Takayasu disease belongs to the group of autoimmune vasculitis which most often affects the aorta and its branches. It is rare, and it mainly affects young women. Recent epidemiologic studies suggest that Takayasu arteritis is being increasingly recognized in Europe. The first symptoms are non-specific and an early diagnosis is difficult and requires clinical awareness and suspicion. Patients with Takayasu arteritis often present increased inflammatory markers, including C-reactive protein and erythrocyte sedimentation rate, but systemic inflammatory response does not always show a positive correlation with inflammatory activity in the vessel wall. Therefore, imaging studies play a principal role in diagnosis and control of the disease. Glucocorticoids remain the most effective and serve as a cornerstone first line treatment. Immunosuppressive drugs play an important role as well, and biological therapy is increasingly being included in the treatment. This article describes the epidemiology, pathophysiology, diagnostics and treatment of this rare disease, so as to alert clinicians because disease left untreated can lead to narrowing and even closure of vital blood vessels. The most common Takayasu arteritis complications include pulmonary thrombosis, aortic regurgitation, congestive heart failure, cerebrovascular events, vision degeneration or blindness, and hearing problems.

• MeSH
• aortitida epidemiologie   patologie   MeSH
• azathioprin aplikace a dávkování   farmakologie   MeSH
• biologická terapie MeSH
• biologické markery krev   MeSH
• cévní endotel imunologie   patologie   MeSH
• cyklofosfamid aplikace a dávkování   farmakologie   MeSH
• diferenciální diagnóza MeSH
• endovaskulární výkony MeSH
• glukokortikoidy aplikace a dávkování   farmakologie   MeSH
• humanizované monoklonální protilátky farmakologie   terapeutické užití   MeSH
• imunosupresiva aplikace a dávkování   farmakologie   MeSH
• lidé MeSH
• methotrexát aplikace a dávkování   farmakologie   MeSH
• patologická angiogeneze epidemiologie   etiologie   patologie   MeSH
• receptory interleukinu-6 antagonisté a inhibitory   MeSH
• Takayasuova arteriitida * diagnóza   epidemiologie   imunologie   terapie   MeSH
• TNF-alfa farmakologie   terapeutické užití   MeSH
• tunica intima imunologie   patologie   MeSH
• ustekinumab farmakologie   terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Intimal arteritis is known to be a negative prognostic factor for kidney allograft survival. Isolated v-lesion (IV) is defined as intimal arteritis with minimal tubulointerstitial inflammation (TI). Although the Banff classification assesses IV as T cell-mediated rejection (TCMR), clinical, and prognostic significance of early IV (early IV, eIV) with negative C4d and donor-specific antibodies (DSA) remains unclear. To help resolve if such eIV truly represents acute rejection, a molecular study was performed. The transcriptome of eIV (n=6), T cell-mediated vascular rejection with rich TI (T cell-mediated vascular rejection, TCMRV, n=4) and non-rejection histologic findings (n=8) was compared using microarrays. A total of 310 genes were identified to be deregulated in TCMRV compared with eIV. Gene enrichment analysis categorized deregulated genes to be associated primarily with T-cells associated biological processes involved in an innate and adaptive immune and inflammatory response. Comparison of deregulated gene lists between the study groups and controls showed only a 1.7% gene overlap. Unsupervised hierarchical cluster analysis revealed clear distinction of eIV from TCMRV and showed similarity with a control group. Up-regulation of immune response genes in TCMRV was validated using RT-qPCR in a different set of eIV (n=12) and TCMRV (n=8) samples. The transcriptome of early IV (< 1 month) with negative C4d and DSA is associated with a weak immune signature compared with TCMRV and shows similarity with normal findings. Such eIV may feature non-rejection origin and reflect an injury distinct from an alloimmune response. The present study supports use of molecular methods when interpreting kidney allograft biopsy findings.

• MeSH
• alografty MeSH
• arteritida genetika   MeSH
• dospělí MeSH
• genová ontologie MeSH
• lidé MeSH
• průřezové studie MeSH
• rejekce štěpu diagnóza   genetika   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• stanovení celkové genové exprese metody   MeSH
• studie případů a kontrol MeSH
• transkriptom * MeSH
• transplantace ledvin metody   MeSH
• tunica intima metabolismus   patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH

Some recent reports suggested that elderly and female patients did not benefit from implantation of the second internal thoracic artery (ITA) during coronary artery bypass surgery (CABG). Macrophages, among other cells, were described to be involved in both atherosclerosis and aortocoronary grafts failure. The aim of the study was to examine the age and gender association with different distribution of CD68+ cells within the layers of ITA wall. This study involved 158 consecutive patients (95 male and 63 female), with the mean age of 64.5±9.5 years, who underwent elective CABG procedures. During surgery, the surplus distal segments of ITA were harvested for immunohistochemical analysis. The number and distribution of CD68+ cells was calculated and plotted against the age and gender of the study participants. CD68+ cells were present in all of the harvested ITA fragments (median 44), more in women (55) than in men (42) (p less than 0.001). However, this difference was of statistical significance exclusively in the tunica intima. Approximately 70% of macrophages were found in the tunica adventitia. The total number of CD68+ cells the in arterial wall as well as in the tunica intima and adventitia correlated positively with the age of patients (r=0.544, r=501 and r=0.462, respectively). The lack of significant advantages of the use of two thoracic arteries, in elderly patients and women, might have resulted from the larger population of CD68+ cells in their walls, especially the tunica intima. However, this result from immunohistochemical analysis needs validation in long-term clinical research on a larger cohort of patients.

• MeSH
• dospělí MeSH
• koronární bypass metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• makrofágy imunologie   MeSH
• mamární tepny imunologie   MeSH
• pohlavní dimorfismus MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• tunica intima imunologie   patologie   MeSH
• věkové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• albuminurie diagnóza   epidemiologie   etiologie   MeSH
• dítě MeSH
• hypertenze * epidemiologie   komplikace   MeSH
• hypertenzní encefalopatie diagnóza   epidemiologie   MeSH
• hypertenzní retinopatie diagnóza   epidemiologie   MeSH
• hypertrofie levé komory srdeční diagnostické zobrazování   epidemiologie   etiologie   MeSH
• kognitivní poruchy epidemiologie   etiologie   MeSH
• lidé MeSH
• tunica intima patofyziologie   patologie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH

Cílem studie je detekce subklinické aterosklerózy pomocí měřením tloušťky intima media a její vztah ke kardiovaskulárním manifestacím, tradičním rizikovým faktorů, klinickým projevům, imunologickému profilu a vybraným laboratorním markerům. Metody: Pacienti byli vyšetřeni v období od března 2015 do ledna 2016. Bylo vyšetřeno čtyřicet dva pacientů se SLE (5 mužů, 37 žen). U těchto pacientů byly detekovány tradiční rizikové faktory, klinické projevy, imunologický profil, aktivita choroby a kumulativní poškození pomocí skórovacích systémů SELENA-SLEDAI 2K a SLICC, kumulativní dávka glukokortikoidů, doba trvání onemocnění, přítomnost kardiovaskulárních příhod. Výsledky byly zhodnoceny statisticky. Výsledky: Patologické IMT bylo zjištěno u 10 pacientů (23,8 %), přítomnost plátů u 7 respondentů (13,7 %). Subklinická ateroskleróza hodnocená alespoň jedním parametrem byla detekována u 14 pacientů (33 %). IMT korelovalo (p ≤ 0,5) s věkem pacientů, s věkem v době diagnózy, délkou a intenzitou kouření, anamnézou ischemické choroby srdeční a cévní mozkové příhody, indexem poškození SLICC, nízkou hladinou trombocytů a C3 komplementu, vysokým titrem antikardiolipinových protilátek IgG i IgM. Přítomnost plátů korelovala s věkem, věkem v době diagnózy, délkou a intenzitou kouření „kouřoroky“, anamnézou ICHS, indexem poškození SLICC a nízkou hladinou trombocytů. Závěr: IMT a detekce plaků jsou velmi důležité markery subklinické aterosklerózy. V našem souboru i v četných dalších studiích korelují s tradičními rizikovými faktory a aktivitou onemocnění, jsou dobrým prognostickým faktorem přítomnosti kardiovaskulárních komorbidit.

The aim of the study was to detect subclinical atherosclerosis by measuring the thickness of intima media and its relation to cardiovascular manifestations, traditional risk factors, clinical manifestations, immunological profile and selected laboratory markers. Methods: Patients were screened between March 2015 and January 2016. Forty-two patients with SLE (5 men, 37 women) were examined. Traditional risk factors, clinical manifestations, immunological profile, disease activity and cumulative damage with SELENA-SLEDAI 2K and SLICC scoring systems, cumulative dose of glucocorticoids, disease duration, and presence of cardiovascular events were assessed in these patients. The results were evaluated statistically. Results: Pathological IMT was found in 10 patients (23.8%), plaque presence in 7 respondents (13.7%). Subclinical atherosclerosis evaluated by at least one parameter was detected in 14 patients (33%). IMT correlated (p ≤0.05) with the age of patients, age at diagnosis, duration and intensity of smoking, history of ischemic heart disease and stroke, SLICC damage index, low platelet count and C3 complement, and high titer of IgG and IgM anti-cardiolipin antibodies. The presence of plates correlated with age, age at diagnosis, length and intensity of smoking “pack years”, history of ischemic heart disease, SLICC damage index, and low platelet count. Conclusion: IMT and plaque detection are very important markers of subclinical atherosclerosis. In our series and in many other studies, these parameters correlate with traditional risk factors and disease activity, and they are a good prognostic factor for the presence of cardiovascular comorbidities..

• MeSH
• ateroskleróza * diagnóza   prevence a kontrola   MeSH
• glukokortikoidy aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• hypertenze MeSH
• interpretace statistických dat MeSH
• kardiovaskulární nemoci * diagnóza   prevence a kontrola   MeSH
• komorbidita MeSH
• kouření škodlivé účinky   MeSH
• lidé MeSH
• rizikové faktory MeSH
• systémový lupus erythematodes * diagnóza   MeSH
• tunica intima diagnostické zobrazování   patologie   MeSH
• tunica media diagnostické zobrazování   patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

Structural changes of thoracic aorta (TA), carotid (CA) and iliac artery (IA) were assessed in Wistar and spontaneously hypertensive rats (SHR) aged 3, 17, and 52 weeks. Systolic blood pressure (sBP) was measured by plethysmography weekly. After perfusion fixation the arteries were processed for electron microscopy. The wall thickness (WT), cross-sectional area (CSA), inner diameter (ID), and WT/ID in all arteries and volume densities of endothelial cells (ECs), muscle cells (SMCs), and extracellular matrix (ECM) in TA were measured and their CSAs were calculated. In 3-week-old SHR compared to Wistar rats, sBP did not differ; in the TA, all parameters (WT, CSA, ID, WT/ID, CSA of SMCs, CSA of ECs, and CSA of ECM) were decreased; in CA, WT and CSA did not differ, ID was decreased, and WT/ID was increased; in IA, WT, CSA, and ID were increased. In 17- and 52-week-old SHRs, sBP and all parameters in all arteries were increased, only ID in IE in 52-week-old SHRs and CSA of ECs in the TA in 17-week-old SHRs did not change. Disproportionality between BP increase and structural alterations during ontogeny in SHR could reflect the flexibility of the arterial tree to the different needs of supplied areas.

• MeSH
• aorta thoracica patologie   patofyziologie   MeSH
• arteria iliaca patologie   patofyziologie   MeSH
• arteriae carotides patologie   patofyziologie   MeSH
• hypertenze patologie   patofyziologie   MeSH
• krevní tlak fyziologie   MeSH
• krysa rodu rattus MeSH
• potkani inbrední SHR MeSH
• potkani Wistar MeSH
• tunica intima patologie   patofyziologie   MeSH
• věkové faktory MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

OBJECTIVE: Abnormal haemodynamics is commonly agreed to be a major contributor to the development of distal anastomotic intimal hyperplasia. A new vascular graft design proposed by computational studies was used to demonstrate its surgical feasibility and to compare it with the conventional graft in a porcine model. METHOD: The device was used in 12 eight-month-old pigs, six received the new graft and six had a conventional graft. The proximal graft end was implanted into the aorta, the distal graft end was implanted into the iliac artery. The host artery was ligated in order to simulate occlusion. At 20 weeks after surgery the pigs were killed and the device was excised for histological and morphometric analysis. RESULTS: In five experimental grafts the reconstruction was occluded due to thrombosis; only one prosthesis was patent showing a minimum of neointimal hyperplasia. In the control group too only three of the six grafts were patent. A histological analysis revealed, as the cause of occlusion, fibrous tissue overgrowth corresponding in structure to neointimal hyperplasia. Differences in the number of obliterations and in occlusion rates between the profiles of the two groups were evaluated using the median test (P<0.05). The results were not statistically significant. CONCLUSION: Although mathematical modelling had shown significant haemodynamic benefits of a naturally bifurcated graft, our study did not confirm its superiority over conventionally used prostheses.

• MeSH
• aorta patologie   chirurgie   MeSH
• cévní endotel patologie   MeSH
• cévní protézy škodlivé účinky   MeSH
• hyperplazie MeSH
• prasata MeSH
• protézy - design MeSH
• studie proveditelnosti MeSH
• tunica intima patologie   MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH

UNLABELLED: OBJECTVES: We investigated whether tacrolimus (FK506) can inhibit neointimal formation in arterialised vein grafts in rats. METHODS: Lewis iliolumbar veins were implanted into the abdominal aorta of isogeneic rats. Animals in the treatment groups had daily intramuscular injections of tacrolimus at 0.2 mg/kg (group B) and 0.1 mg/kg (Group C), respectively. The control group A had no treatment. Light microscope evaluations of arterialised vein grafts were performed 30 days after operation. We determined the presence of endothelial cells, the thickness of intima and media, and the degree of infiltration by MHC class II positive, CD4 positive, and CD8 positive cells into the adventitia. RESULTS: The intimal thickness in group B (5.0±1.0 µm) was statistically lower (P < 0.05) when compared to group C (7.0±3.0 µm). The intimal thickness in untreated group A (12.7±7.0 µm) was statistically higher (P < 0.01) when compared to both treated groups B and C, respectively. The medial thickness and degree of adventitial infiltration by MHC class II positive, CD8 positive, and CD4 positive cells did not differ between groups. CONCLUSION: Treatment with tacrolimus (FK506) showed a dose dependant inhibition of neointimal hyperplasia in arterialised vein grafts in rats (Tab. 1, Fig. 3, Ref. 22).

• MeSH
• aorta abdominalis chirurgie   MeSH
• hyperplazie MeSH
• imunosupresiva farmakologie   MeSH
• krysa rodu rattus MeSH
• neointima prevence a kontrola   MeSH
• potkani inbrední LEW MeSH
• takrolimus farmakologie   MeSH
• tunica intima účinky léků   patologie   MeSH
• vény patologie   transplantace   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

The main complication of aortocoronary reconstruction with vein grafts is restenosis in the course of time. The aim was to assess the effect of a periadventitial polyester mesh releasing sirolimus on intimal hyperplasia of autologous grafts. We implanted v. jugularis ext. into a. carotis communis in rabbits. The vein graft was either intact, or was wrapped with a pure polyester mesh, or with a sirolimus-releasing mesh. Three and six weeks after surgery, the veins were subjected to standard histological staining and the thicknesses of the tunica intima, the media and the intima-media complex were measured. Wrapping the vein with a mesh releasing sirolimus or with a pure mesh decreased the thickness of the intima in comparison with a vein graft by 73 ± 11% or 73 ± 8% after 3 weeks, and by 73 ± 9% or 59 ± 12% after 6 weeks, respectively. Sirolimus-releasing meshes reduced the thickness of the media by 65 ± 9% and 20 ± 12% after 3 and 6 weeks. The thickness of the intima-media complex in grafts with sirolimus-releasing meshes decreased by 60 ± 6% and 30 ± 13% in comparison with pure PES meshes, after 3 and 6 weeks, respectively. A periadventitial polyester mesh releasing sirolimus has the potential to become an effective device in preventing vein graft restenosis.

• MeSH
• chirurgické síťky MeSH
• činčila MeSH
• fixace tkání MeSH
• hyperplazie patologie   MeSH
• imunohistochemie MeSH
• imunosupresiva aplikace a dávkování   terapeutické užití   MeSH
• králíci MeSH
• léky implantované MeSH
• okluze cévního štěpu patologie   prevence a kontrola   MeSH
• počet buněk MeSH
• polyestery MeSH
• proliferace buněk MeSH
• proliferační antigen buněčného jádra metabolismus   MeSH
• sirolimus aplikace a dávkování   terapeutické užití   MeSH
• svaly hladké cévní účinky léků   MeSH
• tunica intima patologie   MeSH
• tunica media patologie   MeSH
• vény transplantace   MeSH
• zalévání tkání do parafínu MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Autologous vein grafts used as aortocoronary bypasses are often prone to intimal hyperplasia, which results in stenosis and occlusion of the vein. The aim of this study was to prevent intimal hyperplasia using a newly developed perivascular system with sustained release of sirolimus. This system of controlled drug release consists of a polyester mesh coated with a copolymer of L-lactic acid and epsilon-caprolactone that releases sirolimus. The mesh is intended for wrapping around the vein graft during surgery. The mesh releasing sirolimus was implanted in periadventitial position onto arteria carotis communis of rabbits, and neointimal hyperplasia was then assessed. We found that implanted sirolimus-releasing meshes reduced intima thickness by 47+/-10 % compared to a vein graft after 3 weeks. The pure polyester mesh decreased vein intima thickness by 35+/-9 %. Thus, our periadventitial system for controlled release of sirolimus prevented the development of intimal hyperplasia in autologous vein grafts in vivo in rabbits. A perivascularly applied mesh releasing sirolimus is a promising device for preventing stenosis of autologous vein grafts.

• MeSH
• hyperplazie prevence a kontrola   MeSH
• kardiovaskulární látky farmakologie   chemie   MeSH
• králíci MeSH
• nosiče léků MeSH
• okluze cévního štěpu patologie   prevence a kontrola   MeSH
• polyestery MeSH
• proliferace buněk účinky léků   MeSH
• sirolimus farmakologie   chemie   MeSH
• tunica intima patologie   účinky léků   MeSH
• venae jugulares patologie   účinky léků   MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• zvířata MeSH
• Publikační typ
• práce podpořená grantem MeSH