Complement Activation ; Humans ; Thrombosis ; immunology

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

OBJECTIVETo investigate the immunoregulation effects of umbilical cord mesenchymal stem cells (UC-MSCs) on the rats with collagen II induced arthritis (CIA).

METHODSThe rats were first immunized by intradermal injection of chicken collagen type II emulsified with complete Freund's adjuvant (CFA) to monitor their swelling of foot, hair color and action state. After injected UC-MSC by caudal vein, the rats were scored with the arthritis index (AI) once a week. Then, the concentration of interleukin (IL-6), tumor necrosis factor-α (TNF-α) in serum and D-dimer (D-D), antithrombin-III (AT-III), thrombomodulin (TM) in plasma were detected by ELISA.

RESULTSObvious swellings of the feet were found in the experiment group compared with normal one. ELISA analysis showed that the concentrations of IL-6, TNF-α, D-D and TM in plasma of the experiment group as of (200.48 ± 15.04) ng/L, (450.25 ± 45.39) ng/L, (274.26 ± 67.93) ng/L and (9.18 ± 0.84) µg/L, respectively were higher than of(167.62 ± 0.97) ng/L, (371.44 ± 21.26) ng/L, (193.95 ± 8.22) ng/L and (6.30 ± 0.32) µg/L respectively in normal group (P < 0.05), but the concentration of AT-III \[(89.57 ± 6.40) ng/L\] was lower than normal group \[(112.82 ± 1.74) ng/L\] (P < 0.05). The levels of cytokines through the UC-MSCs treatment were significantly different from the model group (P < 0.05). After 9 weeks, these cytokines in the UC-MSCs group were mostly the same as the normal group.

CONCLUSIONThe thrombophilia status of the CIA rats was caused by immune injury. The UC-MSCs reduced the production of inflammatory cytokines and regulated and repaired the balance of coagulation and anticoagulation system of the body to cure the immune-related thrombophilia.

Animals ; Antithrombins ; blood ; Arthritis, Experimental ; immunology ; physiopathology ; prevention & control ; Female ; Fibrin Fibrinogen Degradation Products ; analysis ; Inflammation ; Interleukin-6 ; blood ; Mesenchymal Stem Cell Transplantation ; Rats ; Rats, Sprague-Dawley ; Thrombosis ; prevention & control ; Tumor Necrosis Factor-alpha ; blood ; Umbilical Cord ; cytology

OBJECTIVETo explore prognostic factors and the expression of glypican-3, hepatocyte antigen (HEP), alpha-fetoprotein (AFP), CD34 and CD10 in hepatocellular carcinoma (HCC) and their prognostic value.

METHODSClinicopathologic data were analyzed in 375 cases of HCC, in which 80 cases with follow-up were examined by immunohistochemical staining to detect the expression of glypican-3, HEP, AFP, CD34 and CD10 proteins. The relationship between the proteins expression and clinicopathologic features was also evaluated.

RESULTSTumor number (P = 0.000), tumor size (P = 0.025), tumor differentiation (P = 0.001) and vessel invasion (P = 0.000) were closely related to prognosis of HCC patients; the expression of glypican-3 (66/80,82.5%; P = 0.002), HEP (64/80,80.0%; P = 0.021), AFP (38/80,47.5%; P = 0.014) and CD10 (28/80,35.0%; P = 0.002) was significantly related to tumor differentiation; that of glypican-3 was significantly correlated with tumor number and presence of satellite nodules (P = 0.028) and that of AFP and CD10 was significantly correlated with portal vein thrombi (P = 0.000, P = 0.010). On Kaplan-Meier regression analysis, both low expression of HEP and high expression of AFP were closely related to poor prognosis.

CONCLUSIONSTumor number, size, differentiation and vessel invasion were important factors affecting the prognosis of patients with HCC. HEP and AFP have prognostic significance in HCC.

Antigens ; metabolism ; Antigens, CD34 ; metabolism ; Biomarkers, Tumor ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; pathology ; surgery ; Cell Differentiation ; Female ; Follow-Up Studies ; Glypicans ; metabolism ; Hepatocytes ; immunology ; Humans ; Liver Neoplasms ; metabolism ; pathology ; surgery ; Male ; Neprilysin ; metabolism ; Portal Vein ; pathology ; Prognosis ; Survival Rate ; Tumor Burden ; Venous Thrombosis ; etiology ; pathology ; alpha-Fetoproteins ; metabolism

This study was designed to investigate the incidence, causes, and outcomes of new-onset thrombocytopenia (NOT) in Korean intensive care units (ICUs). A prospective cohort study was conducted in medical ICUs of Samsung Medical Center between August 2010 and February 2011. All newly admitted patients were included if they stayed in the ICU for more than 48 hr and did not have thrombocytopenia upon admission. A total of 186 patients were included. NOT developed in 37.1%. Most common cause of NOT was sepsis with disseminated intravascular coagulation (66.7%), followed by drug-induced thrombocytopenia (18.8%), and heparin-induced thrombocytopenia (2.9%). IgG-specific antibody to platelet factor 4/heparin was positive in 2.4% among patients treated with heparin, and thrombosis occurred in two patients. Twenty eight-day mortality was higher in patients that developed NOT compared to those that did not develop NOT (39.1% vs 12%, P < 0.001). NOT increased the odds ratio of 28-day mortality and was an independent risk factor for mortality (OR 3.52; 95% CI 1.32-9.38; P = 0.012). In conclusion, NOT is common and is an independent risk factor for mortality in Korean ICU patients. Therefore, clinicians should make every effort to correct the causes of NOT.
Aged ; Cohort Studies ; Disseminated Intravascular Coagulation/complications ; Female ; Heparin/immunology ; Hospitals ; Humans ; Immunoglobulin G/blood ; Incidence ; Intensive Care Units ; Male ; Middle Aged ; Odds Ratio ; Platelet Factor 4/immunology ; Prognosis ; Prospective Studies ; Republic of Korea ; Risk Factors ; Sepsis/complications ; Survival Analysis ; Thrombocytopenia/*epidemiology/etiology/mortality ; Thrombosis/etiology

This study was designed to investigate the incidence, causes, and outcomes of new-onset thrombocytopenia (NOT) in Korean intensive care units (ICUs). A prospective cohort study was conducted in medical ICUs of Samsung Medical Center between August 2010 and February 2011. All newly admitted patients were included if they stayed in the ICU for more than 48 hr and did not have thrombocytopenia upon admission. A total of 186 patients were included. NOT developed in 37.1%. Most common cause of NOT was sepsis with disseminated intravascular coagulation (66.7%), followed by drug-induced thrombocytopenia (18.8%), and heparin-induced thrombocytopenia (2.9%). IgG-specific antibody to platelet factor 4/heparin was positive in 2.4% among patients treated with heparin, and thrombosis occurred in two patients. Twenty eight-day mortality was higher in patients that developed NOT compared to those that did not develop NOT (39.1% vs 12%, P < 0.001). NOT increased the odds ratio of 28-day mortality and was an independent risk factor for mortality (OR 3.52; 95% CI 1.32-9.38; P = 0.012). In conclusion, NOT is common and is an independent risk factor for mortality in Korean ICU patients. Therefore, clinicians should make every effort to correct the causes of NOT.
Aged ; Cohort Studies ; Disseminated Intravascular Coagulation/complications ; Female ; Heparin/immunology ; Hospitals ; Humans ; Immunoglobulin G/blood ; Incidence ; Intensive Care Units ; Male ; Middle Aged ; Odds Ratio ; Platelet Factor 4/immunology ; Prognosis ; Prospective Studies ; Republic of Korea ; Risk Factors ; Sepsis/complications ; Survival Analysis ; Thrombocytopenia/*epidemiology/etiology/mortality ; Thrombosis/etiology

BACKGROUND: Heparin-induced thrombocytopenia (HIT) is an adverse drug reaction caused by antibodies to the heparin/platelet factor 4 (PF4) complex, resulting in thrombocytopenia and prothrombotic state. HIT diagnosis is challenging and depends on clinical presentation and laboratory tests. We investigated the usefulness of clinical scores and heparin/PF4 ELISA optical density (OD) as a diagnostic marker and thrombosis predictor in HIT. METHODS: We analyzed 92 patients with suspected HIT. The heparin/PF4 antibody was measured using a commercial ELISA kit (GTI, USA). For each patient, the 4 T's score and Chong's score were calculated. RESULTS: Of the 92 patients, 28 were anti-heparin/PF4-seropositive. The 4 T's score and Chong's score showed good correlation (r=0.874). The 4 T's score and OD values showed good performance for diagnosis of the definite and unlikely HIT groups; however, OD levels showed better sensitivity (93.8%) than the 4 T's score used alone (62.5%). Of the 92 patients, 26 developed thrombosis. The OD values were significantly higher in patients with thrombosis than in those without thrombosis (0.52 vs. 0.22, P<0.001). Patients with high OD values (OD>0.4) had an increased risk of thrombosis (adjusted odds ratio 9.44 [3.35-26.6], P<0.001) and a shorter 250-day thrombosis-free survival (32.1% vs. 54.7%, P=0.012). CONCLUSIONS: ELISA OD values in combination with clinical scoring can improve the diagnosis of and thrombosis prediction in HIT. More attention should be paid to the use of clinical scores and OD values as thrombosis predictors in HIT.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibodies/adverse effects/analysis ; Area Under Curve ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay/*methods ; Female ; Heparin/immunology ; Humans ; Infant ; Male ; Middle Aged ; Platelet Factor 4/immunology ; Risk ; Sensitivity and Specificity ; Survival Analysis ; Thrombocytopenia/chemically induced/*diagnosis/mortality ; Thrombosis/*diagnosis/etiology

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

Amoebic liver abscess is a common disease, especially in endemic areas, but it is a rare cause of inferior vena cava (IVC) obstruction, with only a few cases appearing in the literature. We report three cases of amoebic liver abscess complicated with obstruction of the IVC and which responded to conservative treatment or radiological intervention.
Anti-Bacterial Agents/therapeutic use ; Antibodies, Protozoan/analysis ; Entamoeba/immunology/isolation & purification ; Enzyme-Linked Immunosorbent Assay ; Humans ; Liver Abscess, Amebic/complications/*diagnosis/ultrasonography ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Thrombosis/diagnosis/etiology ; Tomography, X-Ray Computed ; Vascular Diseases/*etiology ; *Vena Cava, Inferior ; Young Adult

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