Effects of rivaroxaban and dabigatran on local expression of coagulation and inflammatory factors within human aortic stenotic valves.

BACKGROUND: Treatment with non-vitamin K antagonist oral anticoagulants (NOACs) such as dabigatran (a direct thrombin inhibitor) or rivaroxaban (a direct inhibitor of factor [F] Xa) attenuates atherosclerotic plaque progression in hypercholesterolemic mice. PURPOSE: To evaluate the effect of NOACs application on the expression of coagulation proteins in loco within stenotic aortic valves and in valve interstitial cells (VICs) from patients with severe aortic stenosis (AS). METHODS: Primary cultures of VICs obtained from 90 patients undergoing aortic valve replacement were stimulated with TNF-α (50 ng/mL) and pre-treated with rivaroxaban (1 and 10 ng/mL) or dabigatran (25 and 250 ng/mL). The expression of coagulation proteins was analyzed by immunofluorescence. Cytokine levels were measured by ELISA. RESULTS: FX, FXa, FVII, thrombin and PAR1/2 were present in loco within human aortic stenotic valves. Cultured VICs exhibited constant expression of FX, TF, PAR1/2. Exposure of VICs to TNF-α caused the upregulated expression of TF, PAR1/2 and induced expression of thrombin, FVII and FXa. FX was expressed by 80% of VICs, regardless of stimulation. Cultured VICs were able to synthesize metalloproteinases 1-3, IL-6, IL-32, IL-34, osteopontin and osteocalcin, the levels of which increased under TNF-α stimulation. NOACs added to culture inhibited coagulation factor and PAR1/2 expression. Moreover, NOACs down-regulated VIC-derived proteins responsible for valve calcification and extracellular matrix remodeling. CONCLUSIONS: NOACs at therapeutic concentrations may inhibit the effects of FXa and thrombin at in vitro level. It might be speculated that long-term treatment with rivaroxaban or dabigatran could attenuate the progression of AS in humans.

Quantification of airborne birch (Betula sp.) pollen grains and allergens in Krakow.

INTRODUCTION: Birch (Betula sp.) pollen grains are the main cause of seasonal allergies in northern and central Europe. The allergen particles released from the grains are often well distributed in the air. Due to their size, airborne protein particles can easily penetrate into the lower parts of the respiratory airways and may lead to symptoms of asthma. The purpose of this paper was to quantify both Betula sp. pollen grains and allergens in the air. MATERIAL/METHODS: Materials for the investigation were collected in the spring of 2003 with two Hirst-type pollen volumetric traps. Tapes from one trap served for routine birch pollen grain counts, while those from the second for the immunodetection of birch allergens. As birch pollen allergen concentration is seen as dark spots on X-ray films densitometric measurements of the spots were used to quantify birch-pollen antigen concentrations in the air. RESULTS: In most instances, birch pollen counts corresponded with birch pollen allergen levels. However, on several occasions outside the pollen season, only grains or only allergens were detected. Apart from sampling variability, this could be due to faulty/dead pollen grains or submicronic airborne allergen particles. CONCLUSIONS: Counting intact pollen grains and antibody-based detection of allergen molecules are efficient tools in controlled allergen avoidance.