Therapeutic plasma exchange (TPE) is used as an effective treatment modality for a variety of autoimmune disorders. Apart from its desired effect of removing pathological blood components, it also can remove coagulation factors and drugs. Currently, there is an insufficient amount of information regarding the use of direct oral anticoagulants in this setting. In this article, we present a case report of a patient with myasthenia gravis and chronic anticoagulation with apixaban who underwent a series of TPE while continuing apixaban treatment. We observed that only 10% of daily dose was removed by the procedure and plasma levels of apixaban corresponded with expected range. TPE was not associated with shortened drug plasma half-life. We did not observe any significant alteration of apixaban pharmacokinetics during the period of TPE therapy, as well as no thrombotic or bleeding events. This case report supports the use of apixaban in patients treated by TPE, nevertheless, to firmly establish apixaban efficacy and safety profile in this clinical setting further research is needed.
- MeSH
- Anticoagulants administration & dosage adverse effects MeSH
- Factor Xa Inhibitors * administration & dosage MeSH
- Middle Aged MeSH
- Humans MeSH
- Myasthenia Gravis drug therapy therapy MeSH
- Half-Life MeSH
- Pyrazoles * administration & dosage pharmacokinetics MeSH
- Pyridones * administration & dosage MeSH
- Aged MeSH
- Plasma Exchange * methods MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- Review MeSH
Coronary artery disease is one of the most frequent causes of morbidity and mortality worldwide. It is even more prevalent in patients with type 2 diabetes mellitus who suffer from obesity and increased accumulation of epicardial fat with a possible contributing role in the development of coronary artery disease. We performed an MS-based lipidomic analysis of subcutaneous and epicardial adipose tissue in 23 patients with coronary artery disease stratified for the presence/absence of type 2 diabetes mellitus and a control group of 13 subjects aiming at identification of factors from epicardial fat contributing to the development of coronary artery disease. The samples of adipose tissues were obtained during elective cardiac surgery. They were extracted and analyzed with and without previous triacylglycerols separation by high-pressure liquid chromatography-mass spectrometry (HPLC-MS). Multivariate and univariate analyses were performed. Lipidomics data were correlated with biochemical parameters. We identified multiple changes in monoacylglycerols, diacylglycerols, triacylglycerols, glycerophosphatidylserines, glycerophosphatidylethanolamines, glycerophosphatidylcholines, ceramides, sphingomyelins, and derivatives of cholesterol. Observed changes included molecules with fatty acids with odd (15:0, 15:1, 17:0, 17:1) and even (10:0, 12:0, 14:0, 16:0, 16:1, 18:0, 18:1, 18:2, 20:4, 20:1, 22:0) fatty acids in both types of adipose tissue. More pronounced changes were detected in epicardial adipose tissue compared to subcutaneous adipose tissue of patients with coronary artery disease and type 2 diabetes. Lipidomic analysis of subcutaneous and epicardial adipose tissue revealed different profiles for patients with coronary artery disease and type 2 diabetes, which might be related to coronary artery disease and the presence of type 2 diabetes.
- MeSH
- Diabetes Mellitus, Type 2 * MeSH
- Humans MeSH
- Lipids MeSH
- Coronary Artery Disease * MeSH
- Pericardium MeSH
- Subcutaneous Fat MeSH
- Adipose Tissue MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Type 2 diabetes mellitus (T2DM) is a major epidemiological problem. Metformin and vildagliptin are well-established antidiabetic drugs. The aim of the study was to evaluate the changes of plasma metabolic profile induced by a high-fat diet (HFD) and subsequent oral administration of metformin, vildagliptin, and their combination in a mouse model of diet-induced obesity (DIO)/T2DM analyzed using quadrupole-time-of-flight mass spectrometry (qTOF-MS). Metformin treatment increased the levels of butyrylcarnitine and acylcarnitine C18:1 concentrations and decreased the levels of isoleucine concentrations compared to untreated HFD mice. Vildagliptin treatment increased levels of butyrylcarnitine and acetylcarnitine. In summary, our metabolomics study revealed multiple differences between obese diabetic HFD mice and lean standard chow diet (SCD) mice, which were partially modifiable by subsequent metformin and vildagliptin treatment.
- MeSH
- Diabetes Mellitus, Type 2 blood complications drug therapy metabolism MeSH
- Mass Spectrometry MeSH
- Hypoglycemic Agents administration & dosage therapeutic use MeSH
- Drug Therapy, Combination MeSH
- Metabolomics * MeSH
- Metformin administration & dosage therapeutic use MeSH
- Disease Models, Animal MeSH
- Mice, Inbred C57BL MeSH
- Mice MeSH
- Obesity blood complications metabolism MeSH
- Reproducibility of Results MeSH
- Vildagliptin administration & dosage therapeutic use MeSH
- Animals MeSH
- Check Tag
- Male MeSH
- Mice MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
Recently, a South-to-North oxidative stress marker gradient has been reported; consistent with known differences in the incidence of coronary heart disease between southern and northern European countries. The aim of the present study was to compare the plasma concentrations of 7-oxocholesterol (7OxCH) and 7beta-hydroxycholesterol (7BCH) with systemic antioxidants in healthy Italian and Czech subjects. The study was performed in healthy subjects of Italian (n=131) and Czech (n=84) origins. In all subjects routine biochemistry work-ups were performed; additionally, plasma oxysterols and the peroxyl radicals scavenging activity (PERSA) of the sera were determined. Close relationship of serum bilirubin and uric acid to markers of oxidative stress was observed in both examined populations. Compared to the Czechs, the Italian population showed higher plasma concentrations of both oxysterols (7OxCH: 3.6 vs. 6.0 ng/mL, p<10-6; 7BCH: 5.3 vs. 8.6 ng/mL, p<10-6), lower PERSA (p<10-6), and lower serum concentrations of bilirubin and uric acid (p<10-6 in both cases). The dietary patterns of the Italian population did not match the Mediterranean style, but was more similar to the Continental type of diet, presumably due to non-adherence to a Mediterranean diet.
- MeSH
- White People MeSH
- Bilirubin * blood MeSH
- Biomarkers MeSH
- Cholesterol blood adverse effects MeSH
- Epidemiologic Studies MeSH
- Cardiovascular Diseases diet therapy epidemiology etiology MeSH
- Ketocholesterols blood adverse effects MeSH
- Uric Acid * blood MeSH
- Humans MeSH
- Multicenter Studies as Topic MeSH
- Oxidative Stress * MeSH
- Statistics as Topic MeSH
- Diet, Mediterranean ethnology MeSH
- Feeding Behavior MeSH
- Vitamin E MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
