.2]) in the HS group compared to the Sham group, respectively. At the same time, both CVC (0.25 [0.23;0.30] vs. 0.16 [0.14;0.21]) and CVCmax (0.55 [0.38;0.49] vs 0.24 [0.23; 0.29]) increased after blood loss in the HS group compared to the Sham group. Arterial blood gas analysis revealed metabolic lactic acidosis in the HS group.

Conclusion

In this rat model of HS, alterations in cutaneous blood flow are manifested by a decrease in perfusion (M) and the intensity of PORH (Mmax) with a simultaneous increase in vascular conductance (CVC and CVCmax).

导言激光多普勒血流测量仪(LDF)可对微血管功能进行无创评估。激光多普勒血流测量仪与闭塞功能测试相结合,可对闭塞后反应性充血(PORH)进行研究,提供有关血管运动功能、毛细血管血流储备和微血管系统整体反应性的更多信息。材料和方法体重 400-450 克的雄性 Wistar 大鼠(n = 14)用瓦他敏/唑拉西泮(20 毫克/千克)和异丙嗪(5 毫克/千克)联合麻醉。动物自主呼吸,并以仰卧姿势放在加热平台上。将 PE-50 导管插入颈动脉,测量平均动脉压(MAP)。激光多普勒装置的光学探头安装在一只大鼠后肢的足底表面;气动袖带安装在同一肢体的近端。闭塞时间为 3 分钟。在基线和失血后 30 分钟测量了以下生理变量:MAP,mmHg;平均皮肤血流量(M,PU);皮肤血管传导(CVC = M/MAP);PORH 期间的峰值充血(Mmax,PU)和最大皮肤血管传导(CVCmax)。在 HS 组(n = 7)中,30% 的估计血量是在 5 分钟内抽取的。假手术动物组(Sham,n = 7)没有失血。结果以 Me [25 %;75 %] 表示。采用 U-Mann-Whitney 标准评估组间差异。结果各组在基线时无差异。与 Sham 组相比,失血导致 HS 组的 MAP(43 [31;46] vs. 94 [84;104] mmHg)、M(11.5 [16.9;7.8] vs. 16.7 [20.2;13.9] )和 Mmax(18.1 [16.4;21.8] vs. 25.0 [23.0;26.2] )分别显著下降。同时,与 Sham 组相比,HS 组失血后的 CVC(0.25 [0.23;0.30] vs. 0.16 [0.14;0.21] )和 CVCmax(0.55 [0.38;0.49] vs 0.24 [0.23; 0.29])均有所增加。结论在这种 HS 大鼠模型中,皮肤血流的改变表现为灌注量(M)和 PORH 强度(Mmax)的降低,同时血管传导(CVC 和 CVCmax)的增加。
{"title":"Post-occlusive reactive hyperemia variables can be used to diagnose vascular dysfunction in hemorrhagic shock","authors":"Aleksey Dubensky,&nbsp;Ivan Ryzhkov,&nbsp;Zoya Tsokolaeva,&nbsp;Konstantin Lapin,&nbsp;Sergey Kalabushev,&nbsp;Lidia Varnakova,&nbsp;Vladimir Dolgikh","doi":"10.1016/j.mvr.2023.104647","DOIUrl":"https://doi.org/10.1016/j.mvr.2023.104647","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Laser doppler flowmetry (LDF) allows non-invasive assessment of microvascular functions. The combination of LDF with an occlusion functional test enables study of post-occlusive </span>reactive hyperemia<span> (PORH), providing additional information about vasomotor<span><span> function, capillary blood flow reserve, and the overall reactivity of the </span>microvascular system.</span></span></p></div><div><h3>Aim</h3><p>To identify early alterations of PORH variables in the skin of a rat in hemorrhagic shock (HS).</p></div><div><h3>Material and methods</h3><p><span>Male Wistar rats (</span><em>n</em><span><span><span> = 14) weighing 400–450 g were anesthetized with a combination of tiletamine/zolazepam (20 mg/kg) and xylazine (5 mg/kg). The animals breathed on their own, and were placed on a heated platform in the </span>supine position. A PE-50 catheter was inserted into the </span>carotid artery<span> to measure the mean arterial pressure<span> (MAP). The optical probe of the Laser Doppler device was installed on the plantar surface of the hind limb of a rat; a pneumatic cuff was applied proximal to the same limb. The occlusion time was 3 min. The following physiological variables were measured at baseline and 30 min after blood loss: MAP, mmHg; mean cutaneous blood flow (M, PU); cutaneous vascular conductance (CVC = M/MAP); peak hyperemia (M</span></span></span><sub>max</sub>, PU) and maximum cutaneous vascular conductance (CVC<sub>max</sub>) during PORH. In the HS group (<em>n</em> = 7), 30 % of the estimated blood volume was taken within 5 min. There was no blood loss in the group of sham-operated animals (Sham, n = 7). The results are presented as Me [25 %;75 %]. The U-Mann-Whitney criterion was used to evaluate intergroup differences. Differences were considered statistically significant at <em>p</em> &lt; 0.05.</p></div><div><h3>Results</h3><p>The groups did not differ at baseline. Blood loss led to a significant decrease in MAP (43 [31;46] vs. 94 [84;104] mmHg), M (11.5 [16.9;7.8] vs 16.7 [20.2;13.9]) and M<sub>max</sub> (18.1 [16.4;21.8] vs. 25.0 [23.0;26.2]) in the HS group compared to the Sham group, respectively. At the same time, both CVC (0.25 [0.23;0.30] vs. 0.16 [0.14;0.21]) and CVC<sub>max</sub><span><span> (0.55 [0.38;0.49] vs 0.24 [0.23; 0.29]) increased after blood loss in the HS group compared to the Sham group. Arterial blood gas analysis revealed metabolic </span>lactic acidosis in the HS group.</span></p></div><div><h3>Conclusion</h3><p>In this rat model of HS, alterations in cutaneous blood flow are manifested by a decrease in perfusion (M) and the intensity of PORH (M<sub>max</sub>) with a simultaneous increase in vascular conductance (CVC and CVC<sub>max</sub>).</p></div>","PeriodicalId":18534,"journal":{"name":"Microvascular research","volume":"152 ","pages":"Article 104647"},"PeriodicalIF":3.1,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138581964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Changes in renal microcirculation in patients with nephrotic and nephritic syndrome: The role of resistive index 肾病和肾炎综合征患者肾微循环的变化:阻力指数的作用
IF 3.1 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-12-10 DOI: 10.1016/j.mvr.2023.104641
Antonietta Gigante, Chiara Pellicano, Oriana De Marco, Eleonora Assanto, Georgia Sorato, Alberto Palladini, Edoardo Rosato, Silvia Lai, Maurizio Muscaritoli, Rosario Cianci

Background

Renal Resistive Index (RRI) is an important and non-invasive parameter of renal damage and it is associated with abnormal microcirculation or to a parenchymal injury. The aim of our study was to compare the RRI in a cohort of patients with renal diseases categorized in three groups: nephrotic syndrome (NS), acute nephritic syndrome (ANS) and patients with urinary abnormalities (UA).

Methods

Four hundred eighty-two patients with median age of 48 years (IQR 34–62) with indications for kidney disease were included in the study. Biochemical analyses, clinical assessment with detection of NS, ANS and UA and comorbidities were reported. Renal Doppler ultrasound with RRI was evaluated in all patients at the time of enrolment.

Results

NS was present in 81 (16.8 %) patients while ANS in 81 (16.8 %) and UA in 228 (47.3 %) patients. Patients with ANS showed significant higher RRI compared to both patients with NS [0.71 (IQR 0.67–0.78) vs 0.68 (0.63–0.73), p < 0.001] and UA [0.71 (0.67–0.78) vs 0.65 (0.61–0.71), p < 0.001]; RRI was higher in NS patients than in patients with UA [0.68 (0.63–0.73) vs 0.65 (0.61–0.71), p < 0.001]. Patients with ANS had significantly lower median estimated glomerular filtration rate (eGFR) compared respectively to NS and UA patients [19.7 ml/min vs 54.8 ml/min and vs 72.3 ml/min, p < 0.001], while renal length was significantly higher in patients with NS compared to both patients with ANS and UA [111.88 mm vs 101.98 mm and vs 106.15, p < 0.001]. Patients with ANS had more frequently hematuria and RRI ≥ 0.70 (p < 0.001) compared to both patients with NS and patients with UA. The multiple regression analysis, weighted for age, showed that RRI inversely correlates with eGFR (β coefficient = −0.430, p < 0.001).

Conclusions

Higher and pathological RRI were found in ANS than NS and UA. Renal resistive index in ANS reflects changes in intrarenal perfusion and microvascular dysfunction related to disease characteristics.

背景肾脏阻力指数(Renal Resistive Index,RRI)是肾脏损伤的一个重要非侵入性参数,它与微循环异常或肾实质损伤有关。我们的研究旨在比较一组肾病患者的 RRI,这些患者分为三组:肾病综合征(NS)、急性肾炎综合征(ANS)和泌尿系统异常(UA)患者。研究报告包括生化分析、临床评估、NS、ANS 和 UA 检测以及合并症。结果81例(16.8%)患者出现NS,81例(16.8%)患者出现ANS,228例(47.3%)患者出现UA。与 NS [0.71 (IQR 0.67-0.78) vs 0.68 (0.63-0.73), p < 0.001]和 UA [0.71 (0. 67-0.78) vs 0.68 (0.63-0.73), p < 0.001]患者相比,ANS 患者的 RRI 明显更高。67-0.78) vs 0.65 (0.61-0.71), p <0.001];NS 患者的 RRI 高于 UA 患者[0.68 (0.63-0.73) vs 0.65 (0.61-0.71), p <0.001]。ANS患者的估计肾小球滤过率(eGFR)中位数明显低于NS和UA患者[19.7 ml/min vs 54.8 ml/min and vs 72.3 ml/min, p <0.001],而NS患者的肾长度明显高于ANS和UA患者[111.88 mm vs 101.98 mm and vs 106.15, p <0.001]。与 NS 和 UA 患者相比,ANS 患者更常出现血尿且 RRI ≥ 0.70 (p < 0.001)。根据年龄加权的多元回归分析表明,RRI 与 eGFR 成反比(β 系数 = -0.430,p < 0.001)。ANS的肾阻力指数反映了与疾病特征相关的肾内灌注和微血管功能障碍的变化。
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引用次数: 0
The SNHG12/microRNA-15b-5p/MYLK axis regulates vascular smooth muscle cell phenotype to affect intracranial aneurysm formation SNHG12/microRNA-15b-5p/MYLK轴调控血管平滑肌细胞表型,影响颅内动脉瘤的形成
IF 3.1 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-12-09 DOI: 10.1016/j.mvr.2023.104643
Wenxian Feng , Hao Liang , Dan Liu , Shiwang Ruan

Objective

This research was dedicated to investigating the impact of the SNHG12/microRNA (miR)-15b-5p/MYLK axis on the modulation of vascular smooth muscle cell (VSMC) phenotype and the formation of intracranial aneurysm (IA).

Methods

SNHG12, miR-15b-5p and MYLK expression in IA tissue samples from IA patients were tested by RT-qPCR and western blot. Human aortic vascular smooth muscle cells (VSMCs) were cultivated with H2O2 to mimic IA-like conditions in vitro, and the cell proliferation and apoptosis were measured by MTT assay and Annexin V/PI staining. IA mouse models were established by induction with systemic hypertension combined with elastase injection. The blood pressure in the tail artery of mice in each group was assessed and the pathological changes in arterial tissues were observed by HE staining and TUNEL staining. The expression of TNF-α and IL-1β, MCP-1, iNOS, caspase-3, and caspase-9 in the arterial tissues were tested by RT-qPCR and ELISA. The relationship among SNHG12, miR-15b-5p and MYLK was verified by bioinformatics, RIP, RNA pull-down, and luciferase reporter assays.

Results

The expression levels of MYLK and SNHG12 were down-regulated and that of miR-15b-5p was up-regulated in IA tissues and H2O2-treated human aortic VSMCs. Overexpressed MYLK or SNHG12 mitigated the decrease in proliferation and increase in apoptosis of VSMCs caused by H2O2 induction, and overexpression of miR-15b-5p exacerbated the decrease in proliferation and increase in apoptosis of VSMCs caused by H2O2 induction. Overexpression of miR-15b-5p reversed the H2O2-treated VSMC phenotypic changes caused by SNHG12 up-regulation, and overexpression of MYLK reversed the H2O2-treated VSMC phenotypic changes caused by up-regulation of miR-15b-5p. Overexpression of SNHG12 reduced blood pressure and ameliorated arterial histopathological damage and VSMC apoptosis in IA mice. The mechanical analysis uncovered that SNHG12 acted as an endogenous RNA that competed with miR-15b-5p, thus modulating the suppression of its endogenous target, MYLK.

Conclusion

Decreased expression of SNHG12 in IA may contribute to the increasing VSMC apoptosis via increasing miR-15b-5p expression and subsequently decreasing MYLK expression. These findings provide potential new strategies for the clinical treatment of IA.

方法通过RT-qPCR和Western blot检测IA患者组织样本中SNHG12、miR-15b-5p和MYLK的表达。用 H2O2 在体外培养人主动脉血管平滑肌细胞(VSMC)以模拟 IA 样条件,并通过 MTT 试验和 Annexin V/PI 染色测定细胞增殖和凋亡。通过诱导全身性高血压并注射弹性蛋白酶,建立了 IA 小鼠模型。评估各组小鼠尾动脉的血压,并通过 HE 染色和 TUNEL 染色观察动脉组织的病理变化。通过RT-qPCR和ELISA检测动脉组织中TNF-α和IL-1β、MCP-1、iNOS、caspase-3和caspase-9的表达。结果 在 IA 组织和 H2O2 处理的人主动脉 VSMCs 中,MYLK 和 SNHG12 的表达水平下调,miR-15b-5p 的表达水平上调。过表达 MYLK 或 SNHG12 可减轻 H2O2 诱导的 VSMC 增殖减少和凋亡增加,而过表达 miR-15b-5p 则会加剧 H2O2 诱导的 VSMC 增殖减少和凋亡增加。过表达 miR-15b-5p 逆转了 SNHG12 上调引起的 H2O2 处理 VSMC 表型变化,过表达 MYLK 逆转了 miR-15b-5p 上调引起的 H2O2 处理 VSMC 表型变化。过表达 SNHG12 可降低 IA 小鼠的血压,改善动脉组织病理学损伤和 VSMC 凋亡。机械分析发现,SNHG12 作为一种内源性 RNA 与 miR-15b-5p 竞争,从而调节了对其内源性靶标 MYLK 的抑制。这些发现为内脏癌的临床治疗提供了潜在的新策略。
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引用次数: 0
Platelet functions in lymphatic filariasis patients 淋巴丝虫病患者的血小板功能
IF 3.1 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-12-07 DOI: 10.1016/j.mvr.2023.104642
Sushil Surtani , Jyotsna Kailashiya , Mumtaz Ahmad Ansari , Debabrata Dash , Awadesh Kumar Yadav , Ashutosh Kumar

Filariasis is a chronic disease where parasitic worms survive in human hosts even for decades and lead to complications like lymphedema and elephantiasis. Despite the persistent existence of filarial parasites in human hosts, fatal and thrombotic complications are not known, unlike other parasitic diseases like malaria. This suggests that filarial parasites might be affecting the host's platelet functions. This study was conducted to examine platelet functions in confirmed filariasis patients and healthy controls. Results showed that filariasis patients had larger platelets, inhibited aggregation, and slower speed of aggregation, compared to controls. However, in vivo markers of platelet activation and degranulation (beta thromboglobulin and soluble P-selectin) were not affected. Observations suggested that there is increased platelet turnover, cellular apoptosis and inhibited platelet functions in filariasis patients compared to controls. Platelet function inhibition was not associated with the duration of disease, lymphedema-affected organs, or gender of patients. This study confirms that filarial parasites modulate platelet functions in human hosts.

丝虫病是一种慢性疾病,寄生虫在人类宿主体内存活甚至长达数十年,并导致淋巴水肿和象皮病等并发症。尽管丝虫在人类宿主体内持续存在,但与疟疾等其他寄生虫病不同的是,致命的血栓性并发症并不为人所知。这表明丝虫可能会影响宿主的血小板功能。本研究对确诊丝虫病患者和健康对照组的血小板功能进行了检测。结果显示,与对照组相比,丝虫病患者的血小板较大,聚集受到抑制,聚集速度较慢。然而,血小板活化和脱颗粒的体内标志物(β-血栓球蛋白和可溶性 P-选择素)并未受到影响。观察结果表明,与对照组相比,丝虫病患者的血小板周转、细胞凋亡增加,血小板功能受到抑制。血小板功能抑制与患者的病程、淋巴水肿影响器官或性别无关。这项研究证实,丝虫寄生虫会调节人类宿主的血小板功能。
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引用次数: 0
Revisiting hemodynamics and blood oxygenation in a microfluidic microvasculature replica 重新审视微流控微血管复制品中的血液动力学和血液含氧量
IF 3.1 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-12-07 DOI: 10.1016/j.mvr.2023.104640
Rui Dong , Sijia Liu , Yuewu Li , Fan Gao , Keqiang Gao , Chunxiao Chen , Zhiyu Qian , Weitao Li , Yamin Yang

The complexity of microvascular circulation has led to the development of advanced imaging techniques and biomimetic models. This study developed a multifaceted microfluidic-based microdevice as an in vitro model of microvasculature to replicate important geometric and functional features of in vivo perfusion in mice. The microfluidic device consisted of a microchannel for blood perfusion, mirroring the natural hierarchical branching vascular structures found in mice. Additionally, the device incorporated a steady gradient of oxygen (O2) which diffused through the polydimethylsiloxane (PDMS) layer, allowing for dynamic blood oxygenation. The assembled multi-layered microdevice was accompanied by a dual-modal imaging system that combined laser speckle contrast imaging (LSCI) and intrinsic signal optical imaging (ISOI) to visualize full-field blood flow distributions and blood O2 profiles. By closely reproducing in vivo blood perfusion and oxygenation conditions, this microvasculature model, in conjunction with numerical simulation results, can provide quantitative information on physiologically relevant hemodynamics and key O2 transport parameters that are not directly measurable in traditional animal studies.

微血管循环的复杂性促使人们开发先进的成像技术和生物仿真模型。本研究开发了一种基于微流体的多元微装置,作为微血管的体外模型,以复制小鼠体内灌注的重要几何和功能特征。该微流体装置由一个用于血液灌注的微通道组成,反映了小鼠体内自然的分层分支血管结构。此外,该装置还包含一个稳定的氧气(O2)梯度,通过聚二甲基硅氧烷(PDMS)层扩散,实现动态血液供氧。组装好的多层微型装置配有双模式成像系统,该系统结合了激光斑点对比成像(LSCI)和本征信号光学成像(ISOI),可观察到全场血流分布和血液中氧气的分布情况。通过密切再现体内血液灌注和氧合条件,该微血管模型与数值模拟结果相结合,可提供与生理相关的血液动力学和关键氧气传输参数的定量信息,而这些参数在传统的动物实验中是无法直接测量的。
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引用次数: 0
Goal-directed colloid versus crystalloid therapy and microcirculatory blood flow following ischemia/reperfusion 目标导向胶体与晶体治疗和缺血/再灌注后的微循环血流。
IF 3.1 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-12-02 DOI: 10.1016/j.mvr.2023.104630
Christoph R. Behem , Till Friedheim , Hannes Holthusen , Adina Rapp , Timo Suntrop , Michael F. Graessler , Hans O. Pinnschmidt , Sabine H. Wipper , Mirjam von Lucadou , Edzard Schwedhelm , Thomas Renné , Karin Pfister , Wilma Schierling , Constantin J.C. Trepte

Objective

Ischemia/reperfusion can impair microcirculatory blood flow. It remains unknown whether colloids are superior to crystalloids for restoration of microcirculatory blood flow during ischemia/reperfusion injury. We tested the hypothesis that goal-directed colloid – compared to crystalloid – therapy improves small intestinal, renal, and hepatic microcirculatory blood flow in pigs with ischemia/reperfusion injury.

Methods

This was a randomized trial in 32 pigs. We induced ischemia/reperfusion by supra-celiac aortic-cross-clamping. Pigs were randomized to receive either goal-directed isooncotic hydroxyethyl-starch colloid or balanced isotonic crystalloid therapy. Microcirculatory blood flow was measured using Laser-Speckle-Contrast-Imaging. The primary outcome was small intestinal, renal, and hepatic microcirculatory blood flow 4.5 h after ischemia/reperfusion. Secondary outcomes included small intestinal, renal, and hepatic histopathological damage, macrohemodynamic and metabolic variables, as well as specific biomarkers of tissue injury, renal, and hepatic function and injury, and endothelial barrier function.

Results

Small intestinal microcirculatory blood flow was higher in pigs assigned to isooncotic hydroxyethyl-starch colloid therapy than in pigs assigned to balanced isotonic crystalloid therapy (768.7 (677.2–860.1) vs. 595.6 (496.3–694.8) arbitrary units, p = .007). There were no important differences in renal (509.7 (427.2–592.1) vs. 442.1 (361.2–523.0) arbitrary units, p = .286) and hepatic (604.7 (507.7–701.8) vs. 548.7 (444.0–653.3) arbitrary units, p = .376) microcirculatory blood flow between groups. Pigs assigned to colloid – compared to crystalloid – therapy also had less small intestinal, but not renal and hepatic, histopathological damage.

Conclusions

Goal-directed isooncotic hydroxyethyl-starch colloid – compared to balanced isotonic crystalloid – therapy improved small intestinal, but not renal and hepatic, microcirculatory blood flow in pigs with ischemia/reperfusion injury. Whether colloid therapy improves small intestinal microcirculatory blood flow in patients with ischemia/reperfusion needs to be investigated in clinical trials.

目的:缺血/再灌注可损害微循环血流。在缺血/再灌注损伤中,胶体是否优于晶体恢复微循环血流,目前尚不清楚。我们验证了目标导向胶体治疗(与晶体治疗相比)改善缺血/再灌注损伤猪小肠、肾脏和肝脏微循环血流的假设。方法:32头猪随机试验。我们通过腹腔上主动脉交叉夹持诱导缺血/再灌注。猪随机接受定向等渗羟乙基淀粉胶体或平衡等渗晶体治疗。采用激光散斑对比成像技术测量微循环血流。主要终点是缺血/再灌注后小肠、肾脏和肝脏微循环血流4.5 h。次要结局包括小肠、肾脏和肝脏的组织病理学损伤、大血流动力学和代谢变量,以及组织损伤、肾脏和肝脏功能和损伤的特定生物标志物,以及内皮屏障功能。结果:采用等渗羟乙基淀粉胶体治疗的猪小肠微循环血流量高于采用平衡等渗晶体治疗的猪(768.7(677.2-860.1)比595.6(496.3-694.8)任意单位,p = .007)。肾脏(509.7(427.2-592.1)比442.1(361.2-523.0)任意单位,p = .286)和肝脏(604.7(507.7-701.8)比548.7(444.0-653.3)任意单位,p = .376)微循环血流组间无显著差异。与晶体治疗相比,接受胶体治疗的猪也有更少的小肠,但没有肾脏和肝脏的组织病理学损伤。结论:与平衡等渗晶体治疗相比,目标定向等渗羟乙基淀粉胶体治疗改善了缺血/再灌注损伤猪的小肠微循环血流,但没有改善肾脏和肝脏的微循环血流。胶体治疗是否能改善缺血/再灌注患者的小肠微循环血流,尚需临床试验研究。
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引用次数: 0
Corrigendum to: “Sodium butyrate and voluntary exercise through activating VEGF-A downstream signaling pathway improve heart angiogenesis in type 2 diabetes” is as follows: 48A, Auf dem Mühlberg, 60599 Frankfurt am Main [Microvasc. Res. Volume 147, May 2023, 104475] “丁酸钠和自愿运动通过激活VEGF-A下游信号通路改善2型糖尿病的心脏血管生成”的勘误如下:48A, Auf dem mhlberg, 60599 Frankfurt am Main [Microvasc]。[Res. Volume 147, May 2023, 104475]。
IF 3.1 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-11-29 DOI: 10.1016/j.mvr.2023.104628
Hassan Dariushnejad , Lale Pirzeh , Neda Roshanravan , Vajihe Ghorbanzadeh
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引用次数: 0
Quantitative evaluation of choroidal and retinal microvasculature post-alcohol consumption: A pilot study 酒精消费后脉络膜和视网膜微血管的定量评价:一项初步研究。
IF 3.1 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-11-19 DOI: 10.1016/j.mvr.2023.104629
Xuenan Zhuang , Guiqin He , Yunkao Zeng , Miaoling Li , Yongyue Su , Xuelin Chen , Yining Zhang , Yuhong Gan , Feng Wen , Xiongze Zhang

Purpose

The aim of this study was to assess the impact of acute, heavy alcohol consumption on the ocular microvasculature, providing insight into the largely unexplored response of microvascular structures to excessive drinking.

Methods

Healthy volunteers in this prospective pilot study were tasked with consuming spirits, wine, and water at different times. Alcohol intake was measured according to body weight (g/kg). The ocular microvascular parameters primarily including choroidal volume (CV) and choroidal vessel volume (CVV) reflecting arteriolovenularity, and choroidal capillary density (CCD) reflecting capillary, were evaluated using swept-source optical coherence tomography angiography at baseline and 0.5-, 1-, 2-, and 3-hour post-consumption.

Results

A total of 34 eyes underwent 170 successful examinations in this study. After consuming spirits or wine, we observed significant decreases in CV and CVV values (all P < 0.01 for 0.5-, 1-, 2-, and 3-hour post-consumption), along with significant increase in CCD (P < 0.05 at 0.5-, 1-, 2-hour post-spirits consumption and 1-hour post-wine consumption). The most pronounced changes occurred 1-hour after spirits or wine consumption (all P < 0.001 in both univariate and multivariate model). However, post-consumption changes in the ocular microvasculature showed no significant differences between spirits and wine (P > 0.05). Additionally, no significant differences were observed in any parameters after water intake (all P > 0.05).

Conclusions

Excessive alcohol consumption leads to ocular arteriolovenular vasoconstriction and capillary vasodilation, most evident 1-hour post-consumption of spirits and wine. Our research provides insight into alcohol's immediate ocular microvascular effects, hinting at systemic microvascular effects.

目的:本研究的目的是评估急性大量饮酒对眼部微血管的影响,为微血管结构对过量饮酒的反应提供深入了解。方法:在这项前瞻性先导研究中,健康志愿者被要求在不同时间饮用烈酒、葡萄酒和水。按体重(g/kg)测定酒精摄入量。眼底微血管参数主要包括脉络膜体积(CV)和脉络膜血管体积(CVV)反映动脉静脉,脉络膜血管密度(CCD)反映毛细血管,在基线和0.5小时,1小时,2小时和3小时后使用扫描源光学相干断层扫描血管造影评估。结果:本研究共成功检查34只眼170次。在饮用烈酒或葡萄酒后,我们观察到CV和CVV值显著降低(P均为  0.05)。此外,饮水后各项参数均无显著差异(P均为 > 0.05)。结论:过量饮酒可导致眼动静脉血管收缩和毛细血管舒张,且在饮酒后1小时最为明显。我们的研究揭示了酒精对眼部微血管的直接影响,暗示了对全身微血管的影响。
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引用次数: 0
Investigation of the effects of gestational diabetes and hypertension on retinal and choroidal microvascular circulation using swept-source optical coherence tomography angiography 利用扫描源光学相干断层扫描血管造影研究妊娠期糖尿病和高血压对视网膜和脉络膜微血管循环的影响。
IF 3.1 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-11-17 DOI: 10.1016/j.mvr.2023.104622
Mehmet Erkan Doğan , Çisil Erkan Pota

Purpose

The aim of this study was to investigate the microvascular changes in the retina and choroid in gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH) and to compare the results with those of healthy pregnant subjects.

Methods

Twenty-nine pregnant subjects with coexisting GDM and PIH (group 1) and 36 healthy pregnant subjects (group 2) were enrolled in the study. All subjects were examined by optical coherence tomography (OCT) and angiography (OCTA). The retina, retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), choroidal thickness (CT), superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris (CC) vascular density (VD), and foveal avascular zone (FAZ) were measured.

Results

We observed that the values of CT and VD were lower in group 1 than in group 2. No significant difference was found between groups in RT, FAZ area and CC VD. SCP and DCP VD values were higher in group 2 in all quadrants. We observed a significant increase in FAZ area and CC VD with increasing systolic blood pressure. No correlation was observed between diastolic blood pressure and FBS with other parameters. In group 1, FAZ area was significantly higher in the diet-treated group than in the insulin-treated group.

Conclusion

Monitoring and treatment of pregnant women with PIH and GDM is important because of the risks that may occur during pregnancy. We believe that changes in microvascular circulation can be detected noninvasively with OCTA, even in the absence of clinical or retinal findings.

目的:探讨妊娠期糖尿病(GDM)和妊娠高血压(PIH)患者视网膜和脉络膜微血管的变化,并与健康孕妇进行比较。方法:选取29例GDM合并PIH的孕妇(第一组)和36例健康孕妇(第二组)作为研究对象。所有受试者均行光学相干断层扫描(OCT)和血管造影(OCTA)检查。测量视网膜、视网膜神经纤维层(RNFL)、神经节细胞层(GCL)、脉络膜厚度(CT)、浅毛细血管丛(SCP)、深毛细血管丛(DCP)、绒毛膜毛细血管(CC)血管密度(VD)、中央凹无血管带(FAZ)。结果:1组CT、VD值均低于2组。两组间RT、FAZ面积及CC VD均无显著差异。各组SCP、DCP VD值均高于对照组。我们观察到FAZ面积和CC VD随收缩压升高而显著增加。舒张压、FBS与其他参数无相关性。在1组中,饮食治疗组FAZ面积显著高于胰岛素治疗组。结论:由于妊娠期间可能发生的风险,对妊高围和GDM孕妇进行监测和治疗非常重要。我们相信,即使在没有临床或视网膜发现的情况下,OCTA也可以无创地检测微血管循环的变化。
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引用次数: 0
Cerebral arterioles express the laminin subunits α4 and α5 in conjunction with α6β4 integrin, but strongly downregulate laminin α4 during hypoxia-induced arteriogenic remodeling 脑小动脉联合α6β4整合素表达层粘连蛋白亚基α4和α5,但在缺氧诱导的动脉重构过程中强烈下调层粘连蛋白α4。
IF 3.1 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2023-11-16 DOI: 10.1016/j.mvr.2023.104625
Arjun Sapkota, Sebok K. Halder, Richard Milner

Previous studies have shown that expression of the endothelial laminin receptor α6β4 integrin in the brain is uniquely restricted to arterioles. As exposure to chronic mild hypoxia (CMH, 8 % O2) stimulates robust angiogenic and arteriogenic remodeling responses in the brain, the goal of this study was to determine how CMH influences cerebrovascular expression of the β4 integrin as well as its potential ligands, laminin 411 and 511, containing the α4 and α5 laminin subunits respectively, and then define how aging impacts this expression. We observed the following: (i) CMH launched a robust arteriogenic remodeling response both in the young (10 weeks) and aged (20 months) brain, correlating with an increased number of β4 integrin+ vessels, (ii) while the laminin α4 subunit is expressed evenly across all cerebral blood vessels, laminin α5 was highly expressed preferentially on β4 integrin+ arterioles, (iii) CMH-induced arteriolar remodeling was associated with strong downregulation of the laminin α4 subunit but no change in the laminin α5 subunit, (iv) in addition to its expression on arterioles, β4 integrin was also expressed at lower levels on capillaries specifically in white matter (WM) tracts but not in the grey matter (GM), and (v), these observations were consistent in both the brain and spinal cord, and age had no obvious impact. Taken together, our findings suggest that laminin 511 may be a specific ligand for α6β4 integrin and that dynamic switching of the laminin subunits α4 and α5 might play an instructive role in arteriogenic remodeling. Furthermore, β4 integrin expression differentiates WM from GM capillaries, highlighting a novel and important difference.

先前的研究表明,内皮层粘连蛋白受体α6β4整合素在大脑中的表达仅局限于小动脉。由于暴露于慢性轻度缺氧(CMH, 8 % O2)会刺激大脑中强大的血管生成和动脉生成重塑反应,本研究的目的是确定CMH如何影响β4整合素及其潜在配体,层粘连蛋白411和511(分别由α4和α5层粘连蛋白亚基组成)的脑血管表达,然后确定衰老如何影响这种表达。我们观察到以下情况:(i) CMH在幼龄(10 周)和老年(20 个月)大脑中都启动了强大的动脉重构反应,与β4整合素+血管数量的增加相关;(ii)层粘连蛋白α4亚基在所有脑血管中均匀表达,层粘连蛋白α5优先在β4整合素+小动脉上高表达;(iii) CMH诱导的小动脉重构与层粘连蛋白α4亚基的强烈下调相关,但层粘连蛋白α5亚基没有变化。(iv)除了在小动脉上表达外,β4整合素在毛细血管上也有较低水平的表达,特别是在白质束(WM)中,而在灰质束(GM)中没有表达。(v)这些观察结果在脑和脊髓中都是一致的,年龄没有明显的影响。综上所述,我们的研究结果表明层粘连蛋白511可能是α6β4整合素的特异性配体,层粘连蛋白亚基α4和α5的动态切换可能在动脉重构中起指导作用。此外,β4整合素的表达将WM和GM毛细血管区分开来,突出了一个新的重要差异。
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引用次数: 0
期刊
Microvascular research
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