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Aims Acute myocardial infarction (MI) is the major cause of chronic heart failure. The activity of blood coagulation factor XIII (FXIIIa) plays an important role in rodents as a healing factor after MI, whereas its role in healing and remodelling processes in humans remains unclear. We prospectively evaluated the relevance of FXIIIa after acute MI as a potential early prognostic marker for adequate healing.
Methods and results This monocentric prospective cohort study investigated cardiac remodelling in patients with ST-elevation MI and followed them up for 1 year. Serum FXIIIa was serially assessed during the first 9 days after MI and after 2, 6, and 12 months. Cardiac magnetic resonance imaging was performed within 4 days after MI (Scan 1), after 7 to 9 days (Scan 2), and after 12 months (Scan 3). The FXIII valine-to-leucine (V34L) single-nucleotide polymorphism rs5985 was genotyped. One hundred forty-six patients were investigated (mean age 58 ± 11 years, 13% women). Median FXIIIa was 118 % (quartiles, 102–132%) and dropped to a trough on the second day after MI: 109%(98–109%; P < 0.001). FXIIIa recovered slowly over time, reaching the baseline level after 2 to 6 months and surpassed baseline levels only after 12 months: 124 % (110–142%). The development of FXIIIa after MI was independent of the genotype. FXIIIa on Day 2 was strongly and inversely associated with the relative size of MI in Scan 1 (Spearman’s ρ = –0.31; P = 0.01) and Scan 3 (ρ = –0.39; P < 0.01) and positively associated with left ventricular ejection fraction: ρ = 0.32 (P < 0.01) and ρ = 0.24 (P = 0.04), respectively.
Conclusions FXIII activity after MI is highly dynamic, exhibiting a significant decline in the early healing period, with reconstitution 6 months later. Depressed FXIIIa early after MI predicted a greater size of MI and lower left ventricular ejection fraction after 1 year. The clinical relevance of these findings awaits to be tested in a randomized trial.
Acute ischemic cardiac injury predisposes one to cognitive impairment, dementia, and depression. Pathophysiologically, recent positron emission tomography data suggest astroglial activation after experimental myocardial infarction (MI). We analyzed peripheral surrogate markers of glial (and neuronal) damage serially within 12 months after the first ST-elevation MI (STEMI). Serum levels of glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) were quantified using ultra-sensitive molecular immunoassays. Sufficient biomaterial was available from 45 STEMI patients (aged 28 to 78 years, median 56 years, 11% female). The median (quartiles) of GFAP was 63.8 (47.0, 89.9) pg/mL and of NfL 10.6 (7.2, 14.8) pg/mL at study entry 0–4 days after STEMI. GFAP after STEMI increased in the first 3 months, with a median change of +7.8 (0.4, 19.4) pg/mL (p = 0.007). It remained elevated without further relevant increases after 6 months (+11.7 (0.6, 23.5) pg/mL; p = 0.015), and 12 months (+10.3 (1.5, 22.7) pg/mL; p = 0.010) compared to the baseline. Larger relative infarction size was associated with a higher increase in GFAP (ρ = 0.41; p = 0.009). In contrast, NfL remained unaltered in the course of one year. Our findings support the idea of central nervous system involvement after MI, with GFAP as a potential peripheral biomarker of chronic glial damage as one pathophysiologic pathway.
Self-organization is a promising method within the framework of bottom-up architectures to generate nanostructures in an efficient way. The present work demonstrates that self- organization on the length scale of a few to several tens of nanometers can be achieved by a proper combination of a large (organic) molecule and a vicinal metal surface if the local bonding of the molecule on steps is significantly stronger than that on low-index surfaces. In this case thermal annealing may lead to large mass transport of the subjacent substrate atoms such that nanometer-wide and micrometer-long molecular stripes or other patterns are being formed on high-index planes. The formation of these patterns can be controlled by the initial surface orientation and adsorbate coverage. The patterns arrange self-organized in regular arrays by repulsive mechanical interactions over long distances accompanied by a significant enhancement of surface stress. We demonstrate this effect using the planar organic molecule PTCDA as adsorbate and Ag(10 8 7) and Ag(775)surfaces as substrate. The patterns are directly observed by STM, the formation of vicinal surfaces is monitored by highresolution electron diffraction, the microscopic surface morphology changes are followed by spectromicroscopy, and the macroscopic changes of surface stress are measured by a cantilever bending method. The in situ combination of these complementary techniques provides compelling evidence for elastic interaction and a significant stress contribution to long-range order and nanopattern formation.
Background: Depression and anxiety are common and independent outcome predictors in patients with chronic heart failure (CHF). However, it is unclear whether CHF causes depression. Thus, we investigated whether mice develop anxiety- and depression-like behavior after induction of ischemic CHF by myocardial infarction (MI).
Methods and Results: In order to assess depression-like behavior, anhedonia was investigated by repeatedly testing sucrose preference for 8 weeks after coronary artery ligation or sham operation. Mice with large MI and increased left ventricular dimensions on echocardiography (termed CHF mice) showed reduced preference for sucrose, indicating depression-like behavior. 6 weeks after MI, mice were tested for exploratory activity, anxiety-like behavior and cognitive function using the elevated plus maze (EPM), light-dark box (LDB), open field (OF), and object recognition (OR) tests. In the EPM and OF, CHF mice exhibited diminished exploratory behavior and motivation despite similar movement capability. In the OR, CHF mice had reduced preference for novelty and impaired short-term memory. On histology, CHF mice had unaltered overall cerebral morphology. However, analysis of gene expression by RNA-sequencing in prefrontal cortical, hippocampal, and left ventricular tissue revealed changes in genes related to inflammation and cofactors of neuronal signal transduction in CHF mice, with Nr4a1 being dysregulated both in prefrontal cortex and myocardium after MI.
Conclusions: After induction of ischemic CHF, mice exhibited anhedonic behavior, decreased exploratory activity and interest in novelty, and cognitive impairment. Thus, ischemic CHF leads to distinct behavioral changes in mice analogous to symptoms observed in humans with CHF and comorbid depression.
Die vorliegende Arbeit beschäftigt sich mit den strukturellen Aspekten einer adsorbat-induzierten Facettierung von vizinalen Ag(111)-Oberflächen. Bei dem Adsorbat handelte es sich um das organische Molekül Perylen-3,4,9,10-Tetracarbonsäure-Dianhydrid (PTCDA). Die Experimente wurden unter Ultrahochvakuum-Bedingungen durchgeführt, die Charakterisierung erfolgte hauptsächlich mit den Messmethoden Rastertunnelmikroskopie (STM) und niederenergetische Elektronenbeugung (LEED). Das planare Farbstoffmolekül PTCDA adsorbiert präferentiell an den Stufenkanten der verwendeten 8.5° Ag(111)-Vizinaloberflächen und induziert bei geeigneten Präparationsbedingungen eine Rekonstruktion in stark gestufte Facettenflächen und in stufenfreie (111)-Terrassen. Die beobachteten Facetten sind für das System PTCDA/Ag charakteristisch und stellen durch eine molekulare Überstruktur richtungsselektiv stabilisierte Ag-Kristallebenen dar. Durch die Variation der Stufenrichtung der Startoberfläche wurde eine Vielzahl von Facettentypen erhalten und nach Miller indiziert. In ihrer Gesamtheit erlauben sie einen Rückschluss auf das Aussehen der Gleichgewichtskristallform eines mit PTCDA bedeckten Ag-Kristalles und damit auf das richtungsabhängige Benetzungsverhalten von Ag. Aus der Sicht des Substrates bewirkt das Adsorbat eine massive Erhöhung der Steifheit der Stufen. Die durch eine molekulare Überstruktur stabilisierten Facettenflächen übernehmen die in der Kristallstruktur des Substrates angelegten Stufenrichtungen. Die gefundene Ausbildung von zwei typischen Facettensteigungen ist jedoch nicht durch die Ag-Kristallstruktur motivierbar. Die Facettierung wurde im Rahmen einer speziellen Adaption des Konzepts der Thermodynamik auf ebene gestufte Oberflächen als Orientierungsphasenseparation beschrieben. Dieses Konzept erlaubt eine korrekte Beschreibung der beobachteten lokalen Phänomene und zeigt zudem auf, dass das molekulare Gas, welches in den Messungen nicht erfasst wurde, eine wichtige Rolle bei der Rekonstruktion spielt. Es ergaben sich wichtige Indizien für die Existenz einer kritischen Inselgröße für PTCDA auf Ag(111). Es wurde eine vollständige strukturelle Analyse aller stabilen molekularen Überstrukturen auf vizinalen Ag(111)-Oberflächen durchgeführt. Es wurden insgesamt 16 solcher Überstrukturen gefunden, von denen bisher nur 3 Strukturen bekannt und veröffentlicht waren. Dichte und Kommensurabilität der Facettenüberstrukturen sind systematisch vom Stufentyp der Oberfläche abhängig. Die Frage nach dem Ursprung der beiden charakteristischen Facettensteigungen ist mit der Existenz von zwei Typen von Überstrukturgrenzen verknüpft. Die Grenze bestimmt die Lage der fischgrätartigen Überstruktur zu den Stufenkanten und die Länge und die Breite des Moleküls die beiden charakteristischen Stufenabstände. Letzteres geschieht vermöge einer lokalen Wechselwirkung der PTCDA-Moleküle mit den Stufen. Die Überstrukturgrenzen erweisen sich als wichtiges Element der Rekonstruktion. Es wurden außerdem die Abhängigkeiten der verschiedenen, aneinander angrenzenden Überstrukturen aufgezeigt. Auf den (111)-Terrassen fanden sich 3 metastabile Ausnahme-Strukturen, welche einen vertieften Einblick in die komplexe Bildungskinetik der bisher bekannten stabilen (111)-Struktur erlauben. Die Facetten bilden zusammen mit den benachbarten (111)-Terrassen regelmäßige, einem Reflexionsgitter ähnliche Muster mit einer Strukturweite von 5 bis 75nm. Die beobachteten Strukturweiten erreichen bei ausgedehntem Tempern typische Maximalwerte. STM-Messungen zeigen den Einfluss einer langreichweitigen Wechselwirkung zwischen den Facetten, vermittelt über elastische Eigenschaften des Substrates. Die Muster können als selbstorganisierte Zweiphasensysteme im thermodynamischen Gleichgewicht erklärt werden. Die Facetten wirken wie repulsiv wechselwirkende Defekte in einem elastischen Medium. Die Eignung dieser Muster als Templat wurde in Kooperation mit einer anderen Arbeitsgruppe am Beispiel der selektiven Deposition von Eisen belegt.
In this work the potential of polarimetric Synthetic Aperture Radar (PolSAR) data of dual-polarized TerraSAR-X (HH/VV) and quad-polarized Radarsat-2 was examined in combination with multispectral Landsat 8 data for unsupervised and supervised classification of tundra land cover types of Richards Island, Canada. The classification accuracies as well as the backscatter and reflectance characteristics were analyzed using reference data collected during three field work campaigns and include in situ data and high resolution airborne photography. The optical data offered an acceptable initial accuracy for the land cover classification. The overall accuracy was increased by the combination of PolSAR and optical data and was up to 71% for unsupervised (Landsat 8 and TerraSAR-X) and up to 87% for supervised classification (Landsat 8 and Radarsat-2) for five tundra land cover types. The decomposition features of the dual and quad-polarized data showed a high sensitivity for the non-vegetated substrate (dominant surface scattering) and wetland vegetation (dominant double bounce and volume scattering). These classes had high potential to be automatically detected with unsupervised classification techniques.
The massive infiltration of lymphocytes into the skin is a hallmark of numerous human skin disorders. By co-culturing murine keratinocytes with splenic T cells we demonstrate here that T cells affect and control the synthesis and secretion of chemokines by keratinocytes. While pre-activated CD8\(^+\)T cells induce the synthesis of CXCL9 and CXCL10 in keratinocytes and keep in check the synthesis of CXCL1, CXCL5, and CCL20, keratinocytes dampen the synthesis of CCL3 and CCL4 in pre-activated CD8\(^+\)T cells. One key molecule is IFN-γ that is synthesized by CD8\(^+\)T cells under the control of NFATc1 and NFATc2. CD8\(^+\)T cells deficient for both NFAT factors are unable to induce CXCL9 and CXCL10 expression. In addition, CD8\(^+\)T cells induced numerous type I IFN-inducible “defense genes” in keratinocytes encoding the PD1 and CD40 ligands, TNF-α and caspase-1. The enhanced expression of type I IFN-inducible genes resembles the gene expression pattern at the dermal/epidermal interface in lichen planus, an inflammatory T lymphocyte-driven skin disease, in which we detected the expression of CXCL10 in keratinocytes in close vicinity to the infiltration front of T cells. These data reflect the multifaceted interplay of lymphocytes with keratinocytes at the molecular level.
The development of controlled biodegradable materials is of fundamental importance in immunodrug delivery to spatiotemporally controlled immune stimulation but avoid systemic inflammatory side effects. Based on this, polycarbonate nanogels are developed as degradable micellar carriers for transient immunoactivation of lymph nodes. An imidazoquinoline‐type TLR7/8 agonist is covalently conjugated via reactive ester chemistry to these nanocarriers. The nanogels not only provide access to complete disintegration by the hydrolysable polymer backbone, but also demonstrate a gradual disintegration within several days at physiological conditions (PBS, pH 6.4–7.4, 37 °C). These intrinsic properties limit the lifetime of the carriers but their payload can still be successfully leveraged for immunological studies in vitro on primary immune cells as well as in vivo. For the latter, a spatiotemporal control of immune cell activation in the draining lymph node is found after subcutaneous injection. Overall, these features render polycarbonate nanogels a promising delivery system for transient activation of the immune system in lymph nodes and may consequently become very attractive for further development toward vaccination or cancer immunotherapy. Due to the intrinsic biodegradability combined with the high chemical control during the manufacturing process, these polycarbonate‐based nanogels may also be of great importance for clinical translation.
Anxiety disorders and depression are common comorbidities in cardiac patients. Mice lacking the serotonin transporter (5-HTT) exhibit increased anxiety-like behavior. However, the role of 5-HTT deficiency on cardiac aging, and on healing and remodeling processes after myocardial infarction (MI), remains unclear. Cardiological evaluation of experimentally naïve male mice revealed a mild cardiac dysfunction in ≥4-month-old 5-HTT knockout (−/−) animals. Following induction of chronic cardiac dysfunction (CCD) by MI vs. sham operation 5-HTT−/− mice with infarct sizes >30% experienced 100% mortality, while 50% of 5-HTT+/− and 37% of 5-HTT+/+ animals with large MI survived the 8-week observation period. Surviving (sham and MI < 30%) 5-HTT−/− mutants displayed reduced exploratory activity and increased anxiety-like behavior in different approach-avoidance tasks. However, CCD failed to provoke a depressive-like behavioral response in either 5-Htt genotype. Mechanistic analyses were performed on mice 3 days post-MI. Electrocardiography, histology and FACS of inflammatory cells revealed no abnormalities. However, gene expression of inflammation-related cytokines (TGF-β, TNF-α, IL-6) and MMP-2, a protein involved in the breakdown of extracellular matrix, was significantly increased in 5-HTT−/− mice after MI. This study shows that 5-HTT deficiency leads to age-dependent cardiac dysfunction and disrupted early healing after MI probably due to alterations of inflammatory processes in mice.
Background
Elbow imaging is challenging with conventional multidetector computed tomography (MDCT), while cone-beam CT (CBCT) provides superior options. We compared intra-individually CBCT versus MDCT image quality in cadaveric elbows.
Methods
A twin robotic x-ray system with new CBCT mode and a high-resolution clinical MDCT were compared in 16 cadaveric elbows. Both systems were operated with a dedicated low-dose (LD) protocol (equivalent volume CT dose index [CTDI\(_{vol(16 cm)}\)] = 3.3 mGy) and a regular clinical scan dose (RD) protocol (CTDI\(_{vol(16 cm)}\) = 13.8 mGy). Image quality was evaluated by two radiologists (R1 and R2) on a seven-point Likert scale, and estimation of signal intensity in cancellous bone was conducted. Wilcoxon signed-rank tests and intraclass correlation coefficient (ICC) statistics were used.
Results
The CBCT prototype provided superior subjective image quality compared to MDCT scans (for RD, p ≤ 0.004; for LD, p ≤ 0.001). Image quality was rated very good or excellent in 100% of the cases by both readers for RD CBCT, 100% (R1) and 93.8% (R2) for LD CBCT, 62.6% and 43.8% for RD MDCT, and 0.0% and 0.0% for LD MDCT. Single-measure ICC was 0.95 (95% confidence interval 0.91–0.97; p < 0.001). Software-based assessment supported subjective findings with less “undecided” pixels in CBCT than dose-equivalent MDCT (p < 0.001). No significant difference was found between LD CBCT and RD MDCT.
Conclusions
In cadaveric elbow studies, the tested cone-beam CT prototype delivered superior image quality compared to high-end multidetector CT and showed a potential for considerable dose reduction.