Lower extremity arteriosclerosis obliterans (LEASO) is a vascular disease that may result in adult limb loss worldwide. CD4[+]T cell-mediated immunity plays a significant role in LEASO. The T cell immunoglobulin and mucin domain 3 (Tim-3) and inhibitory receptor programmed cell death-1 (PD-1) are well-known immune checkpoints that play crucial roles in regulating CD4[+]T cell activation or tolerance. In this study, blood mononuclear cells were isolated from the blood samples of healthy controls and patients who were diagnosed with LEASO for the first time [stage III or IV according to the Fontaine classification system and had not received drugs (except for heparin) or surgery treatment]. We concluded the higher proportion of Tim-3[+]PD-1[+]CD4[+]T cells in human higher stage LEASO, and oxidized low-density lipoprotein increased Tim-3 and PD-1 co-expression by activating CD4[+]T cells in a dose- dependent manner. Tim-3[+]PD-1[+]CD4[+]T cells displayed a more active status and produced more anti-atherogenic cytokines compared to Tim-3[-]PD-1[-]CD4[+]T cells. Apart from the increased frequency, the altered function of Tim-3[+]PD-1[+]CD4[+]T cells was also observed in LEASO compared to those from healthy controls. These in vitro results indicated that Tim-3 and PD-1 might be promising early warning targets of higher stage LEASO. In addition, the blockade of Tim-3 and PD-1 signaling pathways aggravated the pro-atherogenic Th1 responses in LEASO, further suggesting that the cardiovascular safety must be a criterion considered in using immune checkpoint inhibitors to reverse T cell exhaustion during tumors and chronic viral infections.

BACKGROUND:

Arteriosclerosis can be reflected in various aspect of the artery, including atherosclerotic plaque formation or stiffening on the arterial wall. Both arteriosclerosis and atherosclerosis are important and closely associated with cardiovascular disease (CVD). The aim of the study was to evaluate the association between systemic arteriosclerosis and multi-site atherosclerotic plaques.

METHODS:

The study was designed as an observational cross-sectional study. A total of 1178 participants (mean age 67.4 years; 52.2% male) enrolled into the observational study from 2010 to 2017. Systemic arteriosclerosis was assessed by carotid femoral artery pulse wave velocity (CF-PWV) and multi-site atherosclerotic plaques (MAP, > = 2 of the below sites) were reflected in the carotid or subclavian artery, abdominal aorta and lower extremities arteries using ultrasound equipment. The associations were assessed by multivariable logistic regression.

RESULTS:

The prevalence of CF-PWV > 12 m/s and MAP were 40.2% and 74.4%. Atherosclerotic plaques in 3 sites were more common in male compared with that in female (48.9% versus 36.9%, p < 0.05). All CVD factors were worse in participants with MAP than that with <=1 site. Participants with CF-PWV > 12 m/s corresponded to a mean 82% probability of MAP with age and sex-adjusted. Patients with peripheral artery disease showed the highest odds ratio (OR) (3.88) for MAP, followed by smoking (2.485), CF-PWV > 12 m/s (2.25), dyslipidemia (1.89), male (1.84), stroke (1.64), hypoglycemic agents (1.56) and age (1.09) (all p < 0.001).

CONCLUSIONS:

MAP was highly prevalent in this cohort, with male showing a higher prevalence than female. Higher systemic arteriosclerosis was independently associated with MAP, which indicating the supplementary value of arteriosclerosis for the earlier identification and intervention on MAP.

TRIAL REGISTRATION:

Clinical Trial

, URL:

http://www.clinicaltrials.gov . Unique identifier: NCT02569268 .

OBJECTIVE:

To evaluate the effectiveness and safety of Ginkgo biloba extract (GBE50) in the treatment of dizziness caused by cerebral arteriosclerosis.

METHODS:

This was a multi-center, double-blind, double-dummy, positive-controlled, parallel randomized controlled clinical trial with 1? allocation. We recruited 404 patients with dizziness caused by cerebral arteriosclerosis (blood stasis symptom pattern) in 10 hospitals in China. GBE50 group received GBE50 and Naoxinqing tablet (NXQ) of mimetic agent, control group received NXQ and GBE50 of mimetic agent. The main outcome was Traditional Chinese Medicine (TCM) symptom pattern score of blood stasis after 6 weeks. The secondary outcomes were changes in the dizziness handicap inventory (DHI) score, vertigo visual analogue scale (VAS) score, the university of California vertigo questionnaire (UCLA-DQ) score and single-item symptom score of TCM from baseline to 2, 4 and 6 weeks. Safety indicators included the incidence of adverse events, severe adverse events and laboratory examination including blood routine, liver function, renal function, and so forth.

RESULTS:

The total effective rate of TCM symptom pattern score in the GBE50 group after 6 weeks of treatment was higher than that in the control group, the difference in rate was statistically significant (92.67% vs 83.07%, P = 0.004). Compared with the control group, there was no difference in the incidence of adverse reactions (9.95% vs 14.85%, P = 0.136).

CONCLUSION:

The treatment of dizziness caused by cerebral arteriosclerosis with GBE50 is effective, safe and reliable.

Objective: To observe the effects of high-flux haemodialysis (HFSD) on fibroblast growth factor 23 (FGF23) levels, calcium and phosphorus metabolism disorders, arteriosclerosis, and cardiac function in patients with end-stage renal disease (ESRD), and further clarify the advantages of HFSD in reducing the complications of ESRD. Methods: Sixty renal failure patients who underwent haemodialysis in our department of nephrology from October 2015 to October 2016 were randomly divided into the observation group and control group, with 30 cases in each group. The patients in the control group were given basic treatment and routine haemodialysis and the patients in the observation group underwent basic treatment and high-throughput haemodialysis. The changes in the FGF23 levels and the related indexes after two, four, and six months of treatment were observed. The carotid intima-media thickness (cIMT) and left ventricular ejection fraction (LVEF) before dialysis treatment and dialysis were observed. Results: After dialysis was completed, the serum P3+ concentration of the two groups was lower than that before treatment, and the serum Ca2+ concentration was negatively correlated with the P3+ concentration. In the second month of dialysis, the serum Ca2+ and P3+ concentrations in the two groups were not significantly changed. In the fourth and sixth months of dialysis, the serum P3+ concentration of the observation group was better than that of the control group, and the serum Ca2+ concentration was better than the control group, the difference was statistically significant (P<0.05). In the second, fourth, and sixth months of the dialysis, the serum FGF23 concentration in the observation group was significantly lower than that in the control group, which was statistically significant (P<0.05). The cIMT and LVEF were lower in both groups after dialysis, and the observation group was superior to the control group (P<0.05). Conclusion: In patients with ESRD, HFHD can eliminate FGF23, correct calcium and phosphorus metabolism disorders, improve arteriosclerosis, and can improve cardiac function.

INTERVENTION:

The volunteer were given an 12‐week treatment with oral administration of bifidobacteria LKM512 powder (10 billion bacterial cells/package) two times per day. The volunteer were given an 12‐week treatment with oral administration of placebo powder without bifidobacteria LKM512 two times per day.

CONDITION:

Patients with high levels of serum triglyceride

PRIMARY OUTCOME:

Inflammation‐related markers (CoQ10, adiponectine, ICAM‐a, TNF‐alpha, s‐LOX, LAB)

INCLUSION CRITERIA:

Outpatients whose serum triglyceride level is 100 to 250 mg/dL

Introduction: Endothelial dysfunction is an early step in the atherosclerotic process and can be quantified by flow‐mediated vasodilation (FMD). Our aim was to investigate the effect of long‐term rosuvastatin therapy on endothelial function in patients with inflammatory joint diseases (IJD) with established atherosclerosis. Furthermore, to evaluate correlations between change in FMD (DELTAFMD) and change in carotid plaque (CP) height, arterial stiffness [aortic pulse wave velocity (aPWV) and augmentation index (AIx)], lipids, disease activity and inflammation. Methods: Eighty‐five statin‐naive patients with IJD and ultrasound‐verified CP (rheumatoid arthritis: n = 53, ankylosing spondylitis: n = 24, psoriatic arthritis: n = 8) received rosuvastatin treatment for 18 months. Paired‐samples t tests were used to assess DELTAFMD from baseline to study end. Linear regression models were applied to evaluate correlations between DELTAFMD and cardiovascular risk factors, rheumatic disease variables and medication. Results: The mean +/‐ SD FMD was significantly improved from 7.10 +/‐ 3.14 % at baseline to 8.70 +/‐ 2.98 % at study end (p < 0.001). Improvement in AIx (p < 0.05) and CP height reduction (p = 0.001) were significantly associated with DELTAFMD (dependent variable). Conclusions: Long‐term lipid lowering with rosuvastatin improved endothelial function in IJD patients with established atherosclerotic disease. Reduced arterial stiffness and CP regression were longitudinally correlated with the improvement in endothelial function measured by FMD. Trial registration: ClinicalTrials.gov NCT01389388. Registered 16 April 2010.

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INTERVENTION:

Ingestion of 35g of paste made from "Kishu plum treated with superheated steam" daily for 12 weeks. Ingestion of 35g of "pickled plum" paste daily for 12 weeks.

CONDITION:

Healthy adults

PRIMARY OUTCOME:

Arteriosclerosis Index, TC, LDL‐C, HDL‐C and TG at 4, 8 and 12 weeks after the beginning of ingestion of test meals.

SECONDARY OUTCOME:

oxo‐LDL, TBARS, VAS questionnaire for lassitude and defecation, frequency of bowel movement, body composition (BW, BFR, BMI)

INCLUSION CRITERIA:

1. Subjects whose arteriosclerosis index is >=1.5. 2. Subjects who agree to participate in the current study with a written informed consent.

BACKGROUND:

The "leave nothing behind" strategies have been becoming a popular treatment for femoropopliteal arteriosclerosis obliterans. Atherectomy before drug-coated balloon (DCB) angioplasty may have an advantage in improving the efficiency of drug delivery into the blood vessel wall. This study aimed to compare the therapeutic effects of directional atherectomy combined with DCB angioplasty with DCB angioplasty alone in the treatment of femoropopliteal arteriosclerosis obliterans.

METHODS:

Patients with femoropopliteal arteriosclerosis obliterans who received endovascular therapy from June 2016 to June 2018 in our hospital and presented with life-limiting claudication or severe chronic limb ischemia comprised the study cohort. The patients were randomized to receive directional atherectomy combined with DCB angioplasty (n = 45) or DCB alone (n = 49). Ninety-four patients were enrolled in our study with 72 males, and the mean age was 67 ± 10 years. The mean lesion length was 112 ± 64 mm.

RESULTS:

There were no significant differences in the baseline characteristics of patients and lesions between the 2 randomized groups (P > 0.05). Flow-limiting dissections occurred more frequently in the DCB group (n = 12; 24.5%) than in the DA-DCB group (n = 2; 4.4%; P = 0.006). The technical success rate in the DA-DCB group was superior to that in the DCB group (95.6% vs. 75.5%, P = 0.006). The mean follow-up duration was 16.7 ± 6.1 months in the DCB group and 15.3 ± 5.8 months in the DA-DCB group. No amputations were performed. The overall mortality in the DCB group was 4.1% (2/49), while all patients survived in the DA-DCB group. The 12-month and 24-month primary patencies in the DA-DCB group were greater than those in the DCB group (80.5% vs. 75.7% and 67.1% vs. 55.1%, respectively); however, using all available patency data, no significant differences over time were observed (P = 0.377).

CONCLUSIONS:

In this study, directional atherectomy combined with DCB angioplasty can decrease the flow-limiting dissection rate in the treatment of femoropopliteal arteriosclerosis obliterans compared with DCB angioplasty alone. There was no significant difference between the 2 groups in terms of primary patency rate which was needed to be further clarified.