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Augmented efficacy of exogenous extracellular vesicles targeted to injured kidneys

Signal Transduction and Targeted Therapy 2020年第1期5卷 817-819页

作者： Xiao-Jun Chen Kai Jiang Christopher M.Ferguson Hui Tang Xiangyang Zhu amir lerman Lilach O.lerman Division of Nephrology and Hypertension Mayo ClinicRochesterMNUSA Department of Nephrology The Second Xiangya Hospital of Central South UniversityChangshaHunanChina Department of Cardiovascular Diseases Mayo ClinicRochesterMNUSA

Dear Editor,Extracellular vesicles(EVs)derived from mesenchymal stem/stromal cells(MSCs)contain genetic and protein material that stimulate tissue repair and ameliorate injury in recipient *** of particulate MSC-EVs over MSCs in treating kidney disease include better penetration of injured glomerular filtration barrier to access podocytes or tubular ***,systemic EV delivery yields low kidney retention efficiency,limiting their regenerative benefits.1 Previously,we coated adipose tissue-derived(AD)-MSC with antibodies against kidney injury molecule(KIM)‐1(ab-KIM1),a protein upregulated in damaged kidneys.2 Conjugating ab-KIM1 did not impair MSC function but increased their retention and reparative potency in murine renal artery stenosis(RAS).2 We hypothesized that ab-KIM1 conjugation would similarly enhance retention of exogenously delivered EVs in ischemic kidneys and confer superior therapeutic benefits.

关键词： kidney retention sized

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Carotid artery endarterectomy in patients with symptomatic non-stenotic carotid artery disease

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Stroke & Vascular Neurology 2022年第3期7卷 251-257页

作者： Valentina Nardi John C Benson Anthony S Larson Waleed Brinjikji Luca Saba Fredric B Meyer Giuseppe Lanzino amir lerman Luis E Savastano Department of Cardiovascular Diseases Mayo ClinicRochesterMinnesotaUSA Radiology Mayo ClinicRochesterMinnesotaUSA Radiology Azienda Ospedaliero UniversitariaCagliariItaly Neurosurgery Mayo ClinicRochesterMinnesotaUSA

Object We sought to determine the safety and efficacy in secondary stroke prevention of carotid endarterectomy(CEA)in patients with symptomatic non-stenotic carotid artery disease(SyNC).Methods This was a single-centre retrospective case *** patients who underwent CEA for unilateral anterior circulation cerebrovascular events with ipsilateral<50%carotid stenosis from 2002 to 2020 were *** hallmarks including the degree of luminal stenosis and the presence of various vulnerable plaque characteristics(eg,intraplaque haemorrhage(IPH)on MR angiography,ulceration or low-density plaque on CT angiography)were *** presence of vulnerable plaque characteristics was compared between arteries ipsilateral to the ischaemic event and contralateral *** prevalence of perioperative/intraoperative complications,as well as recurrent ischaemic events at follow-up was *** Thirty-two patients were included in the analysis,of which 25.0%were *** arteries ipsilateral to an ischaemic event had a significantly higher prevalence of IPH when compared with contralateral arteries(80.0%vs 0.0%;p<0.001).There were no intraoperative *** patient(3.1%)developed symptoms of transient ipsilateral ischaemia 1 day following CEA which resolved without *** a median follow-up of 18.0 months(IQR 5.0-36.0),only one patient(3.1%)experienced a transient neurologic deficit with complete resolution(annualised rate of recurrent stroke after CEA of 1.5%for a total follow-up of 788 patient-months following CEA).All other patients(31/32,96.9%)were free of recurrent ischaemic *** CEA appears to be safe and well-tolerated in patients with *** studies with larger cohorts and longer follow-up intervals are needed in order to determine the role of CEA in this patient population.

关键词： patients carotid prevention

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Long-term outcomes after fractional flow reserve-guided percutaneous coronary intervention in patients with severe coronary stenosis

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Journal of Geriatric Cardiology 2019年第4期16卷 329-337页

作者： Ying-Hua ZHANG Jing LI Andreas J. Flammer Yoshiki Matsuo Moo-Sik Lee Ryan J. Lennon Malcolm R. Bell David R. Holmes John F. Bresnahan Charanjit S. Rihal Lilach O. lerman amir lerman Division of Cardiology Xuanwu Hospital Capital Medical UniversityBeijingChina Division of Cardiovascular Diseases Mayo ClinicRochesterUSA Cardiovascular Center CardiologyUniversity Hospital ZurichSwitzerland Department of Preventive Medicine College of Medicine Konyang UniversityDaejeonSouth Korea Biomedical Statistics Mayo ClinicRochesterUSA Division of Nephrology and Hypertension Mayo ClinicRochesterUSA

Objective To explore the safety and efficacy of FFR-guided percutaneous coronary intervention (PCI) in vessels with severe diameter stenosis. Methods & Results Of 1090 patients undergoing fractional flow reserve (FFR) assessment from 2002 to 2009,we identified 167 patients in whom FFR was measured in at least one 70%–89% stenotic lesion. These patients were subdivided into an FFR-defer group (n = 49) if PCI was deferred (FFR > 0.80),and an FFR-perform group (n = 118) if PCI was performed (FFR ≤ 0.80). Comparatively,an additional 1176 patients undergoing PCI in at least one lesion with 70%–89% stenosis but without measurement of FFR served as a control (angiography- guided) group. Clinical outcomes were compared during a median follow-up of 49.0 months. The 5-year Kaplan-Meier estimated revascularization rates were 16% in the FFR-defer group and 33% in the FFR-perform group (P = 0.046). The incidence of major adverse cardiac events were comparable in these two groups (HR = 0.82,95% CI: 0.37–1.82,P = 0.63). The number of stents placed was significantly lower in the FFR-guided group (0.9 ± 0.8 vs. 1.4 ± 0.8,P < 0.001). Conclusions Functional revascularization for lesions with visually severe stenosis is clinically safe and associated with fewer stents use. This study suggests that extending the use of FFR to more severe coronary lesions may be reasonable.

关键词： Fractional flow reserve Outcome Percutaneous coronary intervention Severe stenosis Stent

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Ex vivo evaluation of IVUS-VH imaging and the role of plaque structure on peripheral artery disease

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Medicine in Novel Technology and Devices 2020年第4期8卷 22-30页

作者： Christopher Noble Kent Carlson Erica Neumann Bradley Lewis Dan Dragomir-Daescu amir lerman Ahmet Erdemir Melissa Young Department of Cardiovascular Medicine Mayo ClinicRochesterMNUSA Department of Physiology and Biomedical Engineering Mayo ClinicRochesterMNUSA Department of Biomedical Engineering and Computational Biomodeling(CoBi)Core Lerner Research InstituteCleveland ClinicClevelandOHUSA Division of Biomedical Statistics and Informatics Mayo ClinicRochesterMNUSA

Peripheral artery disease(PAD)results from the buildup of atherosclerotic plaque in the arterial wall,can progress to severe ischemia and lead to tissue necrosis and limb *** evaluated a means of assessing PAD mechanics ex vivo using ten human peripheral arteries with ***-inflation testing was performed at six physiological pressure intervals ranging from 10 to 200 *** vessels were imaged with IVUS-VH to determine plaque composition and change in vessel structure with *** analysis was performed to determine which plaque structures and distributions of these structures had the greatest influence on wall *** found that fibrous plaque,necrotic core,and calcification had a statistically significant effect on all variables(p<0.05).The presence of large concentrations of fibrous plaque was linked to reduced vessel compliance and ellipticity,which could lead to stent fractures and *** the plaque distribution we found that clustered necrotic core increased overall compliance while clustered calcification decreased overall *** effect of plaque distribution on vessel wall deformation must be considered equally important to plaque concentration.

关键词： Intrasvascular ultrasound Virtual histology Peripheral artery disease Pressure-inflation testing Atherosclerosis

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