Recent Updates and Advances in Winiwarter-Buerger Disease (Thromboangiitis Obliterans): Biomolecular Mechanisms, Diagnostics and Clinical Consequences

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Abstract

Thromboangiitis obliterans (TAO) or Buerger’s disease is a segmental inflammatory, thrombotic occlusive peripheral vascular disease with unknown aetiology that usually involves the medium and small-sized vessels of young male smokers. Due to its unknown aetiology and similarities with atherosclerosis and vasculitis, TAO diagnosis is still challenging. We aimed to review the status of biomolecular and laboratory para-clinical markers in TAO compared to atherosclerosis and vasculitis. We reported that, although some biomarkers might be common in TAO, atherosclerosis, and vasculitis, each disease occurs through a different pathway and, to our knowledge, there is no specific and definitive marker for differentiating TAO from atherosclerosis or vasculitis. Our review highlighted that pro-inflammatory and cell-mediated immunity cytokines, IL-33, HMGB1, neopterin, MMPs, ICAM1, complement components, fibrinogen, oxidative stress, NO levels, eNOS polymorphism, adrenalin and noradrenalin, lead, cadmium, and homocysteine are common markers. Nitric oxide, MPV, TLRs, MDA, ox-LDL, sST2, antioxidant system, autoantibodies, and type of infection are differential markers, whereas platelet and leukocyte count, haemoglobin, lipid profile, CRP, ESR, FBS, creatinine, d-dimer, hypercoagulation activity, as well as protein C and S are controversial markers. Finally, our study proposed diagnostic panels for laboratory differential diagnosis to be considered at first and in more advanced stages.

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Environmental Chemistry and Ecotoxicology of Hazardous Heavy Metals: Environmental Persistence, Toxicity, and Bioaccumulation

Hazrat Ali, Ezzat Khan, Ikram Ilahi (2019)

Heavy metals are well-known environmental pollutants due to their toxicity, persistence in the environment, and bioaccumulative nature. Their natural sources include weathering of metal-bearing rocks and volcanic eruptions, while anthropogenic sources include mining and various industrial and agricultural activities. Mining and industrial processing for extraction of mineral resources and their subsequent applications for industrial, agricultural, and economic development has led to an increase in the mobilization of these elements in the environment and disturbance of their biogeochemical cycles. Contamination of aquatic and terrestrial ecosystems with toxic heavy metals is an environmental problem of public health concern. Being persistent pollutants, heavy metals accumulate in the environment and consequently contaminate the food chains. Accumulation of potentially toxic heavy metals in biota causes a potential health threat to their consumers including humans. This article comprehensively reviews the different aspects of heavy metals as hazardous materials with special focus on their environmental persistence, toxicity for living organisms, and bioaccumulative potential. The bioaccumulation of these elements and its implications for human health are discussed with a special coverage on fish, rice, and tobacco. The article will serve as a valuable educational resource for both undergraduate and graduate students and for researchers in environmental sciences. Environmentally relevant most hazardous heavy metals and metalloids include Cr, Ni, Cu, Zn, Cd, Pb, Hg, and As. The trophic transfer of these elements in aquatic and terrestrial food chains/webs has important implications for wildlife and human health. It is very important to assess and monitor the concentrations of potentially toxic heavy metals and metalloids in different environmental segments and in the resident biota. A comprehensive study of the environmental chemistry and ecotoxicology of hazardous heavy metals and metalloids shows that steps should be taken to minimize the impact of these elements on human health and the environment.

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Oxidative Stress in Cardiovascular Diseases: Still a Therapeutic Target?

Thomas Senoner, Wolfgang Dichtl (2019)

Cardiovascular diseases (CVD) are complex entities with heterogenous pathophysiologic mechanisms and increased oxidative stress has been viewed as one of the potential common etiologies. A fine balance between the presence of reactive oxygen species (ROS) and antioxidants is essential for the proper normal functioning of the cell. A basal concentration of ROS is indispensable for the manifestation of cellular functions, whereas excessive levels of ROS cause damage to cellular macromolecules such as DNA, lipids and proteins, eventually leading to necrosis and apoptotic cell death. CVD is the main cause of death worldwide with several conditions being affected by oxidative stress. Increased ROS lead to decreased nitric oxide availability and vasoconstriction, promoting arterial hypertension. ROS also negatively influence myocardial calcium handling, causing arrhythmia, and augment cardiac remodeling by inducing hypertrophic signaling and apoptosis. Finally, ROS have also been shown to promote atherosclerotic plaque formation. This review aims at giving an introduction into oxidative stress in CVD, with special focus on endothelial dysfunction, and then examining in detail the role of oxidative stress in the most prevalent of these diseases. Finally, potential nutraceuticals and diets that might be beneficial in diminishing the burden of oxidative stress in CVD are presented.

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Targeting Early Atherosclerosis: A Focus on Oxidative Stress and Inflammation

Patricia Marchio, Sol Guerra-Ojeda, José Vila … (2019)

Atherosclerosis is a chronic vascular inflammatory disease associated to oxidative stress and endothelial dysfunction. Oxidation of low-density lipoprotein (LDL) cholesterol is one of the key factors for the development of atherosclerosis. Nonoxidized LDL have a low affinity for macrophages, so they are not themselves a risk factor. However, lowering LDL levels is a common clinical practice to reduce oxidation and the risk of major events in patients with cardiovascular diseases (CVD). Atherosclerosis starts with dysfunctional changes in the endothelium induced by disturbed shear stress which can lead to endothelial and platelet activation, adhesion of monocytes on the activated endothelium, and differentiation into proinflammatory macrophages, which increase the uptake of oxidized LDL (oxLDL) and turn into foam cells, exacerbating the inflammatory signalling. The atherosclerotic process is accelerated by a myriad of factors, such as the release of inflammatory chemokines and cytokines, the generation of reactive oxygen species (ROS), growth factors, and the proliferation of vascular smooth muscle cells. Inflammation and immunity are key factors for the development and complications of atherosclerosis, and therefore, the whole atherosclerotic process is a target for diagnosis and treatment. In this review, we focus on early stages of the disease and we address both biomarkers and therapeutic approaches currently available and under research.