Association of Acute Hyperglycemia and Diabetes Mellitus with Platelet-derived Microparticle (PDMP) Levels During Acute Myocardial Infarction.

Objectives: This research investigates whether there is an association between acute hyperglycemia and diabetes mellitus and the level of circulating platelet-derived microparticles (PDMPs) during an initial episode of acute myocardial infarction (AMI). Methodology: This was a cross-sectional study involving hospitalized AMI patients. Demographic and clinical data were obtained from hospital records. Diabetes mellitus was defined by the history of the disease, anti-diabetes medication use and/ or level of HbA1C ≥6.5%. Levels of HbA1c, admission random and fasting blood glucose levels were measured. Flow-cytometry method was used to determine the levels of PDMPs from collected venous blood through tagging with CD-41 FITC and CD-62 PE markers and a threshold size of <1 µm. The number of circulating PDMPs was compared according to glucometabolic state, namely acute hyperglycemia (admission random glucose ≥200 mg/dL and fasting glucose ≥140 mg/dL) and diabetes mellitus. The comparative analysis between groups was conducted with Student T-test or Mann-Whitney test, where applicable. Results: A total of 108 subjects were included and their data analyzed. The level of circulating PDMPs was significantly lower in subjects with admission random glucose ≥200 mg/dL as compared to those with below level [median (interquartile range (IQR)]: 2,710.0 (718.0-8,167.0) count/mL vs. 4,452.0 (2,128.5-14,499.8) count/mL, p = 0.05) and in subjects with fasting glucose ≥140 mg/dL as compared to those with below level (median (IQR): 2,382.0 (779.0-6,619.0) count/mL vs. 5,972.0 (2,345.7-14,781.3) count/mL, p = 0.006). The level of circulating PDMPs was also significantly lower in patients with diabetes mellitus as compared to those without (median (IQR): 2,655.0 (840.0-5,821.0) count/mL vs. 4,562.0 (2,128.5-15,055.8) count/mL; p = 0.007). Conclusion: Acute hyperglycemia and diabetes mellitus are significantly associated with a lower circulating PDMP level during an initial AMI episode.

Association of monocyte-to-high density lipoprotein ratio with arterial stiffness in patients with diabetes.

BACKGROUND: Previous studies proposed that chronic inflammation in diabetes has a role in abnormal collagen production and elastin degradation, which promotes arterial stiffness. Monocyte-to-High Density Lipoprotein cholesterol ratio (MHR) is a simple measurement associated with inflammation and oxidative stress. However, little is known about the relationship of MHR with arterial stiffness. This study aimed to determine the association of MHR with arterial stiffness in patients with diabetes. METHODS: A total of 81 patients with type 2 diabetes mellitus were enrolled in a cross-sectional study. Arterial stiffness factor in this study was Cardio Ankle Vascular Index (CAVI). We analyzed complete blood count and lipid profile in all participants, then performed statistical analysis to determine the relationship between MHR and CAVI. Receiver operating characteristic (ROC) analysis was used to estimate the cut-off values of MHR to predict CAVI ≥ 9. RESULTS: Median of MHR in this study was 11.91 with the mean of CAVI was 8.13 ± 0.93. Spearman correlation analysis revealed a significant positive correlation between MHR and CAVI (ρ = 0.239, p = 0.031). Multivariate analysis showed the independent association of MHR to arterial stiffness (ß = 0.361, 95% CI 0.023-0.093) and to CAVI ≥ 9 (OR 1.181, 95% CI 1.047-1.332). The cut-off values of MHR for predicting CAVI ≥ 9 were identified as ≥ 13 (OR 3.289, 95% CI 1.036-10.441). CONCLUSION: MHR is associated with CAVI in patients with diabetes, irrespective of various potential confounders.

Chondroitin Sulfate N-acetylgalactosaminyltransferase-2 Impacts Foam Cell Formation and Atherosclerosis by Altering Macrophage Glycosaminoglycan Chain.

OBJECTIVE: Chondroitin sulfate proteoglycans are the primary constituents of the macrophage glycosaminoglycan and extracellular microenvironment. To examine their potential role in atherogenesis, we investigated the biological importance of one of the chondroitin sulfate glycosaminoglycan biosynthesis gene, ChGn-2 (chondroitin sulfate N-acetylgalactosaminyltransferase-2), in macrophage foam cell formation. Approach and Results: ChGn-2-deficient mice showed decreased and shortened glycosaminoglycans. ChGn-2-/-/LDLr-/- (low-density lipoprotein receptor) mice generated less atherosclerotic plaque after being fed with Western diet despite exhibiting a metabolic phenotype similar to that of the ChGn-2+/+/LDLr-/- littermates. We demonstrated that in macrophages, ChGn-2 expression was upregulated in the presence of oxLDL (oxidized LDL), and glycosaminoglycan was substantially increased. Foam cell formation was significantly altered by ChGn-2 in both mouse peritoneal macrophages and the RAW264.7 macrophage cell line. Mechanistically, ChGn-2 enhanced oxLDL binding on the cell surface, and as a consequence, CD36-an important macrophage membrane scavenger receptor-was differentially regulated. CONCLUSIONS: ChGn-2 alteration on macrophages conceivably influences LDL accumulation and subsequently accelerates plaque formation. These results collectively suggest that ChGn-2 is a novel therapeutic target amenable to clinical translation in the future. Graphic Abstract: A graphic abstract is available for this article.

Environmentally friendly non-medical mask: An attempt to reduce the environmental impact from used masks during COVID 19 pandemic.

During COVID-19 pandemic, wearing a mask has become a usual custom as a personal protection in every activity. The growth in consumption of face masks leads the increasing of mask waste and became a particular problem in environment. This study uses analytic hierarchy process (AHP) to determine appropriate material for making environmentally friendly non-medical mask. Filtration efficiency, breathability, and environmental impact index are defined as main criteria and carried out 26 alternative material from previous study. AHP presents a ranking of priority for all the alternative materials with Quilt and Cotton 600 TPI are the best values and fulfilled the material characteristics required by WHO. The sensitivity analysis generates some material with constant global priority results, such as Quilt, Cotton 600 TPI, Quilting cotton, Polycotton, and Polypropylene fabric 1. Quilting cotton with woven structure becomes the third ranking of alternative material, and Polypropylene fabric 1 is the worst material for making environmentally friendly non-medical mask.

Circulating Platelet-Derived Microparticles Associated with Postdischarge Major Adverse Cardiac Events in ST-Elevation Acute Myocardial Infarction.

INTRODUCTION: Platelet-derived microparticles (PDMPs) measurement adds prognostic implication for ST-elevation acute myocardial infarction (STEMI). The long-term implication of PDMPs in STEMI needs to be corroborated. METHODS: The research design was a cohort study. Subjects were STEMI patients and were enrolled consecutively. The PDMPs were defined as microparticles bearing CD41(+) and CD62P(+) markers detected with flow cytometry. The PDMPs were measured on hospital admission and 30 days after discharge. The outcomes were major adverse cardiac events (MACE), i.e., a composite of cardiac death, heart failure, cardiogenic shock, reinfarction, and resuscitated ventricular arrhythmia, occurring from hospitalization until 1 year after discharge. RESULTS: We enrolled 101 subjects with STEMI. During hospitalization, 17 subjects (16.8%) developed MACE. The PDMPs were not different between subjects with MACE and those without (median (IQR): 3305.0/µL (2370.0-14690.5/µL) vs. 4452.0/µL (2024.3-14396.8/µL), p=0.874). Forty-five subjects had increased PDMPs in 30 days after discharge as compared with on-admission measurement. Subjects with increased PDMPs had significantly higher 30-day MACE as compared to subjects with decreased PDMPs 17 (37.8%) vs. 6 (16.7%, p=0.036). There was a trend toward higher MACE in subjects with increased PDMPs as compared to those with decreased PDMPs in 90 days after discharge (48.9% vs. 30.6%, p=0.095) and 1 year after discharge (48.9% vs. 36.1%, p=0.249). CONCLUSION: The PDMPs level was increased from the day of admission to 30 days after discharge in patients with STEMI. The persistent increase in the PDMPs level in 30 days after the STEMI event was associated with the 30-day postdischarge MACE and trended toward increased MACE during the 90-day and 1-year follow-up.

Chondroitin sulfate N-acetylgalactosaminyltransferase-2 deletion alleviates lipoprotein retention in early atherosclerosis and attenuates aortic smooth muscle cell migration.

Glycosaminoglycans (GAGs) play an integral role in low-density lipoprotein (LDL) retention in the vascular intimal layer and have emerged as attractive therapeutic targets for atherosclerosis. GAG biosynthesis involves the cooperation of numerous enzymes. Chondroitin sulfate N-acetylgalactosaminyltransferase-2 (ChGn-2) is a vital Golgi transferase that participates in enzymatic elongation of GAGs. Here, we investigated the effects of ChGn-2 gene deletion on the development of atherosclerosis. Partial carotid artery ligation was performed on ChGn-2-/-/LDLr-/- and ChGn-2+/+/LDLr-/- mice to induce diffuse intimal thickening (DIT). Aortic smooth muscle cells (ASMCs) were isolated to investigate cellular LDL binding and migration. Histological analysis of human coronary artery sections revealed that ChGn-2 was expressed in early and advanced atherosclerotic lesions. Deletion of the ChGn-2 gene significantly reduced LDL retention in the DIT mouse model. Furthermore, LDL binding, visualized using rhodamine-labeled LDLs, was dramatically reduced. Interestingly, a functional assay of ASMCs prepared from ChGn-2-/- mice displayed abrogation of platelet-derived growth factor (PDGF)-mediated migration via reduced PDGF receptor phosphorylation. Taken together, these findings indicate that ChGn-2 is functionally involved in the progression of atherosclerosis both in its early and advanced stages. Therefore, ChGn-2 may serve as a plausible target to treat atherosclerotic-related diseases in the future.

Rhodamine-labeled LDL as a tool to monitor the lipoprotein traffic in experimental model of early atherosclerosis in mice.

Modifications of proteoglycans, subendothelial retention of low-density lipoproteins (LDL) and their subsequent oxidation initiate the development of atherosclerosis. Therefore, detection of lipoprotein entrapment in the arterial wall is an important feature for the analysis of the mechanisms of atherosclerosis. The administration of fluorescent-labeled LDL in vivo is a breakthrough way to assess the traffic of LDL in the arterial wall. The present study demonstrated the feasibility of visualizing LDL in carotid ligation-induced intimal thickening of arterial wall after intravenous rhodamine-labeled LDL injection in mice. Kinetics of rhodamine-labeled LDL showed similar characteristics as native LDL and labeled-LDL could be detected both by spectrophotometric and microscopic analysis. Kinetics analysis of rhodamine-labeled LDL revealed that the labeled LDL was present in almost all tissue, predominantly in the liver, 6 hours after injection. Rhodamine-labeled LDL was visualized in intimal thickening of carotid 6 to 18 hours after injection, indicating that the LDL was actively trapped in the arterial wall. In conclusion, rhodamine-labeled LDL would be a useful tool to investigate the development of atherosclerosis.

Correlation of C4ST-1 and ChGn-2 expression with chondroitin sulfate chain elongation in atherosclerosis.

Subendothelial retention of lipoproteins by proteoglycans (PGs) is the initiating event in atherosclerosis. The elongation of chondroitin sulfate (CS) chains is associated with increased low-density lipoprotein (LDL) binding and progression of atherosclerosis. Recently, it has been shown that 2 Golgi enzymes, chondroitin 4-O-sulfotransferase-1 (C4ST-1) and chondroitin N-acetylgalactosaminyltransferase-2 (ChGn-2), play a critical role in CS chain elongation. However, the roles of C4ST-1 and ChGn-2 during the progression of atherosclerosis are not known. The aim of this study was to analyze the expression of C4ST-1 and ChGn-2 in atherosclerotic lesions in vivo and determine whether their expression correlated with CS chain elongation. Low-density lipoprotein receptor knockout (LDLr KO) mice were fed a western diet for 2, 4, and 8weeks to stimulate development of atherosclerosis. The binding of LDL and CS PG in this mouse model was confirmed by chondroitinase ABC (ChABC) digestion and apolipoprotein B (apo B) staining. Gel filtration analysis revealed that the CS chains began to elongate as early as 2weeks after beginning a western diet and continued as the atherosclerosis progressed. Furthermore, quantitative real-time polymerase chain reaction (qRT-PCR) showed that the mRNA levels of C4ST-1 and ChGn-2 increased after 8weeks of this diet. In contrast, the mRNA levels of their homologs, C4ST-2 and ChGn-1, were unchanged. In addition, immunohistochemical analysis demonstrated that the expression of C4ST-1 and ChGn-2 appeared to have similar site-specific patterns and coincided with biglycan expression at the aortic root. Our results suggested that C4ST-1 and ChGn-2 may be involved in the elongation of CS chains in the arterial wall during the progression of atherosclerosis. Therefore, modulating their expression and activity might be a novel therapeutic strategy for atherosclerosis.