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Clonal haematopoiesis and cardiovascular diseases: A growing relationship.

克隆造血与心血管疾病: 日益增长的关系。

  • 影响因子:2.06
  • DOI:10.1016/j.acvd.2021.01.002
  • 作者列表:"Fawaz S","Mansier O","Pucheu Y","Marti S","Leroy H","Gaufroy A","Broitman J","James C","Couffinhal T
  • 发表时间:2021-03-10

:Cardiovascular diseases, particularly atherothrombosis, are the leading cause of death worldwide, but their mechanisms are not yet fully understood. Traditional cardiovascular risk factors have been known for many years, but are not enough to predict individual risk. Clonal haematopoiesis of indeterminate potential (CHIP) has been described recently; it corresponds to the clonal expansion of a population of haematopoietic cells in response to the acquisition of a somatic mutation, without any clinical or biological sign of haematological malignancy. The prevalence of this condition increases with age, reaching 10-20% of the general population aged>70 years. Recent observational studies have shown a link between CHIP and cardiovascular diseases in humans, revealing that CHIP carriers have a higher risk of myocardial infarction, heart failure and severe aortic valve stenosis. The prognosis of these conditions also seems to be altered by the presence of CHIP. Experimental studies have identified that the immune system and inflammation - particularly interleukin-1β-secreting macrophages - play a critical role in enhancing the cardiovascular consequences of CHIP, through their action on the atherosclerotic plaque and myocardial tissues. We aimed to write an extensive review of what is currently known about CHIP and its cardiovascular consequences, the pathophysiological mechanisms leading to the increased cardiovascular risk and, finally, the expected influence on our daily practice and how we care for patients with CHIP.


: 心血管疾病,尤其是动脉粥样硬化,是世界范围内的主要死亡原因,但其机制尚未完全了解。传统的心血管危险因素已经知道很多年了,但还不足以预测个体风险。最近已经描述了不确定潜能的克隆造血 (CHIP); 它对应于造血细胞群体的克隆扩增,以响应获得体细胞突变,而没有任何血液学恶性肿瘤的临床或生物学迹象。这种疾病的患病率随着年龄的增长而增加,在> 70岁的普通人群中达到10-20%。最近的观察性研究显示了CHIP与人类心血管疾病之间的联系,揭示了CHIP携带者患心肌梗死、心力衰竭和严重主动脉瓣狭窄的风险更高。这些病症的预后似乎也因CHIP的存在而改变。实验研究已经确定,免疫系统和炎症-特别是分泌白细胞介素-1β 的巨噬细胞-通过它们对动脉粥样硬化斑块和心肌组织的作用在增强CHIP的心血管后果中起关键作用。我们的目的是写一篇关于CHIP及其心血管后果的广泛综述,导致心血管风险增加的病理生理机制,最后是对我们日常实践的预期影响以及我们如何护理CHIP患者。



作者列表:["Juan-Carlos PM","Perla-Lidia PP","Stephanie-Talia MM","Mónica-Griselda AM","Luz-María TE"]

METHODS::The ATP binding-cassette superfamily corresponds the mostly transmembrane transporters family found in humans. These proteins actively transport endogenous and exogenous substrates through biological membranes in body tissues, so they have an important role in the regulation of many physiological functions necessary for human homeostasis, as well as in response regulation to several pharmacological substrates. The development of multidrug resistance has become one of the main troubles in conventional chemotherapy in different illnesses including cancer, being the increased efflux of antineoplastic drugs the main reason for this multidrug resistance, with a key role of the ABC superfamily. Likely, the interindividual variability in the pharmacological response among patients is well known, and may be due to intrinsically factors of the disease, genetic and environmental ones. Thus, the understanding of this variability, especially the genetic variability associated with the efficacy and toxicity of drugs, can provide a safer and more effective pharmacological treatment, so ABC genes are considered as important regulators due to their relationship with the reduction in pharmacological response. In this review, updated information about transporters belonging to this superfamily was collected, the possible role of these transporters in cancer, the role of genetic variability in their genes, as well as some therapeutic tools that have been tried to raise against main transporters associated with chemoresistance in cancer.

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作者列表:["Sawada H","Oeda T","Kohsaka M","Tomita S","Umemura A","Park K","Yamamoto K","Kiyohara K"]

METHODS:BACKGROUND:Cholinergic neurotransmission regulates neuroinflammation in Parkinson disease (PD). RESEARCH DESIGN AND METHODS:The authors conducted a delayed-start study of donepezil for cognitive decline in non-demented PD patients. The study consisted of a 96-week randomized placebo-controlled double-blind phase 1, followed by a 24-week donepezil extension phase 2. The primary outcome measure was a change in the Mini-Mental State Examination (MMSE) at week 120. RESULTS:A total of 98 patients were randomly allocated to the early-start (donepezil-to-donepezil) and delayed-start (placebo-to-donepezil) groups. Mean (SD) of the baseline MMSE was 27.6 (2.0) and 28.0 (2.1), respectively. MMSE change at week 120 was better in the early-start group than in the delayed-start group, but the difference was not significant. The MMSE declined in apolipoprotein ε4 carriers, but not in non-carriers, and the factor interaction (intervention × ε4 genotype) was highly significant (P < 0.001). Analyzed with the interaction, the difference was significant (group difference 1.95 [0.33 to 3.57], P = 0.018). The MMSE decline slope in phase 1 was significantly better in the early-start group than in the delayed-start group (P = 0.048). CONCLUSIONS:Cognitive function deteriorated in ε4 carriers, but not in non-carriers, and early-start donepezil may postpone cognitive decline in the former.

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作者列表:["Louvrier A","Terranova L","Meyer C","Meyer F","Euvrard E","Kroemer M","Rolin G"]

METHODS::Since the discovery of dental pulp stem cells, a lot of teams have expressed an interest in dental pulp regeneration. Many approaches, experimental models and biological explorations have been developed, each including the use of stem cells and scaffolds with the final goal being clinical application in humans. In this review, the authors' objective was to compare the experimental models and strategies used for the development of biomaterials for tissue engineering of dental pulp with stem cells. Electronic queries were conducted on PubMed using the following terms: pulp regeneration, scaffold, stem cells, tissue engineering and biomaterial. The extracted data included the following information: the strategy envisaged, the type of stem cells, the experimental models, the exploration or analysis methods, the cytotoxicity or viability or proliferation cellular tests, the tests of scaffold antibacterial properties and take into account the vascularization of the regenerated dental pulp. From the 71 selected articles, 59% focused on the "cell-transplantation" strategy, 82% used in vitro experimentation, 58% in vivo animal models and only one described an in vivo in situ human clinical study. 87% used dental pulp stem cells. A majority of the studies reported histology (75%) and immunohistochemistry explorations (66%). 73% mentioned the use of cytotoxicity, proliferation or viability tests. 48% took vascularization into account but only 6% studied the antibacterial properties of the scaffolds. This article gives an overview of the methods used to regenerate dental pulp from stem cells and should help researchers create the best development strategies for research in this field.

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