Complement Activation ; Humans ; Thrombosis ; immunology

Systemic lupus erythematosus (SLE) is an autoimmune disease caused by abnormal immune regulation and excessive production of autoantibodies, which characterized by T and B cell dysfunction and excessive production of pathological cytokines and autoantibodies. Vascular endothelia and subendothelial collagen were injured by harmful antibodies, so that the body was in a thrombophilic state, increasing the multi-system and multi-organ damage of body. Mesenchymal stem cells (MSC) are as multipotent cells, capable of multilineage differentiation, self-renewal, homing, inflammatory chemotaxis, immune regulation and reconstruction. To date, MSC are known to affect not only T cells, but also other cells of the immune system. MSC can inhibit or promote B cell proliferation, suppress NK cell activation and modulate the cytokine secretion profile of dendritic cells and macrophages. Thus decreasing the secretion of harmful cytokines and autoantibodies, can ease the thrombosis-prone state of the body, reducing the incidence of thrombosis. In addition, MSC are able to differentiate into various types of tissue cells, such as hematopoietic cells, endothelial cells, liver cells, nerve cells, bone cells, cartilage cells etc, therefore, MSC can repair the damaged tissues and organs. In this article, the advance of studies on immune regulation and repair mechanisms of MSC on incident thrombosis in SLE is reviewed.
Humans ; Lupus Erythematosus, Systemic ; immunology ; pathology ; Mesenchymal Stromal Cells ; immunology ; Thrombosis ; immunology ; pathology

Systemic lupus erythematosus (SLE) is an autoimmune disease with causes including activation of innate and adaptive immune systems. SLE patients are with a high risk of thrombosis, which may be due to disease activation, immune complexes, toxic antibodies and high level of inflammation. This article discusses neutrophil/NET factor, antibody factor, platelet factor and particle factor which is involved in coagulation pathways and thrombus formation mechanism under the state of immune disorders in SLE.
Blood Coagulation ; Blood Coagulation Factors ; Humans ; Lupus Erythematosus, Systemic ; immunology ; Thrombophilia ; immunology ; Thrombosis

This review addresses the importance of psychoneuroimmunology (PNI) studies in understanding the role of acute and chronic psychological stressors on the immune system and development of coronary artery disease (CAD). Firstly, it illustrates how psychological stressors change endothelial function and lead to chemotaxis. Secondly, acute psychological stressors lead to leukocytosis, increased natural killer cell cytotoxicity and reduced proliferative response to mitogens while chronic psychological stressors may lead to adverse health effects. This will result in changes in cardiovascular function and development of CAD. Thirdly, acute and chronic psychological stressors will increase haemostatic factors and acute phase proteins, possibly leading to thrombus formation and myocardial infarction. The evidence for the effects of acute and chronic psychological stress on the onset and progression of CAD is consistent and convincing. This paper also highlights potential research areas and implications of early detection of immunological changes and cardiovascular risk in people under high psychological stress.
Acute-Phase Proteins ; Coronary Artery Disease ; immunology ; psychology ; Humans ; Inflammation ; psychology ; Myocardial Infarction ; immunology ; psychology ; Stress, Psychological ; immunology ; Thrombosis ; immunology ; psychology

Since heparin is an anticoagulant commonly used in hemodialysis and the patients on hemodialysis are repeatedly exposed to heparin, heparin may be the cause of the development of heparin-dependent antibodies and thrombotic complications in patients on hemodialysis. The purpose of this study was to determine the prevalence and the clinical significance of the antibodies against heparin-platelet factor 4 complexes as determined by enzyme immunoassay in patients on maintenance hemodialysis. The prevalence of anti-heparin-platelet factor 4 antibodies was higher in hemodialysis patients than in normal subjects (8.8 vs 0.0%, p<0.05). The number of past episodes of vascular access obstruction per year was significantly higher in the anti-heparin-platelet factor 4 antibody positive group than antibody negative group. Anti-heparin-platelet factor 4 antibody positive patients experienced more frequent vascular access obstructions than control subjects. In conclusion, anti-heparin-platelet factor 4 antibody might be a risk factor for vascular access obstructions in patients with end-stage renal disease on maintenance hemodialysis.
Adult ; Autoantibodies/immunology* ; Autoimmune Diseases/immunology* ; Catheters, Indwelling* ; Enzyme-Linked Immunosorbent Assay ; Female ; Heparin/immunology* ; Human ; Kidney Failure, Chronic/blood ; Kidney Failure, Chronic/immunology ; Kidney Failure, Chronic/therapy* ; Male ; Middle Aged ; Platelet Factor 4/immunology* ; Recurrence ; Renal Dialysis* ; Risk Factors ; Thrombophilia/immunology* ; Thrombosis/epidemiology* ; Thrombosis/immunology ; Thrombosis/prevention & control

OBJECTIVETo assess the binding ability of microbubbles targeted to alphavbeta3-integrin (MBp) for thrombus-targeted contrast-enhanced ultrasound.

METHODSTargeted microbubbles were prepared by conjugating the monoclonal antibody against alphavbeta3-integrin to lipid shell of the microbubble via the avidin-biotin bridges. Equivalent isotype control microbubbles (MB) or targeted ultrasound microbubbles (MBp) were randomly added into the flow chamber. After a 30-min incubation with the thrombus fixed in an agarose flow chamber model, the thrombus was washed with a continuous flow of PBS solution (15 cm/s) for 2, 4, 6, 8 and 10 min, followed by thrombus imaging using contrast-enhanced ultrasound and measurement of the video intensity (VI) values of the images.

RESULTSThe VI of the thrombus in MBp group was reduced by 28%-66%, while that in control MB group was decreased by 87%-94%, and the VI values of the thrombus group were significantly greater in former group at each of the time points (P<0.05).

CONCLUSIONMBP has good targeting ability to the thrombus with resistance to the shear stress after adhesion to the thrombus. In vitro evaluation of the thrombus-binding capability of the targeted microbubble (MBp) by simulating the shear stress in vivo can be helpful for predicting the in vivo effects of ultrasonic molecular imaging using MBp.

Antibodies, Monoclonal ; chemistry ; immunology ; Contrast Media ; chemistry ; Humans ; Integrin alphaVbeta3 ; immunology ; metabolism ; Microbubbles ; Sepharose ; Thrombosis ; diagnostic imaging ; Ultrasonography

BACKGROUNDInflammatory mechanisms had played an important role in the occurrence and prognosis of acute myocardial infarction, inflammatory mediators was associated with adverse outcomes of acute myocardial infarction. This study tested the hypothesis that in the acute phase of myocardial infarction with ST-segment elevation, neutrophil count and high-sensitivity C-reactive protein are predictive of angiographic morphologic features that indicate thrombus formation in the infarct-related artery.

METHODSThis retrospective study included 182 consecutive patients with acute myocardial infarction and ST-segment elevation. Patients were assigned to a thrombus-formation group (n = 77) and a non-thrombus-formation group (n = 106). All patients had a Killip's classification

RESULTSThe levels of high-sensitivity C-reactive protein, total leukocyte counts, neutrophil counts, and neutrophil/ lymphocyte ratios were substantially higher in the thrombus-formation group than in the non-thrombus-formation group patients (for each, P < 0.05). Stepwise Logistic regression analyses identified high-sensitivity C-reactive protein, neutrophil count, and neutrophil/lymphocyte ratio as independent predictors of thrombus formation in the infarct-related artery (for each, P < 0.05).

CONCLUSIONSIn patients with acute myocardial infarction, higher neutrophil counts, neutrophil/lymphocyte ratio, and levels of high-sensitivity C-reactive protein are predictors to indicate thrombus formation.

Aged ; C-Reactive Protein ; metabolism ; Female ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Myocardial Infarction ; immunology ; metabolism ; physiopathology ; Retrospective Studies ; Thrombosis ; diagnosis ; immunology ; metabolism

OBJECTIVETo study the plasma HCII activity and antigen level variations and their relationship with arterial and deep venous thrombotic diseases.

METHODSSeventy-five patients with brain infarction (BI), 50 myocardial infarction (MI), 36 deep venous thromboembolic disease (DVT) and 50 healthy controls were entered in this study. Plasma HCII activity was measured with chromogenic substrate method and the HCII antigen level by Western blotting assay. Plasma antithrombin (AT) activity was detected for the HCII deficiency individuals with DVT using chromogenic substrate method.

RESULTSThere was no significant difference in the mean plasma HCII activity and antigen levels between BI group [(99.97 +/- 21.14)% and 0.96 +/- 0.24], MI group [(98.18 +/- 29.35)% and 0.95 +/- 0.20] and healthy controls [(96.80 +/- 20.11)% and 0.93 +/- 0.19]. The plasma HCII activity and antigen concentrations in patients with DVT [(89.57 +/- 17.12)% and 0.87 +/- 10.18] tended to be decreased as compared with healthy controls, but they were not significant. No significant difference was found for the prevalence of HCII deficiency between patient groups and control group. The HCII deficiency individuals with DVT had normal AT activity and fibrinogen concentration.

CONCLUSIONSPlasma HCII deficiency may not be the risk factor for arterial thrombosis in the Han population of Hunan Chinese. It is needed to further confirm if decreased plasma HCII is correlated with venous thrombosis.

Adult ; Aged ; Blotting, Western ; Cerebral Infarction ; blood ; etiology ; Female ; Heparin Cofactor II ; analysis ; deficiency ; immunology ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; blood ; etiology ; Venous Thrombosis ; blood ; etiology

BACKGROUND: The presence of antiphospholipid antibodies (aPLs) is associated with the clinical features of antiphospholipid syndrome (APS), which comprises venous and arterial thrombosis and pregnancy loss, and systemic lupus erythematosus (SLE). The prevalence of aPLs has been reported to be different in patient populations affected by either of these conditions. We performed a retrospective study to evaluate the prevalence and clinical associations of aPLs, including lupus anticoagulant (LAC), anticardiolipin (aCL), and anti-beta2-glycoprotein I antibodies (anti-beta2-GPI) in a cohort of Korean patients with SLE. METHODS: This study included samples from 88 SLE patients for whom aPL testing had been advised between June 2006 and July 2009 at the Dong-A University Hospital. Serum and plasma samples were tested for LAC, aCL (IgG, IgM), and anti-beta2-GPI (IgG, IgM) antibodies. Clinical data from patients were obtained from a review of medical records. RESULTS: LAC was the most common (34.1% of total patients, 30/88) antibody, followed by IgM aCL (31.8%, 28/88), IgG aCL (18.2%, 16/88), and IgM and IgG anti-beta2-GPI (both 5.7%, 5/88 each). Positivity for LAC was strongly associated with venous/arterial thrombosis (P=0.002). CONCLUSIONS: LAC was the most common antibody detected in Korean SLE patients and is shown to have a significant association with the presence of venous/arterial thrombosis. The measurement of LAC may be clinically useful in identifying patients with SLE who are at a high risk for venous/arterial thrombosis.
Adolescent ; Adult ; Antibodies, Anticardiolipin/*blood ; Antibodies, Antiphospholipid/*blood ; Cohort Studies ; Female ; Humans ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Lupus Coagulation Inhibitor/*blood ; Lupus Erythematosus, Systemic/epidemiology/*immunology ; Male ; Middle Aged ; Pregnancy ; Prevalence ; Retrospective Studies ; Risk Factors ; Venous Thrombosis/epidemiology/immunology

OBJECTIVEAntiphospholipid antibody (APL) is a particularly important laboratory diagnostic criterion for antiphospholipid syndrome (APS). The significances of positive APL in childhood are seldom reported nor fully understood. The purpose of this study was to analyze 13 cases with positive APL seen in our hospital and to study the relationship between the positive rates of APL and various clinical diseases especially systemic lupus erythematosus (SLE) in order to improve the clinical diagnoses and treatment level of APS in children.

METHODSThe clinical data collected from 2000 to 2002 of 13 hospitalized children with positive APL were retrospectively evaluated. Enzyme linked immunosorbent assay (ELISA) and indirect immunofluorescence technique were used respectively to detect APL and antineutrophil cytoplasmic autoantibodies (ANCA) of sera from those children. Other various indexes were also detected according to different characteristics of different diseases.

RESULTSEight cases had SLE; 2 had acute post-streptococcal infections. The other 3 cases did not show any evidences of primary diseases; they probably had primary APS. SLE was the most common primary diseases to cause development of APL and the cases with SLE showed more severe cutaneous vasculitis than SLE patients who were negative for APL. There was no significant relationship between the positive rates of APL and that of ANCA. Eight APL positive cases complicated with thrombocytopenia and bleeding were treated with high dosage of immunoglobulin [400 mg/(kg.d), for 3 - 5 d] intravenously; the clinical conditions of these cases were ameliorated soon. While the 5 cases who had thrombotic vasculitis and thromboembolism were treated with anticoagulant and antithrombotic therapy with low molecular weight heparin [50 - 100 U/(kg.d)], which led to good clinical effects.

CONCLUSIONSThe clinical manifestations of children positive for APL were somehow different from those of adults. Positive APL itself may be nonspecific, it can occur from different causes of diseases. APL detection may be useful to suggest anticoagulant and/or antithrombosis therapy. Treatments for APS should be variable according to different causes and severity of diseases, in the cases of thrombocytopenia and bleeding, high dose intravenous immunoglobulin should be given as soon as possible, while in the cases of thrombotic vasculitis and thromboembolism, anticoagulant and antithrombotic therapy should be given soon.

Adult ; Antibodies, Antineutrophil Cytoplasmic ; blood ; Antibodies, Antiphospholipid ; blood ; immunology ; Anticoagulants ; therapeutic use ; Antiphospholipid Syndrome ; blood ; complications ; diagnosis ; therapy ; Child ; Fibrinolytic Agents ; therapeutic use ; Hemorrhage ; etiology ; therapy ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Lupus Erythematosus, Systemic ; immunology ; Streptococcal Infections ; immunology ; Thrombocytopenia ; etiology ; therapy ; Thromboembolism ; drug therapy ; etiology ; Thrombosis ; drug therapy ; etiology ; Vasculitis ; drug therapy ; etiology