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BackgroundNew therapies to treat diabetic peripheral artery disease (PAD) require target-specific non-invasive imaging modalities to follow efficacy. As a translational study, we performed targeted imaging of receptors for vascular endothelial growth factor (VEGF) in response to anterior femoral artery occlusion (FAO) in Yucatan minipigs and compare the normal response to response in diabetic Yucatan minipigs.MethodsEleven Yucatan minipigs, 6 non-diabetic (non-D) and 5 purpose bred diabetic (D) (Sinclair, Auxvasse MO), underwent intravascular total occlusion of the anterior femoral artery (FA). At days 1 and 28, pigs underwent SPECT/CT 201Tl hindlimb perfusion imaging and at day 7 were injected with [99mTc]DOTA-PEG-scVEGF (scV/Tc) tracer targeting VEGF receptor, and underwent biopsies of the hindlimb muscles for gamma counting and histology, followed by imaging. One day after the final scan, pigs underwent contrast angiography of the lower extremities. Counts from scans were converted to percentage injected activity (%IA).ResultsPerfusion was lower in the occluded hindlimb compared to non-occluded on day 1 in both the D and non-D pigs. At day 7, scV/Tc count ratio of counts from ROIs drawn in proximal gastrocnemius muscle for the occluded over non-occluded limb was significantly higher in non-D vs. D pigs (1.32 ± 0.06 vs. 1.04 ± 0.13, P = 0.02) reflecting higher level of angiogenesis. Perfusion increased between days 1 and 28 in the muscles in the occluded limb for the non-diabetic pigs while the diabetic pig showed no increase (+ 0.13 ± 0.08 %IA vs. − 0.13 ± 0.11, P = 0.003). The anterior FA showed poor contrast filling beyond occluder and qualitatively fewer bridging collaterals compared to non-D pigs at 28 days.ConclusionVEGF receptor targeted imaging showed the effects of diabetes to suppress angiogenesis in response to occlusion of the anterior femoral artery of purpose bred diabetic Yucatan minipigs and indicates potential applicability as a marker to follow efficacy of novel therapies to improve blood flow by stimulating angiogenesis in diabetic PAD.

Background Receptor for Advanced Glycated Endproducts (RAGE) plays a major role in the inflammatory response to infectious and toxin induced acute lung injury. We tested the hypothesis that a RAGE blocking antibody when administered after the onset of injury can reduce lung inflammation compared to control antibody. Methods Male and female C57BL/6 (WT) mice were used. Forty-six received lipopolysaccharide (LPS) and 26 PBS by nasal instillation on day one, repeated on day three. On day 2, 36 mice receiving LPS were divided into two groups of 18, one treated with 200 μg of non-immune isotype control IgG and the second group treated with 200 μg of anti-RAGE Ab, each dose divided between IV and IP. Ten of the 46 were not treated. On day 4, before euthanasia, mice were injected with fluorescein isothiocyanate (FITC) labelled albumen. BALF and serum samples were collected as well as lung tissue for immunohistochemistry (IHC). BALF was analyzed for cell (leukocyte) counts, for FITC BALF/serum ratios indicating pulmonary vascular leak, and for cytokines/chemokines using bead based multiplex assays. Quantitative IHC was performed for MPO and RAGE. Results Ten LPS mice showed minimal inflammation by all measures indicating poor delivery of LPS and were excluded from analysis leaving n = 11 in the LPS + IgG group and n = 12 in the LPS + anti-RAGE group. BALF cell counts were low in the PBS administered mice (4.9 ± 2.1 × 10 5 /ml) and high in the LPS injured untreated mice (109 ± 34) and in the LPS + IgG mice (91 ± 54) while in comparison, LPS + anti-RAGE ab mice counts were significantly lower (51.3 ± 18 vs. LPS + IgG, P = 0.03). The BALF/serum FITC ratios were lower for the LPS + anti-RAGE mice than for the LPS + IgG mice indicating less capillary leakiness. Quantitative IHC RAGE staining was lower in the LPS + anti-RAGE ab mice than in the LPS + IgG treated mice (P = 0.02). Conclusions These results describe a four-day LPS protocol to sustain lung injury and allow for treatment and suggests that treatment aimed at blocking RAGE when given after onset of injury can reduce lung inflammation.

Control over cell engraftment, survival, and function remains critical for heart repair. We have established a tissue engineering platform for the delivery of human mesenchymal progenitor cells (MPCs) by a fully biological composite scaffold. Specifically, we developed a method for complete decellularization of human myocardium that leaves intact most elements of the extracellular matrix, as well as the underlying mechanical properties. A cell-matrix composite was constructed by applying fibrin hydrogel with suspended cells onto decellularized sheets of human myocardium. We then implanted this composite onto the infarct bed in a nude rat model of cardiac infarction. We next characterized the myogenic and vasculogenic potential of immunoselected human MPCs and demonstrated that in vitro conditioning with a low concentration of TGF-β promoted an arteriogenic profile of gene expression. When implanted by composite scaffold, preconditioned MPCs greatly enhanced vascular network formation in the infarct bed by mechanisms involving the secretion of paracrine factors, such as SDF-1, and the migration of MPCs into ischemic myocardium, but not normal myocardium. Echocardiography demonstrated the recovery of baseline levels of left ventricular systolic dimensions and contractility when MPCs were delivered via composite scaffold. This adaptable platform could be readily extended to the delivery of other reparative cells of interest and used in quantitative studies of heart repair.

In extensive bone defects, tissue damage and hypoxia lead to cell death, resulting in slow and incomplete healing. Human embryonic stem cells (hESC) can give rise to all specialized lineages found in healthy bone and are therefore uniquely suited to aid regeneration of damaged bone. We show that the cultivation of hESC-derived mesenchymal progenitors on 3D osteoconductive scaffolds in bioreactors with medium perfusion leads to the formation of large and compact bone constructs. Notably, the implantation of engineered bone in immunodeficient mice for 8 wk resulted in the maintenance and maturation of bone matrix, without the formation of teratomas that is consistently observed when undifferentiated hESCs are implanted, alone or in bone scaffolds. Our study provides a proof of principle that tissue-engineering protocols can be successfully applied to hESC progenitors to grow bone grafts for use in basic and translational studies.

Dexmedetomidine, propofol, and sevoflurane are widely used anesthetic agents, but reports of water metabolism disturbances—particularly drug‐induced diabetes insipidus (DI)—associated with their use remain extremely rare. We report a case of a 51‐year‐old Chinese man who developed abrupt high‐volume polyuria (> 600 mL/h; 24‐h output of 8750 mL), hypotonic urine (specific gravity 1.003; osmolality 175 mOsm/kg), progressive hypernatremia (peak 156 mmol/L), hemoconcentration, lactic acidosis, and hypotension following transurethral seminal vesiculoscopy performed under general anesthesia. The patient was initially suspected of having an anaphylactic reaction, but standard interventions were ineffective. After exclusion of other causes, a diagnosis of anesthetic‐associated DI with secondary hypovolemic shock was made. The patient responded to aggressive fluid and electrolyte replacement alongside norepinephrine support. Polyuria resolved within approximately 18 h, serum sodium normalized, and the patient was discharged from the ICU on postoperative Day 3. This case emphasizes that persistent dilute polyuria with rising serum sodium after anesthesia should prompt early evaluation for DI. When such complications arise, timely diagnosis, targeted fluid management, and hormone replacement therapy when appropriate can be crucial for preventing potentially life‐threatening outcomes. Key Clinical Message Transient diabetes insipidus may rarely occur after exposure to anesthetic agents, particularly in the setting of combined drug exposure. In patients with unexplained postoperative polyuria, hypernatremia, and circulatory instability, early recognition of hypotonic water diuresis is essential to prevent severe hypovolemia and shock.

Reproducibility in the synthesis of complex materials such as metal–organic frameworks (MOFs) remains a major challenge. Under seemingly identical experimental conditions, a distribution of MOF crystals with different structural properties is obtained, resulting in a heterogeneous performance. For quality assurance, analytical techniques and protocols are needed to predict MOF crystal quality already during the synthesis process. In this work, in situ Raman spectroscopy is used to monitor the formation of 2D phthalocyanine‐based MOFs at the air–water interface. Raman marker bands are identified that visualise the competing processes of linker aggregation and MOF formation. Using transmission electron microscopy (TEM) measurements on the MOF crystals after synthesis, a correlation between the Raman marker bands and the resulting crystalline domain size distribution of the MOF can be derived. This noninvasive, fast, and simple in situ quality assessment method marks a significant step toward automated MOF synthesis. The properties of 2D conjugated metal–organic frameworks (2D c‐MOFs) are related to their structure and are influenced by the synthesis conditions. Here, in situ, Raman and transmission electron microscopy (TEM) are used to determine Raman marker bands that characterise the reaction progress and yield of phthalocyanine‐based 2D Cu2[ZnPc‐O8] MOFs. Thus, a noninvasive quality assessment method of the synthesised MOFs is established.

Dye-sensitized solar cells (DSSCs) are highly promising since they can potentially solve global energy issues. The development of new photosensitizers is the key to fully realizing perspectives proposed to DSSCs. Being cheap and nontoxic, carbon quantum dots (CQDs) have emerged as attractive candidates for this purpose. However, current methodologies to build up CQD-sensitized solar cells (CQDSCs) result in an imperfect apparatus with extremely low power conversion efficiencies (PCEs). Herein, we present a simple strategy of growing carbon quantum dots (CQDs) onto TiO2 surfaces in situ. The CQDs/TiO2 hybridized photoanode was then used to construct solar cell with an improved PCE of 0.87%, which is higher than all of the reported CQDSCs adopting the simple post-adsorption method. This result indicates that an in situ growing strategy has great advantages in terms of optimizing the performance of CQDSCs. In addition, we have also found that the mechanisms dominating the performance of CQDSCs are different from those behind the solar cells using inorganic semiconductor quantum dots (ISQDs) as the photosensitizers, which re-confirms the conclusion that the characteristics of CQDs differ from those of ISQDs.

Acute cardiac injury is prevalent in critical COVID-19 and associated with increased mortality. Its etiology remains debated, as initially presumed causes — myocarditis and cardiac necrosis — have proved uncommon. To elucidate the pathophysiology of COVID-19–associated cardiac injury, we conducted a prospective study of the first 69 consecutive COVID-19 decedents at CUIMC in New York City. Of 6 acute cardiac histopathologic features, presence of microthrombi was the most commonly detected among our cohort. We tested associations of cardiac microthrombi with biomarkers of inflammation, cardiac injury, and fibrinolysis and with in-hospital antiplatelet therapy, therapeutic anticoagulation, and corticosteroid treatment, while adjusting for multiple clinical factors, including COVID-19 therapies. Higher peak erythrocyte sedimentation rate and C-reactive protein were independently associated with increased odds of microthrombi, supporting an immunothrombotic etiology. Using single-nuclei RNA-sequencing analysis on 3 patients with and 4 patients without cardiac microthrombi, we discovered an enrichment of prothrombotic/antifibrinolytic, extracellular matrix remodeling, and immune-potentiating signaling among cardiac fibroblasts in microthrombi-positive, relative to microthrombi-negative, COVID-19 hearts. Non–COVID-19, nonfailing hearts were used as reference controls. Our study identifies a specific transcriptomic signature in cardiac fibroblasts as a salient feature of microthrombi-positive COVID-19 hearts. Our findings warrant further mechanistic study as cardiac fibroblasts may represent a potential therapeutic target for COVID-19–associated cardiac microthrombi.

Sepsis-induced cardiac dysfunction is one of the most common types of organ dysfunction in sepsis; its pathogenesis is highly complex and not yet fully understood. Cardiomyocytes serve a key role in the pathophysiology of cardiac function; due to the limited ability of cardiomyocytes to regenerate, their loss contributes to decreased cardiac function. The activation of inflammatory signalling pathways affects cardiomyocyte function and modes of cardiomyocyte death in sepsis. Prevention of cardiomyocyte death is an important therapeutic strategy for sepsis-induced cardiac dysfunction. Thus, understanding the signalling pathways that activate cardiomyocyte death and cross-regulation between death modes are key to finding therapeutic targets. The present review focused on advances in understanding of sepsis-induced cardiomyocyte death pathways, including apoptosis, necroptosis, mitochondria-mediated necrosis, pyroptosis, ferroptosis and autophagy. The present review summarizes the effect of inflammatory activation on cardiomyocyte death mechanisms, the diversity of regulatory mechanisms and cross-regulation between death modes and the effect on cardiac function in sepsis to provide a theoretical basis for treatment of sepsis-induced cardiac dysfunction.

Background The purpose of this study is to image the effect of diabetes on expression of receptor for advanced glycation endproducts (RAGE) in limb ischemia in live animals. Methods Male wild-type C57BL/6 mice were either made diabetic or left as control. Two months later, diabetic and non-diabetic mice underwent left femoral artery ligation. The right leg served as lesion control. Five days later, mice were injected with 15.1 ± 4.4 MBq 99m Tc-anti-RAGE F(ab’) 2 and 4 to 5 h later (blood pool clearance) underwent SPECT/CT imaging. At the completion of imaging, mice were euthanized, hind limbs counted and sectioned, and scans reconstructed. Regions of interest were drawn on serial transverse sections comprising the hind limbs and activity in millicuries summed and divided by the injected dose (ID). Quantitative histology was performed for RAGE staining and angiogenesis. Results Uptake of 99m Tc-anti-RAGE F(ab') 2 as %ID × 10 −3 was higher in the left (ischemic) limbs for the diabetic mice ( n = 8) compared to non-diabetic mice ( n = 8) (1.20 ± 0.44% vs. 0.49 ± 0.40%; P = 0.0007) and corresponded to less angiogenesis in the diabetic mice. Uptake was also higher in the right limbs of diabetic compared to non-diabetic animals (0.82 ± 0.33% vs. 0.40 ± 0.14%; P = 0.0004). Conclusions These data show the feasibility of imaging and quantifying the effect of diabetes on RAGE expression in limb ischemia.