• Single-Stranded Oligonucleotide Aptamer Binding to P-Selectin Inhibits Adhesion of Sickle Red Blood Cells and Leukocytes to Endothelial Cells in Sickle Cell Disease Model Mice: Novel Therapeutics for Vaso-occlusive Episodes

      Gutsaeva, Diana R.; Parkerson, James B.; Schaub, Robert G.; Kurz, Jeffrey C.; Head, C. Alvin; Medical College of Georgia; Department of Anesthesiology and Perioperative Medicine (American Society of Hematology, 2009-12)
      Adhesive interactions between circulating red blood cells (RBC), leukocytes, and endothelial cells in post capillary venules have been implicated as a contributing factor to the pathogenesis of vaso-occlusion, the major cause of morbidity and mortality associated with sickle cell disease (SCD). Endothelial cell P-selectin, a member of the selectin family of cell adhesion molecules, plays a key role in leukocyte recruitment as well as in the adhesion of sickle RBC (sRBC) to the endothelium. The expression of P-selectin is elevated in SCD and the interaction of P-selectin and its ligands is likely to contribute to impairment of the microvascular flow and thereby to the development of painful vaso-occlusive episodes. Aptamers, short single-stranded oligonucleotides that fold into complex 3-D structures and bind to ligands, have been developed for a wide range of therapeutic targets. Although anti-P-selectin aptamers have been shown to inhibit leukocyte rolling in vitro and to display efficacy in mouse models for inflammation, anti-adhesion activity of anti-P-selectin aptamers has never been evaluated in SCD.
    • TEE to facilitate anesthetic management during thoracotamy in a patient with severe pulmonary hypertension and pulmonary venous obstruction

      Aryal, Anuj; Mehta, Anand; Arthur, Mary E.; Castresana, Manuel R.; Medical College of Georgia; Department of Anesthesiology and Perioperative Medicine (American Society of Anesthesiologists, 2009-10)
      The lateral decubitus position, use of one-lung ventilation, and the prevention and treatment of hypoxemia continue to present challenges to the anesthesiologist, particularly in the patient with pulmonary hypertension. We describe the utility of intraoperative transesophageal echocardiography in the management of a patient with severe pulmonary hypertension and pulmonary vein stenosis undergoing thoracotomy for tissue diagnosis.