Where the Action Is—Leukocyte Recruitment in Atherosclerosis

Atherosclerosis is the leading cause of death worldwide and leukocyte recruitment is a key element of this phenomenon, thus allowing immune cells to enter the arterial wall. There, in concert with accumulating lipids, the invading leukocytes trigger a plethora of inflammatory responses which promote the influx of additional leukocytes and lead to the continued growth of atherosclerotic plaques. The recruitment process follows a precise scheme of tethering, rolling, firm arrest, crawling and transmigration and involves multiple cellular and subcellular players. This review aims to provide a comprehensive up-to-date insight into the process of leukocyte recruitment relevant to atherosclerosis, each from the perspective of endothelial cells, monocytes and macrophages, neutrophils, T lymphocytes and platelets. In addition, therapeutic options targeting leukocyte recruitment into atherosclerotic lesions—or potentially arising from the growing body of insights into its precise mechanisms—are highlighted.

Nanoparticle-Based Modification of the DNA Methylome: A Therapeutic Tool for Atherosclerosis?

Cardiovascular epigenomics is a relatively young field of research, yet it is providing novel insights into gene regulation in the atherosclerotic arterial wall. That information is already pointing to new avenues for atherosclerosis (AS) prevention and therapy. In parallel, advances in nanoparticle (NP) technology allow effective targeting of drugs and bioactive molecules to the vascular wall. The partnership of NP technology and epigenetics in AS is just beginning and promises to produce novel exciting candidate treatments. Here, we briefly discuss the most relevant recent advances in the two fields. We focus on AS and DNA methylation, as the DNA methylome of that condition is better understood in comparison with the rest of the cardiovascular disease field. In particular, we review the most recent advances in NP-based delivery systems and their use for DNA methylome modification in inflammation. We also address the promises of DNA methyltransferase inhibitors for prevention and therapy. Furthermore, we emphasize the unique challenges in designing therapies that target the cardiovascular epigenome. Lastly, we touch the issue of human exposure to industrial NPs and its impact on the epigenome as a reminder of the undesired effects that any NP-based therapy must avoid to be apt for secondary prevention of AS.

Enhancement of reflection and backscattering components by plane wave imaging for estimation of surface roughness

In the early stage of atherosclerosis, the luminal surface of the arterial wall becomes rough. Methods for distinguishing between the reflected and backscattered components in the ultrasonic echo from the arterial wall has the potential to be used as a method for assessment of the roughness of the arterial wall. In this study, we proposed a method to distinguish between the reflected and backscattered components using a technique based on plane wave compounding. This method was evaluated by experiments using planar phantoms with rough surfaces made of polyurethane rubber. The coefficient of variation calculated from the mean value of the reflection component and the standard deviation of the backscattering component was proportional to the roughness of the rubber phantom. This result shows the potential usefulness of this method for analyzing surface roughness of the arterial wall.

LPA Genotypes and Haplotypes Are Associated with Lipoprotein(a) Levels but Not Arterial Wall Properties in Stable Post-Coronary Event Patients with Very High Lipoprotein(a) Levels

Lipoprotein(a) [Lp(a)] levels are an independent risk factor for coronary artery disease (CAD). Two single-nucleotide polymorphisms (rs10455872, rs3798220) and number of KIV-2 repeats in the gene encoding Lp(a) (LPA) are associated with Lp(a) and CAD. Our aim was to investigate whether in patients with stable CAD and high Lp(a) levels these genetic variants are associated with increased Lp(a) and arterial wall properties. Blood samples underwent biochemical and genetic analyses. Ultrasound measurements for the functional and morphological properties of arterial wall were performed. Genotypes of rs10455872 and haplotypes AT and GT showed significant association with Lp(a) levels. Patients with GG showed significantly higher Lp(a) levels compared with those with AG genotype (2180 vs. 1391 mg/L, p = 0.045). Patients with no AT haplotype had significantly higher Lp(a) compared to carriers of one AT haplotype (2158 vs. 1478 mg/L, p = 0.023) or two AT haplotypes (2158 vs. 1487 mg/L, p = 0.044). There were no significant associations with the properties of the arterial wall. Lp(a) levels significantly correlated also with number of KIV-2 repeats (r = −0.601; p < 0.0001). In our patients, these two LPA polymorphisms and number of KIV-2 repeats are associated with Lp(a), but not arterial wall properties.

Chronic unilateral arm lymphedema correlates with increased intima-media thickness in the brachial artery

Summary: Drainage of the arterial wall via adventitial lymphatic vessels has been shown to play a pivotal role for vessel wall homeostasis. Also, retrograde cholesterol transport is ensured via this route, but no studies exist to demonstrate that lymphatic stasis would represent a mechanism to initiate atherosclerotic lesion formation in human arteries. To test this hypothesis, we embarked on a simple clinical experiment, assessing wall thickness in limb arteries with lymphedema after surgical intervention, with the contralateral limb serving as control. Using ultrasound imaging, the differential thickness was assessed separately for the three arterial wall layers. The potential of disease progression by lymphostasis was addressed by depiction of longitudinal results according to the time after lymph dissection.

Supraceliac aortic cross-clamping to control bleeding from the celiac axis during pancreatic surgery: a case report

Background Intraoperative bleeding from the celiac axis (CA) can occur during pancreatic surgery, and appropriate management is essential to avoid critical complications. Here, we have reported a case that was managed with supraceliac aortic cross-clamping (SAC) for arterial bleeding from the CA during pancreatic surgery. Case presentation A 70-year-old man was diagnosed with pancreatic cancer located in the pancreatic head and body. Preoperative computed tomography showed a stricture at the root of the CA, which may have been caused by a median arcuate ligament. Pancreaticoduodenectomy with division of the median arcuate ligament was scheduled. Uncontrollable bleeding from the root of the CA was observed during surgery. The bleeding was controlled by performing SAC, and a defect in the CA was confirmed. Arterial wall repair was successfully performed under temporal blood control using SAC. The aortic clamp time was 2 min and 51 s, and the intraoperative blood loss was 480 ml. Conclusions Although SAC is primarily a procedure for ruptured abdominal aortic aneurysm, it can be useful for the management of CA injuries during pancreatic surgery.

The Role of Calcification in the Pathogenesis of Inflammatory Reaction in the Arterial Wall (Exemplified by the Vessels of the Neck and Head in Adults)

Calcification provoked by inflammation accompanies many comorbid conditions (including atherosclerosis and fibromuscular dysplasia). What is more, they mutually aggravate each other. The aim of this study was to reveal the patterns of calcification of the arteries of the neck and head in patients with clinical manifestations of vascular disorders of varying severity in inflammatory and non-inflammatory diseases. Materials and methods. A total of 155 patients were examined (mean age 49.1 ± 16.3 years) using computed tomography. The subjects were divided into three groups according to the severity of functional changes in the arterial bed: 1) no vascular obstruction (n = 43); 2) arterial obstruction ≤ 50 % according to NASCET criteria (n = 55); 3) arterial obstruction > 50 % (n = 57). A visual analysis of atherosclerotic lesions of the vessels of the neck and head revealed that the calcification was a dystrophic type of intimal lesion in almost half of the cases (44 %). A visual analysis of stenosis caused by fibromuscular dysplasia showed that calcium deposition is not typical of this process. The absence of calcium phosphate deposition in this case was associated with genetic connective tissue abnormalities. Results. We created a flowchart representing the pathogenesis of artery wall calcification in chronic inflammation. In addition, we revealed previously not described in the literature links between the processes of osteoporosis, progression of biomineralization of atherosclerotic plaques, and decalcification of plaques, which allowed us to indirectly assess their degree of maturation. The results of the study indicate that artery calcification could be considered as a possible marker of the progression of atherosclerosis. For citation: Mal’kov O.A., Govorukhina A.A., Burykin Yu.G., Afineevskaya A.Yu. The Role of Calcification in the Pathogenesis of Inflammatory Reaction in the Arterial Wall (Exemplified by the Vessels of the Neck and Head in Adults). Journal of Medical and Biological Research, 2021, vol. 9, no. 4, pp. 435–443. DOI: 10.37482/2687-1491-Z081

Research Progress on the Relationship between Vascular Aging and Hypertension

Vascular aging refers to the structural and functional changes of the arterial wall with age. Vascular aging plays an important role in elderly diseases, such as hypertension. Therefore, the relationship between vascular aging and hypertension has attracted extensive attention. This article mainly reviews the mechanism of vascular aging and its influence on hypertension, so as to provide new ideas and directions for the research and prevention of hypertension.