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CD163 macrophage and erythrocyte contents in aspirated deep vein thrombus are associated with the time after onset: a pilot study

View Article: PubMed Central - PubMed

ABSTRACT

Background: Thrombolytic therapy is effective in selected patients with deep vein thrombosis (DVT). Therefore, identification of a marker that reflects the age of thrombus is of particular concern. This pilot study aimed to identify a marker that reflects the time after onset in human aspirated DVT.

Methods: We histologically and immunohistochemically analyzed 16 aspirated thrombi. The times from onset to aspiration ranged from 5 to 60 days (median of 13 days). Paraffin sections were stained with hematoxylin and eosin and antibodies for fibrin, glycophorin A, integrin α2bβ3, macrophage markers (CD68, CD163, and CD206), CD34, and smooth muscle actin (SMA).

Results: All thrombi were immunopositive for glycophorin A, fibrin, integrin α2bβ3, CD68, CD163, and CD206, and contained granulocytes. Almost all of the thrombi had small foci of CD34- or SMA-immunopositive areas. CD68- and CD163-immunopositive cell numbers were positively correlated with the time after onset, while the glycophorin A-immunopositive area was negatively correlated with the time after onset. In double immunohistochemistry, CD163-positive cells existed predominantly among the CD68-immunopositive macrophage population. CD163-positive macrophages were closely localized with glycophorin A, CD34, or SMA-positive cell-rich areas.

Conclusions: These findings indicate that CD163 macrophage and erythrocyte contents could be markers for evaluation of the age of thrombus in DVT. Additionally, CD163 macrophages might play a role in organization of the process of venous thrombus.

Electronic supplementary material: The online version of this article (doi:10.1186/s12959-016-0122-0) contains supplementary material, which is available to authorized users.

No MeSH data available.


Related in: MedlinePlus

Representative images of X-ray venography before and after thrombus aspiration. X-ray venography shows an extensive filling defect before thrombus aspiration along the femoral vein, and a considerable reduction in the defect after thrombus aspiration
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Fig1: Representative images of X-ray venography before and after thrombus aspiration. X-ray venography shows an extensive filling defect before thrombus aspiration along the femoral vein, and a considerable reduction in the defect after thrombus aspiration

Mentions: The ethics committee of the Miyazaki University approved the study protocol (approval no. 427). We obtained informed consent from the patients with DVT. Sixteen thrombi were obtained from 16 patients (8 men and 8 women; age range, 35–78 years) with DVT who were diagnosed based on clinical symptoms, laboratory data, and clinical imaging findings. The thrombi were mainly aspirated from the proximal portion of the thrombi with a guiding catheter (Guider Softip Guiding Catheter; Boston Scientific Japan, Tokyo, Japan). This catheter was placed from the popliteal vein to the iliac vein (10 cases), the leg vein to the inferior vena cava (5), and the subclavian vein to the superior vena cava (1). X-ray venography showed an extensive filling defect in the femoral vein before thrombus aspiration and reduction of the filling defect after thrombus aspiration (Fig. 1). An additional movie file shows this in more detail (see Additional file 1). We estimated the time of onset based on clinical symptoms and a medical interview. The times from onset to aspiration varied from 5 to 60 days, with a median of 13 days. The underlying diseases of the patients included the following: trauma and long-term immobilization (n = 5), idiopathic (n = 3), malignant tumor postoperatively (n = 2), chronic inflammatory disease (n = 2), Budd–Chiari syndrome (n = 1), chronic renal failure (n = 1), peripheral artery disease (n = 1), and gynecologic surgery (n = 1). Thirteen of 16 patients were intravenously administered heparin for 1 to 30 days, and six of 16 patients were intravenously administered thrombolytic agents for 1 to 12 days before thrombus aspiration.Fig. 1


CD163 macrophage and erythrocyte contents in aspirated deep vein thrombus are associated with the time after onset: a pilot study
Representative images of X-ray venography before and after thrombus aspiration. X-ray venography shows an extensive filling defect before thrombus aspiration along the femoral vein, and a considerable reduction in the defect after thrombus aspiration
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5120412&req=5

Fig1: Representative images of X-ray venography before and after thrombus aspiration. X-ray venography shows an extensive filling defect before thrombus aspiration along the femoral vein, and a considerable reduction in the defect after thrombus aspiration
Mentions: The ethics committee of the Miyazaki University approved the study protocol (approval no. 427). We obtained informed consent from the patients with DVT. Sixteen thrombi were obtained from 16 patients (8 men and 8 women; age range, 35–78 years) with DVT who were diagnosed based on clinical symptoms, laboratory data, and clinical imaging findings. The thrombi were mainly aspirated from the proximal portion of the thrombi with a guiding catheter (Guider Softip Guiding Catheter; Boston Scientific Japan, Tokyo, Japan). This catheter was placed from the popliteal vein to the iliac vein (10 cases), the leg vein to the inferior vena cava (5), and the subclavian vein to the superior vena cava (1). X-ray venography showed an extensive filling defect in the femoral vein before thrombus aspiration and reduction of the filling defect after thrombus aspiration (Fig. 1). An additional movie file shows this in more detail (see Additional file 1). We estimated the time of onset based on clinical symptoms and a medical interview. The times from onset to aspiration varied from 5 to 60 days, with a median of 13 days. The underlying diseases of the patients included the following: trauma and long-term immobilization (n = 5), idiopathic (n = 3), malignant tumor postoperatively (n = 2), chronic inflammatory disease (n = 2), Budd–Chiari syndrome (n = 1), chronic renal failure (n = 1), peripheral artery disease (n = 1), and gynecologic surgery (n = 1). Thirteen of 16 patients were intravenously administered heparin for 1 to 30 days, and six of 16 patients were intravenously administered thrombolytic agents for 1 to 12 days before thrombus aspiration.Fig. 1

View Article: PubMed Central - PubMed

ABSTRACT

Background: Thrombolytic therapy is effective in selected patients with deep vein thrombosis (DVT). Therefore, identification of a marker that reflects the age of thrombus is of particular concern. This pilot study aimed to identify a marker that reflects the time after onset in human aspirated DVT.

Methods: We histologically and immunohistochemically analyzed 16 aspirated thrombi. The times from onset to aspiration ranged from 5 to 60 days (median of 13 days). Paraffin sections were stained with hematoxylin and eosin and antibodies for fibrin, glycophorin A, integrin α2bβ3, macrophage markers (CD68, CD163, and CD206), CD34, and smooth muscle actin (SMA).

Results: All thrombi were immunopositive for glycophorin A, fibrin, integrin α2bβ3, CD68, CD163, and CD206, and contained granulocytes. Almost all of the thrombi had small foci of CD34- or SMA-immunopositive areas. CD68- and CD163-immunopositive cell numbers were positively correlated with the time after onset, while the glycophorin A-immunopositive area was negatively correlated with the time after onset. In double immunohistochemistry, CD163-positive cells existed predominantly among the CD68-immunopositive macrophage population. CD163-positive macrophages were closely localized with glycophorin A, CD34, or SMA-positive cell-rich areas.

Conclusions: These findings indicate that CD163 macrophage and erythrocyte contents could be markers for evaluation of the age of thrombus in DVT. Additionally, CD163 macrophages might play a role in organization of the process of venous thrombus.

Electronic supplementary material: The online version of this article (doi:10.1186/s12959-016-0122-0) contains supplementary material, which is available to authorized users.

No MeSH data available.


Related in: MedlinePlus