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Cxcl9 modulates aging associated microvascular metabolic and angiogenic dysfunctions in subcutaneous adipose tissue Cxcl9调节皮下脂肪组织中与衰老相关的微血管代谢和血管生成功能障碍
IF 9.2 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-02-11 DOI: 10.1007/s10456-025-09970-y
Xin Fu, Yu Zhao, Xiwei Cui, Siyuan Huang, Yanze Lv, Chen Li, Fuxing Gong, Zhigang Yang, Xiaonan Yang, Ran. Xiao

Microvascular aging, predominantly driven by endothelial cells (ECs) dysfunction, is a critical early event in cardiovascular diseases. However, the specific effects of aging on ECs across the microvascular network segments and the associated mechanisms are not fully understood. In this study, we detected a microvascular rarefaction and a decreased proportion of venular ECs in the subcutaneous adipose tissue of aged mice using light-sheet immunofluorescence microscopy and single-cell RNA sequencing. Moreover, aged ECs, especially in the venular subtype, exhibited a pseudotemporal transition to a terminal state characterized by diminished oxidative phosphorylation and strengthened cytokine signaling. Metabolic flux balance analysis predicted that among the 13 differentially expressed cytokines identified in aged EC subpopulations, Cxcl9 was strongly correlated with impaired oxidative phosphorylation in aged ECs. It was further validated using microvascular ECs treated with Cxcl9. Notably, the G protein-coupled receptor signaling pathway was subsequently suppressed, in which Aplnr suppression was also observed in aged ECs, contributing to their impaired energy metabolism and reduced angiogenesis. Based on these findings, we propose Cxcl9 as a biomarker for aging-related dysfunction of microvascular ECs, suggesting that targeting Cxcl9 signaling may help combat microvascular aging.

微血管老化主要由内皮细胞(ECs)功能障碍驱动,是心血管疾病的关键早期事件。然而,衰老对微血管网络段内皮细胞的具体影响及其相关机制尚不完全清楚。在这项研究中,我们使用薄层免疫荧光显微镜和单细胞RNA测序检测到老年小鼠皮下脂肪组织微血管稀薄和静脉内皮细胞比例减少。此外,衰老的内皮细胞,尤其是小静脉亚型,表现出以氧化磷酸化减少和细胞因子信号传导增强为特征的伪时间过渡到终端状态。代谢通量平衡分析预测,在老年EC亚群中发现的13种差异表达的细胞因子中,Cxcl9与老年EC中氧化磷酸化受损密切相关。用Cxcl9治疗微血管内皮细胞进一步验证了这一点。值得注意的是,G蛋白偶联受体信号通路随后被抑制,其中在老年ECs中也观察到Aplnr的抑制,导致其能量代谢受损和血管生成减少。基于这些发现,我们提出Cxcl9作为微血管内皮细胞衰老相关功能障碍的生物标志物,表明靶向Cxcl9信号传导可能有助于对抗微血管衰老。
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引用次数: 0
Correction: Neuropilin-1 controls vascular permeability through juxtacrine regulation of endothelial adherens junctions 更正:Neuropilin-1通过近肽调节内皮粘附连接来控制血管通透性
IF 9.2 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-02-04 DOI: 10.1007/s10456-024-09968-y
Sagnik Pal, Yangyang Su, Emmanuel Nwadozi, Lena Claesson-Welsh, Mark Richards
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引用次数: 0
The role of liver sinusoidal endothelial cells in metabolic dysfunction-associated steatotic liver diseases and liver cancer: mechanisms and potential therapies 肝窦内皮细胞在代谢功能障碍相关的脂肪变性肝病和肝癌中的作用:机制和潜在的治疗方法
IF 9.2 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-02-03 DOI: 10.1007/s10456-025-09969-5
Hanjun Mo, Pengfei Yue, Qiaoqi Li, Yinxi Tan, Xinran Yan, Xinyue Liu, Yuanwei Xu, Yingzhe Luo, Suruiya Palihati, Cheng Yi, Hua Zhang, Minlan Yuan, Biao Yang

Liver sinusoidal endothelial cells (LSECs), with their unique morphology and function, have garnered increasing attention in chronic liver disease research. This review summarizes the critical roles of LSECs under physiological conditions and in two representative chronic liver diseases: metabolic dysfunction-associated steatotic liver disease (MASLD) and liver cancer. Under physiological conditions, LSECs act as selective barriers, regulating substance exchange and hepatic blood flow. Interestingly, LSECs exhibit contrasting roles at different stages of disease progression: in the early stages, they actively resist disease advancement and help restore sinusoidal homeostasis; whereas in later stages, they contribute to disease worsening. During this transition, LSECs undergo capillarization, lose their characteristic markers, and become dysfunctional. As the disease progresses, LSECs closely interact with hepatocytes, hepatic stellate cells, various immune cells, and tumor cells, driving processes such as steatosis, inflammation, fibrosis, angiogenesis, and carcinogenesis. Consequently, targeting LSECs represents a promising therapeutic strategy for chronic liver diseases. Relevant therapeutic targets and potential drugs are summarized in this review.

肝窦内皮细胞(Liver sinusoidal endothelial cells, LSECs)以其独特的形态和功能在慢性肝病研究中受到越来越多的关注。本文综述了LSECs在生理条件下和两种代表性慢性肝脏疾病:代谢功能障碍相关脂肪变性肝病(MASLD)和肝癌中的关键作用。生理条件下,LSECs作为选择性屏障,调节物质交换和肝脏血流。有趣的是,LSECs在疾病进展的不同阶段表现出不同的作用:在早期阶段,它们积极抵抗疾病进展并帮助恢复正弦稳态;而在后期阶段,它们会导致疾病恶化。在这一转变过程中,LSECs经历毛细化,失去其特征标记,并变得功能失调。随着疾病的发展,LSECs与肝细胞、肝星状细胞、各种免疫细胞和肿瘤细胞密切相互作用,驱动脂肪变性、炎症、纤维化、血管生成和癌变等过程。因此,靶向LSECs是治疗慢性肝病的一种有前景的治疗策略。现就相关的治疗靶点及潜在药物作一综述。
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引用次数: 0
Clioquinol inhibits angiogenesis by promoting VEGFR2 degradation and synergizes with AKT inhibition to suppress triple-negative breast cancer vascularization Clioquinol通过促进VEGFR2降解抑制血管生成,并与AKT抑制协同抑制三阴性乳腺癌血管生成。
IF 9.2 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-02-03 DOI: 10.1007/s10456-024-09965-1
Yuan Gu, Tianci Tang, Moqin Qiu, Hongmei Wang, Emmanuel Ampofo, Michael D. Menger, Matthias W. Laschke

Inhibition of angiogenesis, either as monotherapy or in conjunction with other treatments, holds significant promise in cancer treatment. However, the limited efficacy of clinically approved anti-angiogenic agents underscores the urgent need for the development of novel drugs and therapeutic strategies. In this study, we demonstrate the highly selective inhibitory effects of clioquinol, a topical antifungal and antibiotic agent, on the angiogenic activity of endothelial cells (ECs) in a series of in vitro angiogenesis assays. Moreover, clioquinol effectively suppressed blood vessel formation in ex vivo aortic ring and in vivo Matrigel plug assays. Mechanistic studies revealed that clioquinol directly binds to the ATP-binding site of vascular endothelial growth factor receptor 2 (VEGFR2), promoting its degradation through both proteasome and lysosome pathways. This led to the down-regulation of the downstream extracellular signal-regulated kinase (ERK) pathway. In addition, the combination with the AKT inhibitor MK-2206 synergistically boosted the anti-angiogenic efficacy of clioquinol in vitro and in an in vivo dorsal skinfold chamber model of triple-negative breast cancer (TNBC), leading to the suppression of TNBC growth. Accordingly, clioquinol, either alone or in combination with AKT inhibitors, represents a promising therapeutic agent for future anti-angiogenic cancer treatment.

抑制血管生成,无论是作为单一疗法还是与其他疗法联合使用,在癌症治疗中都具有重要的前景。然而,临床批准的抗血管生成药物的有限疗效强调了迫切需要开发新的药物和治疗策略。在这项研究中,我们在一系列体外血管生成实验中证明了局部抗真菌和抗生素药物clioquinol对内皮细胞(ECs)血管生成活性的高度选择性抑制作用。此外,在体外主动脉环和体内基质塞实验中,氯喹诺可有效抑制血管形成。机制研究表明,氯喹诺直接结合血管内皮生长因子受体2 (VEGFR2)的atp结合位点,通过蛋白酶体和溶酶体途径促进其降解。这导致下游细胞外信号调节激酶(ERK)通路下调。此外,在体外和体内三阴性乳腺癌(TNBC)背侧皮肤褶室模型中,与AKT抑制剂MK-2206联合使用可协同提高氯喹诺的抗血管生成作用,从而抑制TNBC的生长。因此,无论是单独使用还是与AKT抑制剂联合使用,氯喹诺都是一种很有前景的抗血管生成癌症治疗药物。
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引用次数: 0
From bench to bedside: murine models of inherited and sporadic brain arteriovenous malformations 从实验台到床边:遗传性和散发性脑动静脉畸形的小鼠模型。
IF 9.2 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-02-03 DOI: 10.1007/s10456-024-09953-5
Ashely R. Ricciardelli, Gael Genet, Nafiisha Genet, Samuel T. McClugage III, Peter T. Kan, Karen K. Hirschi, Jason E. Fish, Joshua D. Wythe

Brain arteriovenous malformations are abnormal vascular structures in which an artery shunts high pressure blood directly to a vein without an intervening capillary bed. These lesions become highly remodeled over time and are prone to rupture. Historically, brain arteriovenous malformations have been challenging to treat, using primarily surgical approaches. Over the past few decades, the genetic causes of these malformations have been uncovered. These can be divided into (1) familial forms, such as loss of function mutations in TGF-β (BMP9/10) components in hereditary hemorrhagic telangiectasia, or (2) sporadic forms, resulting from somatic gain of function mutations in genes involved in the RAS-MAPK signaling pathway. Leveraging these genetic discoveries, preclinical mouse models have been developed to uncover the mechanisms underlying abnormal vessel formation, and thus revealing potential therapeutic targets. Impressively, initial preclinical studies suggest that pharmacological treatments disrupting these aberrant pathways may ameliorate the abnormal pathologic vessel remodeling and inflammatory and hemorrhagic nature of these high-flow vascular anomalies. Intriguingly, these studies also suggest uncontrolled angiogenic signaling may be a major driver in bAVM pathogenesis. This comprehensive review describes the genetics underlying both inherited and sporadic bAVM and details the state of the field regarding murine models of bAVM, highlighting emerging therapeutic targets that may transform our approach to treating these devastating lesions.

脑动静脉畸形是一种异常的血管结构,其中动脉将高压血液直接分流到静脉,而没有介入毛细血管床。随着时间的推移,这些病变变得高度重塑,并且容易破裂。从历史上看,脑动静脉畸形的治疗一直具有挑战性,主要采用手术方法。在过去的几十年里,这些畸形的遗传原因已经被发现。这些可分为(1)家族性形式,如遗传性出血型毛细血管扩张中TGF-β (BMP9/10)成分的功能突变缺失;或(2)散发性形式,由RAS-MAPK信号通路相关基因的体细胞功能突变获得引起。利用这些基因发现,临床前小鼠模型已经被开发出来,以揭示异常血管形成的机制,从而揭示潜在的治疗靶点。令人印象深刻的是,最初的临床前研究表明,破坏这些异常通路的药物治疗可能会改善这些高流量血管异常的异常病理性血管重塑和炎症和出血性质。有趣的是,这些研究还表明,不受控制的血管生成信号可能是bAVM发病机制的主要驱动因素。这篇全面的综述描述了遗传和散发性脑脊髓瘤的遗传学基础,并详细介绍了脑脊髓瘤小鼠模型的研究现状,强调了可能改变我们治疗这些破坏性病变方法的新兴治疗靶点。
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引用次数: 0
Anti-angiogenic therapy as potential treatment for adenomyosis 抗血管生成治疗作为子宫腺肌症的潜在治疗方法。
IF 9.2 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-01-25 DOI: 10.1007/s10456-024-09960-6
Marissa J. Harmsen, Lynda J. M. Juffermans, Muara O. Kroon, Arjan W. Griffioen, Judith A. F. Huirne

Adenomyosis is characterized by abnormal uterine bleeding, dysmenorrhea and subfertility. Increased expression of angiogenesis markers in adenomyosis presents a treatment opportunity and was studied in an adenomyosis mouse model. Mice were administered tamoxifen (1 mg/kg) on neonatal days 2–5. At six weeks of age, mice received oral treatment with axitinib 3 mg/kg (‘dose I/AX3’, n = 34), axitinib 25 mg/kg (‘dose II/AX25’ n = 34), or with vehicle-only (‘placebo’, n = 34). The prevalence and severity of adenomyosis were assessed. An adenomyosis severity index was calculated by multiplying mean grade/mouse by the percentage affected surface area. Angiogenesis-related gene expression was evaluated using real-time quantitative PCR. 101 mice completed adenomyosis induction and could be analyzed. The prevalence of adenomyosis was 30/33 (90.0%) in dose I, 29/34 (85.3%) in dose II, and 30/34 (88.2%) in placebo treated mice (p = 0.78). High grade (2/3) adenomyosis was significantly less prevalent in mice treated with axitinib dose II (n = 19, 55.9%) than in the placebo group (n = 27, 79.4%, p < 0.05). The adenomyosis severity index was reduced by 48% in the axitinib-treated groups (dose I, p < 0.05). The expression of angiogenic growth factors was reduced in the dose I and II axitinib-treated groups compared to the placebo-treated group. Following these promising first results, further research should focus on commonality among different angiostatic drugs, potential side effects, as well as the method and timing of application.

子宫腺肌症的特点是子宫异常出血,痛经和生育能力低下。在子宫腺肌症小鼠模型中,血管生成标记物的表达增加提供了治疗机会。小鼠在新生儿第2-5天给予他莫昔芬(1 mg/kg)。在6周龄时,小鼠接受口服阿西替尼3mg /kg(剂量I/AX3, n = 34)、阿西替尼25mg /kg(剂量II/AX25, n = 34)或仅给药(安慰剂,n = 34)。评估子宫腺肌症的患病率和严重程度。通过将平均等级/小鼠乘以受影响表面积百分比来计算子宫腺肌症严重性指数。实时定量PCR检测血管生成相关基因表达。101只小鼠完成子宫腺肌症诱导,可进行分析。第一剂量组子宫腺肌症患病率为30/33(90.0%),第二剂量组为29/34(85.3%),安慰剂组为30/34 (88.2%)(p = 0.78)。阿西替尼II剂量组高级别(2/3)子宫腺肌症发生率(n = 19, 55.9%)明显低于安慰剂组(n = 27, 79.4%, p
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引用次数: 0
Ref-1 is overexpressed in neovascular eye disease and targetable with a novel inhibitor Ref-1在新生血管性眼病中过度表达,可被一种新的抑制剂靶向
IF 9.2 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-01-05 DOI: 10.1007/s10456-024-09966-0
Anbukkarasi Muniyandi, Gabriella D. Hartman, Kamakshi Sishtla, Ratan Rai, Cátia Gomes, Kristina Day, Yang Song, Andi R. Masters, Sara K. Quinney, Xiaoping Qi, Hailey Woods, Michael E. Boulton, Jason S. Meyer, Jonah Z. Vilseck, Millie M. Georgiadis, Mark R. Kelley, Timothy W. Corson

Reduction–oxidation factor-1 or apurinic/apyrimidinic endonuclease 1 (Ref-1/APE1) is a crucial redox-sensitive activator of transcription factors such as NF-κB, HIF-1α, STAT-3 and others. It could contribute to key features of ocular neovascularization including inflammation and angiogenesis; these underlie diseases like neovascular age-related macular degeneration (nAMD). We previously revealed a role for Ref-1 in the growth of ocular endothelial cells and in choroidal neovascularization (CNV). Here, we set out to further explore Ref-1 in neovascular eye disease. Ref-1 was highly expressed in human nAMD, murine laser-induced CNV and Vldlr−/− mouse subretinal neovascularization (SRN). Ref-1’s interaction with a redox-specific small molecule inhibitor, APX2009, was shown by NMR and docking. This compound blocks crucial angiogenic features in multiple endothelial cell types. APX2009 also ameliorated murine laser-induced choroidal neovascularization (L-CNV) when delivered intravitreally. Moreover, systemic APX2009 reduced murine SRN and downregulated the expression of Ref-1 redox regulated HIF-1α target carbonic anhydrase 9 (CA9) in the Vldlr−/− mouse model. Our data validate the redox function of Ref-1 as a critical regulator of ocular angiogenesis, indicating that inhibition of Ref-1 holds therapeutic potential for treating nAMD.

还原氧化因子-1或无嘌呤/无嘧啶内切酶1 (Ref-1/APE1)是NF-κB、HIF-1α、STAT-3等转录因子的重要氧化还原敏感激活因子。它可能有助于眼部新生血管的关键特征,包括炎症和血管生成;这些潜在疾病如新生血管性年龄相关性黄斑变性(nAMD)。我们之前揭示了Ref-1在眼内皮细胞生长和脉络膜新生血管(CNV)中的作用。在这里,我们开始进一步探索Ref-1在新生血管性眼病中的作用。Ref-1在人的nAMD、小鼠激光诱导的CNV和Vldlr - / -小鼠视网膜下新生血管(SRN)中高度表达。Ref-1与氧化还原特异性小分子抑制剂APX2009的相互作用经核磁共振和对接证实。该化合物阻断多种内皮细胞类型的血管生成特征。APX2009也改善了小鼠激光诱导的脉络膜新生血管(L-CNV)。此外,在Vldlr - / -小鼠模型中,系统性APX2009降低了小鼠SRN,下调了Ref-1氧化还原调控的HIF-1α靶碳酸酐酶9 (CA9)的表达。我们的数据验证了Ref-1作为眼部血管生成的关键调节因子的氧化还原功能,表明抑制Ref-1具有治疗nAMD的治疗潜力。
{"title":"Ref-1 is overexpressed in neovascular eye disease and targetable with a novel inhibitor","authors":"Anbukkarasi Muniyandi,&nbsp;Gabriella D. Hartman,&nbsp;Kamakshi Sishtla,&nbsp;Ratan Rai,&nbsp;Cátia Gomes,&nbsp;Kristina Day,&nbsp;Yang Song,&nbsp;Andi R. Masters,&nbsp;Sara K. Quinney,&nbsp;Xiaoping Qi,&nbsp;Hailey Woods,&nbsp;Michael E. Boulton,&nbsp;Jason S. Meyer,&nbsp;Jonah Z. Vilseck,&nbsp;Millie M. Georgiadis,&nbsp;Mark R. Kelley,&nbsp;Timothy W. Corson","doi":"10.1007/s10456-024-09966-0","DOIUrl":"10.1007/s10456-024-09966-0","url":null,"abstract":"<div><p>Reduction–oxidation factor-1 or apurinic/apyrimidinic endonuclease 1 (Ref-1/APE1) is a crucial redox-sensitive activator of transcription factors such as NF-κB, HIF-1α, STAT-3 and others. It could contribute to key features of ocular neovascularization including inflammation and angiogenesis; these underlie diseases like neovascular age-related macular degeneration (nAMD). We previously revealed a role for Ref-1 in the growth of ocular endothelial cells and in choroidal neovascularization (CNV). Here, we set out to further explore Ref-1 in neovascular eye disease. Ref-1 was highly expressed in human nAMD, murine laser-induced CNV and <i>Vldlr</i><sup>−/−</sup> mouse subretinal neovascularization (SRN). Ref-1’s interaction with a redox-specific small molecule inhibitor, APX2009, was shown by NMR and docking. This compound blocks crucial angiogenic features in multiple endothelial cell types. APX2009 also ameliorated murine laser-induced choroidal neovascularization (L-CNV) when delivered intravitreally. Moreover, systemic APX2009 reduced murine SRN and downregulated the expression of Ref-1 redox regulated HIF-1α target carbonic anhydrase 9 (CA9) in the <i>Vldlr</i><sup>−/−</sup> mouse model. Our data validate the redox function of Ref-1 as a critical regulator of ocular angiogenesis, indicating that inhibition of Ref-1 holds therapeutic potential for treating nAMD.</p></div>","PeriodicalId":7886,"journal":{"name":"Angiogenesis","volume":"28 1","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142925515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
A novel quantitative angiogenesis assay based on visualized vascular organoid 一种基于可视化血管类器官的新型定量血管生成实验
IF 9.2 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-01-03 DOI: 10.1007/s10456-024-09967-z
Yun Zhao, Mengze Sun, Zihang Pan, Weijing Kong, Zixuan Hong, Wei Zhang, Bingbing Sun, Jingjing Zhang, Xi Wang, Kai Wang

Angiogenesis describes the sprouting of blood vessels from existing vasculatures and it plays a pivotal role in disease progress such as diabetes, age-related macular degeneration and cancer. However, the most widely used anti-angiogenic agents targeting vascular endothelial growth factor (VEGF) pathway still lacked of specificity and therapeutic efficacy. To establish a method suitable for high-throughput drug screening and faithfully recapitulate the feature of in vivo angiogenesis, we generated a PECAM1-mRuby3-secNluc; ACTA2-EGFP dual reporter human pluripotent stem cell (hPSC) line and utilizing the cell line to establish a visualized and quantifiable in vitro angiogenesis model with stem cell-derived vascular organoid. Using this method, we evaluated the anti-angiogenic effect of VEGFR inhibitor and efficiently identified several potential candidates of pro- and anti-angiogenic therapy via bioluminescence-based quantification. Overall, our study provides a valuable platform for in vitro drug screenings.

血管生成是指血管从现有的血管系统中发芽,它在糖尿病、年龄相关性黄斑变性和癌症等疾病的进展中起着关键作用。然而,目前应用最广泛的靶向血管内皮生长因子(VEGF)通路的抗血管生成药物仍缺乏特异性和治疗效果。为了建立一种适合于高通量药物筛选的方法,并忠实地再现体内血管生成的特征,我们生成了PECAM1-mRuby3-secNluc;ACTA2-EGFP双报告细胞人多能干细胞(hPSC)系,并利用该细胞系建立可视化、可量化的干细胞衍生血管类器官体外血管生成模型。利用这种方法,我们评估了VEGFR抑制剂的抗血管生成作用,并通过基于生物发光的量化有效地确定了几种潜在的促血管生成和抗血管生成治疗候选药物。总之,我们的研究为体外药物筛选提供了一个有价值的平台。
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引用次数: 0
Effect of oral nintedanib vs placebo on epistaxis in hereditary hemorrhagic telangiectasia: the EPICURE multicenter randomized double-blind trial 口服尼达尼布与安慰剂对遗传性出血性毛细血管扩张患者鼻出血的影响:EPICURE多中心随机双盲试验
IF 9.2 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-12-24 DOI: 10.1007/s10456-024-09962-4
Ruben Hermann, Vincent Grobost, Xavier Le-Guillou, Christian Lavigne, Antoine Parrot, Sophie Rivière, Julie Séguier, Anne-Emmanuelle Fargeton, Aurélie de-Montigny, Margaux Huot, Evelyne Decullier, Adeline Roux, Caroline Gervaise, César Cartier, Xavier Dufour, Margaux Grall, Frank Jegoux, Laurent Laccourreye, Justin Michel, Nicolas Saroul, Isabelle Wagner, Mallorie Kerjouan, Sophie Dupuis-Girod

Epistaxis greatly affects patients with hereditary hemorrhagic telangiectasia (HHT). Although few systemic treatment exist, nintedanib, is a good candidate thanks to its anti-angiogenic activity. Our main objective was to evaluate the efficacy of oral nintedanib on epistaxis duration in HHT patients with moderate to severe epistaxis. This multicenter phase 2 randomized, placebo-controlled, double-blind trial was conducted between June 2020 and February 2023. Inclusion criteria were being over 18 years old and having a confirmed HHT diagnosis with an epistaxis severity score greater than 4. Sixty patients were randomized to receive either nintedanib or placebo for 12 weeks with a 12 week follow-up. The primary endpoint was the proportion of patients achieving a reduction of at least 50% in mean monthly epistaxis duration comparing the 8 weeks before treatment to the last 8 weeks of treatment. Main secondary outcomes included monthly duration and frequency of epistaxis and hemoglobin levels. Of the 60 randomized patients, 56 completed the trial. Thirteen patients (43%) in the nintedanib group vs 8 (27%) in the placebo group met the primary endpoint (p = 0.28). We observed a significant decrease in median epistaxis (57% vs 27%, p = 0.013) and a significant increase in median hemoglobin levels (+ 18 vs − 1 g/L, p = 0.02) in the nintedanib vs the placebo group. Although we did not achieve our primary outcome, we observed a significant reduction in epistaxis duration and a significant increase in hemoglobin levels in patients treated with nintedanib. This supports the efficacy of nintedanib, and further studies are needed.

鼻衄严重影响遗传性出血性毛细血管扩张(HHT)患者。虽然很少有全身治疗存在,尼达尼布,是一个很好的候选人,由于其抗血管生成活性。我们的主要目的是评估口服尼达尼布对中度至重度鼻出血HHT患者鼻出血持续时间的疗效。这项多中心2期随机、安慰剂对照、双盲试验于2020年6月至2023年2月进行。纳入标准为18岁以上,确诊HHT且鼻出血严重程度评分大于4分。60名患者随机接受尼达尼布或安慰剂治疗12周,随访12周。主要终点是治疗前8周与治疗后8周相比,平均每月鼻出血持续时间减少至少50%的患者比例。主要次要结局包括出血的月持续时间、频次和血红蛋白水平。在60名随机患者中,56名完成了试验。尼达尼布组13例(43%)患者达到主要终点,安慰剂组8例(27%)患者达到主要终点(p = 0.28)。我们观察到,与安慰剂组相比,尼达尼布组中位鼻出血显著减少(57% vs 27%, p = 0.013),中位血红蛋白水平显著增加(+ 18 vs - 1 g/L, p = 0.02)。虽然我们没有达到我们的主要结局,但我们观察到接受尼达尼布治疗的患者鼻出血持续时间显著减少,血红蛋白水平显著升高。这支持了尼达尼布的有效性,需要进一步的研究。
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引用次数: 0
Circulating endothelial cells: a key biomarker of persistent fatigue after hospitalization for COVID-19 循环内皮细胞:COVID-19住院后持续疲劳的关键生物标志物
IF 9.2 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-12-20 DOI: 10.1007/s10456-024-09959-z
David M. Smadja, Sven Günther, Pauline Cavagna, Bertrand Renaud, Dominique Salmon, Bertrand Hermann, Brigitte Ranque, Cédric Lemogne, Jean-Luc Diehl, Aurélien Philippe
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引用次数: 0
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Angiogenesis
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