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Journal & Issues

Volume 94 (2021): Issue 2 (December 2021)

Volume 94 (2021): Issue 1 (July 2021)

Volume 93 (2020): Issue 2 (December 2020)

Volume 93 (2020): Issue 1 (July 2020)

Volume 92 (2019): Issue 2 (December 2019)

Volume 92 (2019): Issue 1 (July 2019)

Volume 91 (2018): Issue 2 (December 2018)

Volume 91 (2018): Issue 1 (July 2018)

Journal Details
Format
Journal
eISSN
2537-5059
First Published
30 Jun 2018
Publication timeframe
2 times per year
Languages
English

Search

Volume 92 (2019): Issue 2 (December 2019)

Journal Details
Format
Journal
eISSN
2537-5059
First Published
30 Jun 2018
Publication timeframe
2 times per year
Languages
English

Search

8 Articles
Open Access

Genomics and informatics The story of a „love marriage”

Published Online: 03 Dec 2020
Page range: 73 - 78

Abstract

Abstract

The rapid development of molecular biology over the past seventy years led to the molecular understanding of the structure and function of hereditary material in the living world. Through the processing of the gigantic amount of data obtained as a result of technological advances and the exploration of different mechanisms of action, information technology has become an indispensable part of genomic research. This article addresses the background of the genomic and bioinformatics revolution, its application areas, and the perspective of personalized medicine.

Keywords

  • genome
  • genomics
  • bioinformatics
Open Access

Where Law and Digital Health Care Meet…

Published Online: 03 Dec 2020
Page range: 79 - 88

Abstract

Abstract

The modern information and communication tools and technologies of the 21st century open up new opportunities for patients and healthcare providers, thus contributing to human health, reducing the number of morbidities and premature deaths.

The application of modern technology in healthcare has resulted in a number of positive changes, but it has also been subject to multiple challenges, including legal dilemmas in this area: e.g. data management, data security and data protection, access to eHealth, etc.

After a brief introduction to the legal history of healthcare and the presentation of key statistics related to the current digital situation, the main objective of the present work is to analyze the relationship between health digitalization and law.

One of the key issues for successful healing in all historical eras is the legal protection and respect of patients and healthcare workers in the face of changes in the modern world. For this reason, it is important to address this unusual dimension of health care.

Keywords

  • e-Health
  • healthcare law
  • patients’ rights
  • legal liability of healthcare workers
Open Access

Current aspects of polycystic ovary syndrome II: treatment of hyperandrogenism, insulin resistance and infertility

Published Online: 03 Dec 2020
Page range: 89 - 104

Abstract

Abstract

This work is a continuation of an earlier article published in this journal (no. 91/1: “Current aspects of polycystic ovary syndrome I: definition, pathophysiology, clinical manifestations, diagnosis and complications”). As the pathology of polycystic ovary syndrome is not fully known, the treatments used do not constitute a causal therapy, only pathogenetical interventions to break the vicious circles of pathological events. It does not currently have a universal therapeutic procedure or an approved specific drug. Treatment may be aimed at reducing hyperandrogenism, inducing ovulation and preventing complications. The patient’s complaints and desire for becoming pregnant should also be taken into account. In mild cases, an appropriate lifestyle (prevention/treatment of obesity) is sufficient, i.e. a 5-10% reduction in body weight can already result in significant improvement and also serves to prevent late complications (diabetes, hypertension, cardiovascular disease, hyperlipidemia). Oral contraceptives and antiandrogens are mainly used to treat hyperandrogenism (hirsutism, acne, and alopecia). A contraceptive whose progestogen component has antiandrogenic properties, or at least is androgen-neutral, is preferred, such as third-generation contraceptives. However, combined contraceptives (containing gestodene, desogestrel, drospirenone and cyproterone acetate) may increase the risk of venous thromboembolism and are therefore contraindicated in case of hypercoagulability. Antiandrogens (cyproterone acetate, spironolactone, finasteride, etc.) can also be used independently, but only with effective contraception (as these can cause feminization of the male fetus). Insulin resistance plays a crucial role in the development of this disease. Metformin is used as primary therapy, as it also has many other beneficial effects (e.g. cardiovascular and anti-cancer) described in recent years. These pleiotropic effects and their subtle mechanisms are discussed in detail. We highlight the possibilities of avoiding side effects and the current interpretation of rare contraindications (acidosis, hypoxic conditions, renal damage). Insulin resistance lowering agents include thiazolidinediones, acarbose, GLP-1 agonists, vitamin D, resveratrol, octreotide, but the beneficial effects of myoinositol and D-chiro-inositol are also mentioned. In the last part of the paper, the treatment options for infertility are discussed, highlighting the efficacy of clomiphene citrate, gonadotropins (“step-up”, “step- down” methods), IVF techniques, and ovarian drilling used for ovulation induction. We detail the importance and possibilities of the prevention of ovarian hyperstimulation syndrome and multiple pregnancies.

Keywords

  • polycystic ovary syndrome
  • contraceptives
  • antiandrogenes
  • metformin
  • induction of ovulation
Open Access

Success of teamwork: diagnosis and personalized treatment of advanced rectal carcinoma - case presentation

Published Online: 03 Dec 2020
Page range: 113 - 118

Abstract

AbstractBackground

Finding the appropriate treatment for advanced rectal cancer patients represents a challenge for surgeons. Determining the right diagnosis and the proper treatment requires multidisciplinary collaboration. Our aim is to present a case with advanced stage rectum cancer, who received successful multidisciplinary treatment.

Material and method

A prospective multidisciplinary research is being conducted at our Department from 2018 within which patients with malignant rectal cancer are examined. Patients’ treatment is realized by the same multidisciplinary team. The patient’s preoperative investigations included MRI and a lymph node map designated by radiologists.

Results

In case of a 60-year-old patient the preoperative MRI showed a stenotic formation in the middle level of the rectum that penetrated the seminal vesicle. During surgery, we found a 10x10 cm stenotic, perforated rectal cancer, which penetrated the bladder, seminal vesicle, prostate and sacrum, respectively a metastatic lesion in the livers 8th segment. During surgery R2 recto-sigmoid resection was performed with colostomy. The patient was mobilized on the first postoperative day and bowel movements were regained on the second day. The patient left the hospital on the eighth postoperative day.

Conclusions

Adequate treatment of patients with advanced rectal cancer can be achieved only through multidisciplinary co-operation. Preoperative radiological examinations are mandatory. A map representing the positive colorectal lymph nodes, implemented by the radiologists, can significantly help the surgeons and pathologists.

Keywords

  • rectum
  • cancer
  • surgical treatment
  • case presentation
Open Access

Heterologous Expression and Purification of the Antimicrobial Peptide Buforin II

Published Online: 03 Dec 2020
Page range: 119 - 125

Abstract

Abstract

Antimicrobial peptides are natural substances that have played a role in the development of the adaptive immune system, and are currently involved in the prevention of infections, through their direct antimicrobial and immunomodulatory properties. While the amino acid composition and spatial structure vary, most antibacterial peptides have a positive surface charge, which allows them to bind to the negative bacterial membranes. Buforin II is a widely studied antimicrobial peptide first obtained through the structural modification of buforin I, a peptide isolated from Bufo gargarizans. The peptide showed significant antibacterial activity against Gram-positive and Gram-negative bacterial strains. The mechanism of action of buforin II differs from that of other antimicrobial peptides, as it binds directly to bacterial DNA and RNA. The aim of our study was to obtain recombinant buforin II with a ubiquitin fusion partner, through heterologous expression in Escherichia coli Rosetta™ (DE3)pLysS cells, using a laboratory scale bioreactor. The incubation of expression host cells in a bioreactor allowed the constant monitoring and control of the process parameters, leading to high biomass levels and an increased production rate of the peptide. The parameters used during incubation were: 37°C, pH=6.9 and dissolved oxygen level above 40%. Purification of the recombinant protein was accomplished by affinity chromatography using a Ni-chelate solid phase to which the 10xHistag of our construct showed affinity. Method optimisation consisted in the use of gradient and linear elution, of which the latter was found to be more effective. Digestion of the fusion partner from the target peptide was performed with ubiquitin carboxyl-terminal hydrolase enzyme. The expression and purification protocols developed in our experiment allow the production of a significant amount of buforin II, allowing its use for further research. Furthermore, the presented methods could be suitable for industrial production of the recombinant peptide..

Keywords

  • buforin II
  • heterologous expression
  • antimicrobial peptide
  • AMP
Open Access

Famous Hungarian Chemists and Pharmacists from Transylvania: 150 years since the birth of Pál Scheitz, collaborator of Professor Lajos Ilosvay

Published Online: 03 Dec 2020
Page range: 126 - 132

Abstract

Abstract

Several Transylvanian chemists and pharmacists have played an important role in the development and advancement of modern Hungarian chemical sciences. Regarding these prominent personalities we paid tribute in our series to the career and role of Lajos Ilosvay, Lajos Winkler and Tibor Széki in Budapest, Hungary. Pál Scheitz who was born 150 years ago in Marosvásárhely/Târgu-Mures worked at the Chemistry Institute of Professor Lajos Ilosvay. After graduating from the University of Munich and earning a PhD degree, he worked at the University of Kolozsvár/Cluj for a short period of time after which he pursued a full-time academic career at the Budapest University of Technology for the rest of his life. During his relatively short life (1870-1912) he managed to produce some outstanding works in the field of analytical chemistry. His most significant work is a contemporary book on methods of qualitative chemical analysis, which was printed in two editions. His studies and investigations of litmus dyes are also significant, which are still considered to be the most comprehensive studies of the Hungarian scientific literature.

Keywords

  • qualitative analytical chemistry
  • litmus
  • colourants
Open Access

Dénes Szabó (1856-1918), the Clinic-founder Professor of Gynecology, A Centennial Commemoration

Published Online: 03 Dec 2020
Page range: 133 - 142

Abstract

Abstract

Dénes Szabó (1856–1918) was the second professor of obstetrics and gynecology of the Franz Joseph University from Kolozsvár (Cluj). This is a centennial commemoration. Szabó was born in the family of a great geologist professor at Pest. He studied at the University from Budapest and Strasbourg. He took his doctor’s degree in 1879. He spent a year with medical studies in foreign countries. In 1881 he became assistant to Professor Tivadar Kézmárszky, head of the Gynecological Clinic No. I. from Budapest. He was qualified as private lecturer in gynecology in 1888. In this period he published a lot of studies and review articles in the weekly medical papers Orvosi Hetilap and Gyógyászat. The Kolozsvár professor of obstetrics János Maizner in 1892 got retired. As a result of a competition Szabó was appointed professor of both obstetrics and gynecology. Until 1899 he worked in very poor conditions in a suburb building. Then the new 2 floor hospital from Mikó Street was built, where there were separate sections for obstetrics and gynecology. There he could also train midwives during 5 month courses. He became member of the Medical section of Transylvanian Museum Society, from 1894 up to 1912 he was the editor of its review journal (Értesítő...). Most of his studies were published there. The Medical Faculty elected him three times dean, in 1905/6 he was the rector of the university. He published around 65 studies. Some of them discuss deontological problems or deal with medical history. He was one of the editors of two memorial volumes, one dedicated to Professor Purjesz (1906), the other to Professor Lechner (1915). He compiled the first history of the Medical Faculty in 1896. He was also one of the editors of the monographic album of the Kolozsvár University from 1903. Five of its chapters were written by him. He was awarded with the title of Court Counselor. During WWI he did much for the medical care of wounded soldiers, so he got military awards, too. A number of medical and civil associations elected him president. He died because of gastric cancer at a Budapest hospital. According to his final wish he was buried in the Házsongárd Cemetery

Keywords

  • university
  • obstetrics
  • gynecology
  • medicine
  • midwife
  • memorial volume
Open Access

The morphological response of the heart and spleen following acute myocardial infarction-induced sterile inflammation: a clinicopathological study

Published Online: 03 Dec 2020
Page range: 105 - 112

Abstract

AbstractIntroduction

as an outcome of sterile inflammation-inducing acute ischemic processes, many splenic cells enter the circulatory system and migrate into the lesion, defending tissues against the spread of ischemia or enhancing necrosis.

Objective

investigating the therapeutic effect of splenic morphological response to sterile inflammation-inducing myocardial infarction.

Material and method

We examined the weight and structure of the heart and spleen of 106 patients deceased due to acute myocardial infarction. These data were correlated with demographic (personal) and epidemiological data, and disease history. After morphological investigation of archived myocardial and splenic tissue samples, the acute ischemia-induced structural alterations of splenic samples were quantified using a digital morphometric method. Results were evaluated in comparison to the myocardial ischemia coefficient. Changes in distribution of ischemia-induced cell types were characterized by defining the immunological phenotypes of macrophages (M1 vs. M2). Spleen samples from patients without history of ischemia were used as controls.

Results

The modification of the spleen weight was associated with an increase in peripheral blood leucocyte levels. Our morphological analysis proved a positive correlation between the ischemia coefficient and the decrease of spleen weight. Structural analysis of splenic tissue revealed the collapse of red pulp sinusoids, a significant size decrease of the white pulp marginal zone (p<0.05), and depleted follicles with irregular margins without any distinct germinative centers. Concurrently, with the proliferation of granulocytes, the increase of M1 macrophages was observed in the myocardium, and a higher M1/M2 ratio was detected in the marginal zone of splenic follicles.

Conclusion

On the background of acute ischemia, time critically determines the dynamic structural changes of the spleen. Along with reducing the marginal zone, immunomodulation targeting its cellular composition will be a putative therapeutic approach in the future.

Keywords

  • myocardial infarction
  • spleen
  • cardio-splenic axis (axis)
8 Articles
Open Access

Genomics and informatics The story of a „love marriage”

Published Online: 03 Dec 2020
Page range: 73 - 78

Abstract

Abstract

The rapid development of molecular biology over the past seventy years led to the molecular understanding of the structure and function of hereditary material in the living world. Through the processing of the gigantic amount of data obtained as a result of technological advances and the exploration of different mechanisms of action, information technology has become an indispensable part of genomic research. This article addresses the background of the genomic and bioinformatics revolution, its application areas, and the perspective of personalized medicine.

Keywords

  • genome
  • genomics
  • bioinformatics
Open Access

Where Law and Digital Health Care Meet…

Published Online: 03 Dec 2020
Page range: 79 - 88

Abstract

Abstract

The modern information and communication tools and technologies of the 21st century open up new opportunities for patients and healthcare providers, thus contributing to human health, reducing the number of morbidities and premature deaths.

The application of modern technology in healthcare has resulted in a number of positive changes, but it has also been subject to multiple challenges, including legal dilemmas in this area: e.g. data management, data security and data protection, access to eHealth, etc.

After a brief introduction to the legal history of healthcare and the presentation of key statistics related to the current digital situation, the main objective of the present work is to analyze the relationship between health digitalization and law.

One of the key issues for successful healing in all historical eras is the legal protection and respect of patients and healthcare workers in the face of changes in the modern world. For this reason, it is important to address this unusual dimension of health care.

Keywords

  • e-Health
  • healthcare law
  • patients’ rights
  • legal liability of healthcare workers
Open Access

Current aspects of polycystic ovary syndrome II: treatment of hyperandrogenism, insulin resistance and infertility

Published Online: 03 Dec 2020
Page range: 89 - 104

Abstract

Abstract

This work is a continuation of an earlier article published in this journal (no. 91/1: “Current aspects of polycystic ovary syndrome I: definition, pathophysiology, clinical manifestations, diagnosis and complications”). As the pathology of polycystic ovary syndrome is not fully known, the treatments used do not constitute a causal therapy, only pathogenetical interventions to break the vicious circles of pathological events. It does not currently have a universal therapeutic procedure or an approved specific drug. Treatment may be aimed at reducing hyperandrogenism, inducing ovulation and preventing complications. The patient’s complaints and desire for becoming pregnant should also be taken into account. In mild cases, an appropriate lifestyle (prevention/treatment of obesity) is sufficient, i.e. a 5-10% reduction in body weight can already result in significant improvement and also serves to prevent late complications (diabetes, hypertension, cardiovascular disease, hyperlipidemia). Oral contraceptives and antiandrogens are mainly used to treat hyperandrogenism (hirsutism, acne, and alopecia). A contraceptive whose progestogen component has antiandrogenic properties, or at least is androgen-neutral, is preferred, such as third-generation contraceptives. However, combined contraceptives (containing gestodene, desogestrel, drospirenone and cyproterone acetate) may increase the risk of venous thromboembolism and are therefore contraindicated in case of hypercoagulability. Antiandrogens (cyproterone acetate, spironolactone, finasteride, etc.) can also be used independently, but only with effective contraception (as these can cause feminization of the male fetus). Insulin resistance plays a crucial role in the development of this disease. Metformin is used as primary therapy, as it also has many other beneficial effects (e.g. cardiovascular and anti-cancer) described in recent years. These pleiotropic effects and their subtle mechanisms are discussed in detail. We highlight the possibilities of avoiding side effects and the current interpretation of rare contraindications (acidosis, hypoxic conditions, renal damage). Insulin resistance lowering agents include thiazolidinediones, acarbose, GLP-1 agonists, vitamin D, resveratrol, octreotide, but the beneficial effects of myoinositol and D-chiro-inositol are also mentioned. In the last part of the paper, the treatment options for infertility are discussed, highlighting the efficacy of clomiphene citrate, gonadotropins (“step-up”, “step- down” methods), IVF techniques, and ovarian drilling used for ovulation induction. We detail the importance and possibilities of the prevention of ovarian hyperstimulation syndrome and multiple pregnancies.

Keywords

  • polycystic ovary syndrome
  • contraceptives
  • antiandrogenes
  • metformin
  • induction of ovulation
Open Access

Success of teamwork: diagnosis and personalized treatment of advanced rectal carcinoma - case presentation

Published Online: 03 Dec 2020
Page range: 113 - 118

Abstract

AbstractBackground

Finding the appropriate treatment for advanced rectal cancer patients represents a challenge for surgeons. Determining the right diagnosis and the proper treatment requires multidisciplinary collaboration. Our aim is to present a case with advanced stage rectum cancer, who received successful multidisciplinary treatment.

Material and method

A prospective multidisciplinary research is being conducted at our Department from 2018 within which patients with malignant rectal cancer are examined. Patients’ treatment is realized by the same multidisciplinary team. The patient’s preoperative investigations included MRI and a lymph node map designated by radiologists.

Results

In case of a 60-year-old patient the preoperative MRI showed a stenotic formation in the middle level of the rectum that penetrated the seminal vesicle. During surgery, we found a 10x10 cm stenotic, perforated rectal cancer, which penetrated the bladder, seminal vesicle, prostate and sacrum, respectively a metastatic lesion in the livers 8th segment. During surgery R2 recto-sigmoid resection was performed with colostomy. The patient was mobilized on the first postoperative day and bowel movements were regained on the second day. The patient left the hospital on the eighth postoperative day.

Conclusions

Adequate treatment of patients with advanced rectal cancer can be achieved only through multidisciplinary co-operation. Preoperative radiological examinations are mandatory. A map representing the positive colorectal lymph nodes, implemented by the radiologists, can significantly help the surgeons and pathologists.

Keywords

  • rectum
  • cancer
  • surgical treatment
  • case presentation
Open Access

Heterologous Expression and Purification of the Antimicrobial Peptide Buforin II

Published Online: 03 Dec 2020
Page range: 119 - 125

Abstract

Abstract

Antimicrobial peptides are natural substances that have played a role in the development of the adaptive immune system, and are currently involved in the prevention of infections, through their direct antimicrobial and immunomodulatory properties. While the amino acid composition and spatial structure vary, most antibacterial peptides have a positive surface charge, which allows them to bind to the negative bacterial membranes. Buforin II is a widely studied antimicrobial peptide first obtained through the structural modification of buforin I, a peptide isolated from Bufo gargarizans. The peptide showed significant antibacterial activity against Gram-positive and Gram-negative bacterial strains. The mechanism of action of buforin II differs from that of other antimicrobial peptides, as it binds directly to bacterial DNA and RNA. The aim of our study was to obtain recombinant buforin II with a ubiquitin fusion partner, through heterologous expression in Escherichia coli Rosetta™ (DE3)pLysS cells, using a laboratory scale bioreactor. The incubation of expression host cells in a bioreactor allowed the constant monitoring and control of the process parameters, leading to high biomass levels and an increased production rate of the peptide. The parameters used during incubation were: 37°C, pH=6.9 and dissolved oxygen level above 40%. Purification of the recombinant protein was accomplished by affinity chromatography using a Ni-chelate solid phase to which the 10xHistag of our construct showed affinity. Method optimisation consisted in the use of gradient and linear elution, of which the latter was found to be more effective. Digestion of the fusion partner from the target peptide was performed with ubiquitin carboxyl-terminal hydrolase enzyme. The expression and purification protocols developed in our experiment allow the production of a significant amount of buforin II, allowing its use for further research. Furthermore, the presented methods could be suitable for industrial production of the recombinant peptide..

Keywords

  • buforin II
  • heterologous expression
  • antimicrobial peptide
  • AMP
Open Access

Famous Hungarian Chemists and Pharmacists from Transylvania: 150 years since the birth of Pál Scheitz, collaborator of Professor Lajos Ilosvay

Published Online: 03 Dec 2020
Page range: 126 - 132

Abstract

Abstract

Several Transylvanian chemists and pharmacists have played an important role in the development and advancement of modern Hungarian chemical sciences. Regarding these prominent personalities we paid tribute in our series to the career and role of Lajos Ilosvay, Lajos Winkler and Tibor Széki in Budapest, Hungary. Pál Scheitz who was born 150 years ago in Marosvásárhely/Târgu-Mures worked at the Chemistry Institute of Professor Lajos Ilosvay. After graduating from the University of Munich and earning a PhD degree, he worked at the University of Kolozsvár/Cluj for a short period of time after which he pursued a full-time academic career at the Budapest University of Technology for the rest of his life. During his relatively short life (1870-1912) he managed to produce some outstanding works in the field of analytical chemistry. His most significant work is a contemporary book on methods of qualitative chemical analysis, which was printed in two editions. His studies and investigations of litmus dyes are also significant, which are still considered to be the most comprehensive studies of the Hungarian scientific literature.

Keywords

  • qualitative analytical chemistry
  • litmus
  • colourants
Open Access

Dénes Szabó (1856-1918), the Clinic-founder Professor of Gynecology, A Centennial Commemoration

Published Online: 03 Dec 2020
Page range: 133 - 142

Abstract

Abstract

Dénes Szabó (1856–1918) was the second professor of obstetrics and gynecology of the Franz Joseph University from Kolozsvár (Cluj). This is a centennial commemoration. Szabó was born in the family of a great geologist professor at Pest. He studied at the University from Budapest and Strasbourg. He took his doctor’s degree in 1879. He spent a year with medical studies in foreign countries. In 1881 he became assistant to Professor Tivadar Kézmárszky, head of the Gynecological Clinic No. I. from Budapest. He was qualified as private lecturer in gynecology in 1888. In this period he published a lot of studies and review articles in the weekly medical papers Orvosi Hetilap and Gyógyászat. The Kolozsvár professor of obstetrics János Maizner in 1892 got retired. As a result of a competition Szabó was appointed professor of both obstetrics and gynecology. Until 1899 he worked in very poor conditions in a suburb building. Then the new 2 floor hospital from Mikó Street was built, where there were separate sections for obstetrics and gynecology. There he could also train midwives during 5 month courses. He became member of the Medical section of Transylvanian Museum Society, from 1894 up to 1912 he was the editor of its review journal (Értesítő...). Most of his studies were published there. The Medical Faculty elected him three times dean, in 1905/6 he was the rector of the university. He published around 65 studies. Some of them discuss deontological problems or deal with medical history. He was one of the editors of two memorial volumes, one dedicated to Professor Purjesz (1906), the other to Professor Lechner (1915). He compiled the first history of the Medical Faculty in 1896. He was also one of the editors of the monographic album of the Kolozsvár University from 1903. Five of its chapters were written by him. He was awarded with the title of Court Counselor. During WWI he did much for the medical care of wounded soldiers, so he got military awards, too. A number of medical and civil associations elected him president. He died because of gastric cancer at a Budapest hospital. According to his final wish he was buried in the Házsongárd Cemetery

Keywords

  • university
  • obstetrics
  • gynecology
  • medicine
  • midwife
  • memorial volume
Open Access

The morphological response of the heart and spleen following acute myocardial infarction-induced sterile inflammation: a clinicopathological study

Published Online: 03 Dec 2020
Page range: 105 - 112

Abstract

AbstractIntroduction

as an outcome of sterile inflammation-inducing acute ischemic processes, many splenic cells enter the circulatory system and migrate into the lesion, defending tissues against the spread of ischemia or enhancing necrosis.

Objective

investigating the therapeutic effect of splenic morphological response to sterile inflammation-inducing myocardial infarction.

Material and method

We examined the weight and structure of the heart and spleen of 106 patients deceased due to acute myocardial infarction. These data were correlated with demographic (personal) and epidemiological data, and disease history. After morphological investigation of archived myocardial and splenic tissue samples, the acute ischemia-induced structural alterations of splenic samples were quantified using a digital morphometric method. Results were evaluated in comparison to the myocardial ischemia coefficient. Changes in distribution of ischemia-induced cell types were characterized by defining the immunological phenotypes of macrophages (M1 vs. M2). Spleen samples from patients without history of ischemia were used as controls.

Results

The modification of the spleen weight was associated with an increase in peripheral blood leucocyte levels. Our morphological analysis proved a positive correlation between the ischemia coefficient and the decrease of spleen weight. Structural analysis of splenic tissue revealed the collapse of red pulp sinusoids, a significant size decrease of the white pulp marginal zone (p<0.05), and depleted follicles with irregular margins without any distinct germinative centers. Concurrently, with the proliferation of granulocytes, the increase of M1 macrophages was observed in the myocardium, and a higher M1/M2 ratio was detected in the marginal zone of splenic follicles.

Conclusion

On the background of acute ischemia, time critically determines the dynamic structural changes of the spleen. Along with reducing the marginal zone, immunomodulation targeting its cellular composition will be a putative therapeutic approach in the future.

Keywords

  • myocardial infarction
  • spleen
  • cardio-splenic axis (axis)

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