Case Reports: Bronchial Mucosal Vasculature Is Also Involved in the Acute Vascular Distress Syndrome of COVID-19

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which targets the pulmonary vasculature is supposed to induce an intrapulmonary right to left shunt with an increased pulmonary blood flow. We report here what may be, to the best of our knowledge, the first videoendoscopic descriptions of an hypervascularization of the bronchial mucosa in two patients hospitalized for coronavirus disease 2019 (COVID-19) pneumonia.Cases Presentation: Two patients, 27- and 37-year-old, were addressed to our Pneumology department for suspicion of COVID-19 pneumonia. Their symptoms (fever, dry cough, and dyspnoea), associated to pulmonary ground glass opacities on thoracic CT, were highly suggestive of a COVID-19 disease despite repeated negative pharyngeal swabs RT-PCR. In both patients, bronchoscopy examination using white light was unremarkable but NBI bronchoscopy revealed a diffuse hypervascularization of the mucosa from the trachea to the sub-segmental bronchi, associated with dilated submucosal vessels. RT-PCR performed in bronchoalveolar lavage (BAL) confirmed the presence of Sars-CoV-2.Conclusions: These two case reports highlight the crucial importance of the vascular component of the viral disease. We suggest that such bronchial hypervascularization with dilated vessels contributes, at least in part, to the intrapulmonary right to left shunt that characterizes the COVID-19 related Acute Vascular Distress Syndrome (AVDS). The presence of diffuse bronchial hypervascularization in the context of COVID-19 pandemic should prompt the search for Sars-CoV-2 in BAL samples.

Osteonecrosis of carpal bones in systemic sclerosis

Background. Systemic sclerosis (SSc) is a rare chronic disease, with unknown aetiology and complex pathogenesis. The hand is often implied in the main clinical findings, being affected primarily by the vascular component (Raynaud phenomenon, digital ulcers). One of the possible complications of the hand vasculopathy is osteonecrosis (ON) of the carpal bones. In these cases, the lunate is the most frequently affected, followed by the scaphoid. In the ON process, not only the vascular supply is important, but the nearby mechanical factors and anatomic variants of the wrist. Our objective was to reveal the most important aspects regarding the ON of the carpal bones in patients with SSc. Methods. A systematic literature review was performed through July 31, 2021 on Pubmed and Cochrane databases. The eligible articles were read in full text and were included in this paper, in the absence of exclusion criteria and after consensus between two reviewers. Results. Ten articles met the inclusion criteria, their main results being described in this review. In all studies, ON of the lunate and the scaphoid is associated with advanced SSc and severe Raynaud phenomenon. Conclusions. In conclusion, carpal ON is a rare complication of SSc, especially of the diffuse type. There is limited data on this condition, its prevalence being difficult to estimate due to the lack of symptoms.

Multimodal characterization of the murine neurovascular niche using a novel microvascular isolation protocol

The blood-brain barrier (BBB) is central to separate blood from the extracellular fluids of the brain. To understand disease-related changes in the BBB is pivotal and such changes can increasingly be studied by single-cell RNA sequencing (scRNAseq), which provides high-resolution insight into gene expression changes related to the pathophysiological response of the vasculature. However, analysis of the vascular cells in the brain is challenging due to the low abundance of these cells relative to neuronal and glial cells, and improved techniques for enrichment of the vascular component is therefore warranted. The present study describes a method whereby panning with CD31-coated magnetic beads allows isolation of brain vasculature without the need for transgenic reporter lines or FACS sorting. The protocol was tested in three modalities: isolation of cells for scRNAseq, western blot (WB) analysis, and primary cell culture. For scRNAseq, a total of 22,515 single-cell transcriptomes were generated from 12-months old mice and separated into 23 clusters corresponding to all known vascular and perivascular cell types. The most abundant cell type was endothelial cells (EC) (Pecam1- and Cdh5-positive), which dispersed into clusters of arterial, capillary, and venous EC according to previously established BBB arterio-venous zonation markers. Furthermore, we identified clusters of microglia (Aif1-positive), one cluster of fenestrated endothelial cells (Plvap-positive; Cldn5-negative), a cluster of pericytes (Kcnj8- and Abcc9-positive) and a cluster of vascular smooth muscle cells (VSMC) (Acta2- and Tagln-positive). WB analysis using established markers for the different cell types (CD31 (EC), SM22 (VSMC), PDGFRB (pericytes), GFAP (astrocytes), and IBA1 (microglia) confirmed their presence in the isolated vascular component and suggests that the protocol is suitable for future proteomic analysis. Finally, we adapted the isolation protocol to accommodate primary culture of brain vascular cells. In conclusion, we have successfully established a simple and fast method for isolating microvasculature from the murine brain independent of cell sorting and alleviating the need to use reporter mouse lines. The protocol is suitable for a multitude of testing modalities, including single-cell analyses, WB and primary cell culture.

BIOENERGY ASPECTS OF FUNCTIONING OF VENOUS WALL COMPONENTS (DEMONSTRATION MATERIALS OF STUDENTS AND YOUNG SCIENTISTS)

The subject of the study – the wall of the venous vessels of the skin. The purpose of the work is to provide demonstration and text materials of the significance of bioenergetic mechanisms of vascular wall components. The vascular component is an integral part of the pathogenesis of most dermatoses. At the same time, the bioenergetic aspects of cell function and the extracellular matrix of the vascular wall, especially venous ones, are still insufficiently taken into account, as they are the most vulnerable to inflammatory dermatoses.Key words: vascular wall components, demonstration materials.

Non Infiltrating Oral Angiolipoma – Report of A Rare Case with Review

The clinical presentation of typical lipomas is often characteristic. But the variations of lipoma based on the associated stroma poses a challenging picture with clinical diagnosis varying from benign tumors, various inflammatory and reactive lesions, salivary gland lesions, to few peripheral odontogenic lesions. Only a thorough clinical and pathological evaluation and correlation will help in arriving at a conclusive diagnosis, in understanding the behaviour, planning the treatment and predicting the prognosis of the lesion. One such case of lipoma presenting as an unassuming swelling clinically, but showing exuberant vascular component occurring on buccal mucosa is presented. A review of this variant of lipoma is discussed in comparison with the present case.

Endothelial glycocalyx in traumatic brain injury associated coagulopathy: potential mechanisms and impact

Traumatic brain injury (TBI) remains one of the leading causes of death and disability worldwide; more than 10 million people are hospitalized for TBI every year around the globe. While the primary injury remains unavoidable and not accessible to treatment, the secondary injury which includes oxidative stress, inflammation, excitotoxicity, but also complicating coagulation abnormalities, is potentially avoidable and profoundly affects the therapeutic process and prognosis of TBI patients. The endothelial glycocalyx, the first line of defense against endothelial injury, plays a vital role in maintaining the delicate balance between blood coagulation and anticoagulation. However, this component is highly vulnerable to damage and also difficult to examine. Recent advances in analytical techniques have enabled biochemical, visual, and computational investigation of this vascular component. In this review, we summarize the current knowledge on (i) structure and function of the endothelial glycocalyx, (ii) its potential role in the development of TBI associated coagulopathy, and (iii) the options available at present for detecting and protecting the endothelial glycocalyx.

Non-productive angiogenesis disassembles Aß plaque-associated blood vessels

The human Alzheimer’s disease (AD) brain accumulates angiogenic markers but paradoxically, the cerebral microvasculature is reduced around Aß plaques. Here we demonstrate that angiogenesis is started near Aß plaques in both AD mouse models and human AD samples. However, endothelial cells express the molecular signature of non-productive angiogenesis (NPA) and accumulate, around Aß plaques, a tip cell marker and IB4 reactive vascular anomalies with reduced NOTCH activity. Notably, NPA induction by endothelial loss of presenilin, whose mutations cause familial AD and which activity has been shown to decrease with age, produced a similar vascular phenotype in the absence of Aß pathology. We also show that Aß plaque-associated NPA locally disassembles blood vessels, leaving behind vascular scars, and that microglial phagocytosis contributes to the local loss of endothelial cells. These results define the role of NPA and microglia in local blood vessel disassembly and highlight the vascular component of presenilin loss of function in AD.

Adult-onset eccrineangiomatous hamartoma treated with excision and skin grafting: a case report

<p>Eccrine angiomatous hamartoma is a rare benign tumour like malformation characterized by intradermal proliferation of eccrine and vascular components. It usually arises before puberty but can occur at any age. It typically presents as a solitary or multiple reddish or brownish plaque or nodule that progressively enlarges in size. Symptoms such as pain and hyperhidrosis may be associated. Lesions are commonly located over distal extremities. We report a case of a 45-year-old lady who presented with a gradually enlarging solitary reddish plaque over the left retro-auricular region of the scalp since the last 12 years and associated with occasional pain. Histopathology revealed pproliferation of eccrine sweat glands and thin-walled blood vessels in the dermis. Additional ultrasound and MRI contrast studies were done to assess the vascular component and involvement of underlying structures. The patient was treated successfully with complete excision of the lesion followed by split thickness skin grafting.</p><p><strong> </strong></p>

Morphological features of the placenta in obese women

Hypothesis/Aims of study. Obesity and severe chronic somatic pathology in a woman leads to a rapid depletion of compensatory and adaptive reserves of the placenta and to the progression of circulatory and dystrophic changes, which causes intrauterine growth retardation and reduces the likelihood of a favorable course of pregnancy and childbirth. The aim of this study was to assess the morphological features of the vascular component of placental villi in obese women. Study design, materials and methods. Histological and immunohistochemical studies were conducted on 41 placentas from obese patients with and without gestational diabetes mellitus and from healthy patients, endothelial marker CD34+ expression being assessed in chorionic villi. Results. In obese patients, chronic placental insufficiency is presented in most cases as a dissociated form with persistence of not only mature but also immature villi, which indicates early structural pathology of the placenta. Conclusion. Obesity in women contributes to more frequent chronic placental insufficiency with severe circulatory disorders and varying degrees of severity of compensatory and adaptive changes.

COMBINED ACTION OF LOW-INTENSITY LASER RADIATION AND AUTOLOGOUS PLASMA WITH BLOOD CELLS ON THE MICROCIRCULATORY APPARATUS OF THE SKIN DURING INVOLUTION CHANGES

Инволюционные изменения кожи связаны с динамикой показателей его микроциркуляторного аппарата, среди которых выделены спастический, атонический и смешанный типы. Изучали комбинированное влияние низкоинтенсивного лазерного излучения и аутологичной плазмы с клетками крови на сосудистый компонент кожи. В свете восстановления микруциркуляторного аппарата кожи при различных типах анализировали клиническую эффективность проводимой терапии. Изучение эффективности комбинированного применения низкоинтенсивного лазерного излучения и аутологичной плазмы с клетками крови проводили на 57 пациентах с клиническими признаками инволюционного изменения кожи. В зависимости от типа микроциркуляторных изменений кожи все пациенты были разделены на три сопоставимые группы: 1-я - атонический тип ( n =24);2-я - спастический ( n =12); 3-я - смешанный ( n =21).Комплексная оценка динамики показателей микроциркуляции кожи, особенностей пассивного и активного кровотока свидетельствует о значимо выраженном положительном комбинированном влиянии низкоинтенсивного лазерного излучения и аутологичной плазмы с клетками крови у пациентов со спастическим типом микроциркуляции. Involutional changes of the skin are associated with changes in its microcirculatory apparatus, among which spastic, atonic and mixed types are distinguished. The effect of low-intensity laser radiation in combination with autologous plasma with blood cells on the vascular component of the skin was studied. In the light of the restoration of the microcirculatory apparatus of the skin in different types, the clinical efficacy of the therapy was analyzed. The study of the effectiveness of low-intensity laser radiation in combination with autologous plasma with blood cells was conducted in 57 patients with clinical signs of involutive skin changes. Depending on the type of microcirculatory skin changes, all patients were divided into 3 comparable groups: the 1- atonic type ( n =24), the 2- spastic ( n =12), the 3- mixed ( n =21).The obtained data of a complex assessment of the dynamics of skin microcirculation, features of passive and active blood flow, indicate a significant pronounced positive effect of low-intensity laser radiation in combination with autologous plasma with blood cells in patients with spastic type of microcirculation.