Successful Treatment of Spontaneous Rupture of the Spleen by Embolization of Splenic Artery in a Patient with Acute Promyelocytic Leukaemia and COVID-19 Infection

Spontaneous rupture of the spleen (SRS) is a rare clinical entity with a potentially poor medical outcome. In most cases, SRS is caused by neoplastic disorder. Acute promyelocytic leukaemia is a rare but important cause of SRS that physicians are required to assess for. We present a 28-year-old woman with APL and COVID-19 pneumonia, who successfully underwent embolisation of the splenic artery for spontaneously occurring splenic rupture during induction chemotherapy. After the intervention the patient completed induction chemotherapy and achieved complete remission. Our case demonstrates that emergent transcatheter arterial embolisation can be lifesaving even in the unfavourable condition of a patient with severe immune deficiency.

Stem cell-derived exosomes-an emerging tool for myocardial regeneration

Cardiovascular diseases(CVDs) continue to represent the number one cause of death and disability in industrialized countries. The most severe form of CVD is acute myocardial infarction(AMI), a devastating disease associated with high mortality and disability. In a substantial proportion of patients who survive AMI, loss of functional cardiomyocytes as a result of ischaemic injury leads to ventricular failure, resulting in significant alteration to quality of life and increased mortality. Therefore, many attempts have been made in recent years to identify new tools for the regeneration of functional cardiomyocytes. Regenerative therapy currently represents the ultimate goal for restoring the function of damaged myocardium by stimulating the regeneration of the infarcted tissue or by providing cellsthat can generate new myocardial tissue to replace the damaged tissue. Stem cells(SCs) have been proposed as a viable therapy option in these cases. However, despite the great enthusiasm at the beginning of the SC era, justified by promising initial results, this therapy has failed to demonstrate a significant benefit in large clinical trials. One interesting finding of SC studies is that exosomes released by mesenchymal SCs(MSCs) are able to enhance the viability of cardiomyocytes after ischaemia/reperfusion injury, suggesting that the beneficial effects of MSCs in the recovery of functional myocardium could be related to their capacity to secrete exosomes. Ten years ago, it was discovered that exosomes have the unique property of transferring miRNA between cells, acting as miRNA nanocarriers. Therefore, exosomebased therapy has recently been proposed as an emerging tool for cardiac regeneration as an alternative to SC therapy in the post-infarction period. This review aims to discuss the emerging role of exosomes in developing innovative therapies for cardiac regeneration as well as their potential role as candidate biomarkers or for developing new diagnostic tools.

Endothelial and platelet markers in diabetes mellitus type 2

Diabetes mellitus(DM) is an extremely common disorder which carries a risk of vascular impairment.DM type 2(DM2) can be characterized by the dysfunction of haemostasis manifesting by stimulated coagulation process,disorder of platelet function and decreased fibrinolytic activity.These all are the reasons why DM2 is the most common acquired thrombophilia.Endothelial dysfunction along with platelet hyperactivity are unquestionably involved in the hyperactivation of platelets and clotting factors in DM.As a natural consequence of continuous investigation,many markers of endothelial dysfunction and diabetic thrombocytopathy have been identified and considered for implementation in clinical practice.Endothelial function can be assessed by the evaluation of endothelial markers,circulating molecules synthesised in various amounts by the endothelium.These markers precede the signs of evident microangiopathy.Platelets have an ethiopathogenic relation to the microangiopathy in DM.Their increased activity was confirmed in both types of DM.Predictors of endothelial and platelet disorder could improve the screening of individuals at increased risk,thus leading to the early diagnosis,appropriate treatment,as well as to the effective prevention of the complications of DM2.In the article we deal with the mechanisms involved in the pathogenesis of endothelial and platelet functional abnormalities,endothelial and platelet markers of DM2 considered for implementation in clinical practice and possibilities of their detection.