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Seminars in Cell & Developmental Biology Mar 2024Owing to their manifold roles in health and disease, there have been intense efforts to synthetically generate blood vessels in vitro from human pluripotent stem cells... (Review)
Review
Owing to their manifold roles in health and disease, there have been intense efforts to synthetically generate blood vessels in vitro from human pluripotent stem cells (hPSCs). However, there are multiple types of blood vessel, including arteries and veins, which are molecularly and functionally different. How can we specifically generate either arterial or venous endothelial cells (ECs) from hPSCs in vitro? Here, we summarize how arterial or venous ECs arise during embryonic development. VEGF and NOTCH arbitrate the bifurcation of arterial vs. venous ECs in vivo. While manipulating these two signaling pathways biases hPSC differentiation towards arterial and venous identities, efficiently generating these two subtypes of ECs has remained challenging until recently. Numerous questions remain to be fully addressed. What is the complete identity, timing and combination of extracellular signals that specify arterial vs. venous identities? How do these extracellular signals intersect with fluid flow to modulate arteriovenous fate? What is a unified definition for endothelial progenitors or angioblasts, and when do arterial vs. venous potentials segregate? How can we regulate hPSC-derived arterial and venous ECs in vitro, and generate organ-specific ECs? In turn, answers to these questions could avail the production of arterial and venous ECs from hPSCs, accelerating vascular research, tissue engineering, and regenerative medicine.
Topics: Humans; Endothelial Cells; Pluripotent Stem Cells; Cell Differentiation; Arteries
PubMed: 37393122
DOI: 10.1016/j.semcdb.2023.06.004 -
The Journal of Maternal-fetal &... Dec 2023Regular and supervised exercise during pregnancy is worldwide recommended due to its proven benefits, but, during exercise, maternal blood flow is redirected from the... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Regular and supervised exercise during pregnancy is worldwide recommended due to its proven benefits, but, during exercise, maternal blood flow is redirected from the viscera to the muscles and how fetal wellbeing may be affected by this redistribution is still not well known.
OBJECTIVE
To analyze the longitudinal effect of a supervised moderate physical exercise program during pregnancy on uteroplacental and fetal Doppler parameters.
METHODS
This is a planned secondary analysis of an randomized controlled trial (RCT), performed at Hospital Universitario de Torrejón, Madrid, Spain, including 124 women randomized from 12 to 15 weeks of gestation to exercise vs. control group. Fetal umbilical artery (UA), middle cerebral artery, and uterine artery pulsatility index (PI), were longitudinally collected by Doppler ultrasound assessment throughout gestation, and derived cerebroplacental ratio (normalized by -score), and maternal mean PI in the uterine arteries (normalized by multiplies of the median). Obstetric appointments were scheduled at 12 (baseline, 12 to 13), 20 (19 to 24), 28 (26 to 31) and 35 weeks (32 to 38) of gestation. Generalized estimating equations were adjusted to assess longitudinal changes in the Doppler measurements according to the randomization group.
RESULTS
No significant differences in the fetal or maternal Doppler measurements were found at any of the different checkup time points studied. The only variable that consistently affected the Doppler standardized values was gestational age at the time of assessment. The evolution of the UA PI -score during the pregnancy was different in the two study groups, with a higher -score in the exercise group at 20 weeks and a subsequent decrease until delivery while in the control group it remained stable at around zero.
CONCLUSIONS
A regular supervised moderate exercise program during pregnancy does not deteriorate fetal or maternal ultrasound Doppler parameters along the pregnancy, suggesting that the fetal well-being is not compromised by the exercise intervention. Fetal UA PI -score decreases during pregnancy to lower levels in the exercise group compared with the control group.
Topics: Pregnancy; Female; Humans; Ultrasonography, Prenatal; Fetus; Prenatal Care; Gestational Age; Middle Cerebral Artery; Ultrasonography, Doppler; Umbilical Arteries; Pulsatile Flow
PubMed: 36889747
DOI: 10.1080/14767058.2023.2183759 -
Neuro-Chirurgie May 2024Vertebral artery dissection (VAD) is an infrequent source of subarachnoid hemorrhage (SAH), with a high mortality rate, primarily due to the risk of rebleeding both... (Review)
Review
BACKGROUND
Vertebral artery dissection (VAD) is an infrequent source of subarachnoid hemorrhage (SAH), with a high mortality rate, primarily due to the risk of rebleeding both before and after medical intervention. This paper provides a comprehensive analysis of the anatomy, pathophysiology, clinical presentation, treatment strategies, and outcomes of intracranial vertebral artery dissections that result in subarachnoid hemorrhage.
METHODS
Comprehensive five-year literature review (2018-2022) and a retrospective analysis of patient records from our institution between 2016 and 2022. We included studies with a minimum of 5 patients.
RESULTS
The study incorporated ten series from the literature and 22 cases from CHUM. Key anatomical factors increasing the risk of VAD include the vertebral artery's origin from the aortic arch, asymmetry of the vertebral artery, and its tortuosity. Patients may display specific collagen and genetic abnormalities. The occurrence of VAD appears to be more prevalent in men. Those with a ruptured intracranial VAD typically show prodromal symptoms and present with severe SAH. Rebleeding within the first 24 h is frequent. While standard imaging methods are usually adequate for VAD diagnosis, they may not provide detailed information about the perforator anatomy. Treatment approaches include both deconstructive and reconstructive methods.
CONCLUSION
Ruptured VAD is a critical, life-threatening condition. Many patients have a poor neurological status at presentation, and rebleeding prior to treatment is a significant concern. Deconstructive techniques are most effective in preventing rebleeding, whereas the efficacy of reconstructive techniques needs more investigation.
Topics: Humans; Subarachnoid Hemorrhage; Vertebral Artery Dissection; Male; Female; Retrospective Studies; Vertebral Artery; Middle Aged; Adult
PubMed: 38277864
DOI: 10.1016/j.neuchi.2023.101526 -
GeroScience Aug 2023Advanced age is accompanied by arterial dysfunction, as well as a diminished glycocalyx, which may be linked to reduced high molecular weight-hyaluronan (HMW-HA)...
Advanced age is accompanied by arterial dysfunction, as well as a diminished glycocalyx, which may be linked to reduced high molecular weight-hyaluronan (HMW-HA) synthesis. However, the impact of glycocalyx deterioration in age-related arterial dysfunction is unknown. We sought to determine if manipulations in glycocalyx properties would alter arterial function. Tamoxifen-induced hyaluronan synthase 2 (Has2) reduction was used to decrease glycocalyx properties. Three weeks post-tamoxifen treatment, glycocalyx thickness was lower in Has2 knockout compared to wild-type mice (P<0.05). Has2 reduction induced arterial dysfunction, demonstrated by impaired endothelium-dependent dilation (EDD) and elevated aortic stiffness (P<0.05). To augment glycocalyx properties, old mice received 10 weeks of a glycocalyx-targeted therapy via Endocalyx™ (old+ECX), which contains HMW-HA and other glycocalyx components. Compared to old control mice, glycocalyx properties and EDD were augmented, and aortic stiffness decreased in old+ECX mice (P<0.05). Old+ECX mice had a more youthful aortic phenotype, demonstrated by lower collagen content and higher elastin content than old control mice (P<0.05). Functional outcomes were repeated in old mice that underwent a diet supplemented solely with HMW-HA (old+HA). Compared to old controls, glycocalyx properties and EDD were augmented, and aortic stiffness was lower in old+HA mice (P<0.05). We did not observe any differences between old+HA and old+ECX mice (P>0.05). Has2 reduction phenocopies age-related arterial dysfunction, while 10 weeks of glycocalyx-targeted therapy that restores the glycocalyx also ameliorates age-related arterial dysfunction. These findings suggest that the glycocalyx may be a viable therapeutic target to ameliorate age-related arterial dysfunction.
Topics: Animals; Mice; Glycocalyx; Arteries; Aorta; Dietary Supplements; Tamoxifen
PubMed: 36787090
DOI: 10.1007/s11357-023-00745-1 -
Neuro Endocrinology Letters Sep 2023This study was aimed to investigate the influence of carotid hemodynamics in common carotid artery (CCA) and internal carotid artery (ICA) on carotid plaque location.
PURPOSE
This study was aimed to investigate the influence of carotid hemodynamics in common carotid artery (CCA) and internal carotid artery (ICA) on carotid plaque location.
METHODS
A total of 4444 participants from Anhui Maanshan People's Hospital were selected from December 2013 to December 2018. Doppler ultrasound was used to measure the location of carotid plaque. Patients were divided into four groups according to plaque location: LEFT, RIGHT, BOTH, and NONE. Multiple logistic regression and smooth curve were applied to determine the relationship of carotid plaque location and hemodynamic indexes.
RESULTS
Compared with the NONE group, the ratio of artery systolic and diastolic blood flow velocity in right internal carotid (RICA S/D) was a risk factor for LEFT group (OR=1.548) after adjustment; artery systolic and diastolic blood flow velocity ratio of left common carotid artery (LCCA S/D) was a risk factor for RIGHT group (OR=1.250); resistance index of right internal carotid (RICA RI) was a protective factor for BOTH group (OR=0.097), while LCCA S/D and RICA S/D were risk factors for BOTH group (OR=1.201, OR=1.457). Compared with the RIGHT group, artery systolic and diastolic blood flow velocity ratio of right common carotid (RCCA S/D) was the risk factor for the LEFT group (OR=1.463), LCCA S/D and RICA S/D were the risk factors for BOTH group (OR=1.706, OR=2.111). After age stratification, resistance index of right common carotid artery (RCCA RI) and resistance index of left internal carotid artery (LICA RI) were protective factors for BOTH group (OR=0.046, OR=0.042) in group younger than 52. RCCA S/D and RICA S/D were risk factors for BOTH group (OR=1.557, OR=1.843). Resistance index of left common carotid artery (LCCA RI) was a protective factor in the LEFT group compared with the RIGHT group (OR=0.476). In group older than 52, RICA S/D was a risk factor for LEFT group (OR=1.388). LCCA S/D was a risk factor for RIGHT group (OR=1.575). LCCA S/D and RICA S/D were risk factors for BOTH group (OR=1.348, OR=1.311). RICA S/D and RCCA S/D were protective factors in the LEFT group compared with the RIGHT group (OR=0.567, OR=0.680).
Topics: Humans; Carotid Arteries; Carotid Artery, Common; Hemodynamics; Plaque, Atherosclerotic; Ultrasonography; Blood Flow Velocity; Carotid Artery, Internal
PubMed: 37776557
DOI: No ID Found -
International Journal of Molecular... Jun 2024Atherosclerosis is an inflammatory reaction that develops at specific regions within the artery wall and at specific sites of the arterial tree over a varying time frame... (Review)
Review
Atherosclerosis is an inflammatory reaction that develops at specific regions within the artery wall and at specific sites of the arterial tree over a varying time frame in response to a variety of risk factors. The mechanisms that account for the interaction of systemic factors and atherosclerosis-susceptible regions of the arterial tree to mediate this site-specific development of atherosclerosis are not clear. The dynamics of blood flow has a major influence on where in the arterial tree atherosclerosis develops, priming the site for interactions with atherosclerotic risk factors and inducing cellular and molecular participants in atherogenesis. But how this accounts for lesion development at various locations along the vascular tree across differing time frames still requires additional study. Currently, murine models are favored for the experimental study of atherogenesis and provide the most insight into the mechanisms that may contribute to the development of atherosclerosis. Based largely on these studies, in this review, we discuss the role of hemodynamic shear stress, SR-B1, and other factors that may contribute to the site-specific development of atherosclerosis.
Topics: Atherosclerosis; Animals; Mice; Disease Models, Animal; Humans; Hemodynamics; Arteries
PubMed: 38928086
DOI: 10.3390/ijms25126375 -
International Journal of Molecular... Feb 2024The normal ageing process affects resistance arteries, leading to various functional and structural changes. Systolic hypertension is a common occurrence in human... (Review)
Review
The normal ageing process affects resistance arteries, leading to various functional and structural changes. Systolic hypertension is a common occurrence in human ageing, and it is associated with large artery stiffening, heightened pulsatility, small artery remodeling, and damage to critical microvascular structures. Starting from young adulthood, a progressive elevation in the mean arterial pressure is evidenced by clinical and epidemiological data as well as findings from animal models. The myogenic response, a protective mechanism for the microcirculation, may face disruptions during ageing. The dysregulation of calcium entry channels (L-type, T-type, and TRP channels), dysfunction in intracellular calcium storage and extrusion mechanisms, altered expression of potassium channels, and a change in smooth muscle calcium sensitization may contribute to the age-related dysregulation of myogenic tone. Flow-mediated vasodilation, a hallmark of endothelial function, is compromised in ageing. This endothelial dysfunction is related to increased oxidative stress, lower nitric oxide bioavailability, and a low-grade inflammatory response, further exacerbating vascular dysfunction. Resistance artery remodeling in ageing emerges as a hypertrophic response of the vessel wall that is typically observed in conjunction with outward remodeling (in normotension), or as inward hypertrophic remodeling (in hypertension). The remodeling process involves oxidative stress, inflammation, reorganization of actin cytoskeletal components, and extracellular matrix fiber proteins. Reactive oxygen species (ROS) signaling and chronic low-grade inflammation play substantial roles in age-related vascular dysfunction. Due to its role in the regulation of vascular tone and structural proteins, the RhoA/Rho-kinase pathway is an important target in age-related vascular dysfunction and diseases. Understanding the intricate interplay of these factors is crucial for developing targeted interventions to mitigate the consequences of ageing on resistance arteries and enhance the overall vascular health.
Topics: Animals; Humans; Young Adult; Adult; Vasoconstriction; Calcium; Proteomics; Arteries; Hypertension; Aging; Inflammation
PubMed: 38473847
DOI: 10.3390/ijms25052601 -
Journal of Anatomy Dec 2023Cerebral blood flow constitutes a critical area of interest for neurologists, neurosurgeons, and interventional radiologists as a social burden related to ischemic...
Cerebral blood flow constitutes a critical area of interest for neurologists, neurosurgeons, and interventional radiologists as a social burden related to ischemic stroke, hemorrhagic stroke, and vascular dementia is expected to intensify. There is a great need to develop new and effective therapies, therefore deepening understanding of cerebrovascular anatomy, physiology, and pathology is crucial. The main aim of the study was to develop a comprehensive classification of the pontine arteries considering their typology, relations to the cranial nerves, branching schemes, and superficial pontine blood supply areas. We prepared 100 anatomical specimens of the human brainstem with the basilar artery, the pontine arteries, and the terminal perforating arteries. With the use of microsurgical microscope, we analyzed morphometry of the basilar artery, origins, courses, and branching patterns of the pontine arteries as well as distribution of the terminal perforators in relation to pontine superficial vascular areas and the cranial nerves. Additionally, we studied presence of pontine branches of the superior cerebellar artery (SCA) and anterior inferior cerebellar artery (AICA). Repetitive branching patterns, origins, and courses led us to distinguish five types of the pontine arteries: type 1-the paramedian branches, type 2-the short circumflex branches, type 3-composition of the paramedian and the short circumflex branches, type 4-long circumflex branches, and type 5-median branches penetrating the pons along the basilar sulcus. Types 1, 2, and 4 were described in the literature previously, but the classification did not include the median branches (the most prevalent branches) and frequently occurring combinations of the types 1 and 2. There were seven pontine arteries on both sides on average that presented the following general pattern: the first pontine artery below the SCA is a type 4 vessel called the posterolateral pontine artery and it is followed by a type 2 vessel-the superolateral pontine artery; the next three arteries represent the types 1, 2, and 3 and supply most of the ventral pontine surface; the sixth artery-the anterolateral pontine artery-is a short circumflex branch and the seventh artery, originating below the AICA, represents long circumflex arteries. Occlusion of each of the abovementioned vessels relates to a specific pontine vascular syndrome. As explained by the phylogenesis and ontogenesis of the central nervous system, the pontine arteries are subject to variability. The SCA and the AICA took part in the pontine blood supply in 2.5% and 12.5% of cases, respectively, therefore neurovascular interventions involving the SCA, or the AICA may lead to pontine ischemia. Contact of the pontine arteries with the cranial nerves depends on the vessel type and origin location.
Topics: Humans; Basilar Artery; Cerebrovascular Circulation; Brain Stem; Central Nervous System; Coronary Vessels
PubMed: 37415277
DOI: 10.1111/joa.13927 -
Magnetic Resonance in Medical Sciences... Oct 2023With the increasing use of 3-tesla MRI scanners and the development of applicable sequences, it has become possible to achieve high-resolution, good contrast imaging,... (Review)
Review
With the increasing use of 3-tesla MRI scanners and the development of applicable sequences, it has become possible to achieve high-resolution, good contrast imaging, which has enabled the imaging of the walls of small-diameter intracranial arteries. In recent years, the usefulness of vessel wall imaging has been reported for numerous intracranial arterial diseases, such as for the detection of vulnerable plaque in atherosclerosis, diagnosis of cerebral arterial dissection, prediction of the rupture of cerebral aneurysms, and status of moyamoya disease and cerebral vasculitis. In this review, we introduce the histological characteristics of the intracranial artery, discuss intracranial vessel wall imaging methods, and review the findings of vessel wall imaging for various major intracranial arterial diseases.
Topics: Humans; Magnetic Resonance Imaging; Moyamoya Disease; Arteries; Intracranial Aneurysm; Intracranial Arterial Diseases; Magnetic Resonance Angiography; Cerebral Arteries
PubMed: 36328569
DOI: 10.2463/mrms.rev.2021-0140 -
Surgical and Radiologic Anatomy : SRA Jun 2024This article presents a comprehensive exploration of neurovascular anatomy of the encephalon, focusing specifically on the intricate network within the posterior... (Review)
Review
PURPOSE
This article presents a comprehensive exploration of neurovascular anatomy of the encephalon, focusing specifically on the intricate network within the posterior circulation and the posterior fossa anatomy; enhancing understanding of its dynamics, essential for practitioners in neurosurgery and neurology areas.
METHOD
A profound literature review was conducted by searching the PubMed and Google Scholar databases using main keywords related to neurovascular anatomy. The selected literature was meticulously scrutinized. Throughout the screening of pertinent papers, further articles or book chapters were obtained through additional assessment of the reference lists. Furthermore, four formalin-fixed, color latex-injected cadaveric specimens preserved in 70% ethanol solution were dissected under surgical microscope (Leica Microsystems Inc, 1700 Leider Ln, Buffalo Grove, IL 60089, USA), using microneurosurgical as well as standard instruments, and a high-speed surgical drill (Stryker Instruments 1941 Stryker Way Portage, MI 49002, USA). Ulterior anatomical dissection was performed.
RESULTS
Detailed examination of the basilar artery (BA), a common trunk formed by the union of the left and right vertebral arteries, denoted a tortuous course across the basilar sulcus. Emphasis is then placed on the Posterior Inferior Cerebellar Artery (PICA), Anterior Inferior Cerebellar Artery (AICA) and Superior Cerebellar Artery (SCA). Each artery's complex course through the posterior fossa, its divisions, and potential stroke-related syndromes are explored in detail. The Posterior Cerebral Artery (PCA) is subsequently unveiled. The posterior fossa venous system is explained, categorizing its channels. A retrograde exploration traces the venous drainage back to the internal jugular vein, unraveling its pathways.
CONCLUSION
This work serves as a succinct yet comprehensive guide, offering fundamental insights into neurovascular anatomy within the encephalon's posterior circulation. Intended for both novice physicians and seasoned neuroanatomists, the article aims to facilitate a more efficient clinical decision-making in neurosurgical and neurological practices.
Topics: Humans; Cadaver; Dissection; Cranial Fossa, Posterior; Vertebral Artery; Basilar Artery
PubMed: 38652250
DOI: 10.1007/s00276-024-03358-1