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Forensic Science International Sep 2023Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality worldwide. The patients' and injuries' heterogeneity associated with TBI, alongside...
BACKGROUND
Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality worldwide. The patients' and injuries' heterogeneity associated with TBI, alongside with its variable clinical manifestations, make it challenging to make diagnosis and predict prognosis. Therefore, the identification of reliable prognostic markers would be relevant both to support clinical decision-making and forensic evaluation of polytraumatic deaths and cases of medical malpractice. This pilot study aimed to evaluate some of the main biomarkers specific for brain damage in sTBI and mmTBI deaths in samples of vitreous humor (VH) in order to verify whether predictors of prognosis in TBI can be found in this matrix.
METHODS
VH were obtained from both eyes (right and left) of 30 cadavers (20 sTBI and 10 mmTBI) and analysed. These factors were evaluated: NSE (neuron-specific enolase), S100 calcium-binding protein (S100), glial fibrillary acidic protein (GFAP), Brain-derived neurotrophic factor (BDNF), Copeptin, Interleukin 6 (IL-6), Ferritin, Lactate dehydrogenase (LDH), C-Reactive Protein (CRP), Procalcitonin (PCT), Glucose and Neutrophil gelatinase-associated lipocalin (N-Gal).
RESULTS
Four of the analysed proteins (LDH, ferritin, S100 and NSE) proved to be particularly promising. In particular, logistic regression analysis found a good discriminatory power.
CONCLUSIONS
Given the peculiarity of the matrix and the poor standardization of the sampling, such promising results need to be furtherly investigated in serum before being implemented in the forensic practice.
Topics: Humans; Pilot Projects; Vitreous Body; S100 Calcium Binding Protein beta Subunit; Brain Injuries, Traumatic; Biomarkers; Glial Fibrillary Acidic Protein; Ferritins
PubMed: 37467521
DOI: 10.1016/j.forsciint.2023.111782 -
Molecular Vision 2021Collagen is a key player contributing to vitreoelasticity and vitreoretinal adhesions. Molecular reorganization causes spontaneous weakening of these adhesions with age,...
PURPOSE
Collagen is a key player contributing to vitreoelasticity and vitreoretinal adhesions. Molecular reorganization causes spontaneous weakening of these adhesions with age, resulting in the separation of the posterior hyaloid membrane (PHM) from the retina in what is called complete posterior vitreous detachment (PVD). Incomplete separation of the posterior hyaloid or tight adherence or both can lead to retinal detachment, vitreomacular traction syndrome, or epiretinal membrane formation, which requires surgical intervention. Pharmacological vitrectomy has the potential of avoiding surgical vitrectomy; it is also useful as an adjunct during retinal surgery to induce PVD. Previously studied enzymatic reagents, such as collagenase derived from are nonspecific and potentially toxic. We studied a novel collagenase from (VMC) which remains active (VMA), even after deletion of 51 C-terminal amino acids. To limit the activity of VMA to the vitreous cavity, a fusion construct (inhibitor of hyaluronic acid-VMA [iHA-VMA]) was made in which a 12-mer peptide (iHA, which binds to HA) was fused to the N-terminus of VMA. The construct was evaluated in the context of PVD.
METHODS
VMA and iHA-VMA were expressed in purified, and characterized with gelatin zymography, collagen degradation assay, fluorescamine-based assay, and cell-based assays. Two sets of experiments were performed in New Zealand albino rabbits. Group A (n = 10) received iHA-VMA, while group B (n = 5) received the equivalent dose of VMA. In both groups, saline was injected as a control in the contralateral eyes. Animals were monitored with indirect ophthalmoscopy, optical coherence tomography (OCT), and B-scan ultrasonography. Retinal toxicity was assessed with hematoxylin and eosin (H&E) staining of retinal tissue.
RESULTS
The activity of iHA-VMA and VMA was comparable and 65-fold lower than that of collagenase Type IV. In the iHA-VMA group, all the rabbits (n = 10) developed PVD, with complete PVD seen in six animals. No statistically significant histomorphological changes were seen. In the VMA group, four of the five rabbits developed complete PVD; however, retinal morphological changes were seen in two animals.
CONCLUSIONS
iHA-VMA displays targeted action confined to the vitreous and shows potential for safe pharmacologic vitreolysis.
Topics: Animals; Cell Survival; Collagenases; Electrophoresis, Polyacrylamide Gel; Flow Cytometry; Goats; Hyaluronic Acid; Intravitreal Injections; Microscopy, Electron, Scanning; Ophthalmoscopy; Rabbits; Recombinant Fusion Proteins; Retina; Vibrio mimicus; Vitrectomy; Vitreous Body; Vitreous Detachment
PubMed: 33907368
DOI: No ID Found -
Pharmacological Research Sep 2021Diabetic retinopathy (DR) is one of the common complications in diabetic patients. Nowadays, VEGF pathway is subject to extensive research. However, about 27% of the...
Diabetic retinopathy (DR) is one of the common complications in diabetic patients. Nowadays, VEGF pathway is subject to extensive research. However, about 27% of the patients have a poor visual outcome, with 50% still having edema after two years' treatment of diabetic macular edema (DME) with ranibizumab. Docosahexaenoic acid (DHA), the primary ω-3 long-chain polyunsaturated fatty acid (LC-PUFA), reduces abnormal neovascularization and alleviates neovascular eye diseases. A study reported that fish oil reduced the incidence of retinopathy of prematurity (ROP) by about 27.5% in preterm infants. Although ω-3 LC-PUFAs protects against pathological retinal neovascularization, the treatment effectiveness is low. It is interesting to investigate why DHA therapy fails in some patients. In human vitreous humor samples, we found that the ratio of DHA and DHA-derived metabolites to total fatty acids was higher in vitreous humor from DR patients than that from macular hole patients; however, the ratio of DHA metabolites to DHA and DHA-derived metabolites was lower in the diabetic vitreous humor. The expression of Mfsd2a, the LPC-DHA transporter, was reduced in the oxygen-induced retinopathy (OIR) model and streptozotocin (STZ) model. In vitro, Mfsd2a overexpression inhibited endothelial cell proliferation, migration and vesicular transcytosis. Moreover, Mfsd2a overexpression in combination with the DHA diet obviously reduced abnormal retinal neovascularization and vascular leakage, which is more effective than Mfsd2a overexpression alone. These results suggest that DHA therapy failure in some DR patients is linked to low expression of Mfsd2a, and the combination of Mfsd2a overexpression and DHA therapy may be an effective treatment.
Topics: Animals; Cell Line; Diabetes Mellitus, Experimental; Diabetes Mellitus, Type 1; Diabetic Retinopathy; Docosahexaenoic Acids; Endothelial Cells; Female; Humans; Macular Edema; Male; Mice, Inbred C57BL; Retina; Symporters; Vitreous Body; Wound Healing; Mice
PubMed: 34229049
DOI: 10.1016/j.phrs.2021.105755 -
Indian Journal of Ophthalmology Apr 2022Diabetic membranes are always a challenge for a surgeon because of sticky nature and chances of iatrogenic break while removing.
BACKGROUND
Diabetic membranes are always a challenge for a surgeon because of sticky nature and chances of iatrogenic break while removing.
PURPOSE
To demonstrate a safe reverse swiss roll technique to dissect diabetic vitreous membranes.
SYNPOSIS
Approaches and techniques for membrane dissection are segmentation, delamination and en-bloc dissection using various types of instruments and illumination. With vitreous cutte, picks and scissors, surgical steps are traditionallu performed by using classic lift and shave technique. After identifying the plane, tissue is lifted and then cut, which puts the retina at risk of break because of traction and active suction. Such a threat can be reduced by placing the cutter above the membrane thereby having the membrane itseld acting as a protective cushion to the retina. Port here, unlike lift and shave technique, doesn't face the edge of membrane but is exactly 180 degree opposite and membrane curls into port because of suction. Also, hemostasis is maintained by continuous aspiration and cutting as the instrument is moved side to side, retracting from the edge.
HIGHLIGHTS
Reverse swiss roll technique is safer compared to lift and shave because of the safety cushion of the membrane between the port and the retina. There is inherently less chances of retinal break because the active suction from the port is directed away from the retina. The technique also minimises traction and localised pull on the atrophic macula.
VIDEO LINK
https://youtu.be/WNnSsP69ZLw.
Topics: Diabetes Mellitus; Humans; Retinal Perforations; Switzerland; Vitrectomy; Vitreous Body
PubMed: 35326086
DOI: 10.4103/ijo.IJO_631_22 -
PloS One 2020The aim of this study was to investigate whether and how the biological media which are in contact with silicone oil play a role in the silicone emulsification process....
The aim of this study was to investigate whether and how the biological media which are in contact with silicone oil play a role in the silicone emulsification process. Commercially available Oxane 1300 silicone oil and potential hydrophilic phases of the emulsions in the eye (porcine aqueous humor, porcine vitreous and balanced salt solution) were investigated separately and in a mixture or emulsions by means of surface tension, rheological, zeta potential measurements and microscopic investigation. The surface tension of biological media (vitreous and aqueous humor) was significantly lower than that of non-biological media, especially in the case of aqueous humor, which indicates a remarkable emulsification tendency with these phases. The biological media are able to form both oil-in-water and water-in-oil emulsions, which can be observed in the clinical practice as well. It was established that the vitreous has a more expressed emulsification ability compared with the aqueous humor because smaller and more stable droplets can form with silicon oil when the vitreous is still there. It can be concluded that the vitreous has a higher impact on emulsification than the aqueous medium, which can predict that the vitreous remaining after vitrectomy has a key role in emulsion formation in the eye with silicone oil endotamponade.
Topics: Animals; Aqueous Humor; Emulsions; Isotonic Solutions; Rheology; Silicone Oils; Surface Tension; Swine; Vitrectomy; Vitreous Body
PubMed: 32559226
DOI: 10.1371/journal.pone.0235067 -
BMJ Case Reports Jan 2017
Topics: Adult; Athletic Injuries; Eye Injuries; Humans; Male; Vitreous Body; Vitreous Hemorrhage; Wounds, Nonpenetrating
PubMed: 28052952
DOI: 10.1136/bcr-2016-218303 -
Fa Yi Xue Za Zhi Feb 2018Estimation of postmortem interval (PMI) plays a crucial role in forensic study and identification work. Because of the unique anatomy location, vitreous humor is... (Review)
Review
Estimation of postmortem interval (PMI) plays a crucial role in forensic study and identification work. Because of the unique anatomy location, vitreous humor is considered to be used for estima- ting PMI, which has aroused interest among scholars, and some researches have been carried out. The detection techniques of vitreous humor are constantly developed and improved which have been gradually applied in forensic science, meanwhile, the study of PMI estimation using vitreous humor is updated rapidly. This paper reviews various techniques and instruments applied to vitreous humor detection, such as ion selective electrode, capillary ion analysis, spectroscopy, chromatography, nano-sensing technology, automatic biochemical analyser, flow cytometer, etc., as well as the related research progress on PMI estimation in recent years. In order to provide a research direction for scholars and promote a more accurate and efficient application in PMI estimation by vitreous humor analysis, some inner problems are also analysed in this paper.
Topics: Autopsy; Body Fluids; Flow Cytometry; Forensic Pathology; Humans; Postmortem Changes; Potassium; Time Factors; Vitreous Body
PubMed: 29577705
DOI: 10.3969/j.issn.1004-5619.2018.01.010 -
The Journal of International Medical... Dec 2022To evaluate the relationship between the microbiological results of the vitreous humor and those of foreign body specimens in patients with intraocular foreign body...
OBJECTIVE
To evaluate the relationship between the microbiological results of the vitreous humor and those of foreign body specimens in patients with intraocular foreign body (IOFB).
METHODS
Seventy-one patients with an IOFB were included in this descriptive prospective case series. All patients underwent immediate IOFB removal. Vitreous sampling was performed during vitrectomy. Foreign bodies were placed directly into culture media for microbiological study.
RESULTS
Thirteen (18.3%) patients developed endophthalmitis. The results of microbiological analysis of IOFB and vitreous humor specimens were negative in nine patients and positive in four. Fifty-eight (81.6%) patients with an IOFB had no evidence of endophthalmitis. Among them, seven patients showed positive microbiological results of foreign bodies with no manifestations of endophthalmitis. In five patients, a strain was observed in the culture of the IOFB specimen. Two patients had only positive smear test results of their vitreous humor specimen.
CONCLUSION
A correlation appears to be present between the microbiological results of the vitreous humor and IOFB specimens in patients with clinical findings of endophthalmitis but not in patients with a pure IOFB without clinical features of endophthalmitis. This may justify early use of intravitreal and intravenous antibiotics before the development of endophthalmitis.
Topics: Humans; Eye Injuries, Penetrating; Eye Foreign Bodies; Vitreous Body; Anti-Bacterial Agents; Endophthalmitis; Vitrectomy; Retrospective Studies
PubMed: 36562091
DOI: 10.1177/03000605221138482 -
Cells Apr 2021In this study, we compare the vitreous cytokine profile in patients with proliferative diabetic retinopathy (PDR) to that of patients without PDR. The identification of...
In this study, we compare the vitreous cytokine profile in patients with proliferative diabetic retinopathy (PDR) to that of patients without PDR. The identification of novel cytokines involved in the pathogenesis of PDR provides candidate therapeutic targets that may stand alone or work synergistically with current therapies in the management of diabetic retinopathy. Undiluted vitreous humor specimens were collected from 74 patients undergoing vitrectomy for various vitreoretinal disorders. Quantitative immunoassay was performed for a panel of 36 neuroinflammatory cytokines in each specimen and assessed to identify differences between PDR ( = 35) and non-PDR ( = 39) patients. Levels of interleukin-8 (IL-8), IL-15, IL-16, vascular endothelial growth factor (VEGF), VEGF-D, c-reactive protein (CRP), serum amyloid-A (SAA), and intracellular adhesion molecule-1 (ICAM1) were significantly increased in the vitreous of PDR patients compared to non-PDR patients ( < 0.05). We report novel increases in IL-15 and IL-16, in addition to the expected VEGF, in the human vitreous humor of patients with PDR. Additionally, we confirm the elevation of ICAM-1, VCAM-1, SAA, IL-8 and CRP in the vitreous of patients with PDR, which has previously been described.
Topics: C-Reactive Protein; Diabetic Retinopathy; Female; Fibroblast Growth Factor 2; Humans; Intercellular Adhesion Molecule-1; Interleukins; Male; Middle Aged; Vascular Cell Adhesion Molecule-1; Vascular Endothelial Growth Factor A; Vitreous Body
PubMed: 33946446
DOI: 10.3390/cells10051069 -
Frontiers in Immunology 2020The complement system plays a crucial role in retinal homeostasis. While the proteomic analysis of ocular tissues in diabetic retinopathy (DR) has shown the deposition...
The complement system plays a crucial role in retinal homeostasis. While the proteomic analysis of ocular tissues in diabetic retinopathy (DR) has shown the deposition of complement proteins, their exact role in the pathogenesis of DR is yet unclear. We performed a detailed investigation of the role of the complement system by evaluating the levels of major complement proteins including C3, C1q, C4b, Complement Factor B (CFB), and Complement Factor H (CFH) and their activated fragments from both the classical and alternative pathways in vitreous humor and serum samples from proliferative DR (PDR) patients and controls. Further, the expressions of complements and several other key pro- and anti-angiogenic genes in the serum and vitreous humor were analyzed in the blood samples of PDR and non-PDR (NPDR) patients along with controls without diabetes. We also assessed the pro-inflammatory cytokines and matrix metalloproteinases in the vitreous humor samples. There was a significant increase in C3 and its activated fragment C3bα' (110 kDa) along with a corresponding upregulation of CFH in the vitreous of PDR patients, which confirmed the increased activation of the alternative complement pathway in PDR. Likewise, a significant upregulation of angiogenic genes and downregulation of anti-angiogenic genes was seen in PDR and NPDR cases. Increased MMP9 activity and upregulation of inflammatory markers IL8 and sPECAM with a downregulation of anti-inflammatory marker IL-10 in PDR vitreous indicated the possible involvement of microglia in DR pathogenesis. Further, a significantly high C3 deposition in the capillary wall along with thickening of basement membranes and co-localization of CFH expression with CD11b activated microglial cells in diabetic retina suggested microglia as a source of CFH in diabetic retina. The increased CFH levels could be a feedback mechanism for arresting excessive complement activation in DR eyes. A gradual increase of and expression in retina with early to late changes in epiretinal membranes of DR patients indicated a major role for the alternative complement pathway in disease progression.
Topics: Aged; Biomarkers; Case-Control Studies; Complement C3; Complement Factor H; Complement Pathway, Alternative; Complement Pathway, Classical; Cytokines; Diabetic Retinopathy; Female; Humans; Male; Microglia; Middle Aged; Neovascularization, Pathologic; Retina; Transcriptome; Vitreous Body
PubMed: 32117292
DOI: 10.3389/fimmu.2020.00154