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Kosmas CE, Silverio D, Sourlas A, Montan PD, Guzman E, Garcia MJ. Anti-inflammatory therapy for cardiovascular disease. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:147. [PMID: 31157268 DOI: 10.21037/atm.2019.02.34] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Chronic subclinical inflammation is a central process in the pathogenesis of cardiovascular disease (CVD) and it has been linked with both the initiation and progression of atherosclerosis. Several pro-inflammatory cytokines, such as the C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) have been described as independent risk factors for coronary heart disease and promoters of atherogenesis. Thus, extensive research is being conducted to assess the role of anti-inflammatory therapy in the primary and secondary prevention of CVD. Our review aims to provide the clinical and scientific data pertaining to the effects of different anti-inflammatory agents administered in patients with CVD.
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Affiliation(s)
| | - Delia Silverio
- Cardiology Clinic, Cardiology Unlimited, PC, New York, NY, USA
| | | | - Peter D Montan
- Cardiology Clinic, Cardiology Unlimited, PC, New York, NY, USA
| | - Eliscer Guzman
- Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Mario J Garcia
- Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
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Dan GA, Dobrev D. Antiarrhythmic drugs for atrial fibrillation: Imminent impulses are emerging. IJC HEART & VASCULATURE 2018; 21:11-15. [PMID: 30225340 PMCID: PMC6138883 DOI: 10.1016/j.ijcha.2018.08.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/15/2018] [Accepted: 08/30/2018] [Indexed: 12/19/2022]
Abstract
Rhythm and rate strategies are considered equivalent for the management of atrial fibrillation (AF). Moreover, both strategies are intended for improving symptoms and quality of life. Despite the clinical availability of several antiarrhythmic drugs (AAD) the alternatives for the patient with comorbidities are significantly fewer because of the concern regarding many adverse effects, including proarrhythmias. The impetuous development of AF ablation gave rise to a false impression that AAD are a second line therapy. All these statements reflect, in fact, the weakness of the classical paradigm and classification regarding AAD and the gap between the current knowledge of AF mechanism and determinants and the "classical" AAD non-discriminatory action. A new paradigm in development of effective and safe AAD is based on modern knowledge of vulnerable parameters involved in the genesis and perpetuation of AF. New AAD will target specific triggers of AF and ion currents which are expressed preferentially in fibrillatory atrium. Such targets will include repolarizing currents and channels, as ultrarapid potassium current, two pore potassium current, the acetylcholine-gated potassium current, small-conductance calcium-dependent potassium channels, but, also, molecular targets involved in intracellular calcium kinetics, as Ca2+-calmodulin-dependent protein kinase, ryanodine receptors and non-coding miRNA. New mechanistic discoveries link AF to inflammation and modern anti-cytokine drugs. There is still a long way to win between basic research and clinical practice, but, without any doubt, antiarrhythmic drug therapy will remain and develop as a cornerstone therapy for AF not in conflict, but complementary and alternative to interventional therapy.
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Affiliation(s)
- Gheorghe-Andrei Dan
- Carol Davila Medicine University, Bucharest, Romania
- Colentina University Hospital, Bucharest, Romania
| | - Dobromir Dobrev
- Institute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen, Essen, Germany
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Quartuccio L. Risk of Thrombosis in Sjögren Syndrome: The Open Question of Endothelial Function Immune-mediated Dysregulation. J Rheumatol 2018; 44:1106-1108. [PMID: 28765343 DOI: 10.3899/jrheum.170462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Luca Quartuccio
- Rheumatology Clinic, University of Udine, DAME, Udine, Italy.
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Zeng J, Pan Y, Cui B, Zhai T, Gao S, Zhao Q, Sun Y. Calcium‑sensing receptors in human peripheral T lymphocytes and AMI: Cause and effect. Int J Mol Med 2018; 42:3437-3446. [PMID: 30320381 DOI: 10.3892/ijmm.2018.3924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 05/21/2018] [Indexed: 11/05/2022] Open
Abstract
Acute myocardial infarction (AMI) is a disease associated with inflammation. T lymphocytes are involved by secreting cytokines and inflammatory factors. In our previous study, it was found that the T lymphocytes exhibited certain functional changes, the onset of which was induced by modulating calcium‑sensing receptor (CaSR) in AMI. In the present study, western blotting was used to verified the expression of T lymphocyte CaSR and pathway proteins, including phosphorylated extracellular signal‑regulated kinase (P‑ERK)1/2 and phosphorylated c‑Jun N‑terminal kinase (P‑JNK), and used cytometric bead array to detect the secretion of interleukin (IL)‑4, IL‑6, IL‑10 and tumor necrosis factor (TNF)‑α in AMI onset, the results demonstrated that they were all increased. In addition, the expression of T lymphocyte pathway proteins, including P‑ERK1/2 and P‑JNK, and the secretion of IL‑4, IL‑6, IL‑10 and TNF‑α decreased after T lymphocytes being transfected by CaSR small interfering RNA. By contrast, the neonatal mouse cardiomyocytes under hypoxia and hypoxia/re‑oxygenation exhibited ultrastructural damage, increased apoptosis, increased production of lactate dehydrogenase (LDH) and malondialdehyde, and reduced superoxide dismutase; these indicators changed extensively when cardiomyocytes were co‑cultured with T lymphocytes. However, the effects were reversed when the cardiomyocytes were co‑cultured with CaSR‑silenced T lymphocytes. These results indicated that CaSR may modulate T lymphocytes to release cytokines through mitogen‑activated protein kinase pathways and affect cardiomyocyte injury. The relationship between AMI and T lymphocyte CaSR is reciprocal.
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Affiliation(s)
- Jingya Zeng
- Department of Clinical Laboratory, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150086, P.R. China
| | - Ying Pan
- Department of Clinical Laboratory, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150086, P.R. China
| | - Baohong Cui
- Department of Clinical Laboratory, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150086, P.R. China
| | - Taiyu Zhai
- Department of Clinical Laboratory, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150086, P.R. China
| | - Song Gao
- Department of Clinical Laboratory, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150086, P.R. China
| | - Qianyu Zhao
- Department of Clinical Laboratory, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150086, P.R. China
| | - Yihua Sun
- Department of Clinical Laboratory, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150086, P.R. China
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Sivalingam Z, Erik Magnusson N, Grove EL, Hvas AM, Dalby Kristensen S, Bøjet Larsen S. Neutrophil gelatinase-associated lipocalin (NGAL) and cardiovascular events in patients with stable coronary artery disease. Scandinavian Journal of Clinical and Laboratory Investigation 2018; 78:470-476. [PMID: 30261750 DOI: 10.1080/00365513.2018.1499956] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Inflammation is an important mediator in the pathogenesis of atherosclerosis. Neutrophil gelatinase-associated lipocalin (NGAL) is a small glycoprotein secreted by neutrophils. NGAL regulates the activity of matrix metalloproteinase-9, which plays a role in plaque instability. It has therefore been hypothesised that NGAL may modulate inflammation and promote the development and progression of atherosclerosis. Our aim was to assess the predictive value of plasma NGAL in a prospective cohort study of 876 high-risk patients with stable coronary artery disease (CAD). NGAL levels were measured using the NGAL TestTM from BioPorto Diagnostics. Clinical follow-up was performed after a median of 3.1 years. The endpoint was a combination of non-fatal acute myocardial infarction (MI), cardiovascular death (CVD), or ischaemic stroke. The NGAL concentration was (median [25;75%]: 64.3 µg/L [51.3;81.4]). The area under the receiver operating characteristic curve (AUC) was 0.56 (95% confidence interval (CI): 0.49;0.64) for the diagnosis of the composite endpoint and 0.66 (95% CI: 0.56;0.75) after adding NGAL to high-sensitive C-reactive protein (hs-CRP), leucocyte count, interleukin-6 (IL-6), calprotectin, age, sex, body mass index (BMI), diabetes mellitus, smoking and creatinine. However, the AUC for hs-CRP, leucocyte count, IL-6, calprotectin, age, sex, BMI, diabetes mellitus, smoking and creatinine without NGAL was similar at 0.66 (95% CI: 0.56;0.76). NGAL alone had no predictive value with respect to the composite endpoint of non-fatal AMI, ischaemic stroke, or CVD in stable CAD patients. NGAL did not add any predictive value to the endpoint compared with existing inflammatory biomarkers and cardiovascular risk factors.
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Affiliation(s)
| | - Nils Erik Magnusson
- b Department of Clinical Medicine Faculty of Health Sciences , The Medical Research Laboratories , Aarhus , Denmark
| | - Erik Lerkevang Grove
- a Department of Cardiology , Aarhus University Hospital , Aarhus , Denmark.,c Department of Clinical Medicine, Faculty of Health , Aarhus University , Aarhus , Denmark
| | - Anne-Mette Hvas
- c Department of Clinical Medicine, Faculty of Health , Aarhus University , Aarhus , Denmark.,d Department of Clinical Biochemistry , Aarhus University Hospital , Aarhus , Denmark
| | - Steen Dalby Kristensen
- a Department of Cardiology , Aarhus University Hospital , Aarhus , Denmark.,c Department of Clinical Medicine, Faculty of Health , Aarhus University , Aarhus , Denmark
| | - Sanne Bøjet Larsen
- a Department of Cardiology , Aarhus University Hospital , Aarhus , Denmark
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Kosmas CE, Silverio D, Sourlas A, Garcia F, Montan PD, Guzman E. Primary genetic disorders affecting high density lipoprotein (HDL). Drugs Context 2018; 7:212546. [PMID: 30214464 PMCID: PMC6135231 DOI: 10.7573/dic.212546] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 08/21/2018] [Accepted: 08/22/2018] [Indexed: 01/21/2023] Open
Abstract
There is extensive evidence demonstrating that there is a clear inverse correlation between plasma high density lipoprotein cholesterol (HDL-C) concentration and cardiovascular disease (CVD). On the other hand, there is also extensive evidence that HDL functionality plays a very important role in atheroprotection. Thus, genetic disorders altering certain enzymes, lipid transfer proteins, or specific receptors crucial for the metabolism and adequate function of HDL, may positively or negatively affect the HDL-C levels and/or HDL functionality and subsequently either provide protection or predispose to atherosclerotic disease. This review aims to describe certain genetic disorders associated with either low or high plasma HDL-C and discuss their clinical features, associated risk for cardiovascular events, and treatment options.
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Affiliation(s)
- Constantine E Kosmas
- Division of Cardiology, Department of Medicine, Mount Sinai Hospital, New York, NY, USA
| | - Delia Silverio
- Cardiology Clinic, Cardiology Unlimited, PC, New York, NY, USA
| | | | - Frank Garcia
- Cardiology Clinic, Cardiology Unlimited, PC, New York, NY, USA
| | - Peter D Montan
- Cardiology Clinic, Cardiology Unlimited, PC, New York, NY, USA
| | - Eliscer Guzman
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
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RAGE and TLRs as Key Targets for Antiatherosclerotic Therapy. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7675286. [PMID: 30225265 PMCID: PMC6129363 DOI: 10.1155/2018/7675286] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/08/2018] [Indexed: 02/08/2023]
Abstract
Receptor for advanced glycation end-products (RAGE) and toll-like receptors (TLRs) are the key factors indicating a danger to the organism. They recognize the microbial origin pathogen-associated molecular patterns (PAMPs) or damage-associated molecular patterns (DAMPs). The primary response induced by PAMPs or DAMPs is inflammation. Excessive stimulation of the innate immune system occurs in arterial wall with the participation of effector cells. Persistent adaptive responses can also cause tissue damage and disease. However, inflammation mediated by the molecules innate responses is an important way in which the adaptive immune system protects us from infection. The specific detection of PAMPs and DAMPs by host receptors drives a cascade of signaling that converges at nuclear factor-κB (NF-κB) and interferon regulatory factors (IRFs) and induces the secretion of proinflammatory cytokines, type I interferon (IFN), and chemokines, which promote direct killing of the pathogen. Therefore, signaling of these receptors' pathways also appear to present new avenue for the modulation of inflammatory responses and to serve as potential novel therapeutic targets for antiatherosclerotic therapy.
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Kosmas CE, Silverio D, Tsomidou C, Salcedo MD, Montan PD, Guzman E. The Impact of Insulin Resistance and Chronic Kidney Disease on Inflammation and Cardiovascular Disease. CLINICAL MEDICINE INSIGHTS-ENDOCRINOLOGY AND DIABETES 2018; 11:1179551418792257. [PMID: 30083062 PMCID: PMC6071166 DOI: 10.1177/1179551418792257] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 07/07/2018] [Indexed: 12/13/2022]
Abstract
There is extensive evidence showing that insulin resistance (IR) is associated
with chronic low-grade inflammation. Furthermore, IR has been shown to increase
the risk for cardiovascular disease (CVD), even in nondiabetic patients, and is
currently considered as a “nontraditional” risk factor contributing to CVD by
promoting hypertension, oxidative stress, endothelial dysfunction, dyslipidemia,
and type 2 diabetes mellitus. However, chronic kidney disease (CKD) is also
considered a state of low-grade inflammation. In addition, CKD is considered an
IR state and has been described as an independent risk factor for the
development of CVD, as even early-stage CKD is associated with an estimated 40%
to 100% increase in CVD risk. There is also strong evidence indicating that
inflammation per se plays a crucial role in both the initiation and progression
of CVD. Given the above, the combined effect of IR and CKD may significantly
increase the risk of inflammation and CVD. This review aims to focus on the
complex interplay between IR, CKD, inflammation, and CVD and will present and
discuss the current clinical and scientific data pertaining to the impact of IR
and CKD on inflammation and CVD.
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Affiliation(s)
- Constantine E Kosmas
- Division of Cardiology, Department of Medicine, Mount Sinai Hospital, New York, NY, USA
| | - Delia Silverio
- Cardiology Clinic, Cardiology Unlimited PC, New York, NY, USA
| | - Christiana Tsomidou
- Department of Medicine, General Clinic of Piraeus "Hippocrates", Piraeus, Greece
| | - Maria D Salcedo
- Cardiology Clinic, Cardiology Unlimited PC, New York, NY, USA
| | - Peter D Montan
- Cardiology Clinic, Cardiology Unlimited PC, New York, NY, USA
| | - Eliscer Guzman
- Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
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Molina M, Allende LM, Ramos LE, Gutiérrez E, Pleguezuelo DE, Hernández ER, Ríos F, Fernández C, Praga M, Morales E. CD19 + B-Cells, a New Biomarker of Mortality in Hemodialysis Patients. Front Immunol 2018; 9:1221. [PMID: 29963040 PMCID: PMC6013647 DOI: 10.3389/fimmu.2018.01221] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 05/15/2018] [Indexed: 12/19/2022] Open
Abstract
Background and objectives Mortality of patients on hemodialysis (HD) remains very high despite recent improvements in HD techniques. Cardiovascular (CV) complications and infections are the main causes of death. Some studies suggest that disturbances in the immune system could play a role in this disproportionate mortality, through the links of immunity with inflammation and propensity to infections. However, few studies have addressed the role of lymphocyte populations and the global and CV mortality of HD patients. Aim To analyze the relationship of peripheral blood lymphocyte populations (PBLP) and all-cause and CV mortality of HD patients. Design, setting, participants, and measurements We design a prospective observational single center study in a cohort of HD prevalent patients. PBLP were analyzed at baseline and after 1 year and patients were followed for a 5-year period. Main outcomes were all-cause and CV mortality. Results One hundred and four patients (51% male, mean age 64.8 ± 15 years) were included. Follow-up was 18 (7–47) months. Fifty-five patients (52.8%) died, main causes of death being CVD (40%) and infections (29.1%). Low total lymphocyte counts were found in 47 patients (45.2%), and the most frequency lymphopenias were CD19+ B-cell (57.7%), CD3+ (40.4%), and CD4+ (36.5%). After 1 year, all determinations were lower except CD56+CD16+CD3− natural killer. Patient survival was significantly lower in patients with a CD19+ B-cell count < 100 cells/μL at baseline as compared to patients with CD19+ B-cell ≥ 100 cells/μL counts at the end of follow-up (16.5 vs 54%, p = 0.003). By multivariable analysis, age, history of CV disease, Charlson index, a KT/V < 1.2, and a CD19+ B-cell count < 100 cells/μL at baseline and after 1-year were factors associated with of all-cause mortality. A CD19+ B-cell count < 100 cells/μL at baseline was associated with CV mortality. Conclusion CD19+ B-cell lymphopenia is very common among HD patients, and it could be an independent predictor of all-cause and CV mortality. More studies are needed to confirm these findings.
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Affiliation(s)
- María Molina
- Department of Nephrology, Hospital Universitario 12 de Octubre and Research Institute i+12, Madrid, Spain
| | - Luis M Allende
- Department of Immunology, Hospital Universitario 12 de Octubre and Research Institute i+12, Madrid, Spain
| | - Luis E Ramos
- Department of Nephrology, Hospital Universitario 12 de Octubre and Research Institute i+12, Madrid, Spain
| | - Eduardo Gutiérrez
- Department of Nephrology, Hospital Universitario 12 de Octubre and Research Institute i+12, Madrid, Spain
| | - Daniel E Pleguezuelo
- Department of Immunology, Hospital Universitario 12 de Octubre and Research Institute i+12, Madrid, Spain
| | - Eduardo R Hernández
- Department of Nephrology, Hospital Universitario 12 de Octubre and Research Institute i+12, Madrid, Spain
| | - Francisco Ríos
- San Luciano Hemodialysis Unit, Fresenius Medical Care, Madrid, Spain
| | - Cristina Fernández
- Department of Epidemiology and Preventive Medicine, Hospital Universitario Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Manuel Praga
- Department of Nephrology, Hospital Universitario 12 de Octubre and Research Institute i+12, Madrid, Spain.,Department of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Enrique Morales
- Department of Nephrology, Hospital Universitario 12 de Octubre and Research Institute i+12, Madrid, Spain
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Abstract
Background There is evidence for inflammation, autophagy, and apoptosis in the ischemic heart. Autophagy is a physiologic process for tissue survival. Apoptosis, on the other hand, is a mechanism that serves to clear the debris in the setting of tissue injury. The balance between autophagy and apoptosis may be important in cell survival and cardiac function. Methods and Results We examined the interplay of inflammation and myocyte autophagy and apoptosis during the ischemic process. We subjected mice to total left coronary artery ligation and studied these animals for up to 4 weeks. The inflammatory (tumor necrosis factor [TNF]‐α, monocyte chemoattractant protein‐1, interleukin‐6, and interleukin‐1β) and autophagic signals (light chain‐3 and beclin‐1) were strongest during the first week and then began to decline. However, the apoptotic signals peaked at week 2 after left coronary artery ligation, and the elevated levels persisted until the end of the fourth week. To elucidate the role of inflammation in the regulation of myocyte autophagy and apoptosis, we administered TNF‐α inhibitor (CAS1049741‐03‐8, Millipore, Burlington, MA) to the mice daily during the first week of myocardial infarction. Anti‐TNF‐α therapy reduced the levels of inflammatory cytokines and the inflammatory cell infiltration in and around the infarct area. However, cardiac function measured by echocardiography (fractional shortening and ejection fraction) worsened with anti‐TNF‐α therapy. More importantly, application of TNF‐α inhibitor markedly inhibited autophagy and promoted myocyte apoptosis in the border zone. Conclusions These observations suggest that inflammatory response may be protective in the early stage of the myocardial infarction through stimulation of myocyte autophagy. Anti‐inflammatory treatment early after coronary occlusion may have an adverse effect.
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Affiliation(s)
- Xianwei Wang
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang, Henan, China .,Central Arkansas Veterans Healthcare System, Little Rock, AR.,Division of Cardiology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Zhikun Guo
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang, Henan, China
| | - Zufeng Ding
- Central Arkansas Veterans Healthcare System, Little Rock, AR.,Division of Cardiology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Jawahar L Mehta
- Central Arkansas Veterans Healthcare System, Little Rock, AR .,Division of Cardiology, University of Arkansas for Medical Sciences, Little Rock, AR
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Larsen SB, Grove EL, Würtz M, Neergaard-Petersen S, Hvas AM, Kristensen SD. The influence of low-grade inflammation on platelets in patients with stable coronary artery disease. Thromb Haemost 2017; 114:519-29. [DOI: 10.1160/th14-12-1007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 05/07/2015] [Indexed: 12/19/2022]
Abstract
SummaryInflammation is likely to be involved in all stages of atherosclerosis. Numerous inflammatory biomarkers are currently being studied, and even subtle increases in inflammatory biomarkers have been associated with increased risk of cardiovascular events in patients with coronary artery disease (CAD). Low-grade inflammation may influence both platelet production and platelet activation potentially leading to enhanced platelet aggregation. Thrombopoietin is considered the primary regulator of platelet production, but it likely acts in conjunction with numerous cytokines, of which many have altered levels in CAD. Previous studies have shown that high-sensitive C-reactive protein (CRP) independently predicts increased platelet aggregation in stable CAD patients. Increased levels of CRP, fibrinogen, interleukin-6, stromal cell-derived factor-1, CXC motif ligand 16, macrophage migration inhibitory factor, RANTES, calprotectin, and copeptin have been associated with increased risk of cardiovascular events in CAD patients. Additionally, some of these inflammatory markers have been associated with enhanced platelet activation and aggregation. However, CRP and other inflammatory markers provide only limited additional predictive value to classical risk factors such as smoking, blood pressure, and cholesterol levels. Existing data do not clarify whether inflammation simply accompanies CAD and increased production and aggregation of platelets, or whether a causal relationship exists. In this review, we provide a comprehensive overview of inflammatory markers in stable CAD with particular emphasis on platelet production, activation, and aggregation in CAD patients.
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Yang L, Yang Y, Si D, Shi K, Liu D, Meng H, Meng F. High expression of long chain acyl-coenzyme A synthetase 1 in peripheral blood may be a molecular marker for assessing the risk of acute myocardial infarction. Exp Ther Med 2017; 14:4065-4072. [PMID: 29104625 PMCID: PMC5658692 DOI: 10.3892/etm.2017.5091] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 06/22/2017] [Indexed: 01/10/2023] Open
Abstract
The current study aimed to investigate whether the increased expression of long chain acyl-coenzymeA synthetase 1 (ACSL1) in peripheral blood leukocytes (PBL) may be a molecular marker for the genetic evaluation of acute myocardial infarction (AMI). The mechanism of action of ACSL1 in the pathogenesis of AMI was also investigated. A total of 75 patients with AMI and 70 individuals without coronary heart disease were selected to participate in the present study. The demographic and clinical information of the enrolled subjects was recorded. Reverse transcription quantitative polymerase chain reaction and western blot analysis were applied to measure the expression of ACSL1 at the mRNA and protein levels. It was demonstrated that the expression of ACSL1 mRNA and protein in PBL was increased in patients with AMI compared with controls. Logistic regression analysis indicated that ACSL1 expression in PBL was an independent risk factor of AMI. There was a significant positive association between the level of ACSL1 expression and the degree of atherosclerosis in the coronary artery. Furthermore, patients with AMI exhibited an increased risk of atherosclerosis due to increased fasting blood glucose, total cholesterol, triglyceride and lipoprotein levels and decreased high-density lipoprotein levels, compared with controls. Therefore, the current study demonstrated that ACSL1 expression was increased in the PBLs of patients with AMI. The elevated expression of ACSL1 acts an independent risk factor of AMI and may act as a potential biomarker when determining the risk of AMI.
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Affiliation(s)
- Liping Yang
- Department of Cardiology, The China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Yushuang Yang
- Department of Cardiology, The China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Daoyuan Si
- Department of Cardiology, The China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Kaiyao Shi
- Department of Cardiology, The China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Dongna Liu
- Department of Cardiology, The China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Heyu Meng
- Medical College, Yanbian University, Yanji, Jilin 130002, P.R. China
| | - Fanbo Meng
- Department of Cardiology, The China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
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Golimbet VE, Volel BA, Korovaitseva GI, Kasparov SV, Kondratiev NV, Kopylov FY. [Association of inflammatory genes with neuroticism, anxiety and depression in male patients with coronary heart disease]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:74-79. [PMID: 28399100 DOI: 10.17116/jnevro20171173174-79] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIM To explore the relationship of depression and its endophenotypes (neuroticism and trait anxiety) with inflammatory genes in patients with coronary heart disease (CHD). MATERIAL AND METHODS A sample consisted of 78 male CHD patients with depression, 91 CHD patients without depression and 127 healthy men. Polymorphisms of the genes encoding interleukine-4 (IL-4 -589 C/T), interleukine-6 (IL-6 -174 G/C), tumor-necrosis factor alpha (TNF-α -308 G/A) and C-reactive protein (CRP -717A/G) were studied. RESULTS There was the association between the IL-6 -174 G/C and depression comorbid to CHD (р=0.01; OR=2.3 CI 95% 1.2-4.3). The frequency of the 'high expression' allele G in this group was higher compared to controls. The association between IL-4 -589 C/T and CHD was found. Compared to the control group, the frequency of the IL-4 -589CC genotype was higher in patients regardless of whether they had symptoms of depression (р=0.007; OR=2.1 CI 95% 1.2-3.4). No association between the TNF-α -308G/A and the CRP -717A/G with depression in CHD was observed. There were no differences between neuroticism and anxiety scores in patients with different IL-4 -589 C/T, IL-6 -174 G/C, TNF-α -308 G/A, CRP -717A/G genotypes. CONCLUSION The finding of the association between the IL-6 -174G/C and depression, comorbid to CHD, is in line with literature on a role of IL-6 in the development of depression in patients with CHD.
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Affiliation(s)
| | - B A Volel
- Sechenov First Moscow Medical University, Moscow, Russia
| | | | | | | | - F Yu Kopylov
- Sechenov First Moscow Medical University, Moscow, Russia
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Li Y, Zhang Y, Wen M, Zhang J, Zhao X, Zhao Y, Deng J. Ginkgo biloba extract prevents acute myocardial infarction and suppresses the inflammation- and apoptosis-regulating p38 mitogen-activated protein kinases, nuclear factor-κB and B-cell lymphoma 2 signaling pathways. Mol Med Rep 2017; 16:3657-3663. [DOI: 10.3892/mmr.2017.6999] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 04/19/2017] [Indexed: 11/06/2022] Open
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Kawaguchi Y, Nakano M, Yasuda T, Seki S, Suzuki K, Yahara Y, Makino H, Kitajima I, Kimura T. Serum biomarkers in patients with ossification of the posterior longitudinal ligament (OPLL): Inflammation in OPLL. PLoS One 2017; 12:e0174881. [PMID: 28467440 PMCID: PMC5414934 DOI: 10.1371/journal.pone.0174881] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 03/16/2017] [Indexed: 12/12/2022] Open
Abstract
Backgroud Ossification of the posterior longitudinal ligament (OPLL) is characterized by replacement of ligamentous tissue by ectopic new bone formation. OPLL causes narrowing of the spinal canal, resulting in neurological impairment. However, the pathogenesis of OPLL has not been fully elucidated. We investigated whether inflammation occurs in OPLL or not using high-sensitivity CRP (hs-CRP) in a case-control study. Methods and findings This study included 103 patients with OPLL in the patient group and 95 age- and sex-matched volunteers with degenerative spinal disease in the control group. Of the 103 OPLL patients, 88 patients who were available for more than 2 years follow-up were checked for OPLL progression. A blood sample was obtained and Hs-CRP, and other routine data, including total protein (TP), albumin (ALB), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), glucose (Glu), calcium (Ca), inorganic phosphate (Pi), white blood cell count (WBC), hemoglobin (Hb) and platelet (PLT), were analyzed. The data were compared between the patients with OPLL and the controls. The severity of the ossified lesions in the whole spine were evaluated by the ossification index (OS index) in patients with OPLL. The data were also compared between the patients with OPLL progression (the progression group) and the patients without OPLL progression (the non-progression group). In the results, the mean hs-CRP in the OPLL group was higher than that in the controls. The Pi in the OPLL group was lower than that in the control group. A negative correlation was found between the Pi and the OS index. The mean hs-CRP in the progression group was higher than that in the non-progression group. There was a positive correlation between the average length of the OPLL progression per year and the hs-CRP. Conclusions The results may suggest the occurrence of local inflammation in OPLL and the inflammation might cause OPLL progression. These facts are important for understanding the pathology of OPLL.
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Affiliation(s)
- Yoshiharu Kawaguchi
- Department of Orthopaedic Surgery, University of Toyama, Toyama, Japan
- * E-mail:
| | - Masato Nakano
- Department of Orthopaedic Surgery, University of Toyama, Toyama, Japan
| | - Taketoshi Yasuda
- Department of Orthopaedic Surgery, University of Toyama, Toyama, Japan
| | - Shoji Seki
- Department of Orthopaedic Surgery, University of Toyama, Toyama, Japan
| | - Kayo Suzuki
- Department of Orthopaedic Surgery, University of Toyama, Toyama, Japan
| | - Yasuhito Yahara
- Department of Orthopaedic Surgery, University of Toyama, Toyama, Japan
| | - Hiroto Makino
- Department of Orthopaedic Surgery, University of Toyama, Toyama, Japan
| | - Isao Kitajima
- Department of Clinical Laboratory Medicine, University of Toyama, Toyama, Japan
| | - Tomoatsu Kimura
- Department of Orthopaedic Surgery, University of Toyama, Toyama, Japan
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Moreira DM, Lueneberg ME, da Silva RL, Fattah T, Gottschall CAM. MethotrexaTE THerapy in ST-Segment Elevation MYocardial InfarctionS. J Cardiovasc Pharmacol Ther 2017; 22:538-545. [DOI: 10.1177/1074248417699884] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: Methotrexate is an anti-inflammatory drug that has been shown to have anti-ischemic effects. Our aim was to evaluate if methotrexate could reduce infarct size in patients with ST-segment elevation myocardial infarction (STEMI). Methods: We randomly assigned patients with STEMI to receive either methotrexate or placebo. Primary outcome was infarct size determined by calculating the area under the curve (AUC) for creatine kinase (CK) release. Secondary outcomes were AUC of CK MB (CK-MB) and AUC of troponin I; peak CK, peak CK-MB, and troponin I; B-type natriuretic peptide (BNP) level, high-sensitivity C-reactive protein (hsCRP) result, and erythrocyte sedimentation rate (ESR); left ventricular ejection fraction (LVEF); thrombolysis in myocardial infarction (TIMI) frame count; Killip score; mortality and reinfarction incidence; and incidence of adverse reactions. Results: We included 84 patients. Median AUC of CK was 78 861.0 in the methotrexate group and 68 088.0 in the placebo group ( P = .10). Patients given methotrexate and placebo exhibited, respectively, median AUC for CK-MB of 9803.4 and 8037.0 ( P = .42); median AUC for troponin of 3691.1 and 2132.6 ( P = .09); peak CK of 2806.0 and 2147.0 ( P = .05); peak CK-MB of 516.0 and 462.3 ( P = .25); and peak troponin of 121.0 and 85.1 ( P = .06). At 3 months, LVEF was lower in patients who received methotrexate (49.0% ± 14.1%) than in patients given placebo (56.4% ± 10.0%; P = .01). There were no differences in hsCRP, ESR, BNP, Killip scores, TIMI frame count, reinfarction, and mortality rates. There was a higher median serum glutamic–pyruvic transaminase levels in the methotrexate group. Conclusion: Methotrexate did not reduce infarction size and worsened LVEF at 3 months ( Clinicaltrials.gov identifier NCT01741558).
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Affiliation(s)
- Daniel Medeiros Moreira
- Instituto de Cardiologia de Santa Catarina, São José, Santa Catarina, Brazil
- Instituto de Cardiologia do Rio Grande do Sul—FUC, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | - Tammuz Fattah
- Instituto de Cardiologia de Santa Catarina, São José, Santa Catarina, Brazil
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Cholesterol crystals enhance TLR2- and TLR4-mediated pro-inflammatory cytokine responses of monocytes to the proatherogenic oral bacterium Porphyromonas gingivalis. PLoS One 2017; 12:e0172773. [PMID: 28235036 PMCID: PMC5325525 DOI: 10.1371/journal.pone.0172773] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 02/09/2017] [Indexed: 12/30/2022] Open
Abstract
Cholesterol deposits and pro-inflammatory cytokines play an essential role in the pathogenesis of atherosclerosis, a predominant cause of cardiovascular disease (CVD). Epidemiological evidence has linked periodontal disease (PD) with atherosclerotic CVD. Accordingly, viable periodontal pathogens, including Porphyromonas gingivalis, have been found in atherosclerotic plaques in humans and mice. We aimed to determine whether cholesterol crystals (CHCs) and oral bacteria synergize in the stimulation of human monocytes. Incubation of human monocytes with CHCs induced secretion of interleukin (IL)-1β, tumor necrosis factor (TNF)-α, IL-6, and IL-8. Moreover, CHCs markedly enhanced secretion of IL-1β by monocytes stimulated with the toll-like receptor (TLR) 4 agonist Escherichia coli lipopolysaccharide (LPS), and the TLR2 agonist Staphylococcus aureus lipoteichoic acid. Notably, CHCs also enhanced IL-1β secretion induced by P. gingivalis LPS and IL-1β secretion induced by whole P. gingivalis bacteria. This enhancement was abrogated by the NLRP3 inflammasome inhibitors Z-YVAD-FMK and glibenclamide. CHCs had no effect on cytokine production induced by P. gingivalis gingipains. Taken together, our findings support that CHCs, via stimulation of NLRP3 inflammasomes, act in synergy with the periodontal pathogen P. gingivalis to promote monocyte secretion of pro-atherogenic cytokines.
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Kizilay Mancini Ö, Lora M, Shum-Tim D, Nadeau S, Rodier F, Colmegna I. A Proinflammatory Secretome Mediates the Impaired Immunopotency of Human Mesenchymal Stromal Cells in Elderly Patients with Atherosclerosis. Stem Cells Transl Med 2017; 6:1132-1140. [PMID: 28194905 PMCID: PMC5442842 DOI: 10.1002/sctm.16-0221] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 10/08/2016] [Accepted: 11/07/2016] [Indexed: 12/29/2022] Open
Abstract
Inflammation plays a pivotal role in the initiation and progression of atherosclerosis (ATH). Due to their potent immunomodulatory properties, mesenchymal stromal cells (MSCs) are evaluated as therapeutic tools in ATH and other chronic inflammatory disorders. Aging reduces MSCs immunopotency potentially limiting their therapeutic utility. The mechanisms that mediate the effect of age on MSCs immune-regulatory function remain elusive and are the focus of this study. Human adipose tissue-derived MSCs were isolated from patients undergoing coronary artery bypass graft surgery. MSCs:CD4+ T-cell suppression, a readout of MSCs' immunopotency, was assessed in allogeneic coculture systems. MSCs from elderly subjects were found to exhibit a diminished capacity to suppress the proliferation of activated T cells. Soluble factors and, to a lesser extent, direct cell-cell contact mechanisms mediated the MSCs:T-cell suppression. Elderly MSCs exhibited a pro-inflammatory secretome with increased levels of interleukin-6 (IL-6), IL-8/CXCL8, and monocyte chemoattractant protein-1 (MCP-1/CCL2). Neutralization of these factors enhanced the immunomodulatory function of elderly MSCs. In summary, our data reveal that in contrast to young MSCs, MSCs from elderly individuals with ATH secrete high levels of IL-6, IL-8/CXCL8 and MCP-1/CCL2 which mediate their reduced immunopotency. Consequently, strategies aimed at targeting pro-inflammatory cytokines/chemokines produced by MSCs could enhance the efficacy of autologous cell-based therapies in the elderly. Stem Cells Translational Medicine 2017;6:1132-1140.
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Affiliation(s)
- Özge Kizilay Mancini
- Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada.,Division of Rheumatology, McGill University, Montreal, Quebec, Canada
| | - Maximilien Lora
- Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada.,Division of Rheumatology, McGill University, Montreal, Quebec, Canada
| | - Dominique Shum-Tim
- Divisions of Cardiac Surgery and Surgical Research, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Stephanie Nadeau
- CRCHUM and Institut du cancer de Montréal, Montreal, Quebec, Canada.,Department of Radiology, Radio-Oncology and Nuclear Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Francis Rodier
- CRCHUM and Institut du cancer de Montréal, Montreal, Quebec, Canada.,Department of Radiology, Radio-Oncology and Nuclear Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Inés Colmegna
- Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada.,Division of Rheumatology, McGill University, Montreal, Quebec, Canada
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Luo JY, Li XM, Zhou Y, Zhao Q, Chen BD, Liu F, Chen XC, Zheng H, Ma YT, Gao XM, Yang YN. Mutant DD genotype of NFKB1 gene is associated with the susceptibility and severity of coronary artery disease. J Mol Cell Cardiol 2017; 103:56-64. [PMID: 28088561 DOI: 10.1016/j.yjmcc.2017.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 12/22/2016] [Accepted: 01/10/2017] [Indexed: 12/18/2022]
Abstract
Nuclear factor κappa B (NF-κB) is an important transcription factor in the development and progression of coronary artery disease (CAD). Recent evidence suggests that -94 ATTG ins/del mutant in the promoter of NFKB1 gene is an essential functional mutant. The present study demonstrated the frequencies of the del/del (DD) genotype and del (D) allele were significantly higher in CAD patients than in controls. CAD patients carrying mutant DD genotype had worse stenosis of diseased coronary arteries compared to those carrying ins/ins (II) or ins/del (ID) genotype. Plasma levels of endothelial nitric oxide synthase (eNOS) were lower, while inflammatory cytokine incnterlukin-6 (IL-6) was higher in CAD patients with DD genotype than those with II or ID genotype (both P<0.05). In vitro study showed that mutant human umbilical vein endothelial cells (DD genotype HUVECs) were more susceptible to H2O2-induced apoptosis, which was accompanied with a decreased Bcl-2 expression. Further, mutant HUVECs had lower eNOS but higher IL-6 mRNA levels and decreased phosphorylation of eNOS under H2O2-stimulation (both P<0.05). Compared to wild type cells (II genotype), significantly downregulated protein expression of total NF-κB p50 subunit were observed in mutant HUVECs with or without oxidative stress, and a lower expression of unclear p50 was associated with a decreased p50 nuclear translocation in mutant HUVECs versus wild type cells under H2O2-stimulation (both P<0.05). In conclusion, mutant DD genotype of NFKB1 gene is associated with the risk and severity of CAD. Dwonregulation of NF-κB p50 subunit leads to exacerbated endothelial dysfunction and apoptosis and enhanced inflammatory response that is the potential underlying mechanism.
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Affiliation(s)
- Jun-Yi Luo
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Xiao-Mei Li
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yun Zhou
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Qiang Zhao
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Bang-Dang Chen
- Xinjiang Key Laboratory of Cardiovascular Research, Urumqi, Xinjiang, China
| | - Fen Liu
- Xinjiang Key Laboratory of Cardiovascular Research, Urumqi, Xinjiang, China
| | - Xiao-Cui Chen
- Xinjiang Key Laboratory of Cardiovascular Research, Urumqi, Xinjiang, China
| | - Hong Zheng
- Department of Anaesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yi-Tong Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
| | - Xiao-Ming Gao
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia; Xinjiang Key Laboratory of Medical Animal Model Research, Urumqi, Xinjiang, China; Department of Surgery, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
| | - Yi-Ning Yang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
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Riis JL, Vestergaard C, Hjuler KF, Iversen L, Jakobsen L, Deleuran MS, Olsen M. Hospital-diagnosed atopic dermatitis and long-term risk of myocardial infarction: a population-based follow-up study. BMJ Open 2016; 6:e011870. [PMID: 27836869 PMCID: PMC5129053 DOI: 10.1136/bmjopen-2016-011870] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Atopic dermatitis (AD) is an inflammatory skin disorder with a childhood prevalence reaching 20%. An estimated 50% of patients have a life-long chronic course. The purpose of this study was to estimate the risk of first-time myocardial infarction (MI) in patients with AD compared with a general population cohort. DESIGN Cohort study. SETTING Denmark. PARTICIPANTS Using population-based medical registries, we identified individuals born in Denmark from 1947 to 1983 with at least two hospital-diagnoses of AD following inpatient admissions or hospital-based outpatient visits at any age from 1977 to 2013. Individuals with AD were matched with general population controls (10:1) for birth-year and gender. Unique personal identifiers permitted unambiguous data linkage. PRIMARY OUTCOME MEASURES Follow-up began on the date of AD diagnosis (index date for general population controls) and continued until death, emigration, MI or the year 2013. We computed the 15-year-cumulative incidence of MI following a diagnosis of AD. Comparing patients with AD with the general population cohort, we computed HRs of MI presented with 95% CIs and adjusted for history of diabetes mellitus, hypertension, hyperlipidaemia or stroke, educational level, birth-year and sex. RESULTS We identified 4814 patients diagnosed with AD. The cumulative incidence of MI was 0.6% for patients with AD and 0.4% for their matched controls. The corresponding adjusted HR was 1.74 (1.21 to 2.49). The HR for patients who were not in need of systemic treatment was 1.58 (1.02 to 2.45) and it was 2.40 (1.27 to 4.45) for those who were treated with azathioprine, methotrexate or cyclosporine. CONCLUSIONS Hospital-diagnosed AD was associated with increased risk of MI compared with the general population.
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Affiliation(s)
| | | | | | - Lars Iversen
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Lars Jakobsen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Mette S Deleuran
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Morten Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
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Cardoso CRL, Leite NC, Salles GF. Prognostic Importance of C-Reactive Protein in High Cardiovascular Risk Patients With Type 2 Diabetes Mellitus: The Rio de Janeiro Type 2 Diabetes Cohort Study. J Am Heart Assoc 2016; 5:JAHA.116.004554. [PMID: 27912211 PMCID: PMC5210335 DOI: 10.1161/jaha.116.004554] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background The prognostic value of C‐reactive protein (CRP) is controversial in type 2 diabetes mellitus. We aimed to assess it in a cohort of high cardiovascular risk diabetic patients. Methods and Results CRP was measured at baseline and during the second year of follow‐up in 616 patients. The primary end points were a composite of total fatal and nonfatal cardiovascular events (CVEs), major CVEs, and all‐cause and cardiovascular mortalities. Association between baseline and second‐year CRP with end points were evaluated by multivariable Cox survival analyses. Baseline median CRP was 2.8 mg/L (interquartile range: 1.2–6.0 mg/L), and 47.8% of the patients either increased or persisted with high CRP levels during the first 2 years of follow‐up. After a median follow‐up of 8.4 years, 131 total CVEs occurred (89 major CVEs), and 129 patients died (53 of cardiovascular causes). Baseline and second‐year CRP, analyzed as a continuous variable and dichotomized at >3.0 mg/L, were significantly associated with total and major CVEs occurrence (with adjusted hazard ratios between 1.22 and 1.34 for increments of 1‐SD log of continuous CRP, and between 1.47 and 1.89 for dichotomized CRP), but not with mortality. Additionally, increasing CRP levels or persisting with high levels were associated with a 1.84 (95% CI: 1.10–3.06) excess risk of major CVEs, independent of baseline CRP values. Conclusions Baseline and serial changes in CRP levels provide cardiovascular risk prediction independent of standard risk factors and glycemic control, and may be useful to refine cardiovascular risk stratification in high‐risk patients with type 2 diabetes mellitus.
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Affiliation(s)
- Claudia R L Cardoso
- Department of Internal Medicine, University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Brazil
| | - Nathalie C Leite
- Department of Internal Medicine, University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Brazil
| | - Gil F Salles
- Department of Internal Medicine, University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Brazil
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Turak O, Afsar B, Siriopol D, Yayla C, Oksuz F, Cagli K, Burlacu A, Covic A, Kanbay M. Severity of coronary artery disease is an independent risk factor for decline in kidney function. Eur J Intern Med 2016; 33:93-7. [PMID: 27406080 DOI: 10.1016/j.ejim.2016.06.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 06/10/2016] [Accepted: 06/27/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIM Chronic kidney disease (CKD) and cardiovascular disease are closely interrelated and the presence of one condition synergistically affects the prognosis of the other, in a negative manner. There are surprisingly very few data on the relationship between baseline coronary artery disease (CAD) severity and subsequent decline in kidney function. We aimed to evaluate for the first time whether baseline coronary artery lesion severity predicts the decline in kidney function. MATERIALS AND METHODS The study population was derived from a series of consecutive patients presenting with stable angina pectoris or angina equivalents, who underwent coronary angiography. SYNTAX score for each patient was calculated to define severity of CAD. Change in kidney function was defined by calculating the rates of change in eGFR. RESULTS Among the 823 patients included in our study, the mean age was 59.2±10.7years, 78.4% were males, and 32% had diabetes. The mean baseline eGFR was 87.3±24.9ml/min/1.73m(2) and the median Syntax score was 14 (IQR=10-20). The median length of follow-up was 2.75years (IQR=2.42-3.50). The mean yearly change for eGFR in the entire study population was 4.06 (95% CI: 3.59-4.51)ml/min/1.73m(2). A higher Syntax score was associated with a significantly faster decline in eGFR in all (unadjusted and adjusted) models. During the follow-up, 103 patients developed CKD. A higher Syntax score, analyzed both as continuous and categorical variable, was associated with incident CKD in all models. CONCLUSION We have demonstrated for the first time that severity of CAD is an independent risk factor for the decline in kidney function. Studies are needed to highlight the potential mechanisms regarding the association between severity of CAD and decline in kidney function.
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Affiliation(s)
- Osman Turak
- Department of Cardiology, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Baris Afsar
- Department of Medicine, Division of Nephrology, Konya Numune State Hospital, Konya, Turkey
| | - Dimitrie Siriopol
- Nephrology Clinic, Dialysis and Renal Transplant Center, 'C.I. PARHON' University Hospital, and 'Grigore T. Popa' University of Medicine, Iasi, Romania
| | - Cagri Yayla
- Department of Cardiology, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Fatih Oksuz
- Department of Cardiology, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Kumral Cagli
- Department of Cardiology, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Alexandru Burlacu
- Department of Cardiology, 'C.I. PARHON' University Hospital, and 'Grigore T. Popa' University of Medicine, Iasi, Romania
| | - Adrian Covic
- Nephrology Clinic, Dialysis and Renal Transplant Center, 'C.I. PARHON' University Hospital, and 'Grigore T. Popa' University of Medicine, Iasi, Romania
| | - Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey.
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Li JF, Peng DY, Ling M, Yin Y. Evaluation of Adenosine Triphosphate-Binding Cassette Transporter A1 (ABCA1) R219K and C-Reactive Protein Gene (CRP) +1059G/C Gene Polymorphisms in Susceptibility to Coronary Heart Disease. Med Sci Monit 2016; 22:2999-3008. [PMID: 27560308 PMCID: PMC5003147 DOI: 10.12659/msm.897104] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background This meta-analysis investigated the correlation of ABCA1 R219K and CRP +1059G/C gene polymorphisms with susceptibility to coronary heart disease (CHD). Material/Methods We searched PubMed, Springer link, Wiley, EBSCO, Ovid, Wanfang database, VIP database, and China National Knowledge Infrastructure (CNKI) databases to retrieve published studies by keyword. Searches were filtered using our stringent inclusion and exclusion criteria. Resultant high-quality data collected from the final selected studies were analyzed using Comprehensive Meta-analysis 2.0 software. Eleven case-control studies involving 3053 CHD patients and 3403 healthy controls met our inclusion criteria. Seven studies were conducted in Asian populations, 3 studies were done in Caucasian populations, and 1 was in an African population. Results Our major finding was that ABCA1 R219K polymorphism increased susceptibility to CHD in allele model (OR=0.729, 95% CI=0.559~0.949, P=0.019) and dominant model (OR=0.698, 95% CI=0.507~0.961, P=0.027). By contrast, we were unable to find any significant association between the CRP +1059G/C polymorphism and susceptibility to CHD (allele model: OR=1.170, 95% CI=0.782~1.751, P=0.444; dominant model: OR=1.175, 95% CI=0.768~1.797, P=0.457). Conclusions This meta-analysis provides convincing evidence that polymorphism of ABCA1 R219K is associated with susceptibility to CHD while the CRP +1059G/C polymorphism appears to have no correlation with susceptibility to CHD.
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Affiliation(s)
- Jing-Fang Li
- Department of Cardiology, Linyi People's Hospital, Linyi, Shandong, China (mainland)
| | - Dian-Ying Peng
- Department of General Surgery, People's Hospital of Pingyi County, Linyi, Shandong, China (mainland)
| | - Mei Ling
- Department of Ophthalmology, People's Hospital of Pingyi County, Linyi, Shandong, China (mainland)
| | - Yong Yin
- Department of Internal Neurology, Second Ward, People's Hospital of Pingyi County, Linyi, Shandong, China (mainland)
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Zhang D, Zhang Y, Zhao C, Zhang W, Shao G, Zhang H. Effect of lysophosphatidic acid on the immune inflammatory response and the connexin 43 protein in myocardial infarction. Exp Ther Med 2016; 11:1617-1624. [PMID: 27168781 DOI: 10.3892/etm.2016.3132] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 02/09/2016] [Indexed: 12/16/2022] Open
Abstract
Lysophosphatidic acid (LPA) is an intermediate product of membrane phospholipid metabolism. Recently, LPA has gained attention for its involvement in the pathological processes of certain cardiovascular diseases. The aim of the present study was to clarify the association between the effect of LPA and the immune inflammatory response, and to investigate the effects of LPA on the protein expression levels of connexin 43 during myocardial infarction. Surface electrocardiograms of myocardial infarction rats and isolated rat heart tissue samples were obtained in order to determine the effect of LPA on the incidence of arrhythmia in rats that exhibited changes in immune status. The results demonstrated that the incidence of arrhythmia decreased when the rat immune systems were suppressed, and the incidence of arrhythmia increased when the rat immune systems were enhanced. The concentration levels of tumor necrosis factor (TNF)-α were determined by ELISA, and the results demonstrated that LPA induced T lymphocyte synthesis and TNF-α release. Using a patch-clamp technique, LPA was shown to increase the current amplitude of the voltage-dependent potassium channels (Kv) and calcium-activated potassium channels (KCa) in Jurkat T cells. The protein expression of connexin 43 (Cx43) was determined by immunohistochemical staining. The results indicated that LPA caused the degradation of Cx43 and decreased the expression of Cx43. This effect was associated with the immune status of the rats. There was a further decrease in Cx43 expression in the rats of the immune-enhanced group. To the best of our knowledge, these results provide the first evidence that LPA causes arrhythmia through the regulation of immune inflammatory cells and the decrease of Cx43 protein expression. The present study provided an experimental basis for the treatment of arrhythmia and may guide clinical care.
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Affiliation(s)
- Duoduo Zhang
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China; Department of Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Yan Zhang
- Department of Anesthesiology, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Chunyan Zhao
- Department of Physiology, Norman Bethune College of Medicine, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Wenjie Zhang
- Department of Physiology, Norman Bethune College of Medicine, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Guoguang Shao
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Hong Zhang
- Department of Physiology, Norman Bethune College of Medicine, Jilin University, Changchun, Jilin 130021, P.R. China
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Roth L, Rombouts M, Schrijvers DM, Martinet W, De Meyer GRY. Cholesterol-independent effects of atorvastatin prevent cardiovascular morbidity and mortality in a mouse model of atherosclerotic plaque rupture. Vascul Pharmacol 2016; 80:50-8. [PMID: 26826559 DOI: 10.1016/j.vph.2016.01.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 01/09/2016] [Accepted: 01/21/2016] [Indexed: 01/11/2023]
Abstract
Because cholesterol-independent effects of statins are difficult to determine in patients, we studied these pleiotropic effects in apolipoprotein E-deficient (ApoE(-/-)) mice with a mutation in the fibrillin-1 gene (Fbn1(C1039G+/-)). These mice develop exacerbated atherosclerosis and spontaneous plaque ruptures, accompanied by myocardial infarctions (MI) and sudden death. ApoE(-/-)Fbn1(C1039G+/-) mice were fed a Western diet (WD). At week 10 of WD, mice were divided in a control (WD), atorvastatin (10mg/kg/day + WD) and cholesterol withdrawal group (cholW, normal chow). The latter was included to compare the effects of atorvastatin with dietary lipid lowering. Fifteen weeks later, the mice were sacrificed. CholW, but not atorvastatin, reduced plasma cholesterol. Survival increased from 50% to 90% both in cholW and atorvastatin treated mice. CholW as well as atorvastatin treatment increased plaque collagen and fibrous cap thickness, but they did not affect the amount of plaque macrophages and T cells. MMP-2 and MMP-9 activity was significantly lower and the expression of MMP-12, TNF-α and IL-1β was strongly reduced in both treatment groups. Blood monocytes and neutrophils returned to baseline levels (ApoE(-/-) mice before the onset of atherosclerosis). Importantly, atorvastatin but not cholW significantly reduced coronary stenosis (from 50 to 28%) and the occurrence of MI (from 43 to 10%). In conclusion, independent of cholesterol lowering, atorvastatin significantly reduced mortality, plaque vulnerability and inflammation to the same extent as cholW. In addition, atorvastatin but not cholW reduced coronary stenosis and the occurrence of MI. These data unequivocally illustrate the significance of the pleiotropic effects of atorvastatin in the prevention of cardiovascular morbidity and mortality.
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Affiliation(s)
- Lynn Roth
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium.
| | - Miche Rombouts
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
| | | | - Wim Martinet
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
| | - Guido R Y De Meyer
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
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76
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Luo JY, Xu R, Li XM, Zhou Y, Zhao Q, Liu F, Chen BD, Ma YT, Gao XM, Yang YN. MIF Gene Polymorphism rs755622 Is Associated With Coronary Artery Disease and Severity of Coronary Lesions in a Chinese Kazakh Population: A Case-Control Study. Medicine (Baltimore) 2016; 95:e2617. [PMID: 26825917 PMCID: PMC5291587 DOI: 10.1097/md.0000000000002617] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Inflammation plays an important role in the pathogenesis of atherosclerosis. Recent studies indicate that macrophage migration inhibitory factor (MIF) is a potent proinflammatory cytokine which mediates the inflammatory process during atherosclerosis. The polymorphism of MIF gene (rs755622 [-173G/C], rs1007888, and rs2096525) were genotyped by TaqMan single nucleotide polymorphism (SNP) genotyping assay in 320 patients with coronary artery disease (CAD) and 603 controls in a Chinese Kazakh population. Coronary angiography was performed on all CAD patients and Gensini score was used to assess the severity of coronary artery lesions. The frequency of the CC genotype and C allele of rs755622 were significantly higher in CAD patients than that in control subjects (8.4% vs. 5.1%, P < 0.001, 30.3% vs. 22.1%, P < 0.001, respectively). Multivariate logistic regression analysis showed that individuals with CC genotype or C allele had a higher risk for CAD (CC genotype vs. GG genotype, OR = 2.224, 95% CI, 1.239-3.992, P = 0.007, and C allele vs. G allele, OR = 1.473, 95% CI, 1.156-1.876, P = 0.002, respectively). Moreover, CAD patients with rs755622 C allele (CC + CG genotype) have higher levels of Gensini score when compared to C allele noncarriers (32.74 ± 26.66 vs. 21.44 ± 19.40, P < 0.001, adjusted). Our results suggested that the CC genotype and C allele of MIF rs755622 SNP may be a genetic marker for the risk of CAD and potentially predict the severity of CAD in Chinese Kazakh population.
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Affiliation(s)
- Jun-Yi Luo
- From the Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China (J-YL, X-ML, YZ, QZ, Y-TM, Y-NY); Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, Xinjiang, China (J-YL, X-ML, FL, B-DC, Y-TM, X-MG, Y-NY); Department of Cadres Health, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China (RX); Clinical Medical Research Institute, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China (X-MG); Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (X-MG); and Department of Surgery, Central Clinical School, Monash University, Melbourne, Victoria, Australia (X-MG)
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77
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Zyryanov SK, Ushkalova EA. [Enoxaparin is a low-molecular-weight heparin with a complex chemical structure and various non-anticoagulant properties]. TERAPEVT ARKH 2016. [PMID: 28635885 DOI: 10.17116/terarkh20168812109-115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The paper discusses the non-anticoagulant properties of unfractionated heparin and enoxaparin and their relation to their chemical structures. It is emphasized that enoxaparin has multiple, often interrelated, non-anticoagulant effects that can complement its antithrombotic activity and enhance the efficiency of therapy in patients receiving the drug for various indications. The realization of these effects requires the complex structure with the standard distribution of molecular weight (Mw) (average Mw, about 4500 Da, as well as Mw of less than 2000 Da (<20%), 2000 to 8000 Da (>68%), and more than 8000 Da (<18%), and with the standard content of 1.6-anhidro rings (15-25%), which is determined by the source of raw materials and by the production technology of the original drug and cannot be fully reproduced when designing its bioanalogues.
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Affiliation(s)
- S K Zyryanov
- Peoples' Friendship University of Russia, Moscow, Russia
| | - E A Ushkalova
- Peoples' Friendship University of Russia, Moscow, Russia
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78
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van Zuylen VL, den Haan MC, Geutskens SB, Roelofs H, Fibbe WE, Schalij MJ, Atsma DE. Post-myocardial infarct inflammation and the potential role of cell therapy. Cardiovasc Drugs Ther 2015; 29:59-73. [PMID: 25583678 DOI: 10.1007/s10557-014-6568-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Myocardial infarction triggers reparative inflammatory processes programmed to repair damaged tissue. However, often additional injury to the myocardium occurs through the course of this inflammatory process, which ultimately can lead to heart failure. The potential beneficial effects of cell therapy in treating cardiac ischemic disease, the number one cause of death worldwide, are being studied extensively, both in clinical trials using adult stem cells as well as in fundamental research on cardiac stem cells and regenerative biology. This review summarizes the current knowledge on molecular and cellular processes implicated in post-infarction inflammation and discusses the potential beneficial role cell therapy might play in this process. Due to its immunomodulatory properties, the mesenchymal stromal cell is a candidate to reverse the disease progression of the infarcted heart towards heart failure, and therefore is emphasized in this review.
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Affiliation(s)
- Vanessa-leigh van Zuylen
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, The Netherlands
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79
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Zhang P, Zhu D, Chen X, Li Y, Li N, Gao Q, Li L, Zhou X, Lv J, Sun M, Mao C, Xu Z. Prenatal hypoxia promotes atherosclerosis via vascular inflammation in the offspring rats. Atherosclerosis 2015; 245:28-34. [PMID: 26691907 DOI: 10.1016/j.atherosclerosis.2015.11.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/06/2015] [Accepted: 11/24/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Hypoxia is a critical contributor to increased risks of cardiovascular diseases, including atherosclerosis, but the detailed mechanism that hypoxia leads to atherosclerosis remains unknown. METHODS Pregnant rats were treated with hypoxia (10.5% oxygen) during pregnancy, and HUVEC cells treated with 1% of oxygen. Blood lipids were tested at fetal stage and adult stage of offspring rats; the level of pro-inflammatory cytokines of HUVEC and offspring rats were investigated, and HIF-1α and NFκB mRNA level were also measured by Q-PCR and Elisa. RESULTS We found that TC, LDL-C, ox-LDL-C, and the receptors of ox-LDL-C (lox-1) of the adult offspring were significantly higher than that of the control, while HDL-C was significantly reduced in hypoxia group. The internal elastic lamina was blocked by smooth muscle cells; and the migration of smooth muscle cells into the intima were observed in hypoxia offspring. Luciferase reporter gene experiment showed that HIF-1α activated NFκB transcription at four discrete binding sites of NFκBp65 promoter, although there was no obvious difference among the four discrete binding sites. Using transfection of pCDNA3.1-HIF-1α on HUVEC cells, HIF-1α significantly activated NFκB transcription at hypoxic conditions (1% O2), and concurrent with increased expression of IL-1β and TNF-α. CONCLUSION Hypoxia during pregnancy activated NFκB transcription to induce pro-inflammatory cytokines, leading to the early stage of atherosclerosis.
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Affiliation(s)
- Pengjie Zhang
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China
| | - Di Zhu
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China
| | - Xionghui Chen
- Emergency Department, First Hospital of Soochow University, Suzhou, China
| | - Yongmei Li
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China
| | - Na Li
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China
| | - Qinqin Gao
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China
| | - Lingjun Li
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China
| | - Xiuwen Zhou
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China
| | - Juanxiu Lv
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China
| | - Miao Sun
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China
| | - Caiping Mao
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China
| | - Zhice Xu
- Institute for Fetology, First Hospital of Soochow University, Suzhou, China; Center for Prenatal Biology, Loma Linda University, CA, USA.
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80
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Assar ME, Angulo J, Rodríguez-Mañas L. Diabetes and ageing-induced vascular inflammation. J Physiol 2015; 594:2125-46. [PMID: 26435167 DOI: 10.1113/jp270841] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 09/28/2015] [Indexed: 12/16/2022] Open
Abstract
Diabetes and the ageing process independently increase the risk for cardiovascular disease (CVD). Since incidence of diabetes increases as people get older, the diabetic older adults represent the largest population of diabetic subjects. This group of patients would potentially be threatened by the development of CVD related to both ageing and diabetes. The relationship between CVD, ageing and diabetes is explained by the negative impact of these conditions on vascular function. Functional and clinical evidence supports the role of vascular inflammation induced by the ageing process and by diabetes in vascular impairment and CVD. Inflammatory mechanisms in both aged and diabetic vasculature include pro-inflammatory cytokines, vascular hyperactivation of nuclear factor-кB, increased expression of cyclooxygenase and inducible nitric oxide synthase, imbalanced expression of pro/anti-inflammatory microRNAs, and dysfunctional stress-response systems (sirtuins, Nrf2). In contrast, there are scarce data regarding the interaction of these mechanisms when ageing and diabetes co-exist and its impact on vascular function. Older diabetic animals and humans display higher vascular impairment and CVD risk than those either aged or diabetic, suggesting that chronic low-grade inflammation in ageing creates a vascular environment favouring the mechanisms of vascular damage driven by diabetes. Further research is needed to determine the specific inflammatory mechanisms responsible for exacerbated vascular impairment in older diabetic subjects in order to design effective therapeutic interventions to minimize the impact of vascular inflammation. This would help to prevent or delay CVD and the specific clinical manifestations (cognitive decline, frailty and disability) promoted by diabetes-induced vascular impairment in the elderly.
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Affiliation(s)
- Mariam El Assar
- Instituto de Investigación Sanitaria del Hospital Universitario de Getafe, Getafe, Spain
| | - Javier Angulo
- Instituto Ramón y Cajal de Investigación Sanitaria, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Leocadio Rodríguez-Mañas
- Instituto de Investigación Sanitaria del Hospital Universitario de Getafe, Getafe, Spain.,Servicio de Geriatría, Hospital Universitario de Getafe, Getafe, Spain
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Zhu M, Lei L, Zhu Z, Li Q, Guo D, Xu J, Chen J, Sha H, Zhang X, Yang X, Song B, Li B, Yan Y, Xiong Y. Excess TNF-α in the blood activates monocytes with the potential to directly form cholesteryl ester-laden cells. Acta Biochim Biophys Sin (Shanghai) 2015; 47:899-907. [PMID: 26373842 DOI: 10.1093/abbs/gmv092] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 07/27/2015] [Indexed: 01/26/2023] Open
Abstract
The tumor necrosis factor-α (TNF-α) and monocytic cells play a critical role in the development of atherosclerosis, which is the major cause of coronary heart disease (CHD). In this work, we investigated the effect of excess TNF-α on monocytes in the blood and found that blood monocytes from the CHD patients had the potential to directly form cholesteryl ester (CE)-laden cells under the in vitro incubation with oxLDL. The plasma levels of proinflammatory cytokines, such as TNF-α, interleukin 6 (IL-6), and C reactive protein (CRP), in the CHD patients were significantly higher than those in the control healthy volunteers. However, only the plasma level of TNF-α, but not of IL-6 or CRP, is positively correlated with the potential of blood monocytes to directly form CE-laden cells. By using human blood monocytes and monocytic THP-1 cells, the activating effect of TNF-α on the formation of the CE-laden cells was demonstrated, which could be specifically blocked by the anti-TNF-α antibody. Furthermore, it was also revealed that TNF-α could boost adhesion and oxLDL uptake of the monocytes by enhancing the expression of the functional adhesion molecules and scavenger receptors, respectively. Finally, the results of in vivo and in vitro experiments with a mouse model confirmed that excess TNF-α in the blood activates monocytes with the potential to directly form CE-laden cells. These data demonstrate that excess TNF-α in the blood is the primary trigger for the development of atherosclerosis and CHD.
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Affiliation(s)
- Ming Zhu
- Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Lei Lei
- Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Zhenhua Zhu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200031, China
| | - Qin Li
- Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Dongqing Guo
- Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Jiajia Xu
- Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Jia Chen
- Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Huifang Sha
- Basic Research Laboratory, Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China
| | - Xiaowei Zhang
- Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Xinying Yang
- Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Baoliang Song
- Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China College of Life Sciences, the Institute for Advanced Studies, Wuhan University, Wuhan 430072, China
| | - Boliang Li
- Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
| | - Yan Yan
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200031, China
| | - Ying Xiong
- Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
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Abstract
In the era of biologic therapies, methotrexate (MTX), a classic immunomodulator, is still the cornerstone of systemic treatment of psoriasis. MTX has been used for many years, achieving good responses with a good safety profile. However, only a few randomized clinical trials have been performed involving MTX, and most of the current evidence comes from pivotal studies of biologic drugs. The aim of this article is to make an extensive review of the MTX mechanism of action, pharmacokinetics, efficacy, safety and tolerability, especially focusing on the future perspective of this old drug and recent advances in the field of pharmacogenetics.
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Affiliation(s)
- Oriol Yélamos
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, C/Sant Antoni Maria Claret 167, 08025 Barcelona, Spain
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Circulating miR-765 and miR-149: potential noninvasive diagnostic biomarkers for geriatric coronary artery disease patients. BIOMED RESEARCH INTERNATIONAL 2015; 2015:740301. [PMID: 25664324 PMCID: PMC4312568 DOI: 10.1155/2015/740301] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 11/19/2014] [Accepted: 11/19/2014] [Indexed: 01/06/2023]
Abstract
The purpose of this study was to evaluate the diagnostic value of circulating miR-765 and miR-149 as noninvasive early biomarkers for geriatric coronary artery disease (CAD) patients. A total of 69 angiographically documented CAD patients including 37 stable CAD (72.9 ± 4.2 years) and 32 unstable CAD (72.03 ± 4.3 years) and 20 healthy subjects (71.7 ± 5.2 years), matched for age, sex, smoking habit, hypertension, and diabetes, were enrolled in this study. Compared with healthy subjects, circulating miR-765 levels were increased by 2.9-fold in stable CAD and 5.8-fold in unstable CAD patients, respectively, while circulating miR-149 levels were downregulated by 3.5-fold in stable CAD and 4.2-fold in unstable CAD patients, respectively. Furthermore, plasma levels of miR-765 were found to be positively correlated with ages within control, stable, and unstable groups. The ROC curves of miR-765 and miR-149 represented significant diagnostic values with an area under curve (AUC) of 0.959, 0.972 and 0.938, 0.977 in stable CAD patients and unstable CAD patients as compared with healthy subjects, respectively. Plasma levels of miR-765 and miR-149 might be used as noninvasive biomarkers for the diagnosis of CAD in geriatric people.
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