651
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Sookoian S, Pirola CJ. Repurposing drugs to target nonalcoholic steatohepatitis. World J Gastroenterol 2019; 25:1783-1796. [PMID: 31057294 PMCID: PMC6478618 DOI: 10.3748/wjg.v25.i15.1783] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/21/2019] [Accepted: 03/30/2019] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a complex disorder that has evolved in recent years as the leading global cause of chronic liver damage. The main obstacle to better disease management pertains to the lack of approved pharmacological interventions for the treatment of nonalcoholic steatohepatitis (NASH) and NASH-fibrosis-the severe histological forms. Over the past decade, tremendous advances have been made in NAFLD research, resulting in the discovery of disease mechanisms and novel therapeutic targets. Hence, a large number of pharmacological agents are currently being tested for safety and efficacy. These drugs are in the initial pharmacological phases (phase 1 and 2), which involve testing tolerability, therapeutic action, and pharmacological issues. It is thus reasonable to assume that the next generation of NASH drugs will not be available for clinical use for foreseeable future. The expected delay can be mitigated by drug repurposing or repositioning, which essentially relies on identifying and developing new uses for existing drugs. Here, we propose a drug candidate selection method based on the integration of molecular pathways of disease pathogenesis into network analysis tools that use OMICs data as well as multiples sources, including text mining from the medical literature.
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Affiliation(s)
- Silvia Sookoian
- Department of Clinical and Molecular Hepatology, National Scientific and Technical Research Council (CONICET), University of Buenos Aires, Institute of Medical Research (IDIM), Ciudad Autónoma de Buenos Aires 1427, Argentina
| | - Carlos J Pirola
- Department of Molecular Genetics and Biology of Complex Diseases, National Scientific and Technical Research Council (CONICET), University of Buenos Aires, Institute of Medical Research (IDIM), Ciudad Autonoma de Buenos Aires 1427, Argentina
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652
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Cho O, Jang YJ, Park KY, Heo TH. Beneficial anti-inflammatory effects of combined rosuvastatin and cilostazol in a TNF-driven inflammatory model. Pharmacol Rep 2019; 71:266-271. [DOI: 10.1016/j.pharep.2018.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/07/2018] [Accepted: 12/14/2018] [Indexed: 02/07/2023]
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653
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Henninger C, Pohlmann S, Ziegler V, Ohlig J, Schmitt J, Fritz G. Distinct contribution of Rac1 expression in cardiomyocytes to anthracycline-induced cardiac injury. Biochem Pharmacol 2019; 164:82-93. [PMID: 30936017 DOI: 10.1016/j.bcp.2019.03.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 03/28/2019] [Indexed: 12/16/2022]
Abstract
Cardiotoxicity is the dose limiting adverse effect of anthracycline-based anticancer therapy. Inhibitor studies point to Rac1 as therapeutic target to prevent anthracycline-induced cardiotoxicity. Yet, supporting genetic evidence is still missing and the pathophysiological relevance of different cardiac cell types is unclear. Here, we employed a tamoxifen-inducible cardiomyocyte-specific rac1 knock-out mouse model (Rac1flox/flox/MHC-MerCreMer) to investigate the impact of Rac1 expression in cardiomyocytes on cardiac injury following doxorubicin treatment. Distinctive stress responses resulting from doxorubicin treatment were observed, including upregulation of systemic markers of inflammation (IL-6, IL-1α, MCP-1), cardiac damage (ANP, BNP), DNA damage (i.e. DNA double-strand breaks (DSB)), DNA damage response (DDR) and cell death. Measuring the acute doxorubicin response, the serum level of MCP-1 was elevated, cardiac mRNA expression of Hsp70 was reduced and cardiac DDR was specifically enhanced in Rac1 deficient mice. The frequency of apoptotic heart cells remained unaffected by Rac1. Employing a subactue model, the number of doxorubicin-induced DSB was significantly reduced if Rac1 is absent. Yet, the doxorubicin-triggered increase in serum ANP and BNP levels remained unaffected by Rac1. Overall, knock-out of rac1 in cardiomyocytes confers partial protection against doxorubicin-induced cardiac injury. Hence, the data provide first genetic evidence supporting the view that pharmacological targeting of Rac1 is useful to widen the therapeutic window of anthracycline-based anticancer therapy by alleviating acute/subacute cardiomyocyte damage. Furthermore, considering published data obtained from the use of pharmacological Rac1 inhibitors, the results of our study indicate that Rac1-regulated functions of cardiac cell types others than cardiomyocytes additionally influence the adverse outcomes of anthracycline treatment on the heart.
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Affiliation(s)
- Christian Henninger
- Institute of Toxicology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, Germany
| | - Stephanie Pohlmann
- Institute of Toxicology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, Germany
| | - Verena Ziegler
- Institute of Toxicology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, Germany
| | - Jan Ohlig
- Division of Cardiology, Pneumology and Angiology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, Germany
| | - Joachim Schmitt
- Institute of Pharmacology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, Germany
| | - Gerhard Fritz
- Institute of Toxicology, Medical Faculty, Heinrich-Heine University Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, Germany.
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654
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Biocatalyzed Synthesis of Statins: A Sustainable Strategy for the Preparation of Valuable Drugs. Catalysts 2019. [DOI: 10.3390/catal9030260] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Statins, inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, are the largest selling class of drugs prescribed for the pharmacological treatment of hypercholesterolemia and dyslipidaemia. Statins also possess other therapeutic effects, called pleiotropic, because the blockade of the conversion of HMG-CoA to (R)-mevalonate produces a concomitant inhibition of the biosynthesis of numerous isoprenoid metabolites (e.g., geranylgeranyl pyrophosphate (GGPP) or farnesyl pyrophosphate (FPP)). Thus, the prenylation of several cell signalling proteins (small GTPase family members: Ras, Rac, and Rho) is hampered, so that these molecular switches, controlling multiple pathways and cell functions (maintenance of cell shape, motility, factor secretion, differentiation, and proliferation) are regulated, leading to beneficial effects in cardiovascular health, regulation of the immune system, anti-inflammatory and immunosuppressive properties, prevention and treatment of sepsis, treatment of autoimmune diseases, osteoporosis, kidney and neurological disorders, or even in cancer therapy. Thus, there is a growing interest in developing more sustainable protocols for preparation of statins, and the introduction of biocatalyzed steps into the synthetic pathways is highly advantageous—synthetic routes are conducted under mild reaction conditions, at ambient temperature, and can use water as a reaction medium in many cases. Furthermore, their high selectivity avoids the need for functional group activation and protection/deprotection steps usually required in traditional organic synthesis. Therefore, biocatalysis provides shorter processes, produces less waste, and reduces manufacturing costs and environmental impact. In this review, we will comment on the pleiotropic effects of statins and will illustrate some biotransformations nowadays implemented for statin synthesis.
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655
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Cimaglia P, Vieceli Dalla Sega F, Vitali F, Lodolini V, Bernucci D, Passarini G, Fortini F, Marracino L, Aquila G, Rizzo P, Ferrari R, Campo G. Effectiveness of a Novel Nutraceutical Compound Containing Red Yeast Rice, Polymethoxyflavones and Antioxidants in the Modulation of Cholesterol Levels in Subjects With Hypercholesterolemia and Low-Moderate Cardiovascular Risk: The NIRVANA Study. Front Physiol 2019; 10:217. [PMID: 30914970 PMCID: PMC6421317 DOI: 10.3389/fphys.2019.00217] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 02/20/2019] [Indexed: 12/15/2022] Open
Abstract
Background: Red yeast rice supplements are broadly accepted as treatment for dyslipidaemia in subjects without high cardiovascular (CV) risk. Their effect on lipid profile is well known, but few data are available on their effect on endothelial function. Objectives: To study the effect of a novel nutraceutical compound (NC) containing low monacolin K dose, polymethoxyflavones and antioxidants on lipid profile, endothelial function and oxidative stress. Methods: Fifty-two subjects with low-moderate CV risk and dyslipidaemia (according to European guidelines) were enrolled and treated for 8 weeks with the NC. Blood samples were collected at baseline and at the end of treatment to assess changes in lipid profile, endothelial function and oxidative stress. The primary endpoint was the reduction of low density lipoprotein (LDL) cholesterol. Endothelial function was assessed through measurement of rate of apoptosis and nitric oxide (NO) production in human umbilical vein endothelial cells (HUVECs) treated with subject's serum. High-sensitivity C-reactive protein, 4-hydroxynonenal (HNE) and oxidized LDL (oxLDL) were markers of oxidative stress. Results: Fifty subjects completed the study. The treatment caused a significant decrease in LDL (-15.6%, p < 0.001), oxLDL (-21.5%, p < 0.001), total cholesterol (TC), triglycerides, and ApoB. Apoptosis rate of HUVECs significantly decreased (-15.9%, p < 0.001). No changes were noted for NO levels and 4-HNE protein adducts. The reduction of the apoptosis rate was correlated to the reduction of oxLDL. Conclusion: An 8-week treatment based on a novel NC containing low manocolin K dose, polymethoxyflavones and antioxidants improved lipid profile in subjects with dyslipidaemia and low-moderate CV risk. Secondarily, we observed an improvement in surrogate markers of endothelial function that may result from the reduction of oxLDL (Registered at www.clinicaltrials.gov, NCT03216811).
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Affiliation(s)
- Paolo Cimaglia
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | | | - Francesco Vitali
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | - Veronica Lodolini
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | - Davide Bernucci
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | - Giulia Passarini
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | | | - Luisa Marracino
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giorgio Aquila
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Paola Rizzo
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
| | - Roberto Ferrari
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
| | - Gianluca Campo
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
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656
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Kim J, You NY, Lee JW, Kim Y, Kim YW, Kang HT. Inverse Association Between Statin Use and Overall Cancer Incidence in Individuals With Hypercholesterolemia, Based on the Korean Health Insurance Service Between 2002 and 2015. Asia Pac J Public Health 2019; 31:136-146. [DOI: 10.1177/1010539519830235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The Korean National Health Insurance Service provided the Health Screening Cohort Database. To investigate the cumulative effect of statins on cancer development, we defined statin users as those who used statins during 2002 to 2003 at baseline. Statin users were divided into high and low users. Statin nonusers were defined as individuals who had never used statins during the entire period of 2002 to 2015, despite having hypercholesterolemia. In total, 17 737 statin users and 13 412 statin nonusers were included in the final analyses. The median follow-up duration was 12.6 years. Compared with nonusers, the hazard ratios (95% confidential intervals) for any cancer incidence of low users and high users were 1.047 (0.941-1.164) and 0.663 (0.589-0.747) in men and 1.057 (0.938-1.190) and 0.592 (0.517-0.678) in women, respectively, after fully adjusting for possible confounding factors. An inverse association between statin use and any cancer incidence in individuals with hypercholesterolemia was observed.
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Affiliation(s)
- Joungyoun Kim
- Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Na-Young You
- Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Jae-Woo Lee
- Chungbuk National University Hospital, Seowon-gu, Cheongju, Republic of Korea
| | - Yesul Kim
- Chungbuk National University Hospital, Seowon-gu, Cheongju, Republic of Korea
| | - Yong-Whan Kim
- Chungbuk National University Hospital, Seowon-gu, Cheongju, Republic of Korea
| | - Hee-Taik Kang
- Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
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657
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Pourhosseini H, Lashkari R, Aminorroaya A, Soltani D, Jalali A, Tajdini M. Effects of high dose atorvastatin before elective percutaneous coronary intervention on highly sensitive troponin T and one year major cardiovascular events; a randomized clinical trial. IJC HEART & VASCULATURE 2019; 22:96-101. [PMID: 30671535 PMCID: PMC6328087 DOI: 10.1016/j.ijcha.2018.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Some studies have demonstrated that post-PCI elevated cardiac enzymes are associated with worse outcomes. In this study, we aimed to determine if high-dose treatment with atorvastatin before planned elective PCI reduces PMI or MACE at 1-year median follow-up. MATERIAL AND METHODS Eligible participants were randomly allocated to group A (80 mg atorvastatin 12 h and 40 mg 2 h before PCI) and group B (40 mg atorvastatin daily). Blood samples were obtained before and at 24 h after PCI to measure hsTnT. All patients were followed regarding MACE (combination of death, re-hospitalizations for ACS, and unplanned coronary revascularization) during one year after PCI. RESULTS 207 patients randomly assigned to Group A (n = 97) or group B (n = 110). The rate of PMI was lower in group A (5.2%) compared to group B (10.9%); despite near to 50% lower rate of PMI in group A, binary logistic regression showed no significant association between atorvastatin recapture and PMI. The occurrence of MACE in 97 patients of group A was 11 (11.3%), higher than 11 (10%) cases of 110 patients in group B. Cox proportional hazards regression model shows no significant difference in MACE of study groups. CONCLUSION Pretreatment of patients with stable angina who were planned to undergo an elective PCI with 120 mg of atorvastatin before the procedure confer them the same benefit in terms of PMI and MACE as 40 mg routine daily dosage of this statin does.
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Affiliation(s)
- HamidReza Pourhosseini
- Tehran Heart Center and School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Lashkari
- Tehran Heart Center and School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Arya Aminorroaya
- Tehran Heart Center and School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Danesh Soltani
- Tehran Heart Center and School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Tehran Heart Center and School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Masih Tajdini
- Tehran Heart Center, Tehran University of Medical Sciences, North Kargar Ave., Tehran, Iran
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658
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Sookoian S, Pirola CJ. Review article: shared disease mechanisms between non-alcoholic fatty liver disease and metabolic syndrome - translating knowledge from systems biology to the bedside. Aliment Pharmacol Ther 2019; 49:516-527. [PMID: 30714632 DOI: 10.1111/apt.15163] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 12/20/2018] [Accepted: 01/01/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease worldwide. Characterised by abnormal fat accumulation in the liver, NAFLD presents high degree of comorbidity with disorders of the metabolic syndrome, including type 2 diabetes, obesity and cardiovascular disease. These comorbidities have strong negative impact on the natural course of NAFLD and vice versa, whereby the presence of NAFLD substantially modifies the course and prognosis of metabolic syndrome-associated diseases. AIM To use systems biology strategies to interrogate disease mechanisms that are common to NAFLD and metabolic syndrome. METHODS We mapped shared gene/protein-disease interaction networks, we performed gene-disease enrichment analysis to assess pleiotropy, and we created a gene-drug connectivity network. RESULTS We found that a shared network of genes/proteins is overrepresented by immune response-related pathways, post-translational modifications of nuclear receptors, and platelet-related processes, including activation and platelet signalling. Likewise, gene-based disease-enrichment analysis suggested underlying molecular effectors that are shared with major systemic disorders, including diverse autoimmune diseases, kidney, respiratory and nervous system disorders, cancer and infectious diseases. The shared list of genes/proteins was enriched in drug targets for anti-inflammatory therapy, drugs used to treat cardiovascular diseases, antimicrobial agents and phytochemicals, among many other approved pharmaceutical compounds. By leveraging on publicly available OMICs data, we were able to show that shared loci are not necessarily affected by reverse causality. CONCLUSION We provide evidence indicating that NAFLD treatment, including severe histological traits, cannot be limited to the use of a single drug, as it rather requires a multi-target therapeutic approach.
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Affiliation(s)
- Silvia Sookoian
- School of Medicine, Institute of Medical Research A. Lanari, University of Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.,Department of Clinical and Molecular Hepatology, National Scientific and Technical Research Council (CONICET), Institute of Medical Research (IDIM), University of Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Carlos J Pirola
- School of Medicine, Institute of Medical Research A. Lanari, University of Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.,Department of Molecular Genetics and Biology of Complex Diseases, National Scientific and Technical Research Council (CONICET), Institute of Medical Research (IDIM), University of Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
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659
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Paone S, Baxter AA, Hulett MD, Poon IKH. Endothelial cell apoptosis and the role of endothelial cell-derived extracellular vesicles in the progression of atherosclerosis. Cell Mol Life Sci 2019; 76:1093-1106. [PMID: 30569278 PMCID: PMC11105274 DOI: 10.1007/s00018-018-2983-9] [Citation(s) in RCA: 187] [Impact Index Per Article: 37.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/15/2018] [Accepted: 11/26/2018] [Indexed: 12/15/2022]
Abstract
To maintain physiological homeostasis, cell turnover occurs every day in the body via a form of programmed cell death called apoptosis. During apoptosis, cells undergo distinct morphological changes culminating in the disassembly of the dying cell into smaller fragments known as apoptotic bodies (ApoBDs). Dysregulation of apoptosis is associated with diseases including infection, cancer and atherosclerosis. Although the development of atherosclerosis is largely attributed to the accumulation of lipids and inflammatory debris in vessel walls, it is also associated with apoptosis of macrophages, smooth muscle cells (SMCs) and endothelial cells. During cellular activation and apoptosis, endothelial cells can release several types of membrane-bound extracellular vesicles (EVs) including exosomes, microvesicles (MVs)/microparticles and ApoBDs. Emerging evidence in the field suggests that these endothelial cell-derived EVs (EndoEVs) can contribute to intercellular communication during the development of atherosclerosis via the transfer of cellular contents such as protein and microRNA, which may prevent or promote disease progression depending on the context. This review provides an up-to-date overview of the known causes and consequences of endothelial cell death during atherosclerosis along with highlighting current methodological approaches to studying EndoEVs and the potential roles of EndoEVs in atherosclerosis development.
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Affiliation(s)
- Stephanie Paone
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Amy A Baxter
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Mark D Hulett
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Ivan K H Poon
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Melbourne, VIC, 3086, Australia.
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660
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Venuraju S, Jeevarethinam A, Mehta VS, Ruano S, Dumo A, Nair D, Rosenthal M, Darko D, Cohen M, Rakhit R, Lahiri A. Predicting Severity of Coronary Artery Disease in Patients With Diabetes Using Endothelial Function Measured With Peripheral Arterial Tonometry: PROCEED Study. Angiology 2019; 70:613-620. [PMID: 30813747 DOI: 10.1177/0003319719833265] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Endothelial dysfunction is common in patients with type 2 diabetes mellitus (T2DM) and is associated with atherosclerotic disease. This study aimed to determine prognostic factors for endothelial dysfunction and identify relationships between reactive hyperemia index (RHI) score, clinically relevant coronary artery disease (>50% stenosis), and major adverse cardiovascular events (MACEs) in patients with T2DM. Endothelial function was assessed using peripheral arterial tonometry and correlated with patient characteristics and cardiovascular outcomes during a median follow-up of 22.8 months. Among 235 patients with a median duration of T2DM of 13 years, mean (standard deviation) RHI score was 2.00 (0.76). Serum low- and high-density lipoprotein cholesterol levels positively (P = .004) and negatively (P = .02) predicted RHI score, respectively. Median coronary artery calcium (CAC) score was 109 Agatston units, but no correlation between CAC and RHI scores was observed. The RHI score did not predict the number or severity of coronary plaques identified using computed tomography coronary angiography. Additionally, there was no association between RHI score and the risk of an MACE during follow-up. Overall, endothelial function was not predictive of CAC score, extent, and severity of coronary plaque or MACEs and did not demonstrate utility in cardiovascular risk stratifying patients with T2DM.
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Affiliation(s)
- Shreenidhi Venuraju
- 1 Bedford Hospital, Bedford, United Kingdom.,2 Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Anand Jeevarethinam
- 2 Institute of Cardiovascular Science, University College London, London, United Kingdom.,3 Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | | | | | - Alain Dumo
- 1 Bedford Hospital, Bedford, United Kingdom
| | - Devaki Nair
- 5 Department of Diabetes and Endocrinology, Royal Free Hospital, London, United Kingdom
| | - Miranda Rosenthal
- 5 Department of Diabetes and Endocrinology, Royal Free Hospital, London, United Kingdom
| | | | - Mark Cohen
- 4 Barnet Hospital, London, United Kingdom
| | - Roby Rakhit
- 2 Institute of Cardiovascular Science, University College London, London, United Kingdom.,5 Department of Diabetes and Endocrinology, Royal Free Hospital, London, United Kingdom
| | - Avijit Lahiri
- 6 Imperial College School of Medicine, London, United Kingdom.,7 Healthcare Science, Middlesex University, London, United Kingdom.,8 Cardiac Imaging and Research Centre, Wellington Hospital, London, United Kingdom
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661
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Systematic review of the predictors of statin adherence for the primary prevention of cardiovascular disease. PLoS One 2019; 14:e0201196. [PMID: 30653535 PMCID: PMC6336256 DOI: 10.1371/journal.pone.0201196] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 06/21/2018] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Previous research has shown that statin adherence for the primary prevention of CVD is lower compared to secondary prevention populations. Therefore the aim of this systematic review was to review predictors of statin adherence for the primary prevention of CVD. METHODS A systematic search of papers published between Jan 1984 and May 2017 was conducted in PubMed, PsycINFO, EMbase and CINAHL databases. A study was eligible for inclusion if; 1) it was a study of the general population or of patients with familial hypercholesterolemia, hypertension, diabetes or arthritis; 2) statins were prescribed; 3) adherence was defined and measured as the extent to which patients followed their statin regimen during the period of prescription, and 4) it was an original trial or observational study (excluding case reports). A study was subsequently excluded if 1) results were not presented separately for primary prevention; 2) it was a trial of an intervention (for example patient education). Papers were reviewed by two researchers and consensus agreed with a third. A quality assessment (QA) tool was used to formally assess each included article. To evaluate the effect of predictors, data were quantitatively and qualitatively synthesised. RESULTS In total 19 studies met the inclusion criteria and nine were evaluated as high quality using the QA tool. The proportion of patients classed as "adherent" ranged from 17.8% to 79.2%. Potential predictors of statin adherence included traditional risk factors for CVD such as age, being male, diabetes and hypertension. Income associated with adherence more strongly in men than women, and highly educated men were more likely and highly educated women less likely to be adherent. Alcohol misuse and high BMI associated with non-adherence. There was no association between polypharmacy and statin adherence. The evidence base for the effect of other lifestyle factors and health beliefs on statin adherence was limited. CONCLUSION Current evidence suggests that patients with more traditional risk factors for CVD are more likely to be adherent to statins. The implications for future research are discussed.
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662
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Chen Y, Li X, Zhang R, Xia Y, Shao Z, Mei Z. Effects of statin exposure and lung cancer survival: A meta-analysis of observational studies. Pharmacol Res 2019; 141:357-365. [PMID: 30641276 DOI: 10.1016/j.phrs.2019.01.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 12/15/2022]
Abstract
Statin exposure has been reported to improve survival in several cancers. However, studies evaluating the association between statins and prognostic outcomes in patients with lung cancer are conflicting and heterogeneous. Pubmed, EMBASE and reference lists of included studies were searched to identify studies investigating the association between statin exposure and lung cancer prognosis. The primary outcome measure was overall survival (OS) and secondary ones included cancer-specific survival (CSS) and recurrence-free survival (RFS). Hazard ratios (HRs) with 95% confidence intervals (95% CIs) of these outcomes were pooled using random-effects models. Thirteen studies with data from 99,297 individuals satisfying the inclusion criteria were identified. Studies were ranked to be at low to moderate risk of bias. Meta-analysis showed that statin exposure was significantly associated with improved OS (pooled HR 0.79, 95% CI 0.72-0.86), CSS (pooled HR 0.83, 95% CI 0.77-0.89) and RFS (pooled HR 0.85, 95% CI 0.81-0.89). Subgroup analyses showed that statin users after diagnosis of lung cancer had more survival benefit for OS (HR 0.68, 95% CI 0.51-0.92) than those before diagnosis (HR 0.86, 95% CI 0.81-0.90) and current users (HR 0.79, 95% CI 0.62-1.02) (P for interaction <0.001). Besides, statin users were likely to have more survival benefits in stage IV lung cancer patients (HR 0.77, 95% CI 0.74-0.79) than in mixed stage (I-IV or I-III) patients (P for interaction = 0.004). Statin exposure is associated with significantly improved survival in patients with lung cancer. Future studies are warranted to further demonstrate the therapeutic role of statins in specific lung cancer patients.
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Affiliation(s)
- Yafei Chen
- Second Department of Respiratory and Critical Care Medicine, Xinxiang Central Hospital, Xinxiang, Henan, China
| | - Xiaoli Li
- Second Department of Respiratory and Critical Care Medicine, Xinxiang Central Hospital, Xinxiang, Henan, China
| | - Rui Zhang
- Second Department of Respiratory and Critical Care Medicine, Xinxiang Central Hospital, Xinxiang, Henan, China
| | - Yuhong Xia
- Second Department of Respiratory and Critical Care Medicine, Xinxiang Central Hospital, Xinxiang, Henan, China
| | - Zhuo Shao
- Department of General Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, China.
| | - Zubing Mei
- Department of Anorectal Surgery, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Anorectal Disease Institute of Shuguang Hospital, Shanghai, China.
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663
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Cardiovascular Comorbidities in Chronic Obstructive Pulmonary Disease (COPD)-Current Considerations for Clinical Practice. J Clin Med 2019; 8:jcm8010069. [PMID: 30634565 PMCID: PMC6352261 DOI: 10.3390/jcm8010069] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 01/07/2019] [Indexed: 12/14/2022] Open
Abstract
In patients with chronic obstructive pulmonary disease (COPD), cardiovascular comorbidities are highly prevalent and associated with considerable morbidity and mortality. This coincidence is increasingly seen in context of a “cardiopulmonary continuum” rather than being simply attributed to shared risk factors such as cigarette smoking. Overlapping symptoms such as dyspnea or chest pain lead to a worse prognosis due to missed concomitant diagnoses. Moreover, medication is often withheld as a result of unfounded concerns about side effects. Despite the frequent coincidence, current guidelines are still mostly restricted to the management of the individual disease. Future diagnostic and therapeutic strategies should therefore be guided by an integrative perspective as well as a refined phenotyping of disease entities.
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664
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Almeida SO, Budoff M. Effect of statins on atherosclerotic plaque. Trends Cardiovasc Med 2019; 29:451-455. [PMID: 30642643 DOI: 10.1016/j.tcm.2019.01.001] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/27/2018] [Accepted: 01/01/2019] [Indexed: 01/08/2023]
Abstract
Lipid lowering therapy has been the mainstay of cardiovascular risk reduction and prevention. Statin drugs have been shown to reduce serum cholesterol along with significant reduction in morbidity and mortality of cardiovascular disease. Whether these benefits are purely through lipid lowering or pleiotropic (cholesterol independent) effects has yet to be fully understood. Advances in cardiac imaging, from intravascular ultrasound to multi-detector coronary computed tomography angiography, have furthered our understanding of statin's effect on atherosclerotic plaque. Notably, statins play a role in plaque regression with reduction in lipid content. These drugs further stabilize atherosclerotic plaque with thickened fibrous caps and macrocalcification that serves to stabilize atheromas.
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Affiliation(s)
- Shone O Almeida
- Los Angeles Biomedical Institute, 1124W Carson St, Torrance, CA 90502, USA.
| | - Matthew Budoff
- Los Angeles Biomedical Institute, 1124W Carson St, Torrance, CA 90502, USA
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665
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Mittal R, Jhaveri VM, Kay SIS, Greer A, Sutherland KJ, McMurry HS, Lin N, Mittal J, Malhotra AK, Patel AP. Recent Advances in Understanding the Pathogenesis of Cardiovascular Diseases and Development of Treatment Modalities. Cardiovasc Hematol Disord Drug Targets 2019; 19:19-32. [PMID: 29737266 DOI: 10.2174/1871529x18666180508111353] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 12/15/2017] [Accepted: 03/28/2018] [Indexed: 06/08/2023]
Abstract
Cardiovascular Diseases (CVDs) are a leading cause of morbidity and mortality worldwide. The underlying pathology for cardiovascular disease is largely atherosclerotic in nature and the steps include fatty streak formation, plaque progression and plaque rupture. While there is optimal drug therapy available for patients with CVD, there are also underlying drug delivery obstacles that must be addressed. Challenges in drug delivery warrant further studies for the development of novel and more efficacious medical therapies. An extensive understanding of the molecular mechanisms of disease in combination with current challenges in drug delivery serves as a platform for the development of novel drug therapeutic targets for CVD. The objective of this article is to review the pathogenesis of atherosclerosis, first-line medical treatment for CVD, and key obstacles in an efficient drug delivery.
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Affiliation(s)
- Rahul Mittal
- Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida FL, United States
| | - Vasanti M Jhaveri
- Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida FL, United States
| | - Sae-In Samantha Kay
- College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida FL, United States
| | - Aubrey Greer
- Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida FL, United States
| | - Kyle J Sutherland
- Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida FL, United States
| | - Hannah S McMurry
- Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida FL, United States
| | - Nicole Lin
- Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida FL, United States
| | - Jeenu Mittal
- Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida FL, United States
| | - Arul K Malhotra
- Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida FL, United States
| | - Amit P Patel
- College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida FL, United States
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666
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Zhao J, Cheng Q, Liu Y, Yang G, Wang X. Atorvastatin alleviates early hypertensive renal damage in spontaneously hypertensive rats. Biomed Pharmacother 2019; 109:602-609. [DOI: 10.1016/j.biopha.2018.10.165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 10/26/2018] [Accepted: 10/26/2018] [Indexed: 10/27/2022] Open
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667
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Mao B, Yi Y, Mo Q, Yang C, Zhong Q. Metabolic profiling reveals the heterogeneity of vascular endothelial function phenotypes in individuals at extreme cardiovascular risk. RSC Adv 2019; 9:30033-30044. [PMID: 35530249 PMCID: PMC9072126 DOI: 10.1039/c9ra05526f] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 09/04/2019] [Indexed: 12/17/2022] Open
Abstract
Maladapted vascular endothelial metabolism in the context of endothelial function differing in phenotype remains unknown, which limits our understanding of the heterogeneous pathogenesis of atherosclerotic cardiovascular disease (CVD). This study aimed to profile serum metabolic alterations of different vascular endothelial function phenotypes in asymptomatic adults at extreme cardiovascular risk. In addition to 12 CVD patients, 103 individuals free of CVD were categorized as having normal endothelial function (NEF) (n = 30), cardiovascular risk-promoting endothelial function (PEF) (n = 18), cardiovascular risk-resistant endothelial function (REF) (n = 25), and vulnerable endothelial function (VEF) (n = 30). Serum metabolic profiles were detected using gas chromatography time-of-flight/mass spectrometry and multivariate statistics. Compared to the NEF group, a total of 17, 17, 22, and 13 differential metabolites were identified in the PEF, REF, VEF, and CVD groups, respectively. Of the altered metabolic pathways, multiple pathways were consistent between the PEF and CVD groups, including pyrimidine metabolism, starch and sucrose metabolism, aminoacyl-tRNA biosynthesis, arginine and proline metabolism, and d-glutamine and d-glutamate metabolism. Notably, a relative increase in low-calorie sugar in galactose metabolism was exclusively found in the REF group, and a relative increase in the ratio of acetyl-CoA to CoA was suggested in the VEF group based on elevated butanoate metabolism and reduced pantothenate and CoA biosynthesis. Our findings clearly indicate distinct metabolic patterns across groups with heterogeneous vascular endothelial function in the context of extreme cardiovascular risk, and improve our understanding of the pathogenic heterogeneity of early CVD in asymptomatic populations. This metabolomics analysis has revealed the maladapted vascular endothelial metabolism across individuals with heterogeneous vascular endothelial function in the context of extreme cardiovascular risk.![]()
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Affiliation(s)
- Baoyu Mao
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases
- Guangxi Medical University School of Public Health
- Nanning 530021
- China
| | - Yanshan Yi
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases
- Guangxi Medical University School of Public Health
- Nanning 530021
- China
| | - Qiuyan Mo
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases
- Guangxi Medical University School of Public Health
- Nanning 530021
- China
| | - Chunxiu Yang
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases
- Guangxi Medical University School of Public Health
- Nanning 530021
- China
| | - Qiuan Zhong
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases
- Guangxi Medical University School of Public Health
- Nanning 530021
- China
- Department of Epidemiology
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668
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Grigoropoulou P, Tentolouris A, Eleftheriadou I, Tsilingiris D, Vlachopoulos C, Sykara M, Tentolouris N. Effect of 12-month intervention with low-dose atorvastatin on pulse wave velocity in subjects with type 2 diabetes and dyslipidaemia. Diab Vasc Dis Res 2019; 16:38-46. [PMID: 30328360 DOI: 10.1177/1479164118805320] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Cardiovascular disease is the leading cause of morbidity and mortality in subjects with type 2 diabetes mellitus. Increased aortic stiffness, assessed with the carotid-femoral pulse wave velocity, is an independent risk factor for cardiovascular disease. Statins reduce effectively cardiovascular disease and mortality in high-risk patients. The aim of this prospective non-randomized, observational study was to examine the impact of treatment with either 10 mg atorvastatin plus diet or diet alone on carotid-femoral pulse wave velocity in subjects with type 2 diabetes mellitus and dyslipidaemia. A total of 79 subjects with type 2 diabetes mellitus and dyslipidaemia were included; 46 subjects were treated with atorvastatin 10 mg daily plus diet and 33 were managed by diet alone for 12 months. Carotid-femoral pulse wave velocity and carotid-radial pulse wave velocity were measured using applanation tonometry. In the atorvastatin-treated group, carotid-femoral pulse wave velocity reduced significantly during the study and there was a trend for reduction in the carotid-radial pulse wave velocity. Total cholesterol, low-density lipoprotein cholesterol, triglycerides and C-reactive protein were reduced only in the atorvastatin-treated participants. No significant changes were found in body mass index, blood pressure, heart rate, diabetes control and high-density lipoprotein cholesterol in either study group. Treatment with low-dose atorvastatin for 12 months improves carotid-femoral pulse wave velocity in subjects with type 2 diabetes mellitus and dyslipidaemia.
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Affiliation(s)
- Pinelopi Grigoropoulou
- 1 Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Anastasios Tentolouris
- 1 Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Ioanna Eleftheriadou
- 1 Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Dimitrios Tsilingiris
- 1 Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Charalambos Vlachopoulos
- 2 First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Maria Sykara
- 1 Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Nikolaos Tentolouris
- 1 Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
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669
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Sørensen AL, Hasselbalch HC, Nielsen CH, Poulsen HE, Ellervik C. Statin treatment, oxidative stress and inflammation in a Danish population. Redox Biol 2018; 21:101088. [PMID: 30594900 PMCID: PMC6307042 DOI: 10.1016/j.redox.2018.101088] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/18/2018] [Accepted: 12/19/2018] [Indexed: 01/14/2023] Open
Abstract
Background While statins may have anti-inflammatory effects, anti-oxidative effects are controversial. We investigated if statin treatment is associated with differences in oxidatively generated nucleotide damage and chronic inflammation, and the relationship between nucleotide damage and chronic inflammation. Methods We included 19,795 participants from the Danish General Suburban Population Study. In 3420 participants, we measured urinary 8-oxodG and 8-oxoGuo by liquid chromatography-tandem mass spectrometry as markers of oxidatively generated damage to DNA and RNA, respectively. We used a composite score for chronic inflammation (INFLA score) of hsCRP, WBC, platelet count, and neutrophil granulocyte to lymphocyte ratio. Associations were assessed using multivariate linear regression models. Results Compared with non-users, statin users had 4.3–6.0% lower 8-oxodG in three separate models (p < 0.05); there were no differences in 8-oxoGuo. Among participants aged > 60 y, statin users had 11.4% lower 8-oxodG (95%CI: 6.7–15.9%, pinteraction<0.001) and 3.9% lower 8-oxoGuo (95%CI: 0.1–7.5%, pinteraction = 0.002), compared with non-users. Compared with non-users, statin users had 11.1% (95%CI: 5.4–16.5%, pinteraction<0.001) lower 8-oxodG in participants treated for hypertension, and 18.6% (95%CI: 6.8–28.9%, pinteraction<0.001) lower 8-oxodG in participants with decreased renal function. Compared with non-users, statin users had significantly lower INFLA score (p < 0.001). 8-oxodG and 8-oxoGuo associated positively with markers of chronic inflammation. Conclusions Oxidatively generated DNA damage and inflammatory burden are lower in statin users compared with non-users. Together, anti-oxidative and anti-inflammatory effects may contribute to the beneficial effects of statins. Statin users have lower oxidatively generated DNA damage than non-users. The protective effect of statins is more pronounced in high-risk groups. Statin users have lower levels of chronic inflammation than non-users.
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Affiliation(s)
- Anders L Sørensen
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark; Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Hans C Hasselbalch
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | - Claus H Nielsen
- Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Henrik E Poulsen
- Department of Clinical Pharmacology, Bispebjerg Frederiksberg Hospitals, Copenhagen, Denmark
| | - Christina Ellervik
- Department of Laboratory Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Production, Research and Innovation, Region Zealand, Sorø, Denmark
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670
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Gurzeler E, Aavik E, Laine A, Valkama T, Niskanen H, Huusko J, Kaikkonen MU, Ylä-Herttuala S. Therapeutic effects of rosuvastatin in hypercholesterolemic prediabetic mice in the absence of low density lipoprotein receptor. Biochim Biophys Acta Gen Subj 2018; 1863:481-490. [PMID: 30508567 DOI: 10.1016/j.bbagen.2018.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/27/2018] [Accepted: 11/20/2018] [Indexed: 10/27/2022]
Abstract
Statins are effective drugs used to prevent and treat cardiovascular diseases but their effects in the absence of low density lipoprotein receptor (LDLR) and on the risk of diabetes are not yet well characterized. The aim of this study was to clarify systemic and pleiotropic effects of rosuvastatin on cardiovascular and diabetic phenotypes. IGF-II/LDLR-/-ApoB100/100 hypercholesterolemic prediabetic mice were used to test the effects of rosuvastatin on plasma glucose, insulin, lipids, atherosclerosis and liver steatosis. To get a more comprehensive view about changes in gene expression RNA-sequencing was done from the liver. Rosuvastatin significantly reduced plasma cholesterol in hypercholesterolemic mice in the absence of LDLR but had no effects on atherosclerosis at aortic sinus level or in coronary arteries. Rosuvastatin also significantly reduced liver steatosis without any harmful effects on glucose or insulin metabolism. RNA-sequencing showed relatively specific effects of rosuvastatin on genes involved in cholesterol metabolism together with a significant anti-inflammatory gene expression profile in the liver. In addition, significant changes were found in the expression of Perilipin 4 and 5 which are involved in lipid droplet formation in the liver. For the first time it could be shown that Tribbles proteins are affected by rosuvastatin treatment in the hyperlipidemic mice. Rosuvastatin had several positive effects on hypercholesterolemic mice showing early signs of diabetes, many of which are unrelated to cholesterol and lipoprotein metabolism. These results increase our understanding about the systemic and pleiotropic effects of rosuvastatin in the absence of LDLR expression.
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Affiliation(s)
- Erika Gurzeler
- A.I.Virtanen Institute for Molecular Sciences, University of Eastern Finland, 70210 Kuopio, Finland
| | - Einari Aavik
- A.I.Virtanen Institute for Molecular Sciences, University of Eastern Finland, 70210 Kuopio, Finland
| | - Anssi Laine
- A.I.Virtanen Institute for Molecular Sciences, University of Eastern Finland, 70210 Kuopio, Finland
| | - Teemu Valkama
- A.I.Virtanen Institute for Molecular Sciences, University of Eastern Finland, 70210 Kuopio, Finland
| | - Henri Niskanen
- A.I.Virtanen Institute for Molecular Sciences, University of Eastern Finland, 70210 Kuopio, Finland
| | - Jenni Huusko
- A.I.Virtanen Institute for Molecular Sciences, University of Eastern Finland, 70210 Kuopio, Finland
| | - Minna U Kaikkonen
- A.I.Virtanen Institute for Molecular Sciences, University of Eastern Finland, 70210 Kuopio, Finland
| | - Seppo Ylä-Herttuala
- A.I.Virtanen Institute for Molecular Sciences, University of Eastern Finland, 70210 Kuopio, Finland; Gene Therapy Unit, Kuopio University Hospital, Kuopio, 70211 Kuopio, Finland; Heart Center, Kuopio University Hospital, 70211 Kuopio, Finland.
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671
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Pontremoli M, Brioschi M, Baetta R, Ghilardi S, Banfi C. Identification of DKK-1 as a novel mediator of statin effects in human endothelial cells. Sci Rep 2018; 8:16671. [PMID: 30420710 PMCID: PMC6232108 DOI: 10.1038/s41598-018-35119-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 10/29/2018] [Indexed: 12/18/2022] Open
Abstract
This study shows that DKK-1, a member of the Dickkopf family and a regulator of the Wnt pathways, represents a novel target of statins which, through the inhibition of HMG-CoA reductase and of non-steroidal isoprenoid intermediates, exert extra-beneficial effect in preventing atherosclerosis beyond their effect on the lipid profile. We found that atorvastatin downregulates DKK-1 protein (−88.3 ± 4.1%) and mRNA expression (−90 ± 4.2%) through the inhibition of Cdc42, Rho and Rac geranylgeranylated proteins. Further, a combined approach based on the integration of label-free quantitative mass spectrometry based-proteomics and gene silencing allowed us to demonstrate that DKK-1 itself mediates, at least in part, statin effects on human endothelial cells. Indeed, DKK-1 is responsible for the regulation of the 21% of the statin-modulated proteins, which include, among others, clusterin/apoJ, plasminogen activator inhibitor type 1 (PAI-1), myristoylated alanine-rich C-kinase substrate (MARCKS), and pentraxin 3 (PTX3). The Gene Ontology enrichment annotation revealed that DKK-1 is also a potential mediator of the extracellular matrix organization, platelet activation and response to wounding processes induced by statin. Finally, we found that plasma level of DKK-1 from cholesterol-fed rabbits treated with atorvastatin (2.5 mg/kg/day for 8 weeks) was lower (−42 ± 23%) than that of control animals. Thus, DKK-1 is not only a target of statin but it directly regulates the expression of molecules involved in a plethora of biological functions, thus expanding its role, which has been so far restricted mainly to cancer.
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672
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Chellan B, Sutton NR, Hofmann Bowman MA. S100/RAGE-Mediated Inflammation and Modified Cholesterol Lipoproteins as Mediators of Osteoblastic Differentiation of Vascular Smooth Muscle Cells. Front Cardiovasc Med 2018; 5:163. [PMID: 30467547 PMCID: PMC6235906 DOI: 10.3389/fcvm.2018.00163] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 10/19/2018] [Indexed: 01/01/2023] Open
Abstract
Arterial calcification is a feature of atherosclerosis and shares many risk factors including diabetes, dyslipidemia, chronic kidney disease, hypertension, and age. Although there is overlap in risk factors, anti-atherosclerotic therapies, including statins, fail to reduce arterial, and aortic valve calcifications. This suggests that low density lipoprotein (LDL) may not be the main driver for aortic valve disease and arterial calcification. This review focuses on modified LDLs and their role in mediating foam cell formation in smooth muscle cells (SMCs), with special emphasis on enzyme modified non-oxidized LDL (ELDL). In vivo, ELDL represents one of the many forms of modified LDLs present in the atherosclerotic vessel. Phenotypic changes of macrophages and SMCs brought about by the uptake of modified LDLs overlap significantly in an atherosclerotic milieu, making it practically impossible to differentiate between the effects from oxidized LDL, ELDL, and other LDL modification. By studying in vitro-generated modifications of LDL, we were able to demonstrate marked differences in the transcriptome of human coronary artery SMCs (HCASMCs) upon uptake of ELDL, OxLDL, and native LDL, indicating that specific modifications of LDL in atherosclerotic plaques may determine the biology and functional consequences in vasculature. Enzyme-modified non-oxidized LDL (ELDL) induces calcification of SMCs and this is associated with reduced mRNA levels for genes protective for calcification (ENPP1, MGP) and upregulation of osteoblastic genes. A second focus of this review is on the synergy between hyperlipidemia and accelerated calcification In vivo in a mouse models with transgenic expression of human S100A12. We summarize mechanisms of S100A12/RAGE mediated vascular inflammation promoting vascular and valve calcification in vivo.
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Affiliation(s)
- Bijoy Chellan
- Department of Medicine, University of Illinois, Chicago, IL, United States
| | - Nadia R Sutton
- Department of Medicine, University of Michigan, Ann Arbor, MI, United States
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673
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Simvastatin Impairs the Inflammatory and Repair Phases of the Postinjury Skeletal Muscle Regeneration. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7617312. [PMID: 30519583 PMCID: PMC6241344 DOI: 10.1155/2018/7617312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 10/08/2018] [Accepted: 10/17/2018] [Indexed: 12/27/2022]
Abstract
Background Recent clinical data have suggested that the chronic use of high-lipophilic statins impairs the regenerative capacity of skeletal muscle. Because this activity of statins is poorly understood, we aimed to investigate the effect of simvastatin (SIM) on postinjury myofibre regeneration. Methods The porcine model was used in this study. The animals were divided into two groups: nontreated (control; n=24) and SIM-treated (40 mg/day; n=24). On the 15th day (day 0) of the experiment, a bupivacaine hydrochloride- (BPVC-) induced muscle injury was established, and the animals were sacrificed in the following days after muscle injury. The degree of regeneration was assessed based on histopathological and immunohistochemical examinations. The presence and degree of extravasation, necrosis, and inflammation in the inflammatory phase were assessed, whereas the repair phase was evaluated based on the numbers of muscle precursor cells (MPCs), myotube and young myofibres. Results In the inflammatory phase, SIM increased the distribution and prolonged the period of extravasation, prolonged the duration of necrosis, and prolonged and enhanced the infiltration of inflammatory cells. In the repair phase, SIM delayed and prolonged the activity of MPCs, delayed myotube formation, and delayed and decreased the formation of young myofibres. Our results indicated that SIM did not improve blood vessel stabilization at the site of the injury, did not exert an anti-inflammatory effect, prolonged and enhanced the inflammatory response, and impaired MPC activity, differentiation, and fusion. Moreover, SIM appeared to reduce M1 macrophage activity, resulting in slower removal of necrotic debris and sustained necrosis. Conclusion This study shows that SIM negatively affects the inflammatory and repair phases of the postinjury muscle regeneration. These findings are unique, strengthen the available knowledge on the side effects of SIM, and provide evidence showing that statin therapy is associated with an increased risk of impairment of the regenerative capacity of muscle.
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674
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Hansen M, Kuhlman ACB, Sahl RE, Kelly B, Morville T, Dohlmann TL, Chrøis KM, Larsen S, Helge JW, Dela F. Inflammatory biomarkers in patients in Simvastatin treatment: No effect of co-enzyme Q10 supplementation. Cytokine 2018; 113:393-399. [PMID: 30389229 DOI: 10.1016/j.cyto.2018.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 10/08/2018] [Accepted: 10/14/2018] [Indexed: 01/17/2023]
Abstract
PURPOSE Atherosclerosis is a major risk factor for cardiovascular disease (CVD) and is known to be an inflammatory process. Statin therapy decreases both cholesterol and inflammation and is used in primary and secondary prevention of CVD. However, a statin induced decrease of plasma concentrations of the antioxidant coenzyme Q10 (CoQ10), may prevent the patients from reaching their optimal anti-inflammatory potential. Here, we studied the anti-inflammatory effect of Simvastatin therapy and CoQ10 supplementation. METHODS 35 patients in primary prevention with Simvastatin (40 mg/day) were randomized to receive oral CoQ10 supplementation (400 mg/d) or placebo for 8 weeks. 20 patients with hypercholesterolemia who received no cholesterol-lowering treatment was a control group. Plasma concentrations of lipids and inflammatory biomarkers (interleukin-6 (IL6); -8 (IL8); -10 (IL10), tumor necrosis factor-α (TNFα); high-sensitivity C reactive protein (hsCRP)) as well as glycated hemoglobin (HbA1c) were quantified before and after the intervention. RESULTS No significant change in inflammatory markers or lipids was observed after CoQ10 supplementation Patients in Simvastatin therapy had significantly (P < 0.05) lower baseline concentration of IL6 (0.31 ± 0.03 pg/ml), IL8 (1.6 ± 0.1 pg/ml) IL10 (0.16 ± 0.02 pg/ml) and borderline (P = 0.053) lower TNFα (0.88 ± 0.05 pg/ml), but not hsCRP (1.34 ± 0.19 mg/l) compared with the control group (0.62 ± 0.08, 2.6 ± 0.2, 0.25 ± 0.01, 1.07 ± 0.09, and 1.90 ± 0.35, respectively). CONCLUSIONS Simvastatin therapy has beneficial effects on inflammatory markers in plasma, but CoQ10 supplementation seems to have no additional potentiating effect in patients in primary prevention. In contrast, glucose homeostasis may improve with CoQ10 supplementation.
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Affiliation(s)
- Maria Hansen
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Anja C B Kuhlman
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Ronni E Sahl
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Bo Kelly
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Thomas Morville
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Tine L Dohlmann
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Karoline M Chrøis
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Steen Larsen
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland
| | - Jørn W Helge
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Flemming Dela
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Geriatrics, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Denmark.
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675
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Eggers KM, Lindahl B, Venge P, Lind L. Predictors of 10-year changes in levels of N-terminal pro B-type natriuretic peptide and cardiac troponin I in the elderly. Int J Cardiol 2018; 257:300-305. [PMID: 29506712 DOI: 10.1016/j.ijcard.2017.10.095] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 10/16/2017] [Accepted: 10/20/2017] [Indexed: 10/17/2022]
Abstract
BACKGROUND Measurement of N-terminal pro B-type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) might be useful for monitoring of cardiovascular disease in the elderly. However, it is not clear whether changes in these biomarkers are associated with changes in the cardiovascular risk profile and if this pattern could be modified by changes in lifestyle habits or medications. METHODS We measured levels of NT-proBNP and cTnI in community-dwelling subjects (PIVUS study) upon visits scheduled at age 70 (n=1007), 75 (n=825) and 80 (n=602). The associations of these biomarkers with repeated measurements of clinical variables (risk factors, lifestyle habits, echocardiographic data and medications) were investigated using sex-adjusted linear mixed random effect models. RESULTS NT-proBNP and cTnI were positively associated with increasing age. NT-proBNP, but not cTnI, was affected by changes of renal function and the degree of obesity. NT-proBNP was more closely related than cTnI to changes in echocardiographic estimates of cardiac geometry and function. Biomarker levels and/or their changes were inversely associated with a physically more active lifestyle (both NT-proBNP and cTnI) and statin treatment at age 70 (only cTnI). Changes in smoking status or antihypertensive treatment had no effect on biomarker levels. CONCLUSIONS Changes in NT-proBNP and cTnI levels are associated with different patterns of cardiovascular disease burden when using a longitudinal approach. However, levels of both biomarkers and their changes also reflect changes in the cardiovascular risk profile that might be modifiable. This is an important aspect for the use of any cardiovascular biomarker in an elderly population.
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Affiliation(s)
- Kai M Eggers
- Department of Medical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden.
| | - Bertil Lindahl
- Department of Medical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden; Uppsala Clinical Research Centre, Uppsala University, SE-752 37 Uppsala, Sweden
| | - Per Venge
- Department of Clinical Chemistry, Uppsala University, SE-751 85 Uppsala, Sweden
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden
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676
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Schol-Gelok S, Galema-Boers JAMH, van Gelder T, Kruip MJHA, Roeters van Lennep JE, Versmissen J. No effect of PCSK9 inhibitors on D-dimer and fibrinogen levels in patients with familial hypercholesterolemia. Biomed Pharmacother 2018; 108:1412-1414. [PMID: 30372843 DOI: 10.1016/j.biopha.2018.09.164] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/28/2018] [Accepted: 09/28/2018] [Indexed: 02/06/2023] Open
Abstract
Statins are generally believed to have cardiovascular protective effects independent of low-density lipoprotein-cholesterol (LDL-C) lowering, such as antithrombotic effects characterized by a decrease in D-dimer levels. For the recently introduced Proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors antithrombotic effects are yet unknown. We determined the effect of starting PCSK9 inhibitors on D-dimer and fibrinogen levels as most robust markers for thrombogenicity in statin-intolerant patients with familial hypercholesterolemia. We determined D-dimer and fibrinogen levels before and after start of evolocumab (n = 19) or alirocumab (n = 11). Baseline median D-dimer levels were 0.34 mg/L (IQR 0.24-0.59 mg/L) and baseline median fibrinogen levels 3.2 g/L (IQR 2.88-3.63 g/L). At follow-up D-dimer levels (median 0.31 mg/L (IQR 0.25-0.59 mg/L); p = 0.37), and fibrinogen levels (median 3.4 g/L (IQR 2.98-3.62 g/L); p = 0.38) did not change significantly. We therefore conclude PCSK9 inhibitors do not seem to have a profound antithrombotic effect, although a more subtle effect can not been excluded.
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Affiliation(s)
- Suzanne Schol-Gelok
- Department of Hospital Pharmacy and Internal Medicine, Erasmus Medical Center, 's Gravendijkwal 230, 3015CE, Rotterdam, the Netherlands; Department of Internal Medicine, Vascular and Metabolic Diseases Section, Erasmus University Medical Center, 's Gravendijkwal 230, 3015CE, Rotterdam, the Netherlands
| | - J Annette M H Galema-Boers
- Department of Internal Medicine, Vascular and Metabolic Diseases Section, Erasmus University Medical Center, 's Gravendijkwal 230, 3015CE, Rotterdam, the Netherlands
| | - Teun van Gelder
- Department of Hospital Pharmacy and Internal Medicine, Erasmus Medical Center, 's Gravendijkwal 230, 3015CE, Rotterdam, the Netherlands; Department of Internal Medicine, Vascular and Metabolic Diseases Section, Erasmus University Medical Center, 's Gravendijkwal 230, 3015CE, Rotterdam, the Netherlands
| | - Marieke J H A Kruip
- Department of Hematology, Erasmus Medical Center, 's Gravendijkwal 230, 3015CE, Rotterdam, the Netherlands
| | - Jeanine E Roeters van Lennep
- Department of Internal Medicine, Vascular and Metabolic Diseases Section, Erasmus University Medical Center, 's Gravendijkwal 230, 3015CE, Rotterdam, the Netherlands
| | - Jorie Versmissen
- Department of Internal Medicine, Vascular and Metabolic Diseases Section, Erasmus University Medical Center, 's Gravendijkwal 230, 3015CE, Rotterdam, the Netherlands.
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677
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Korani S, Korani M, Bahrami S, Johnston TP, Butler AE, Banach M, Sahebkar A. Application of nanotechnology to improve the therapeutic benefits of statins. Drug Discov Today 2018; 24:567-574. [PMID: 30292917 DOI: 10.1016/j.drudis.2018.09.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/16/2018] [Accepted: 09/28/2018] [Indexed: 12/17/2022]
Abstract
Hyperlipidemia is defined as an elevated level of lipids and lipoproteins in the blood and is considered to be a significant risk factor for accelerating the process of atherosclerosis and, consequently, cardiovascular disease. The level of cholesterol, especially low-density lipoprotein cholesterol (LDL-C), is commonly elevated in hyperlipidemia and represents the primary therapeutic target. Statins are a group of drugs that function by inhibiting 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase and are extremely efficacious in reducing elevated LDL-C in the serum and preventing atherosclerotic cardiovascular disease. However, statins have some limitations, such as poor aqueous solubility, low oral absorption, and, consequently, limited bioavailability when administered by the oral route. The field of nanotechnology is now well developed and some of these newer nanotechnology strategies offer systems with enhanced aqueous solubility of the statin, increased absorption, bioavailability, and controlled release of the statin at the site of administration. Here, we discuss nano-sized drug delivery systems to enhance the therapeutic potential of statins.
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Affiliation(s)
- Shahla Korani
- Research Center of Oils and Fats, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mitra Korani
- Nanotechnology Research Center, Buali (Avicenna) Research Center, Mashhad University of Medical Science, Mashhad, Iran
| | - Samira Bahrami
- Biotechnology Department, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Thomas P Johnston
- Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Alexandra E Butler
- Diabetes Research Center, Qatar Biomedical Research Institute, Doha, Qatar
| | - Maciej Banach
- Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Zeromskiego 113, Lodz, Poland; Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Amirhossein Sahebkar
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
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678
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Fedson DS. Influenza, evolution, and the next pandemic. EVOLUTION MEDICINE AND PUBLIC HEALTH 2018; 2018:260-269. [PMID: 30455951 PMCID: PMC6234328 DOI: 10.1093/emph/eoy027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 08/29/2018] [Indexed: 12/14/2022]
Abstract
Mortality rates in influenza appear to have been shaped by evolution. During the 1918 pandemic, mortality rates were lower in children compared with adults. This mortality difference occurs in a wide variety of infectious diseases. It has been replicated in mice and might be due to greater tolerance of infection, not greater resistance. Importantly, combination treatment with inexpensive and widely available generic drugs (e.g. statins and angiotensin receptor blockers) might change the damaging host response in adults to a more tolerant response in children. These drugs might work by modifying endothelial dysfunction, mitochondrial biogenesis and immunometabolism. Treating the host response might be the only practical way to reduce global mortality during the next influenza pandemic. It might also help reduce mortality due to seasonal influenza and other forms of acute critical illness. To realize these benefits, we need laboratory and clinical studies of host response treatment before and after puberty.
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679
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Sanja M, Jozsef P, Sanja PG, Ivana C, Ivana G, Lana G, Gordana S, Renata L, Lepej Snjezana Z. Cytokines and statin therapy in chronic obstructive pulmonary disease patients. Scandinavian Journal of Clinical and Laboratory Investigation 2018; 78:533-538. [PMID: 30278779 DOI: 10.1080/00365513.2018.1514464] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cytokines are biological response modifiers involved in the pathophysiology of chronic obstructive pulmonary disease (COPD). This study investigated the potential use of cytokines as disease severity biomarkers in COPD patients and the possible effect of statin therapy on cytokine expression. Possible associations between cytokines, body mass index (BMI) and smoking have also been studied. Cytokines IFN-γ, IL-2, IL-12 p70, TNF-α, TNF-β, IL-4, IL-5, IL-6, IL-10, IL-1β and IL-8 were measured in the plasma of 100 clinically stable COPD patients using a fluorescent bead immunoassay on a flow cytometer. When patients were grouped according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage (A-D), no significant differences in cytokine concentrations were found (p > .05). Significantly decreased concentrations of IL-1β, IL-2, IL-4, IL-8, IL-10, IL-12p70 and TNF-α were found in COPD patients receiving statin therapy in comparison with COPD patients not receiving statin therapy (p < .05). COPD patients with increased BMI (>25) had decreased IL-2 (p=.038), IL-8 (p = .039) and IL-10 (p = .005) concentrations compared to normal BMI (20-25) patients. Current COPD smokers had increased concentrations of IL-5 (p = .037) compared to former COPD smokers. Hierarchical cluster analysis showed several patterns of measured cytokines in serum of patients with stable COPD. Statin therapy is associated with decreased expression of selected Th1 and Th2 cytokines in COPD, and this effect could be of relevance in COPD patients with increased cardiovascular risk. Concentrations of Th1 and Th2 cytokines in plasma cannot be used as biomarkers of disease severity or progression of COPD.
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Affiliation(s)
- Marevic Sanja
- a Department of Medical Biochemistry and Hematology , University Hospital for Infectious Diseases ''Dr. Fran Mihaljevic'' , Zagreb , Croatia
| | - Petrik Jozsef
- b Faculty of Pharmacy and Biochemistry, Department of Medical Biochemistry and Hematology , University of Zagreb , Zagreb , Croatia
| | - Popovic Grle Sanja
- c Clinic for Lung Diseases, Jordanovac , University Hospital Centre Zagreb , Zagreb , Croatia
| | - Cepelak Ivana
- c Clinic for Lung Diseases, Jordanovac , University Hospital Centre Zagreb , Zagreb , Croatia
| | - Grgic Ivana
- d Department of Molecular Diagnostics and Flow Cytometry , University Hospital for Infectious Diseases ''Dr. Fran Mihaljevic'' , Zagreb , Croatia
| | - Gorenec Lana
- d Department of Molecular Diagnostics and Flow Cytometry , University Hospital for Infectious Diseases ''Dr. Fran Mihaljevic'' , Zagreb , Croatia
| | | | - Laskaj Renata
- a Department of Medical Biochemistry and Hematology , University Hospital for Infectious Diseases ''Dr. Fran Mihaljevic'' , Zagreb , Croatia
| | - Zidovec Lepej Snjezana
- d Department of Molecular Diagnostics and Flow Cytometry , University Hospital for Infectious Diseases ''Dr. Fran Mihaljevic'' , Zagreb , Croatia
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680
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Witkamp RF, van Norren K. Let thy food be thy medicine….when possible. Eur J Pharmacol 2018; 836:102-114. [DOI: 10.1016/j.ejphar.2018.06.026] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 06/06/2018] [Accepted: 06/19/2018] [Indexed: 02/09/2023]
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681
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Pentz R, Kaun C, Thaler B, Stojkovic S, Lenz M, Krychtiuk KA, Zuckermann A, Huber K, Wojta J, Hohensinner PJ, Demyanets S. Cardioprotective cytokine interleukin-33 is up-regulated by statins in human cardiac tissue. J Cell Mol Med 2018; 22:6122-6133. [PMID: 30216659 PMCID: PMC6237563 DOI: 10.1111/jcmm.13891] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 07/24/2018] [Accepted: 08/08/2018] [Indexed: 01/20/2023] Open
Abstract
Interleukin (IL)‐33 is a member of the IL‐1 family and is able to act cardioprotective. The aim of this study was to investigate the regulation of IL‐33 by 3‐hydroxy‐3‐methylglutaryl‐coenzyme‐A (HMG‐CoA) reductase inhibitors (statins) and bisphosphonates (BPs) in human cardiac tissue. The lipophilic fluvastatin, simvastatin, atorvastatin, and lovastatin as well as the nitrogenous BPs alendronate and ibandronate, but not hydrophilic pravastatin increased IL‐33 mRNA and intracellular IL‐33 protein levels in both human adult cardiac myocytes (HACM) and fibroblasts (HACF). Additionally, fluvastatin reduced soluble ST2 secretion from HACM. IL‐33 was also up‐regulated by the general inhibitor of prenylation perillic acid, a RhoA kinase inhibitor Y‐27632, and by latrunculin B, but statin‐induced IL‐33 expression was inhibited by mevalonate, geranylgeranyl pyrophosphate (GGPP) and RhoA activator U‐46619. The IL‐33 promoter was 2.3‐fold more accessible in statin‐treated HACM compared to untreated cells (P = 0.037). In explanted hearts of statin‐treated patients IL‐33 protein was up‐regulated as compared with the hearts of non‐statin‐treated patients (P = 0.048). As IL‐33 was previously shown to exert cardioprotective effects, one could speculate that such up‐regulation of IL‐33 expression in human cardiac cells, which might happen mainly through protein geranylgeranylation, could be a novel mechanism contributing to known cardioprotective effects of statins and BPs.
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Affiliation(s)
- Richard Pentz
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Christoph Kaun
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Barbara Thaler
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Stefan Stojkovic
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Max Lenz
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Konstantin A Krychtiuk
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | | | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminen Hospital, Vienna, Austria.,Medical Faculty, Sigmund Freud Private University, Vienna, Austria.,Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
| | - Johann Wojta
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria.,Core Facilities, Medical University of Vienna, Vienna, Austria
| | - Philipp J Hohensinner
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Svitlana Demyanets
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
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682
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Huai J, Yang Z, Yi YH, Wang GJ. Different Effects of Pravastatin on Preeclampsia-like Symptoms in Different Mouse Models. Chin Med J (Engl) 2018; 131:461-470. [PMID: 29451152 PMCID: PMC5830832 DOI: 10.4103/0366-6999.225058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Pravastatin (Pra) exerts protective effects on preeclampsia. Preeclampsia is a multifactorial and pathogenic pathway syndrome. The present study compared the effects of Pra on clinical manifestations of preeclampsia in different pathogenic pathways. Methods Two different preeclampsia-like mouse models used in this study were generated with Nω-nitro-L-arginine methyl ester (L-NAME) and used lipopolysaccharide (LPS) from day 7 of gestation, respectively. Pra treatment was administered on day 2 after the models were established in each group (L-NAME + Pra, LPS + Pra, and Control + Pra, n = 8) or normal saline (NS) for the control group (L-NAME + NS, LPS + NS, and Control + NS, n = 8). Maternal weight, serum lipids, the histopathological changes, and lipid deposition in the liver and placenta were observed. The pregnancy outcomes were compared. The blood pressure analysis was carried out on repeated measurements of variance. Student's t-test was used for comparing the two groups. The enumeration data were compared by Chi-square test. Results The mean arterial pressure (MAP) and 24-h urinary protein in the L-NAME + NS and LPS + NS groups were significantly higher than the Control + NS group (F = 211.05 and 309.92 for MAP, t = 6.63 and 8.63 for 24-h urinary protein; all P < 0.05) and reduced in the L-NAME + Pra group as compared to the L-NAME + NS group (F = 208.60 for MAP, t = 6.77 for urinary protein; both P < 0.05). Urinary protein was decreased in the LPS + Pra group as compared to the LPS + NS group (t = 5.33; P < 0.05), whereas MAP had no statistical significance (F = 3.37; P > 0.05). Compared to the Control + NS group, the placental efficiency in the L-NAME + NS and LPS + NS groups decreased significantly (t = 3.09 and 2.89, respectively; both P < 0.05); however, no significant difference was observed in L-NAME + Pra and LPS + Pra groups (t = 1.37 and 0.58, respectively; both P > 0.05). Free fatty acid was elevated in the L-NAME + NS group as compared to the Control + NS group (t = 3.99; P < 0.05) at day 18 of pregnancy and decreased in the L-NAME + Pra group as compared to the L-NAME + NS group (t = 3.28; P < 0.05); however, no significant change was observed in the LPS model (F = 0.32; P > 0.05). Conclusion This study suggested that Pra affected the clinical manifestations differently in preeclampsia-like mouse models generated in various pathogenic pathways.
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Affiliation(s)
- Jing Huai
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China, china
| | - Zi Yang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China, china
| | - Yan-Hong Yi
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China, china
| | - Guang-Jiao Wang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China, china
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683
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Godoy JC, Niesman IR, Busija AR, Kassan A, Schilling JM, Schwarz A, Alvarez EA, Dalton ND, Drummond JC, Roth DM, Kararigas G, Patel HH, Zemljic-Harpf AE. Atorvastatin, but not pravastatin, inhibits cardiac Akt/mTOR signaling and disturbs mitochondrial ultrastructure in cardiac myocytes. FASEB J 2018; 33:1209-1225. [PMID: 30169110 DOI: 10.1096/fj.201800876r] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Statins, which reduce LDL-cholesterol by inhibition of 3-hydroxy-3-methylglutaryl-coenzyme A reductase, are among the most widely prescribed drugs. Skeletal myopathy is a known statin-induced adverse effect associated with mitochondrial changes. We hypothesized that similar effects would occur in cardiac myocytes in a lipophilicity-dependent manner between 2 common statins: atorvastatin (lipophilic) and pravastatin (hydrophilic). Neonatal cardiac ventricular myocytes were treated with atorvastatin and pravastatin for 48 h. Both statins induced endoplasmic reticular (ER) stress, but only atorvastatin inhibited ERK1/2T202/Y204, AktSer473, and mammalian target of rapamycin signaling; reduced protein abundance of caveolin-1, dystrophin, epidermal growth factor receptor, and insulin receptor-β; decreased Ras homolog gene family member A activation; and induced apoptosis. In cardiomyocyte-equivalent HL-1 cells, atorvastatin, but not pravastatin, reduced mitochondrial oxygen consumption. When male mice underwent atorvastatin and pravastatin administration per os for up to 7 mo, only long-term atorvastatin, but not pravastatin, induced elevated serum creatine kinase; swollen, misaligned, size-variable, and disconnected cardiac mitochondria; alteration of ER structure; repression of mitochondria- and endoplasmic reticulum-related genes; and a 21% increase in mortality in cardiac-specific vinculin-knockout mice during the first 2 months of administration. To our knowledge, we are the first to demonstrate in vivo that long-term atorvastatin administration alters cardiac ultrastructure, a finding with important clinical implications.-Godoy, J. C., Niesman, I. R., Busija, A. R., Kassan, A., Schilling, J. M., Schwarz, A., Alvarez, E. A., Dalton, N. D., Drummond, J. C., Roth, D. M., Kararigas, G., Patel, H. H., Zemljic-Harpf, A. E. Atorvastatin, but not pravastatin, inhibits cardiac Akt/mTOR signaling and disturbs mitochondrial ultrastructure in cardiac myocytes.
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Affiliation(s)
- Joseph C Godoy
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Ingrid R Niesman
- Department of Anesthesiology, University of California, San Diego, San Diego, California, USA
| | - Anna R Busija
- Department of Anesthesiology, University of California, San Diego, San Diego, California, USA
| | - Adam Kassan
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Anesthesiology, University of California, San Diego, San Diego, California, USA.,Department of Pharmaceutical Sciences, School of Pharmacy, West Coast University, North Hollywood, California, USA
| | - Jan M Schilling
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Anesthesiology, University of California, San Diego, San Diego, California, USA
| | - Anna Schwarz
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Erika A Alvarez
- Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Nancy D Dalton
- Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - John C Drummond
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Anesthesiology, University of California, San Diego, San Diego, California, USA
| | - David M Roth
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Anesthesiology, University of California, San Diego, San Diego, California, USA
| | - Georgios Kararigas
- Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Berlin, Germany
| | - Hemal H Patel
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Anesthesiology, University of California, San Diego, San Diego, California, USA
| | - Alice E Zemljic-Harpf
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Anesthesiology, University of California, San Diego, San Diego, California, USA
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684
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Krysiak R, Szkróbka W, Okopień B. Different Effects of Atorvastatin on Cardiometabolic Risk Factors in Young Women With and Without Hyperprolactinemia. J Clin Pharmacol 2018; 59:83-89. [PMID: 30129670 DOI: 10.1002/jcph.1301] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 07/23/2018] [Indexed: 12/20/2022]
Abstract
Long-term prolactin excess is often accompanied by numerous metabolic complications. No previous study has compared the effect of statin therapy on circulating levels of cardiometabolic risk factors in patients with elevated and normal prolactin levels. The study population consisted of 3 age-, weight-, and lipid-matched groups of young women: 19 women with untreated hyperprolactinemia (group A), 20 normoprolactinemic women receiving bromocriptine treatment (because of previous hyperprolactinemia) (group B), and 20 untreated women with prolactin levels within the reference range (group C). Because of elevated total and low-density lipoprotein cholesterol levels, all women were then treated with atorvastatin (40 mg daily). Apart from measuring plasma lipids, glucose homeostasis markers, and hormone levels at the beginning of the study and 12 weeks later, we measured circulating levels of uric acid, high-sensitivity C-reactive protein, homocysteine, and fibrinogen. Despite similar baseline levels of plasma lipids, levels of uric acid, high-sensitivity C-reactive protein, homocysteine, and fibrinogen as well as the degree of insulin resistance were higher in group A than in the remaining 2 groups. Atorvastatin reduced total and low-density lipoprotein cholesterol levels in all study groups. However, only in normoprolactinemic women (groups B and C) did atorvastatin reduce circulating levels of nonlipid cardiometabolic risk factors, whereas only in group A did the drug slightly impair insulin sensitivity. The results of the study suggest that cardiometabolic effects of atorvastatin depend on the prolactin status of patients.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
| | - Witold Szkróbka
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
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685
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Wu Q, Qu J, Yin Y, Wang A, Cheng W, Duan R, Zhang B. Morning hypertension is a risk factor of macrovascular events following cerebral infarction: A retrospective study. Medicine (Baltimore) 2018; 97:e12013. [PMID: 30142846 PMCID: PMC6113038 DOI: 10.1097/md.0000000000012013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 07/30/2018] [Indexed: 12/04/2022] Open
Abstract
This study aimed to investigate risk factors (such as morning hypertension, drug compliance, and biochemical parameters) of macrovascular events after cerebral infarction.This was a retrospective study of patients with cerebral infarction admitted between May 2015 and April 2016 at the Fengxian Branch, 6th People's Hospital of Shanghai. They were divided into the macrovascular events and control groups according to the diagnosis of macrovascular events following cerebral infarction.Among the 702 patients included for analysis, 122 patients were with macrovascular events and 580 were without macrovascular events (controls). Morning hypertension (P = .01), dyslipidemia (P = .007), atrial fibrillation (P = .039), carotid artery plaque (P = .014), inflammatory infection (P = .005), high homocysteine (P = .032), antithrombotic compliance (P < .001), statins compliance (P < .001), morning diastolic blood pressure (P < .001), morning systolic blood pressure (P < .001), and morning heart rate (morHR) (P = .033) were associated with macrovascular events. Multivariable analysis showed that morning hypertension (P = .021, odds ratio [OR] = 1.753, 95% confidence interval [CI] [1.088, 2.826]), dyslipidemia (P = .021, OR = 1.708, 95% CI [1.085, 2.687]), and inflammatory infection (P = .031, OR = 2.263, 95% CI [1.078, 4.752]) were independent risk factors for macrovascular events, while antithrombotic compliance (P < .001, OR = 0.488, 95% CI [0.336, 0.709]), statin compliance (P = .02, OR = 0.64, 95% CI [0.44, 0.931]), and morHR (P = .027, OR = 0.977, 95% CI [0.958, 0.997]) were independent protective factors against macrovascular events. Atrial fibrillation showed a tendency to be associated with macrovascular events (P = .077, OR = 1.531, 95% CI [0.955, 2.454]).Morning hypertension, dyslipidemia, and inflammatory infection may increase the risk of macrovascular events following cerebral infarction. Improving morning blood pressure management and drug compliance (antithrombotic drugs and statins) may reduce the risk of macrovascular events following cerebral infarction.
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686
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Yi SW, Ohrr H. Reply to: “Strokes, cholesterol and statins: When mortality is an endpoint”. Atherosclerosis 2018; 275:451-452. [DOI: 10.1016/j.atherosclerosis.2018.06.861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 06/15/2018] [Indexed: 10/28/2022]
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687
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Tissier F, Farhat F, Philouze C, Desfontis JC, Didier R, Gilard M, Mallem MY, Mansourati J, Moisan C, Pichavant-Rafini K, Theron M, Amérand A. Long-term atorvastatin treatment decreases heart maximal oxygen consumption and its vulnerability to in vitro oxidative stress in Watanabe heritable hyperlipidemic rabbit. Can J Physiol Pharmacol 2018; 96:1112-1118. [PMID: 30011375 DOI: 10.1139/cjpp-2018-0085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Statins are currently used in prevention of cardiovascular diseases in high-risk populations, and could be considered in primary prevention. However, few studies are available on the long-term effects of low doses of statins, especially on mitochondrial function and reactive oxygen species (ROS) metabolism at cardiac level. This study aimed to determine potential effects of a long-term atorvastatin treatment, at low-dose concentration, on the myocardium mitochondrial respiration. Thirty-four Watanabe rabbits were treated or not with atorvastatin (2.5 mg·kg-1·day-1) from the age of 3 to 12 months. Every 3 months, proton leak, basal (V0), and maximal (Vmax) mitochondrial respiration on cardiac permeabilized fibers were measured. Additionally, the vulnerability to ROS, cardiac enzymatic antioxidant defenses, and oxidative damage (lipoperoxidation) were analyzed. Proton leak increased over the duration of the experiment (up to 60% from Vmax at 12 months). Moreover, the statin treatment induced a decrease of Vmax and a decrease of ROS susceptibility of cardiac mitochondria. However, the lipoperoxidation and the antioxidant defenses were not dependent on the presence of statin treatment, or on its duration. This is the first study showing a protective effect of long-term statins treatment against the ROS susceptibility in the cardiac muscle.
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Affiliation(s)
- Florine Tissier
- a EA 4324 ORPHY, Université de Bretagne Occidentale, IBSAM, Brest, France
| | - Firas Farhat
- a EA 4324 ORPHY, Université de Bretagne Occidentale, IBSAM, Brest, France
| | - Clothilde Philouze
- a EA 4324 ORPHY, Université de Bretagne Occidentale, IBSAM, Brest, France
| | - Jean-Claude Desfontis
- b LUNAM Université, UPSP 5304 de physiopathologie animale et pharmacologie fonctionnelle, Oniris, Nantes, France
| | - Romain Didier
- a EA 4324 ORPHY, Université de Bretagne Occidentale, IBSAM, Brest, France.,c Département de cardiologie, CHRU, Brest, France
| | - Martine Gilard
- a EA 4324 ORPHY, Université de Bretagne Occidentale, IBSAM, Brest, France.,c Département de cardiologie, CHRU, Brest, France
| | - M Yassine Mallem
- b LUNAM Université, UPSP 5304 de physiopathologie animale et pharmacologie fonctionnelle, Oniris, Nantes, France
| | - Jacques Mansourati
- a EA 4324 ORPHY, Université de Bretagne Occidentale, IBSAM, Brest, France.,c Département de cardiologie, CHRU, Brest, France
| | - Christine Moisan
- a EA 4324 ORPHY, Université de Bretagne Occidentale, IBSAM, Brest, France
| | | | - Michael Theron
- a EA 4324 ORPHY, Université de Bretagne Occidentale, IBSAM, Brest, France
| | - Aline Amérand
- a EA 4324 ORPHY, Université de Bretagne Occidentale, IBSAM, Brest, France
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688
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Riesinger L, Saemisch M, Nickmann M, Methe H. CD34 + circulating cells display signs of immune activation in patients with acute coronary syndrome. Heart Vessels 2018; 33:1559-1569. [PMID: 30003322 DOI: 10.1007/s00380-018-1220-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 07/06/2018] [Indexed: 01/20/2023]
Abstract
Bone marrow-derived endothelial progenitor cells (EPC) are released into the peripheral blood in situations of vascular repair/angiogenesis. Regulation of vascular repair and angiogenesis by EPC depends not only on the number of circulating EPC but also on their functionality. As endothelial cells can act as antigen-presenting cells in coronary artery disease (CAD), we postulated that EPC can be immune activated here as well. CD34+-EPC were isolated from peripheral blood of patients with ST-elevation myocardial infarction (STEMI, n = 12), non-STEMI/unstable angina (UA, n = 15), and stable CAD (SA, n = 18). Expression of HLA-DR, adhesion and costimulatory molecules by isolated CD34+-EPC were compared with levels in healthy controls (n = 18). There were no significant differences in VCAM-1 and CD80 expression by peripheral circulating CD34+-EPC between the four groups, yet expression of CD86 was highest in UA (p < 0.05). ICAM-1 expression was lowest in SA (p < 0.01). CD34+-EPC constitutively expressed HLA-DR across all groups. Of note, patients pretreated with HMG-CoA reductase inhibitors exhibited lower expression of VCAM-1 by CD34+-EPC throughout all patient groups; furthermore, statins significantly limited ex vivo-induced upregulation of ICAM-1 by TNF-alpha. To the best of our knowledge, this is the first study to examine the expression of immune markers in peripheral circulating CD34+-EPC ex vivo. We demonstrate that CD34+-EPC display different patterns of adhesion and costimulatory molecules in various states of CAD. Expression levels were affected by pretreatment with statins. Hence, immune activity of peripheral circulating CD34+ cells might play a pathophysiologic role in evolution of CAD.
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Affiliation(s)
- Lisa Riesinger
- Department of Cardiology, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Michael Saemisch
- Department of Cardiology, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany
- Department of Internal Medicine, Kliniken Neumarkt, Neumarkt, Germany
| | - Markus Nickmann
- Department of Internal Medicine/Cardiology, Kliniken an der Paar, Aichach, Germany
| | - Heiko Methe
- Department of Cardiology, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany.
- Department of Internal Medicine/Cardiology, Kliniken an der Paar, Aichach, Germany.
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA.
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689
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Schol-Gelok S, van der Hulle T, Biedermann JS, van Gelder T, Klok FA, van der Pol LM, Versmissen J, Huisman MV, Kruip MJHA. Clinical effects of antiplatelet drugs and statins on D-dimer levels. Eur J Clin Invest 2018; 48:e12944. [PMID: 29682728 PMCID: PMC6055760 DOI: 10.1111/eci.12944] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 04/18/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Acute pulmonary embolism may be ruled out by combining nonhigh clinical probability and a normal D-dimer level. Both antiplatelet drugs and HMG-CoA reductase inhibitors (statins) have been associated with effects on thrombus formation, potentially influencing D-dimer levels in this setting, leading to a higher rate of false-negative tests. Therefore, we determined whether D-dimer levels in patients with suspected pulmonary embolism are affected by concomitant use of antiplatelet drugs and/or statins and evaluated whether the effect of antiplatelet drugs or statins might affect diagnostic accuracy. MATERIALS AND METHODS We performed a posthoc analysis in the YEARS diagnostic study, comparing age- and sex-adjusted D-dimer levels among users of antiplatelet drugs, statins and nonusers. We then reclassified patients within the YEARS algorithm by developing a model in which we adjusted D-dimer cut-offs for statin use and evaluated diagnostic accuracy. RESULTS We included 156 statins users, 147 antiplatelet drugs users and 726 nonusers of either drugs, all with suspected pulmonary embolism. Use of antiplatelet drugs did not have a significant effect, whereas statin use was associated with 15% decrease in D-dimer levels (95% CI, -28% to -0.6%). An algorithm with lower D-dimer thresholds in statin users yielded lower specificity (0.42 compared to 0.33) with no difference in false-negative tests. CONCLUSIONS We conclude that use of statins but not of antiplatelet agents is associated with a modest decrease in D-dimer levels. Adjusting D-dimer cut-offs for statin use did, however, not result in a safer diagnostic strategy in our cohort.
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Affiliation(s)
- Suzanne Schol-Gelok
- Department of Hospital pharmacy and Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Tom van der Hulle
- Department of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Joseph S Biedermann
- Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Teun van Gelder
- Department of Hospital pharmacy and Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Frederikus A Klok
- Department of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Liselotte M van der Pol
- Department of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Jorie Versmissen
- Department of Hospital pharmacy and Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Menno V Huisman
- Department of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Marieke J H A Kruip
- Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
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690
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Kang JH, Kao LT, Lin HC, Wang TJ, Yang TY. Do outpatient statins and ACEIs/ARBs have synergistic effects in reducing the risk of pneumonia? A population-based case-control study. PLoS One 2018; 13:e0199981. [PMID: 29953536 PMCID: PMC6023201 DOI: 10.1371/journal.pone.0199981] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 05/11/2018] [Indexed: 01/05/2023] Open
Abstract
Whether statins and an angiotensin-converting enzyme inhibitors (ACEIs) / angiotensin receptor blockors (ARBs) are associated with reduced risks of infection events is still inconclusive. This study aimed to explore the risk of hospitalization for pneumonia among patients who had received treatment with ACEIs/ARBs and/or statins using a population-based dataset. This study included 19,281 patients as cases who were hospitalized for pneumonia and 19,281 controls. We used a logistic regression to compute the odds ratio (OR) and 95% confidence interval (CI) for having previously used statins or an ACEI/ ARB between patients who were hospitalized for pneumonia treatment and controls. We found there were significant associations between hospitalization for pneumonia and statin-only users (p<0.001), ACEI/ARB-only users (p<0.001), and statin and ACEI/ARB users (p<0.001). The logistic regression analysis suggested that statin-only users (adjusted OR = 0.38, 95% CI = 0.34~0.43), ACEI/ARB-only users (adjusted OR = 0.86, 95% CI = 0.82~0.91), and statin and ACEI/ARB users (adjusted OR = 0.47, 95% CI = 0.44~0.50) were all less likely to be hospitalized for pneumonia treatment than were non-users. Furthermore, we found that statin-only users (adjusted OR = 0.44, 95% CI = 0.40~0.50) and statin and ACEI/ARB users (adjusted OR = 0.55, 95% CI = 0.52~0.58) were less likely to be hospitalized for pneumonia treatment compared to ACEI-only users. However, combined statin and ACEI/ARB users (adjusted OR = 1.24, 95% CI = 1.10~1.40) were more likely to have been hospitalized for pneumonia treatment compared to statin-only users. Although we found use of both statins and ACEI/ARB were significantly associated with a lower risk of pneumonia, the combination of the two medications did not provide additional protection against pneumonia risk.
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Affiliation(s)
- Jiunn-Horng Kang
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Li-Ting Kao
- Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan
- Department of Pharmacy Practice, Tri-Service General Hospital, Taipei, Taiwan
| | - Herng-Ching Lin
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- * E-mail:
| | - Ta-Jung Wang
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Tsung-Yeh Yang
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
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691
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Rocha KCE, Pereira BMV, Rodrigues AC. An update on efflux and uptake transporters as determinants of statin response. Expert Opin Drug Metab Toxicol 2018; 14:613-624. [PMID: 29842801 DOI: 10.1080/17425255.2018.1482276] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Statins are used in the treatment of dyslipidemia promoting primary and secondary prevention against detrimental cardiovascular events. ATP-binding cassette (ABC) and solute carrier (SLC) membrane transporters transport statins across the cell membrane. Differences in drug transporter tissue expression and activity contribute to variability in statin pharmacokinetics (PK) and response. Areas covered: The purpose of this review is to discuss factors impacting transporter expression and the effect this has on statin efficacy and safety. Previous studies have demonstrated that genetic polymorphisms, drug-drug interactions (DDI), nuclear receptors, and microRNAs affect statin PK and pharmacodynamics. Expert opinion: Genetic variants of ABCG2 and SLCO1B1 transporters affect statin PK and, as a result, the intended lipid-lowering response. However, the effect size is small, limiting its applicability in clinical practice. Furthermore, genetic variants do not totally explain the observed intervariability in statin response. Thus, it is likely that transcriptional and post-transcriptional regulation of drug transporters are also highly involved. Further studies are required to understand the contribution of each of these new factors in statin disposition and toxicity.
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Affiliation(s)
- Karina Cunha E Rocha
- a Department of Pharmacology , Institute of Biomedical Sciences, University of Sao Paulo , Sao Paulo , SP , Brazil
| | - Beatriz Maria Veloso Pereira
- a Department of Pharmacology , Institute of Biomedical Sciences, University of Sao Paulo , Sao Paulo , SP , Brazil
| | - Alice Cristina Rodrigues
- a Department of Pharmacology , Institute of Biomedical Sciences, University of Sao Paulo , Sao Paulo , SP , Brazil
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692
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Adam C, Glück L, Ebert R, Goebeler M, Jakob F, Schmidt M. The MEK5/ERK5 mitogen-activated protein kinase cascade is an effector pathway of bone-sustaining bisphosphonates that regulates osteogenic differentiation and mineralization. Bone 2018; 111:49-58. [PMID: 29567200 DOI: 10.1016/j.bone.2018.03.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/15/2018] [Accepted: 03/18/2018] [Indexed: 01/24/2023]
Abstract
Bisphosphonates play an important role in the treatment of metabolic bone diseases such as osteoporosis. In addition to their anti-resorptive activity by triggering osteoclast apoptosis, nitrogen-containing bisphosphonates (N-BP) may also influence osteogenic differentiation, which might rely on their capacity to inhibit the mevalonate pathway. In vascular endothelial cells inhibition of this pathway by cholesterol-lowering statins activates the MEK5/ERK5 mitogen-activated protein kinase cascade, which plays an important role in cellular differentiation, apoptosis or inflammatory processes. Here we evaluated whether N-BP may also target the MEK5/ERK5 pathway and analysed the consequences of ERK5 activation on osteogenic differentiation. We show that N-BP dose-dependently activate ERK5 in primary human endothelial cells and osteoblasts. The mechanism likely involves farnesyl pyrophosphate synthase inhibition and subsequent functional inhibition of the small GTPase Cdc42 since siRNA-mediated knockdown of both genes could reproduce N-BP-induced ERK5 activation. ERK5 activation resulted in regulation of several bone-relevant genes and was required for calcification and osteogenic differentiation of bone marrow-derived mesenchymal stems cells as evident by the lack of alkaline phosphatase induction and alizarin-red S staining observed upon ERK5 knockdown or upon differentiation initiation in presence of a pharmacological ERK5 inhibitor. Our data provide evidence that N-BP activate the MEK5/ERK5 cascade and reveal an essential role of ERK5 in osteogenic differentiation and mineralization of skeletal precursors.
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Affiliation(s)
- Christian Adam
- Department of Dermatology, University Hospital Würzburg, Germany
| | - Lucia Glück
- Department of Dermatology, University Hospital Würzburg, Germany
| | - Regina Ebert
- Orthopedic Center for Musculoskeletal Research, Orthopedic Department, University of Würzburg, Germany
| | | | - Franz Jakob
- Orthopedic Center for Musculoskeletal Research, Orthopedic Department, University of Würzburg, Germany
| | - Marc Schmidt
- Department of Dermatology, University Hospital Würzburg, Germany.
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693
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Effects of Rosuvastatin on the expression of the genes involved in cholesterol metabolism in rats: adaptive responses by extrahepatic tissues. Gene 2018; 661:45-50. [DOI: 10.1016/j.gene.2018.03.092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/25/2018] [Accepted: 03/28/2018] [Indexed: 01/21/2023]
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694
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Jeong A, Suazo KF, Wood WG, Distefano MD, Li L. Isoprenoids and protein prenylation: implications in the pathogenesis and therapeutic intervention of Alzheimer's disease. Crit Rev Biochem Mol Biol 2018; 53:279-310. [PMID: 29718780 PMCID: PMC6101676 DOI: 10.1080/10409238.2018.1458070] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The mevalonate-isoprenoid-cholesterol biosynthesis pathway plays a key role in human health and disease. The importance of this pathway is underscored by the discovery that two major isoprenoids, farnesyl and geranylgeranyl pyrophosphate, are required to modify an array of proteins through a process known as protein prenylation, catalyzed by prenyltransferases. The lipophilic prenyl group facilitates the anchoring of proteins in cell membranes, mediating protein-protein interactions and signal transduction. Numerous essential intracellular proteins undergo prenylation, including most members of the small GTPase superfamily as well as heterotrimeric G proteins and nuclear lamins, and are involved in regulating a plethora of cellular processes and functions. Dysregulation of isoprenoids and protein prenylation is implicated in various disorders, including cardiovascular and cerebrovascular diseases, cancers, bone diseases, infectious diseases, progeria, and neurodegenerative diseases including Alzheimer's disease (AD). Therefore, isoprenoids and/or prenyltransferases have emerged as attractive targets for developing therapeutic agents. Here, we provide a general overview of isoprenoid synthesis, the process of protein prenylation and the complexity of prenylated proteins, and pharmacological agents that regulate isoprenoids and protein prenylation. Recent findings that connect isoprenoids/protein prenylation with AD are summarized and potential applications of new prenylomic technologies for uncovering the role of prenylated proteins in the pathogenesis of AD are discussed.
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Affiliation(s)
- Angela Jeong
- Departments of Experimental and Clinical Pharmacolog,University of Minnesota, Minneapolis, MN 55455
| | | | - W. Gibson Wood
- Departments of Pharmacology, University of Minnesota, Minneapolis, MN 55455
| | - Mark D. Distefano
- Departments of Chemistry,University of Minnesota, Minneapolis, MN 55455
| | - Ling Li
- Departments of Experimental and Clinical Pharmacolog,University of Minnesota, Minneapolis, MN 55455
- Departments of Pharmacology, University of Minnesota, Minneapolis, MN 55455
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695
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Cerrato R, Crabtree M, Antoniades C, Kublickiene K, Schiffrin EL, Channon KM, Böhm F. Effects Of Endothelin-1 On Intracellular Tetrahydrobiopterin Levels In Vascular Tissue. SCAND CARDIOVASC J 2018; 52:163-169. [PMID: 29566572 DOI: 10.1080/14017431.2018.1453942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 03/08/2018] [Accepted: 03/12/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Tetrahydrobiopterin (BH4) is the essential cofactor of endothelial nitric oxide synthase (eNOS) and intracellular levels of BH4 is regulated by oxidative stress. The aim of this paper was to describe the influence of exogenous endothelin-1 on intracellular BH4 and its oxidation products dihydrobiopterin (BH2) and biopterin (B) in a wide range of vascular tissue. DESIGN Segments of internal mammary artery (IMA) and human saphenous vein (SV) from 41 patients undergoing elective surgery were incubated in ET-1 (0.1 μM). Aorta and lung from transgenic mice overexpressing ET-1 in the endothelium (ET-TG) were analysed with regards to intracellular biopterin levels. Human umbilical vein endothelial cells (HUVEC) were incubated in ET-1 (0.1 μM) and intracellular biopterin levels were analysed. From 6 healthy women undergoing caesarean section, subcutaneous fat was harvested and the resistance arteries in these biopsies were tested for ET-mediated endothelial dysfunction. RESULTS In HUVEC, exogenous ET-1 (0.1 μM) did not significantly change intracellular BH4, 1.54 ± 1.7 vs 1.68 ± 1.8 pmol/mg protein; p = .8. In IMA and SV, exogenous ET-1(0.1 μM) did not change intracellular BH4 n = 10, p = .4. In aorta from wild type vs ET-TG mice there was no significant difference in intracellular BH4 between the groups: 1.3 ± 0.49 vs 1.23 ± 0.3 pmol/mg protein; p = .6. In resistance arteries (n = 6) BH4 together with DTE (an antioxidant) was not able to prevent ET-mediated endothelial dysfunction. CONCLUSION ET-1 did not significantly alter intracellular tetrahydrobiopterin levels in IMA, SV, HUVEC or aorta from ET-TG mice. These findings are important for future research in ET-1 mediated superoxide production and endothelial dysfunction.
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Affiliation(s)
- Ruha Cerrato
- a Department of Medicine, Cardiology unit, Karolinska Institutet , Karolinska University Hospital , Stockholm , Sweden
| | - Mark Crabtree
- b Department of Cardiovascular Medicine , John Radcliffe Hospital, University of Oxford , Oxford , UK
| | - Charalambos Antoniades
- b Department of Cardiovascular Medicine , John Radcliffe Hospital, University of Oxford , Oxford , UK
| | - Karolina Kublickiene
- c Department of Obstetrics & Gynecology, Karolinska Institutet, Institution of Medicine and Institution for Clinical Science, Intervention & Technology , Karolinska University Hospital , Stockholm , Sweden
| | - Ernesto L Schiffrin
- d Department of Medicine, Lady Davis Institute for Medical Research , Sir Mortimer B. Davis-Jewish General Hospital, McGill University , Montreal , Quebec , Canada
| | - Keith M Channon
- b Department of Cardiovascular Medicine , John Radcliffe Hospital, University of Oxford , Oxford , UK
| | - Felix Böhm
- a Department of Medicine, Cardiology unit, Karolinska Institutet , Karolinska University Hospital , Stockholm , Sweden
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696
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Zambrano T, Salazar LA. microRNAs and response to statins in patients with hypercholesterolemia: from basic research to precision medicine. Pharmacogenomics 2018; 19:748-751. [PMID: 29785870 DOI: 10.2217/pgs-2018-0051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Tomás Zambrano
- Center of Molecular Biology & Pharmacogenetics, Scientific & Technological Bioresource Nucleus (BIOREN), Universidad de La Frontera, Temuco, Chile.,Department of Medical Technology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Luis A Salazar
- Center of Molecular Biology & Pharmacogenetics, Scientific & Technological Bioresource Nucleus (BIOREN), Universidad de La Frontera, Temuco, Chile
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697
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Kostis JB, Dobrzynski JM. Statins and Erectile Function. Can J Cardiol 2018; 34:813.e5. [PMID: 29729881 DOI: 10.1016/j.cjca.2018.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 02/15/2018] [Indexed: 11/19/2022] Open
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698
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Abstract
Statins are used for the primary and secondary prevention of cardiovascular disease by inhibiting cholesterol synthesis in the liver. Statins have also noncholesterol-related effects, called pleiotropic effects, which arise from statins' anti-inflammatory, immunomodulatory and antioxidant properties. These effects are especially attractive for the treatment of various brain diseases ranging from stroke to neurodegenerative diseases. Still, low brain concentrations after oral drug administration hinder the clinical application of statins in these pathologies. Pharmaceutical nanotechnologies may offer a solution to this problem, as local or targeted delivery of nanoencapsulated statins may increase brain availability. This special report rapidly summarizes the potential of statins in the treatment of brain diseases and the pharmaceutical nanotechnologies that could provide a viable approach to enable these indications.
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699
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Abstract
Portal hypertension is one cause and a part of a dynamic process triggered by chronic liver disease, mostly induced by alcohol or incorrect nutrition and less often by viral infections and autoimmune or genetic disease. Adequate staging - continuously modified by current knowledge - should guide the prevention and treatment of portal hypertension with defined endpoints. The main goals are interruption of etiology and prevention of complications followed, if necessary, by treatment of these. For the past few decades, shunts, mostly as intrahepatic stent bypass between portal and hepatic vein branches, have played an important role in the prevention of recurrent bleeding and ascites formation, although their impact on survival remains ambiguous. Systemic drugs, such as non-selective beta-blockers, statins, or antibiotics, reduce portal hypertension by decreasing intrahepatic resistance or portal tributary blood flow or by blunting inflammatory stimuli inside and outside the liver. Here, the interactions among the gut, liver, and brain are increasingly examined for new therapeutic options. There is no general panacea. The interruption of initiating factors is key. If not possible or if not possible in a timely manner, combined approaches should receive more attention before considering liver transplantation.
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Affiliation(s)
| | | | - Jonel Trebicka
- Department of Internal Medicine, University of Bonn, Bonn, Germany.,European Foundation for Study of Chronic Liver Failure, Barcelona, Spain
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700
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Impact of smoking on stroke outcome after endovascular treatment. PLoS One 2018; 13:e0194652. [PMID: 29718909 PMCID: PMC5931491 DOI: 10.1371/journal.pone.0194652] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 03/07/2018] [Indexed: 12/21/2022] Open
Abstract
Background Recent studies suggest a paradoxical association between smoking status and clinical outcome after intravenous thrombolysis (IVT). Little is known about relationship between smoking and stroke outcome after endovascular treatment (EVT). Methods We analyzed data of all stroke patients treated with EVT at the tertiary stroke centre of Berne between January 2005 and December 2015. Using uni- and multivariate modeling, we assessed whether smoking was independently associated with excellent clinical outcome (modified Rankin Scale (mRS) 0–1) and mortality at 3 months. In addition, we also measured the occurrence of symptomatic intracranial hemorrhage (sICH) and recanalization. Results Of 935 patients, 204 (21.8%) were smokers. They were younger (60.5 vs. 70.1 years of age, p<0.001), more often male (60.8% vs. 52.5%, p = 0.036), had less often from hypertension (56.4% vs. 69.6%, p<0.001) and were less often treated with antithrombotics (35.3% vs. 47.7%, p = 0.004) as compared to nonsmokers. In univariate analyses, smokers had higher rates of excellent clinical outcome (39.1% vs. 23.1%, p<0.001) and arterial recanalization (85.6% vs. 79.4%, p = 0.048), whereas mortality was lower (15.6% vs. 25%, p = 0.006) and frequency of sICH similar (4.4% vs. 4.1%, p = 0.86). After correcting for confounders, smoking still independently predicted excellent clinical outcome (OR 1.758, 95% CI 1.206–2.562; p<0.001). Conclusion Smoking in stroke patients may be a predictor of excellent clinical outcome after EVT. However, these data must not be misinterpreted as beneficial effect of smoking due to the observational study design. In view of deleterious effects of cigarette smoking on cardiovascular health, cessation of smoking should still be strongly recommended for stroke prevention.
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