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Platelet release of Vascular Endothelial Growth Factor (VEGF) in patients undergoing chemotherapy for breast cancer. 乳腺癌化疗患者血小板释放血管内皮生长因子(VEGF)
Pub Date : 2009-10-24 DOI: 10.1186/2040-2384-1-7
Cliona C Kirwan, Gerard J Byrne, Shant Kumar, Garry McDowell

Background: Venous thromboembolism (VTE) following breast cancer chemotherapy is common. Chemotherapy-induced alterations in markers of haemostasis occur during chemotherapy. In this study we investigated the changes in serum and plasma VEGF, together with platelet release of VEGF and related these to the development of VTE at 3 months.

Methods: Serum and plasma VEGF, together with platelet release of VEGF were measured prior to chemotherapy and at 24 hours; four-, eight days and three months following commencement of chemotherapy in early and advanced breast cancer patients and in age and sex matched controls. Duplex ultrasound imaging was performed after one month or if symptomatic.

Results: Of 123 patients 9.8% developed VTE within three months. Serum and plasma VEGF were increased in advanced breast cancer as was platelet release of VEGF. Prior to chemotherapy a 100 microg/ml increase in serum VEGF was associated with a 40% increased risk of VTE, while a 10 microg/ml increase in plasma VEGF was associated with a 20% increased risk of VTE. Serum VEGF showed a different response to chemotherapy in those who developed VTE.

Conclusion: A group of patients at risk of VTE could be identified, allowing targeted thromboprophylaxis. Whether or not the response in VEGF during chemotherapy has any angiogenic significance remains to be elucidated.

背景:乳腺癌化疗后静脉血栓栓塞(VTE)很常见。化疗引起的止血标志物的改变发生在化疗期间。在这项研究中,我们研究了血清和血浆中VEGF的变化,以及血小板中VEGF的释放,并将其与3个月时静脉血栓栓塞的发展联系起来。方法:测定化疗前和化疗后24h血清、血浆VEGF及血小板VEGF释放量;在化疗开始后的4、8天和3个月分别对早期和晚期乳腺癌患者以及年龄和性别匹配的对照组进行研究。术后1个月或出现症状时行双工超声显像。结果:123例患者中,9.8%在3个月内发生静脉血栓栓塞。晚期乳腺癌患者血清和血浆VEGF水平升高,血小板VEGF释放水平升高。化疗前,血清VEGF升高100微克/毫升与静脉血栓栓塞风险增加40%相关,而血浆VEGF升高10微克/毫升与静脉血栓栓塞风险增加20%相关。静脉血栓栓塞患者的血清VEGF对化疗的反应不同。结论:一组有静脉血栓栓塞风险的患者可以被识别,允许有针对性的血栓预防。化疗期间VEGF的反应是否有血管生成的意义还有待阐明。
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引用次数: 8
Welcome to Journal of Angiogenesis Research. 欢迎来到血管生成研究杂志。
Pub Date : 2009-09-21 DOI: 10.1186/2040-2384-1-1
Mark Slevin, Yihai Cao, Jan Kitajewski

Angiogenesis is the growth of new blood vessels and is a key process which occurs during both physiological and pathological disease processes. Knowledge of the mechanisms through which this process is initiated and maintained will have a significant impact on the treatment of these diseases. Pathological angiogenesis occurs in major diseases such as cancer, diabetic retinopathies, age-related macular degeneration and atherosclerosis. In other diseases such as stroke and myocardial infarction, insufficient or improper angiogenesis results in tissue loss and ultimately higher morbidity and mortality.

血管生成是新生血管的生长,是疾病生理和病理过程中的一个关键过程。了解这一过程的启动和维持机制将对这些疾病的治疗产生重大影响。病理性血管生成发生在癌症、糖尿病视网膜病变、年龄相关性黄斑变性和动脉粥样硬化等重大疾病中。在其他疾病中,如中风和心肌梗死,血管生成不足或不当导致组织损失,最终导致更高的发病率和死亡率。
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引用次数: 9
DCE-MRI assessment of the effect of vandetanib on tumor vasculature in patients with advanced colorectal cancer and liver metastases: a randomized phase I study. DCE-MRI评估vandetanib对晚期结直肠癌癌症和肝转移患者肿瘤血管系统的影响:一项随机I期研究。
Pub Date : 2009-09-21 DOI: 10.1186/2040-2384-1-5
Klaus Mross, Ulrike Fasol, Annette Frost, Robin Benkelmann, Jan Kuhlmann, Martin Büchert, Clemens Unger, Hubert Blum, Jürgen Hennig, Tsveta P Milenkova, Jean Tessier, Annetta D Krebs, Anderson J Ryan, Richard Fischer

Background: Vandetanib is a once-daily oral inhibitor of VEGFR, EGFR and RET signaling pathways. In patients with advanced colorectal cancer and liver metastases, the effect of vandetanib on tumor vasculature was assessed using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).

Methods: Eligible patients received vandetanib 100 or 300 mg/day. DCE-MRI (iAUC(60 )and K(trans)) was used to quantify the primary endpoints of tumor perfusion and vascular permeability. An exploratory assessment of tumor oxygenation was performed using MRI/T2*. All MRI parameters were measured at baseline (twice) and on days 2, 8, 29 and 57.

Results: Twenty-two patients received vandetanib (n = 10, 100 mg; n = 12, 300 mg). Baseline measurements of iAUC(60 )and K(trans )were reproducible, with low intrapatient coefficients of variation (11% and 24%, respectively). Estimates of mean % changes from baseline were -3.4% (100 mg) and -4.6% (300 mg) for iAUC(60), and -4.6% (100 mg) and -2.7% (300 mg) for K(trans); these changes were not significantly different between doses. The exploratory T2* measurement showed a significant increase at 300 mg versus 100 mg (P = 0.006). Both doses of vandetanib were generally well tolerated; common toxicities were fatigue, rash and diarrhea (majority CTC grade 1 or 2). The pharmacokinetic profile of vandetanib was similar to that observed previously. There were no RECIST-defined objective responses; five patients experienced stable disease >/=8 weeks.

Conclusion: In this study in patients with advanced colorectal cancer, vandetanib did not modulate gadolinium uptake in tumor vasculature and tissue measured by the DCE-MRI parameters iAUC(60 )and K(trans).

Trial registration: NCT00496509 (ClinicalTrials.gov); D4200C00050 (AstraZeneca).

背景:范德塔尼是VEGFR、EGFR和RET信号通路的每日一次口服抑制剂。在晚期癌症和肝转移患者中,使用动态对比增强磁共振成像(DCE-MRI)评估万代替尼对肿瘤血管系统的影响。DCE-MRI(iAUC(60)和K(trans))用于量化肿瘤灌注和血管通透性的主要终点。使用MRI/T2*对肿瘤氧合进行了探索性评估。在基线时(两次)以及第2、8、29和57天测量所有MRI参数。结果:22名患者接受了vandetanib(n=10100mg;n=12300mg)。iAUC(60)和K(反式)的基线测量是可重复的,患者体内变异系数较低(分别为11%和24%)。iAUC(60)与基线相比的平均百分比变化估计值分别为-3.4%(100 mg)和-4.6%(300 mg),K(反式)与基线的平均百分比分别为-4.6%(100 mg;这些变化在不同剂量之间没有显著差异。探索性T2*测量显示,与100mg相比,300mg时显著增加(P=0.006)。两种剂量的凡得替尼通常耐受性良好;常见的毒性是疲劳、皮疹和腹泻(大多数CTC为1或2级)。vandetanib的药代动力学特征与之前观察到的相似。没有RECIST定义的客观反应;5例患者病情稳定>/=8周。结论:在这项针对晚期癌症患者的研究中,通过DCE-MRI参数iAUC(60)和K(trans)测量,vandetanib不调节肿瘤血管系统和组织中钆的摄取。试验注册:NCT00496509(ClinicalTrials.gov);D4200C00050(阿斯利康)。
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引用次数: 53
CD105 positive neovessels are prevalent in early stage carotid lesions, and correlate with the grade in more advanced carotid and coronary plaques. CD105阳性新血管常见于早期颈动脉病变,并与晚期颈动脉和冠状动脉斑块的分级相关。
Pub Date : 2009-09-21 DOI: 10.1186/2040-2384-1-6
Ana Luque, Mark Slevin, Marta M Turu, Oriol Juan-Babot, Lina Badimon, Jerzy Krupinski

Background: Previous studies have demonstrated that expression of CD105 is a sensitive marker and indicator of endothelial cell/microvessel activation and proliferation in aggressive solid tumour growth and atherosclerotic plaque lesions. Since intimal neovascularization contributes significantly to subsequent plaque instability, haemorrhage and rupture.

Methods: We have used immunohistochemical analysis to investigate the expression of CD105-positive vessels in both large (carotid) and medium calibre (coronary and middle cerebral artery, MCAs) diseased vessels in an attempt to identify any correlation with plaque growth, stage and complication/type.

Results: Here we show, that carotid arteries expressed intimal neovascularization associated with CD105-positive endothelial cells, concomitant with increased inflammation in early stage lesions, preatheroma (I-III) whilst they were not present in coronary plaques of the same grade. Some of these CD105-positive neovessels were immature, thin walled and without smooth muscle cell coverage making them more prone to haemorrhage and rupture. In high-grade lesions, neovessel proliferation was similar in both arterial types and significantly higher numbers of CD105-positive vasa vasorum were associated with plaque regions in coronary arteries. In contrast, although the MCAs exhibited expanded intimas and established plaques, there were very few CD105 positive neovessels.

Conclusion: Our results show that CD105 is a useful marker of angiogenesis within adventitial and intimal vessels and suggest the existence of significant differences in the pathological development of atherosclerosis in separate vascular beds which may have important consequences when considering management and treatment of this disease.

背景:先前的研究表明,CD105的表达是侵袭性实体瘤生长和动脉粥样硬化斑块病变中内皮细胞/微血管激活和增殖的敏感标志物和指标。因为内膜新生血管对随后的斑块不稳定、出血和破裂起着重要的作用。方法:我们使用免疫组织化学分析来研究cd105阳性血管在大(颈动脉)和中口径(冠状动脉和大脑中动脉,MCAs)病变血管中的表达,试图确定其与斑块生长、分期和并发症/类型的关系。结果:在这里,我们发现颈动脉表达与cd105阳性内皮细胞相关的内膜新生血管,在早期病变、动脉粥样硬化前期(I-III)伴有炎症增加,而在相同级别的冠状动脉斑块中不存在炎症。其中一些cd105阳性的新血管不成熟,壁薄,没有平滑肌细胞覆盖,使它们更容易出血和破裂。在高级别病变中,两种动脉类型的新血管增殖相似,冠状动脉斑块区cd105阳性血管数量显著增加。相比之下,尽管mca表现出内膜扩张和斑块形成,但很少有CD105阳性的新血管。结论:我们的研究结果表明,CD105是血管外膜和内膜血管生成的有用标记物,表明动脉粥样硬化在不同血管床的病理发展存在显著差异,这可能在考虑该疾病的管理和治疗时具有重要意义。
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引用次数: 27
William Harvey and the discovery of the circulation of the blood. 威廉·哈维和血液循环的发现。
Pub Date : 2009-09-21 DOI: 10.1186/2040-2384-1-3
Domenico Ribatti

This Commentary emphasizes the fundamental contribution of William Harvey to the discovery of the circulation of the blood and his scientific and experimental approach to this matter.

本评论强调威廉·哈维对发现血液循环的基本贡献,以及他对这一问题的科学和实验方法。
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引用次数: 55
Controlling the angiogenic switch in developing atherosclerotic plaques: possible targets for therapeutic intervention. 控制动脉粥样硬化斑块形成中的血管生成开关:治疗干预的可能目标。
Pub Date : 2009-09-21 DOI: 10.1186/2040-2384-1-4
Mark Slevin, Jerzy Krupinski, Lina Badimon

Plaque angiogenesis may have an important role in the development of atherosclerosis. Vasa vasorum angiogenesis and medial infiltration provides nutrients to the developing and expanding intima and therefore, may prevent cellular death and contribute to plaque growth and stabilization in early lesions. However in more advanced plaques, inflammatory cell infiltration, and concomitant production of numerous pro-angiogenic cytokines may be responsible for induction of uncontrolled neointimal microvessel proliferation resulting in production of immature and fragile neovessels similar to that seen in tumour development. These could contribute to development of an unstable haemorrhagic rupture-prone environment. Increasing evidence has suggested that the expression of intimal neovessels is directly related to the stage of plaque development, the risk of plaque rupture, and subsequently, the presence of symptomatic disease, the timing of ischemic neurological events and myocardial/cerebral infarction. Despite this, there is conflicting evidence regarding the causal relationship between neovessel expression and plaque thrombosis with some in vivo experimental models suggesting the contrary and as yet, few direct mediators of angiogenesis have been identified and associated with plaque instability in vivo.In recent years, an increasing number of angiogenic therapeutic targets have been proposed in order to facilitate modulation of neovascularization and its consequences in diseases such as cancer and macular degeneration. A complete knowledge of the mechanisms responsible for initiation of adventitial vessel proliferation, their extension into the intimal regions and possible de-novo synthesis of neovessels following differentiation of bone-marrow-derived stem cells is required in order to contemplate potential single or combinational anti-angiogenic therapies. In this review, we will examine the importance of angiogenesis in complicated plaque development, describe the current knowledge of molecular mechanisms of its initiation and maintenance, and discuss possible future anti-angiogenic therapies to control plaque stability.

斑块血管生成可能在动脉粥样硬化的发展中起重要作用。血管血管新生和内侧浸润为内膜的发育和扩张提供营养,因此可以防止细胞死亡,并有助于斑块的生长和早期病变的稳定。然而,在更晚期的斑块中,炎症细胞浸润和伴随的大量促血管生成细胞因子的产生可能是诱导不受控制的内膜微血管增殖的原因,导致不成熟和脆弱的新血管的产生,类似于肿瘤发展中所见的情况。这些可能会导致不稳定的出血破裂环境的发展。越来越多的证据表明,内膜新生血管的表达与斑块发展的阶段、斑块破裂的风险以及随后出现的症状性疾病、缺血性神经事件和心肌/脑梗死的时间直接相关。尽管如此,关于新血管表达与斑块血栓形成之间的因果关系存在相互矛盾的证据,一些体内实验模型表明相反,迄今为止,很少有血管生成的直接介质被确定并与体内斑块不稳定相关。近年来,越来越多的血管生成治疗靶点被提出,以促进调节新生血管及其在癌症和黄斑变性等疾病中的后果。为了考虑潜在的单一或联合抗血管生成疗法,需要全面了解内皮血管增殖的启动机制,它们延伸到内膜区域,以及骨髓来源干细胞分化后新血管的可能重新合成。在这篇综述中,我们将探讨血管生成在复杂斑块发展中的重要性,描述其启动和维持的分子机制的现有知识,并讨论未来可能的抗血管生成疗法来控制斑块稳定性。
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引用次数: 57
Akt promotes endocardial-mesenchyme transition. Akt促进心内膜-间质转化。
Pub Date : 2009-09-21 DOI: 10.1186/2040-2384-1-2
Kafi N Meadows, Seema Iyer, Mark V Stevens, Duanning Wang, Sharon Shechter, Carole Perruzzi, Todd D Camenisch, Laura E Benjamin

Endothelial to mesenchyme transition (EndMT) can be observed during the formation of endocardial cushions from the endocardium, the endothelial lining of the atrioventricular canal (AVC), of the developing heart at embryonic day 9.5 (E9.5). Many regulators of the process have been identified; however, the mechanisms driving the initial commitment decision of endothelial cells to EndMT have been difficult to separate from processes required for mesenchymal proliferation and migration. We have several lines of evidence that suggest a central role for Akt signaling in committing endothelial cells to enter EndMT. Akt1 mRNA was restricted to the endocardium of endocardial cushions while they were forming. The PI3K/Akt signaling pathway is necessary for mesenchyme outgrowth, as sprouting was inhibited in AVC explant cultures treated with the PI3K inhibitor LY294002. Furthermore, endothelial marker, VE-cadherin, was downregulated and mesenchyme markers, N-cadherin and Snail, were induced in response to expression of a constitutively active form of Akt1 (myrAkt1) in endothelial cells. Finally, we isolated the function of Akt1 signaling in the commitment to the transition using a transgenic model where myrAkt1 was pulsed only in endocardial cells and turned off after EndMT initiation. In this way, we determined that increased Akt signaling in the endocardium drives EndMT and discounted its other functions in cushion mesenchymal cells.

在胚胎第9.5天(E9.5)心脏发育过程中,可以观察到心内膜向间质转化(EndMT),心内膜是房室管(AVC)的内皮衬里。已经确定了该过程的许多监管机构;然而,驱动内皮细胞向EndMT的初始承诺决定的机制很难与间质增殖和迁移所需的过程分开。我们有几条证据表明Akt信号在内皮细胞进入EndMT过程中起核心作用。在心内膜缓冲垫形成过程中,Akt1 mRNA局限于心内膜。PI3K/Akt信号通路是间质生长所必需的,因为PI3K抑制剂LY294002处理的AVC外植体培养物的发芽受到抑制。此外,内皮细胞标记物VE-cadherin下调,间充质标记物N-cadherin和Snail在内皮细胞中表达构成型活性Akt1 (myrAkt1)时被诱导。最后,我们使用转基因模型分离了Akt1信号在过渡过程中的功能,其中myrAkt1仅在心内膜细胞中被脉冲,并在EndMT启动后被关闭。通过这种方式,我们确定心内膜中Akt信号的增加驱动了EndMT,而忽略了它在缓冲间充质细胞中的其他功能。
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引用次数: 50
期刊
Journal of angiogenesis research
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