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Macrophage Targeting: A Promising Strategy for Delivery of Chemotherapeutics in Leishmaniasis and Other Visceral Diseases
Published in Sarwar Beg, Mahfoozur Rahman, Md. Abul Barkat, Farhan J. Ahmad, Nanomedicine for the Treatment of Disease, 2019
Jaya Gopal Meher, Pankaj K. Singh, Yuvraj Singh, Mohini Chaurasia, Anita Singh, Manish K. Chourasia
Experimental autoimmune myocarditis is related to the inflammatory cardiomyopathy leading to heart failure. In autoimmune myocarditis, macrophages play a vital role. It has been verified that CD 68+ macrophages are involved in this disorder and androgen receptors are found to be responsible for exerting pro-inflammatory reaction of macrophages. Considering the role of androgen receptors, Ma et al. have worked on macrophage targeting with an AR degradation enhancer ASC-J9 and they are in vivo findings suggested reduction in severity of autoimmune myocarditis, reduced macrophage infiltration as well as drop-in pro-inflammatory cytokines. Additionally, it was also observed that the treatment could restrict polarization of Raw264.7 cells to pro-inflammatory phenotype macrophages (Ma et al., 2017).
Molecular and Cellular Imaging of Myocardial Inflammation
Published in Robert J. Gropler, David K. Glover, Albert J. Sinusas, Heinrich Taegtmeyer, Cardiovascular Molecular Imaging, 2007
Myocarditis is defined as inflammation and injury of the myocardium in the absence of ischemia (1). Myocarditis is most commonly caused by viruses but can also be caused by other infectious agents such as bacteria, fungi, and various parasites, as well as by numerous noninfectious agents such as certain drugs or chemical toxins. Spontaneous recovery usually occurs. However, sudden death or progression to dilated cardiomyopathy can occur in up to 10% of cases (9). The “gold standard” for diagnosis in patients with suspected myocarditis is percutaneous right ventricular endomyocardial biopsy (10). However, biopsy techniques are laborious and carry significant risk, particularly since the disease is often benign. Furthermore, sampling errors limit the sensitivity and specificity of biopsy techniques (10,11). It was estimated that it would require up to 17 biopsy specimens to achieve an 80% sensitivity for myocarditis (12). In addition, it is not possible to predict which of the acute cases will progress to chronic myocarditis and dilated cardiomyopathy based on the analysis of biopsy samples. For these reasons, the diagnosis of myocarditis is usually made through the exclusion of coronary artery disease on the basis of clinical and laboratory findings. A noninvasive imaging approach for accurately and specifically diagnosing and monitoring myocarditis is needed.
Mechanical circulatory support device selection for bridging to cardiac transplantation: a clinical guide
Published in Expert Review of Medical Devices, 2023
Tamari Miller, Veli K. Topkara
The new US heart organ allocation system has favorably impacted outcomes of patients awaiting cardiac transplantation with lower waitlist mortality rates and shorter time to transplantation. New 6-tiered priority status has allowed for allocation of the donor hearts to sickest patients on the waitlist that are supported by temporary MCS devices. As a result, utilization of temporary MCS devices has significantly increased under the new policy. In addition, patients can be transitioned to cardiac transplantation in a relatively short time frame on temporary MCS device support. While this is ideal for most patients on the transplant waitlist, patients with high likelihood of myocardial recovery may not be best served with a rapid transition to cardiac transplantation. We have shown that the incidence of myocardial recovery following temporary MCS device support has significantly declined under the new policy [15]. This is likely an unintended consequence of the new policy due to rapid availability of donor hearts for patients supported with temporary MCS devices, which may not provide enough time and opportunity for evaluation and optimization of myocardial recovery. Therefore, younger patients with shorter duration of heart failure and particularly those with potentially reversible heart failure etiologies such as myocarditis, toxic, or peripartum cardiomyopathies should be routinely assessed for myocardial recovery as opposed to urgent heart transplantation. Emerging machine learning algorithms may be useful for identifying patients who are likely to recover on temporary or durable MCS [45].
A review of algal toxin exposures on reserved federal lands and among trust species in the United States
Published in Critical Reviews in Environmental Science and Technology, 2022
Zachary R. Laughrey, Victoria G. Christensen, Robert J. Dusek, Sarena Senegal, Julia S. Lankton, Tracy A. Ziegler, Lee C. Jones, Daniel K. Jones, Brianna M. Williams, Stephanie Gordon, Gerald A. Clyde, Erich B. Emery, Keith A. Loftin
Although acute poisonings with domoic acid are better understood, the extent and effect of chronic domoic acid exposure is less well researched. Goldstein et al. (2008) observed two types of California sea lion (Zalophus californianus) domoic acid exposure cases admitted to rehabilitation facilities, for which the clinical signs of acute cases had previously been described in the literature, as well as chronic cases where clinical signs and brain lesions differed, including behavioral changes, seizures, and atrophy of the hippocampal formation. These chronic cases displayed marked behavioral differences when compared to acute exposure cases or healthy sea lions. For example, acute poisonings tend to strand in groups while chronic cases tend to strand singly (Bargu et al., 2012; Goldstein et al., 2008). The clinical signs for chronic exposure are similar to those described in humans, mice, and rats (Lefebvre et al., 2017; Ramsdell & Gulland, 2014). Other neurological impairments, which may develop due to chronic exposure, include the loss of long and short-term spatial memory (Cook et al., 2015), interfering with food gathering and avoidance behavior resulting in malnutrition, injury, and death. In addition to neurological damage, domoic acid exposure is correlated with myocarditis and dilated cardiomyopathy (Kreuder et al., 2005).
Pediatric ventricular assist devices: what are the key considerations and requirements?
Published in Expert Review of Medical Devices, 2020
Roland Hetzer, Mariano Francisco del Maria Javier, Eva Maria Javier Delmo
VADs can reliably support the circulation in children with failing hearts, with equally good results for weeks, months and even years. The economic unsustainability of expensive production combined with a small market has seen production and development of pediatric size systems lag behind that of adult VADs. VADs have now evolved to be an established treatment for children suffering from cardiogenic shock or from end-stage heart failure of any etiology. With constant innovations in device designs and expanding experience, the landscape of pediatric VADs continues to grow toward refinement. This great innovation has facilitated a leading edge in management of advanced heart failure either as a bridge to transplantation or as a bridge to myocardial recovery. In newborns and small children, the EXCOR Pediatric VAD remains the only reliable option. In some patients with myocarditis and with dilated cardiomyopathy, ventricular unloading may lead to complete myocardial recovery. Patients with end-stage CHD primarily uncorrected or after surgery show the lowest survival rate. Recent results have shown significant improvements in the survival and discharge rate, especially in children <1 year of age.