51
|
Wang Y, Li Y, Wu Y, Jia L, Wang J, Xie B, Hui M, Du J. 5TNF-α and IL-1β neutralization ameliorates angiotensin II-induced cardiac damage in male mice. Endocrinology 2014; 155:2677-87. [PMID: 24877626 DOI: 10.1210/en.2013-2065] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Inflammation is a key event in hypertensive organ damage, and TNF-α and IL-1β are elevated in hypertension. In this study, we evaluated the effects of TNF-α and IL-1β elevation on hypertensive cardiac damage by treatment with a bifunctional inflammatory inhibitor, TNF receptor 2-fragment crystalization-IL-1 receptor antagonist (TFI), which can neutralize these 2 cytokines simultaneously. A mouse hypertension model of angiotensin II (Ang II) infusion (1500 ng/kg·min for 7 d) was induced in wild-type mice. TNF-α and IL-1β were inhibited by TFI administration (5 mg/kg, every other day), the effects of inhibition on cardiac damage were examined, and its mechanism on inflammatory infiltration was further studied in vivo and in vitro. Ang II infusion induced cardiac injury, including increased macrophage infiltration, expression of inflammatory cytokines (IL-12, IL-6, etc), and cardiac fibrosis, such as elevated α-smooth muscle actin, collagen I, and TGF-β expression. Importantly, the Ang II-induced cardiac injury was suppressed by TFI treatment. Moreover, TFI reduced the expression of adhesion molecules (intercellular adhesion molecule-1 and vascular cell adhesion molecule-1) and monocyte chemotactic protein-1 expression in Ang II-treated hearts. Additionally, blockade of TNF-α and IL-1β by TFI reduced monocyte adherence to endothelia cell and macrophage migration. This study demonstrates that blocking TNF-α and IL-1β by TFI prevents cardiac damage in response to Ang II, and targeting these 2 cytokines simultaneously might be a novel tool to treat hypertensive heart injury.
Collapse
MESH Headings
- Angiotensin II
- Animals
- Blotting, Western
- Cell Adhesion/drug effects
- Cell Line, Tumor
- Cell Movement/drug effects
- Cells, Cultured
- Chemokine CCL2/genetics
- Chemokine CCL2/metabolism
- Heart Diseases/chemically induced
- Heart Diseases/metabolism
- Heart Diseases/prevention & control
- Humans
- Interleukin 1 Receptor Antagonist Protein/genetics
- Interleukin 1 Receptor Antagonist Protein/metabolism
- Interleukin 1 Receptor Antagonist Protein/pharmacology
- Interleukin-12/metabolism
- Interleukin-1beta/antagonists & inhibitors
- Interleukin-1beta/genetics
- Interleukin-1beta/metabolism
- Interleukin-6/metabolism
- Macrophages/drug effects
- Macrophages/metabolism
- Male
- Mice
- Mice, Inbred BALB C
- Mice, Inbred C57BL
- Mice, Transgenic
- Myocardium/metabolism
- Myocardium/pathology
- Receptors, Tumor Necrosis Factor, Type II/genetics
- Receptors, Tumor Necrosis Factor, Type II/metabolism
- Recombinant Fusion Proteins/genetics
- Recombinant Fusion Proteins/metabolism
- Recombinant Fusion Proteins/pharmacology
- Reverse Transcriptase Polymerase Chain Reaction
- Tumor Necrosis Factor-alpha/antagonists & inhibitors
- Tumor Necrosis Factor-alpha/genetics
- Tumor Necrosis Factor-alpha/metabolism
Collapse
Affiliation(s)
- Yueli Wang
- Beijing Anzhen Hospital (Y.Wa., Y.L., Y.Wu, L.J., J.W., J.D.), Capital Medical University, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing 100029, China; and National Key Laboratory of Biochemical Engineering (B.X., M.H.), Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
| | | | | | | | | | | | | | | |
Collapse
|
52
|
Dolenc J, Šebeštjen M, Vrtovec B, Koželj M, Haddad F. Pulmonary hypertension in patients with advanced heart failure is associated with increased levels of interleukin-6. Biomarkers 2014; 19:385-90. [PMID: 24831174 DOI: 10.3109/1354750x.2014.918654] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Inflammatory, endothelial and neurohormonal biomarkers are involved in heart failure (HF) and pulmonary hypertension (PH) pathogenesis. OBJECTIVE To study these biomarkers in PH due to advanced HF. MATERIALS AND METHODS Thirty adults with HF were included. Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hsCRP), endothelin-1 and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) were measured in peripheral vein and pulmonary artery during right heart catheterisation. RESULTS IL-6, TNF-α, hsCRP and NT-proBNP correlated with pulmonary pressures independent of ventricular function, HF etiology and vascular bed. IL-6 was independent predictor of systolic pulmonary artery pressure (sPAP). DISCUSSION AND CONCLUSION Inflammatory biomarkers correlate to PH severity. IL-6 predicts sPAP in advanced HF.
Collapse
Affiliation(s)
- Jure Dolenc
- Department of Cardiology, University Medical Centre Ljubljana , Ljubljana , Slovenia
| | | | | | | | | |
Collapse
|
53
|
Harkness K, Heckman GA, McKelvie RS. The older patient with heart failure: high risk for frailty and cognitive impairment. Expert Rev Cardiovasc Ther 2014; 10:779-95. [DOI: 10.1586/erc.12.49] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
54
|
Fonfara S, Hetzel U, Tew SR, Cripps P, Dukes-McEwan J, Clegg PD. Myocardial cytokine expression in dogs with systemic and naturally occurring cardiac diseases. Am J Vet Res 2013; 74:408-16. [PMID: 23438116 DOI: 10.2460/ajvr.74.3.408] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare myocardial cytokine expression in dogs with naturally occurring cardiac or systemic diseases and dogs without cardiac or systemic diseases (control dogs) SAMPLE Myocardial tissue samples from 7 systemic disease-affected dogs (SDDs), 7 cardiac disease-affected dogs (CDDs), and 8 control dogs. PROCEDURES mRNA expression of interleukin (IL)-1, IL-2, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, transforming growth factor (TGF)-β1, TGF-β2, TGF-β3, and growth differentiation factor-15 in myocardial tissue samples obtained from CDDs, SDDs, and control dogs were analyzed via quantitative PCR assays. RESULTS In control dogs, only mRNA for TNF-α, TGF-β1, and TGF-β3 was detected; concentrations were significantly higher in male than in female dogs. In SDDs and CDDs, all cytokines, growth factors, and growth differentiation factor-15 were expressed. Compared with findings in SDDs, IL-1, IL-6, IL-8, IL-10, TNF-α, and IFN-γ expression was significantly increased in CDDs; specifically, IL-1, IL-8, TNF-α, TGF-β1, and TGF-β3 expression was increased in the atria and IL-8, IL-10, TNF-α, and IFN-γ expression was increased in the ventricles of CDDs. CONCLUSIONS AND CLINICAL RELEVANCE Data suggested that the alterations in cytokine expression in SDDs and CDDs, compared with control dog findings, were a result of inflammatory system activation. The differences in cytokine expression in atria and ventricles between SDDs and CDDs were suggestive of different remodeling processes. A better knowledge of myocardial involvement in SDDs and of immune regulation in CDDs might beneficially affect morbidity and mortality rates and provide new treatment approaches.
Collapse
Affiliation(s)
- Sonja Fonfara
- Small Animal Teaching Hospital, School of Veterinary Science, University of Liverpool, Leahurst Campus, Neston CH64 7TE, England.
| | | | | | | | | | | |
Collapse
|
55
|
Rafeq Z, Roh JD, Guarino P, Kaufman J, Joseph J. Adverse myocardial effects of B-vitamin therapy in subjects with chronic kidney disease and hyperhomocysteinaemia. Nutr Metab Cardiovasc Dis 2013; 23:836-842. [PMID: 22902185 DOI: 10.1016/j.numecd.2012.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 06/18/2012] [Accepted: 07/03/2012] [Indexed: 01/25/2023]
Abstract
BACKGROUND & AIMS Hyperhomocysteinaemia (HHCY), a common finding in patients with chronic kidney disease (CKD), has been shown to contribute to adverse cardiac remodelling and failure. We hypothesised that in human subjects with CKD, HHCY would be associated with myocardial dysfunction, and that homocysteine (HCY)-lowering therapy would improve myocardial remodelling and heart-failure (HF) outcomes. METHODS AND RESULTS Post hoc analysis of the Homocysteinemia in Kidney and End Stage Renal Disease (HOST) trial (n=2056) was performed to determine if HCY-lowering therapy with high dose B vitamins affects HF outcomes in patients with CKD. In addition, effects on myocardial remodelling were assessed in a subgroup of 220 trial subjects who had transthoracic echocardiograms done before study randomisation and during the course of the study as part of their routine clinical care. HF outcomes were not significantly affected by treatment compared to the placebo. HCY levels were inversely correlated with diastolic function (R=-0.21; p=0.038). Vitamin therapy resulted in a significant increase in left atrial size (+0.15±0.8 cm vs. -0.13±0.07 cm; p=0.0095). No other echocardiographic parameters were significantly associated with baseline HCY levels or changes with vitamin therapy. CONCLUSION HHCY is associated with diastolic dysfunction in patients with CKD. However, B-vitamin therapy did not improve HF outcomes despite lowering of plasma HCY levels, and was associated with an increase in left atrial size, which is a surrogate for worsening left ventricular diastolic dysfunction. These findings suggest that high-dose B vitamin therapy may be harmful in patients with CKD.
Collapse
Affiliation(s)
- Z Rafeq
- Veteran Affairs Boston Healthcare System, Department of Medicine, Boston, MA, USA
| | | | | | | | | |
Collapse
|
56
|
Colombo PC, Ganda A, Lin J, Onat D, Harxhi A, Iyasere JE, Uriel N, Cotter G. Inflammatory activation: cardiac, renal, and cardio-renal interactions in patients with the cardiorenal syndrome. Heart Fail Rev 2013; 17:177-90. [PMID: 21688186 DOI: 10.1007/s10741-011-9261-3] [Citation(s) in RCA: 146] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although inflammation is a physiologic response designed to protect us from infection, when unchecked and ongoing it may cause substantial harm. Both chronic heart failure (CHF) and chronic kidney disease (CKD) are known to cause elaboration of several pro-inflammatory mediators that can be detected at high concentrations in the tissues and blood stream. The biologic sources driving this chronic inflammatory state in CHF and CKD are not fully established. Traditional sources of inflammation include the heart and the kidneys which produce a wide range of pro-inflammatory cytokines in response to neurohormones and sympathetic activation. However, growing evidence suggests that non-traditional biomechanical mechanisms such as venous and tissue congestion due to volume overload are also important as they stimulate endotoxin absorption from the bowel and peripheral synthesis and release of pro-inflammatory mediators. Both during the chronic phase and, more rapidly, during acute exacerbations of CHF and CKD, inflammation and congestion appear to amplify each other resulting in a downward spiral of worsening cardiac, vascular, and renal functions that may negatively impact patients' outcome. Anti-inflammatory treatment strategies aimed at attenuating end organ damage and improving clinical prognosis in the cardiorenal syndrome have been disappointing to date. A new therapeutic paradigm may be needed, which involves different anti-inflammatory strategies for individual etiologies and stages of CHF and CKD. It may also include specific (short-term) anti-inflammatory treatments that counteract inflammation during the unsettled phases of clinical decompensation. Finally, it will require greater focus on volume overload as an increasingly significant source of systemic inflammation in the cardiorenal syndrome.
Collapse
Affiliation(s)
- Paolo C Colombo
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, College of Physicians and Surgeons, New York, NY, USA.
| | | | | | | | | | | | | | | |
Collapse
|
57
|
Papadopoulos N, Bakhtiary F, Grün V, Weber CF, Strasser C, Moritz A. The effect of normovolemic modified ultrafiltration on inflammatory mediators, endotoxins, terminal complement complexes and clinical outcome in high-risk cardiac surgery patients. Perfusion 2013; 28:306-14. [DOI: 10.1177/0267659113478450] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: The clinical benefit of normovolemic modified ultrafiltration (N-MUF) after cardiac surgery is still debated. As we have shown in a previous publication, there is a significant improvement in platelet function, so we were interested in whether ultrafiltration can reduce plasma levels of endotoxins, terminal complement complexes and cytokines after cardiopulmonary bypass (CPB) in adults with increased risk profiles. Methods: In this single-center, prospective, randomized trial, fifty high-risk patients (mean logistic EuroSCORE II: 17.5%) who underwent cardiac surgery were randomized. After CPB, Group 1 (n = 25) served as the control and in, Group 2 (n= 25), an N-MUF of 3000 ml was performed, using a BC140plus filter after weaning from CPB. Blood samples were taken after the induction of anesthesia, before CPB, before CPB weaning, 30 minutes after CPB and at 6, 24 and 48 hours postoperatively. Primary outcomes were plasma levels of lipopolysaccharide-binding protein (LBP), terminal complement complex (C5b9) and cytokines (IL-6, IL-10, IL-1beta, TNF-α). Secondary outcomes focused on differences in the clinical outcome. Results: A significant reduction in LBP concentration (preoperatively: 23.8±8.4 pg/ml, postoperatively: 14.2±12.9 pg/ml) and C5b9 (preoperatively: 4.18±2.6 pg/ml, postoperatively: 3.05±2.39 pg/ml) were detected 6 hours after N-MUF. In the N-MUF group, significantly lower concentrations of lactate could be detected in the early postoperative period. Furthermore, postoperative chest tube blood loss was significantly lower in the N-MUF group at 24 and 48 hours. Conclusions: N-MUF leads to a significant reduction of lipopolysaccharide-binding protein and terminal complement complex and was associated with reduced blood loss and postoperative lactate concentrations shortly after surgery.
Collapse
Affiliation(s)
- N Papadopoulos
- Department of Thoracic and Cardiovascular Surgery, J.-W. Goethe University Hospital, Frankfurt, Germany
| | - F Bakhtiary
- Department of Thoracic and Cardiovascular Surgery, University Hopital Leipzig, Leipzig, Germany
| | - V Grün
- Department of Thoracic and Cardiovascular Surgery, J.-W. Goethe University Hospital, Frankfurt, Germany
| | - CF Weber
- Clinic for Anesthesiology, Intensive Care Medicine and Pain Therapy, J.-W. Goethe University Hospital, Frankfurt, Germany
| | - C Strasser
- Clinic for Anesthesiology, Intensive Care Medicine and Pain Therapy, J.-W. Goethe University Hospital, Frankfurt, Germany
| | - A Moritz
- Department of Thoracic and Cardiovascular Surgery, J.-W. Goethe University Hospital, Frankfurt, Germany
| |
Collapse
|
58
|
Cao Y, Tang J, Yang T, Ma H, Yi D, Gu C, Yu S. Cardioprotective effect of ghrelin in cardiopulmonary bypass involves a reduction in inflammatory response. PLoS One 2013; 8:e55021. [PMID: 23359315 PMCID: PMC3554674 DOI: 10.1371/journal.pone.0055021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 12/18/2012] [Indexed: 01/04/2023] Open
Abstract
Background Ghrelin has been reported to protect the cardiovascular system; however, the cardioprotective effect of ghrelin against cardiopulmonary bypass (CPB) induced myocardial injury are unclear. In this study, the protective effect of ghrelin on CPB induced myocardial injury and the underlying mechanisms were investigated. Methods and Results Adult male rats were subjected to CPB and randomly to receive vehicle (n = 8), ghrelin (n = 8), ghrelin plus [D-Lys3]-GHRP-6, a GHSR-1a inhibitor (n = 8), or ghrelin plus wortmannin, a phosphoinositide 3′-kinase (PI3K) inhibitor (n = 8). In vitro study was performed on cultured cardiomyocytes subjected to simulated cardiopulmonary bypass (SCPB). Ghrelin attenuated the inflammatory response, as evidenced by reduced induction of TNF-α, IL-6 and myocardial myeloperoxidase activity and concurrent reduction in apoptosis, oxidative stress, and levels of myocardial injury markers following CPB. Moreover, ghrelin significantly increased cardiac function after CPB. In cultured cardiomyocytes subjected to simulated CPB, ghrelin increased cell viability and decreased the percentage of apoptotic myocytes. Inhibition of ghrelin downstream signaling blocked the cardioprotective effects both in vivo and vitro. Conclusions Ghrelin could provide an effective approach to the attenuation of CPB induced myocardial injury. The cardioprotective effects elicited by ghrelin may contribute to the inhibition of inflammatory response through the Akt-activated pathway.
Collapse
Affiliation(s)
- Yukun Cao
- Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi Province, China
| | - Jun Tang
- Department of Anesthesiology, School of Stomatology, Fourth Military Medical University, Xi’an, Shaanxi Province, China
| | - Ting Yang
- Department of Oral Anatomy and Physiology and TMD, School of Stomatology, Fourth Military Medical University, Xi’an, Shaanxi Province, China
| | - Heng Ma
- Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi Province, China
| | - Dinghua Yi
- Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi Province, China
- * E-mail: (DHY); (CHG); (SQY)
| | - Chunhu Gu
- Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi Province, China
- * E-mail: (DHY); (CHG); (SQY)
| | - Shiqiang Yu
- Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi Province, China
- * E-mail: (DHY); (CHG); (SQY)
| |
Collapse
|
59
|
Budd SJ, Aris RM, Medaiyese AA, Tilley SL, Neuringer IP. Increased plasma mannose binding lectin levels are associated with bronchiolitis obliterans after lung transplantation. Respir Res 2012; 13:56. [PMID: 22762710 PMCID: PMC3441326 DOI: 10.1186/1465-9921-13-56] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Accepted: 04/09/2012] [Indexed: 11/11/2022] Open
Abstract
Background Long-term lung allograft survival is limited by bronchiolitis obliterans syndrome (BOS). Mannose binding lectin (MBL) belongs to the innate immune system, participates in complement activation, and may predispose to graft rejection. We investigated mannose binding (MBL) during cold ischemia and in tissue samples from explanted lungs with BOS, and assessed MBL and complement proteins in plasma post-lung transplantation relative to BOS staging. Methods MBL was detected by immunohistochemistry lung tissue at the time of cold ischemia and in samples with BOS. MBL was assayed in the peripheral blood of 66 lung transplant patients transplanted between 1990–2007. Results MBL localized to vasculature and basement membrane during cold ischemia and BOS. Patients further out post-lung transplant > 5 years (n = 33), had significantly lower levels of MBL in the blood compared to lung transplant patients < 5 years with BOS Op-3 (n = 17), 1738 ± 250 ng/ml vs 3198 ± 370 ng/ml, p = 0.027, and similar levels to lung transplant patients < 5 years with BOS 0 (n = 16), 1738 ± 250 ng/ml vs 1808 ± 345 ng/ml. MBL levels in all BOS 0 (n = 30) vs. all BOS Op-3 (n = 36) were 1378 ± 275 ng/ml vs. 2578 ± 390 ng/ml, p = 0.001, respectively. C3 plasma levels in BOS 0 (n = 30) vs. BOS Op-3 (n = 36) were 101 ± 19.8 mg/ml vs. 114 ± 25.2 mg/ml, p = 0.024, respectively. Conclusions MBL localizes within the lung during graft ischemia and BOS, higher levels of plasma MBL are associated with BOS Op-3 and < 5 years post-transplant, and higher level of plasma complement protein C3 was associated with BOS Op-3 clinical status. MBL may serve as a biomarker for poorer outcome post-lung transplantation.
Collapse
|
60
|
Quercetin reduces inflammatory responses in LPS-stimulated cardiomyoblasts. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2012; 2012:837104. [PMID: 22685622 PMCID: PMC3364695 DOI: 10.1155/2012/837104] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 03/22/2012] [Indexed: 01/22/2023]
Abstract
Flavonoids possess several biological and pharmacological activities. Quercetin (Q), a naturally occurring flavonoid, has been shown to downregulate inflammatory responses and provide cardioprotection. However, the mechanisms behind the anti-inflammatory properties of Q in cardiac cells are poorly understood. In inflammation, nitric oxide (NO) acts as a proinflammatory mediator and is synthesized by inducible nitric oxide synthase (iNOS) in response to pro-inflammatory agents such as lipopolysaccharide (LPS), a causative agent in myocardial depression during sepsis. In the present study, we evaluated the protective effect of Q on rat cardiac dysfunction during sepsis induced by LPS. Pretreatment of H9c2 cardiomyoblasts with Q inhibited LPS-induced iNOS expression and NO production and counteracted oxidative stress caused by the unregulated NO production that leads to the generation of peroxynitrite and other reactive nitrogen species. In addition, Q pretreatment significantly counteracted apoptosis cell death as measured by immunoblotting of the cleaved caspase 3 and caspase 3 activity. Q also inhibited the LPS-induced phosphorylation of the stress-activated protein kinases (JNK/SAPK) and p38 MAP kinase that are involved in the inhibition of cell growth as well as the induction of apoptosis. In conclusion, these results suggest that Q might serve as a valuable protective agent in cardiovascular inflammatory diseases.
Collapse
|
61
|
Sandek A, Bjarnason I, Volk HD, Crane R, Meddings JB, Niebauer J, Kalra PR, Buhner S, Herrmann R, Springer J, Doehner W, von Haehling S, Anker SD, Rauchhaus M. Studies on bacterial endotoxin and intestinal absorption function in patients with chronic heart failure. Int J Cardiol 2012; 157:80-5. [DOI: 10.1016/j.ijcard.2010.12.016] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Accepted: 12/04/2010] [Indexed: 12/19/2022]
|
62
|
Herrmann R, Sandek A, von Haehling S, Doehner W, Schmidt HB, Anker SD, Rauchhaus M. Risk stratification in patients with chronic heart failure based on metabolic-immunological, functional and haemodynamic parameters. Int J Cardiol 2012; 156:62-8. [DOI: 10.1016/j.ijcard.2010.10.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Revised: 10/18/2010] [Accepted: 10/23/2010] [Indexed: 11/25/2022]
|
63
|
Chen TH, Wo HT, Wu CC, Wang JL, Wang CC, Hsieh IC, Kuo CY, Liu CT. Exendin-4 attenuates lipopolysaccharides induced inflammatory response but does not protects H9c2 cells from apoptosis. Immunopharmacol Immunotoxicol 2011; 34:484-90. [PMID: 22121853 DOI: 10.3109/08923973.2011.630398] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Glucagon-like peptide-1 (GLP-1) and its analogues are reported to exert wide-ranging cardiovascular actions in preclinical and clinical studies. We thus investigated whether the GLP-1 receptor agonist, exendin-4, has inhibitory effects on LPS-stimulated inflammatory response in cardiomyoblasts. METHODS H9c2 cardiomyoblasts were exposed to LPS and treated with exendin-4. Expressions of proinflammatory mediators were assessed using quantitative real-time PCR. Nuclear localization of NF-κB was examined using immunoblotting. mRNA expression of inducible nitric oxide synthase (iNOS) and nitric oxide (NO) production were evaluated by q PCR and NO assay. Furthermore, anti-apoptotic effect of exendin-4 in LPS-stimulated H9c2 cells was determined using qPCR and immunoblot. RESULTS Exposure to LPS increased mRNA expressions of TNF-α, COX-2 and MMP-9 in H9c2 cells. It also caused increases in iNOS mRNA expression and NF-κB nuclear translocation. Exendin-4 dose-dependently downregulated mRNA levels of TNF-α, COX-2 and MMP-9 in LPS-stimulated H9c2 cells. It also reduced NF-κB nuclear translocation. Treatment with exendin-4 showed no effect on LPS-induced apoptosis in H9c2 cells. CONCLUSIONS Exendin-4 exerts an effect on cardiomyoblast exposed to LPS by inhibiting mRNA expression of inflammatory mediators and suppressing NF-κB activation. These effects are consistent with some of the observed anti-inflammatory properties of exendin-4, as well as its beneficial actions on the cardiovascular system.
Collapse
Affiliation(s)
- Tien-Hsing Chen
- Department of Cardiology, Chang-Gung Memorial Hospital and Chang Gung University College of Medicine, Taipei, Taiwan
| | | | | | | | | | | | | | | |
Collapse
|
64
|
Fonfara S, Tew SR, Cripps P, Dukes-McEwan J, Clegg PD. Increased blood mRNA expression of inflammatory and anti-fibrotic markers in dogs with congestive heart failure. Res Vet Sci 2011; 93:879-85. [PMID: 22100243 DOI: 10.1016/j.rvsc.2011.10.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 09/19/2011] [Accepted: 10/24/2011] [Indexed: 01/28/2023]
Abstract
Inflammation and extracellular matrix (ECM) remodeling contribute to the development of congestive heart failure (CHF), but the pathogenesis is still incompletely understood. Therefore, whole blood samples from eight dogs without cardiac disease and eight dogs with CHF were investigated for mRNA expression of IL1β, IL2, IL4, IL6, IL8, IL10, TNFα, IFNγ, TGFβ1-3, MMP1, -2, -3, -9 and TIMP1-4 using quantitative PCR. Dogs with CHF had significantly higher IL1β (P=0.015), IL2 (P=0.043), MMP1 (P=0.031), TIMP3 (P=0.012) and lower TNFα (P<0.001), TGFβ3 (P=0.006), TIMP1 (P=0.015) and TIMP2 (P=0.011) mRNA levels. Increased pro-inflammatory IL1β and anti-fibrotic MMP1 and reduced pro-fibrotic TGFβ and TIMP1 and TIMP2 in dogs with CHF suggest progressive left ventricular remodeling. The reduction of TNFα and increase of immunomodulatory IL2 and TIMP3 might suggest control of the inflammatory response. A better understanding of inflammation and ECM remodeling in cardiac diseases may lead to novel treatment approaches.
Collapse
Affiliation(s)
- S Fonfara
- Small Animal Teaching Hospital, University of Liverpool, Leahurst Campus, Neston CH64 7TE, UK.
| | | | | | | | | |
Collapse
|
65
|
Roy RA, Boucher JP, Comtois AS. Inflammatory response following a short-term course of chiropractic treatment in subjects with and without chronic low back pain. J Chiropr Med 2011; 9:107-14. [PMID: 22027032 DOI: 10.1016/j.jcm.2010.06.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Revised: 05/17/2010] [Accepted: 06/09/2010] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP) have not been evaluated in response to a short course of lumbar spinal manipulation. The purpose of this study is to observe the responses of inflammatory markers (IL-6 and CRP) after a series of 9 chiropractic spinal manipulations. METHODS Twenty-one participants were assigned to a treatment or a control group. Only the treatment group received 9 chiropractic interventions. Pre- and postintervention measures were recorded for blood samples for detection of proinflammatory cytokines IL-6 and CRP. RESULTS Mediators of inflammation (IL-6 and high-sensitivity CRP) were modified by the intervention received in the treatment group, and the effect size demonstrated a tendency toward the control group values. CONCLUSION A total of 9 chiropractic lower back manipulations caused the mediators of inflammation to present a normalization response in individuals suffering from chronic low back pain.
Collapse
Affiliation(s)
- Richard A Roy
- PhD Graduate Student, Département de Kinanthropologie, Université du Québec à Montréal, Montréal, Québec, Canada; Chiropractor, Private Practice, LaSalle, Québec, Canada
| | | | | |
Collapse
|
66
|
Haider DG, Ferrari J, Mittermayer F, Wolzt M, Hörl WH, Lalouschek W, Lang W. A Transient Improvement in Renal Function Occurs after Ischemic Stroke. Ren Fail 2011; 34:7-12. [DOI: 10.3109/0886022x.2011.623439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
67
|
Polak J, Kotrc M, Wedellova Z, Jabor A, Malek I, Kautzner J, Kazdova L, Melenovsky V. Lipolytic effects of B-type natriuretic peptide 1-32 in adipose tissue of heart failure patients compared with healthy controls. J Am Coll Cardiol 2011; 58:1119-25. [PMID: 21884948 DOI: 10.1016/j.jacc.2011.05.042] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 05/03/2011] [Accepted: 05/31/2011] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Our goal was to examine the role of B-type natriuretic peptide (BNP) in lipolysis regulation in heart failure (HF) patients. BACKGROUND Enhanced adipose tissue lipolysis can contribute to myocardial lipid overload, insulin resistance, and cachexia in advanced HF. Natriuretic peptides were recently recognized to stimulate lipolysis in healthy subjects. METHODS Ten nondiabetic HF patients (New York Heart Association functional class III, 50% nonischemic etiology) and 13 healthy subjects (control subjects) of similar age, sex, and body composition underwent a microdialysis study of subcutaneous abdominal adipose tissue. Four microdialysis probes were simultaneously perfused with 0.1 μM BNP(1-32,) 10 μM BNP(1-32), 10 μM norepinephrine (NE) or Ringer's solution. Outgoing dialysate glycerol concentration (DGC) was measured as an index of lipolysis. RESULTS Spontaneous lipolysis was higher in HF patients compared with control subjects (DGC: 189 ± 37 μmol/l vs. 152 ± 35 μmol/l, p < 0.01). Response to NE was similar (p = 0.35) in HF patients and control subjects (DGC increase of 1.7 ± 0.2-fold vs. 1.7 ± 0.4-fold). BNP(1-32) 10 μM markedly increased lipolysis in both HF patients and control subjects (DGC increase of 2.8 ± 0.5-fold vs. 3.2 ± 0.3-fold), whereas the response to 0.1 μM BNP(1-32) was more pronounced in HF patients (p = 0.02). In HF patients, spontaneous lipolysis positively correlated with insulin resistance and the response to BNP(1-32) negatively correlated with adiposity. CONCLUSIONS BNP(1-32) exerts strong lipolytic effects in humans. Despite marked elevation of plasma immunoreactive BNP, the responsiveness of adipose tissue to BNP(1-32) is not attenuated in HF, possibly reflecting a deficiency of endogenous bioactive BNP. Lipolytic effects of BNP can contribute to excessive fatty acid mobilization in advanced HF.
Collapse
Affiliation(s)
- Jan Polak
- Department of Cardiology, Institute of Clinical and Experimental Medicine, IKEM, Videnska 1958/9, Prague, Czech Republic
| | | | | | | | | | | | | | | |
Collapse
|
68
|
Telomere/telomerase system impairment in circulating angiogenic cells of geriatric patients with heart failure. Int J Cardiol 2011; 164:99-105. [PMID: 21737157 DOI: 10.1016/j.ijcard.2011.06.091] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Revised: 05/09/2011] [Accepted: 06/15/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND The functional characteristics of circulating angiogenic cells (CACs) are impaired in congestive heart failure (CHF) patients, suggesting that CAC dysfunction could contribute to CHF pathogenesis. However, the underlying mechanisms are only partly unraveled. No data are currently available regarding telomere/telomerase system in CACs of CHF patients. METHODS CACs were obtained from 80 subjects: 40 healthy control subjects (CTR) [median age (IQR), 80 (76-85 yrs)] and 40 patients affected by post-ischemic cardiomyopathy CHF [median age (IQR), 82 (77-89)]. CAC and leukocyte telomere length, assessed as T/S ratio, and telomerase (TERT) activity were determined in all the enrolled subjects. Specificity and sensitivity of CAC and leukocyte T/S in discriminating between CHF and CTR were evaluated using Receiver Operator Characteristic (ROC) curve analysis and reported as AUC values. CD34+/VEGFR2+ number and pro-inflammatory cytokines plasma levels, such as IL-6 and TNF-α, were also measured. RESULTS CAC T/S and TERT activity were significantly reduced in CHF patients compared to CTR subjects. In leukocytes, only a significant T/S reduction was observed. AUC values were higher for CAC T/S with respect to leukocyte T/S (AUC=0.89, and AUC=0.73, P<0.01, respectively). In multivariate analysis, leukocyte T/S, CAC T/S, CAC TERT activity and NT-proBNP levels were confirmed as parameters significantly associated with CHF. CD34+/VEGFR2+ number, IL-6 and TNF-α plasma levels were significantly increased in CHF patients. CONCLUSIONS CACs from CHF patients are characterized by telomere/telomerase system impairment, providing new insight into the clinical relevance of CACs in CHF pathogenesis.
Collapse
|
69
|
Núñez J, Núñez E, Miñana G, Sanchis J, Bodí V, Rumiz E, Palau P, Olivares M, Merlos P, Bonanad C, Mainar L, Llàcer A. Effectiveness of the relative lymphocyte count to predict one-year mortality in patients with acute heart failure. Am J Cardiol 2011; 107:1034-9. [PMID: 21296316 DOI: 10.1016/j.amjcard.2010.11.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 11/12/2010] [Accepted: 11/12/2010] [Indexed: 12/01/2022]
Abstract
Several works have endorsed a significant role of the immune system and inflammation in the pathogenesis of heart failure. As indirect evidence, an association between a low relative lymphocyte count (RLC%) and worse outcomes found in this population has been suggested. Nevertheless, the role of RLC% for risk stratification in a large and nonselected population of patients with acute heart failure (AHF) has not yet been determined. Thus, the aim of this study was to determine the association between low RLC% and 1-year mortality in patients with AHF and consequently to define whether it has any role for early risk stratification. A total of 1,192 consecutive patients admitted for AHF were analyzed. Total white blood cell and differential counts were measured on admission. RLC% (calculated as absolute lymphocyte count/total white blood cell count) was categorized in quintiles and its association with all-cause mortality at 1 year assessed using Cox regression. At 1 year, 286 deaths (24%) were identified. A negative trend was observed between 1-year mortality rates and quintiles of RLC%: 31.5%, 27.2%, 23.1%, 23%, and 15.5% in quintiles 1 to 5, respectively (p for trend <0.001). After thorough covariate adjustment, only patients in the lowest quintile (<9.7%) showed an increased risk for mortality (hazard ratio 1.76, 95% confidence interval 1.17 to 2.65, p = 0.006). When RLC% was modeled with restricted cubic splines, a stepped increase in risk was observed patients in quintile 1: those with RLC% values <7.5% and <5% showed 1.95- and 2.66-fold increased risk for death compared to those in the top quintile. In conclusion, in patients with AHF, RLC% is a simple, widely available, and inexpensive biomarker, with potential for identifying patients at increased risk for 1-year mortality.
Collapse
Affiliation(s)
- Julio Núñez
- Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universitat de Valencia, Valencia, Spain.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
70
|
Predicting and preventing cardiotoxicity in the era of breast cancer targeted therapies. Novel molecular tools for clinical issues. Breast 2011; 20:176-83. [DOI: 10.1016/j.breast.2010.11.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 10/01/2010] [Accepted: 11/05/2010] [Indexed: 11/22/2022] Open
|
71
|
Onyimba JA, Coronado MJ, Garton AE, Kim JB, Bucek A, Bedja D, Gabrielson KL, Guilarte TR, Fairweather D. The innate immune response to coxsackievirus B3 predicts progression to cardiovascular disease and heart failure in male mice. Biol Sex Differ 2011; 2:2. [PMID: 21338512 PMCID: PMC3049118 DOI: 10.1186/2042-6410-2-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Accepted: 02/21/2011] [Indexed: 01/05/2023] Open
Abstract
Background Men are at an increased risk of dying from heart failure caused by inflammatory heart diseases such as atherosclerosis, myocarditis and dilated cardiomyopathy (DCM). We previously showed that macrophages in the spleen are phenotypically distinct in male compared to female mice at 12 h after infection. This innate immune profile mirrors and predicts the cardiac immune response during acute myocarditis. Methods In order to study sex differences in the innate immune response, five male and female BALB/c mice were infected intraperitoneally with coxsackievirus B3 (CVB3) or phosphate buffered saline and their spleens were harvested 12 h later for microarray analysis. Gene expression was determined using an Affymetrix Mouse Gene 1.0 ST Array. Significant gene changes were verified by quantitative real-time polymerase chain reaction or ELISA. Results During the innate immune response to CVB3 infection, infected males had higher splenic expression of genes which are important in regulating the influx of cholesterol into macrophages, such as phospholipase A2 (PLA2) and the macrophage scavenger receptor compared to the infected females. We also observed a higher expression in infected males compared to infected females of squalene synthase, an enzyme used to generate cholesterol within cells, and Cyp2e1, an enzyme important in metabolizing cholesterol and steroids. Infected males also had decreased levels of the translocator protein 18 kDa (TSPO), which binds PLA2 and is the rate-limiting step for steroidogenesis, as well as decreased expression of the androgen receptor (AR), which indicates receptor activation. Gene differences were not due to increased viral replication, which was unaltered between sexes. Conclusions We found that, compared to females, male mice had a greater splenic expression of genes which are important for cholesterol metabolism and activation of the AR at 12 h after infection. Activation of the AR has been linked to increased cardiac hypertrophy, atherosclerosis, myocarditis/DCM and heart failure in male mice and humans.
Collapse
Affiliation(s)
- Jennifer A Onyimba
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Michael J Coronado
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Amanda E Garton
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Joseph B Kim
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Adriana Bucek
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Djahida Bedja
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Kathleen L Gabrielson
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Tomas R Guilarte
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA.,Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - DeLisa Fairweather
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA.,Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| |
Collapse
|
72
|
Hennig F, Stepanenko AV, Lehmkuhl HB, Kukucka M, Dandel M, Krabatsch T, Hetzer R, Potapov EV. Neurohumoral and inflammatory markers for prediction of right ventricular failure after implantation of a left ventricular assist device. Gen Thorac Cardiovasc Surg 2011; 59:19-24. [DOI: 10.1007/s11748-010-0669-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 07/08/2010] [Indexed: 11/29/2022]
|
73
|
von Haehling S, Lainscak M, Doehner W, Ponikowski P, Rosano G, Jordan J, Rozentryt P, Rauchhaus M, Karpov R, Tkachuk V, Parfyonova Y, Zaritskey AY, Shlyakhto EV, Cleland JG, Anker SD. Diabetes mellitus, cachexia and obesity in heart failure: rationale and design of the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF). J Cachexia Sarcopenia Muscle 2010; 1:187-194. [PMID: 21475696 PMCID: PMC3060647 DOI: 10.1007/s13539-010-0013-3] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Accepted: 11/03/2010] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND: Chronic heart failure (CHF) is increasing in prevalence. Patients with CHF usually have co-morbid conditions, but these have been subjected to little research and consequently there is a paucity of guidance on how to manage them. Obesity and diabetes mellitus are common antecedents of CHF and often complicate management and influence outcome. Cachexia is an ominous and often missed sign in patients with CHF. METHODS: This manuscript describes the rationale and the design of Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF), a prospective, multicentre, multinational, longitudinal, pathophysiological evaluation study, which is being conducted in 11 centres across six countries in the European Union and in Russia. We aim to recruit >1,600 patients with CHF due to various common aetiologies, irrespective of left ventricular ejection fraction, and with or without co-morbidities at study entry. In addition, >300 patients with type 2 diabetes mellitus without CHF and >150 healthy subjects will serve as control groups. Participants will be systematically investigated at annual intervals for up to 48 months. Additional investigations focusing on cellular and subcellular mechanisms, adipose and skeletal muscle tissue, and in endothelial progenitor cells will be performed in selected subgroups. CONCLUSIONS: SICA-HF will provide insights into common co-morbidities in CHF with a specific emphasis on diabetes mellitus and body mass. This will provide a more thorough pathophysiological understanding of the complexity of CHF that will help develop therapies tailored to manage specific co-morbidities.
Collapse
Affiliation(s)
- Stephan von Haehling
- Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
- Center for Cardiovascular Research (CCR), Charité Medical School, Campus Mitte, Berlin, Germany
| | - Mitja Lainscak
- Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
- Division of Cardiology, University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
| | - Wolfram Doehner
- Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
- Center for Stroke Research Berlin, Charité Medical School, Berlin, Germany
| | - Piotr Ponikowski
- Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
- Cardiology Department, Military Hospital, Wroclaw, Poland
| | - Giuseppe Rosano
- Centre for Clinical and Basic Research, IRCCS San Raffaele, Rome, Italy
| | - Jens Jordan
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - Piotr Rozentryt
- Third Department of Cardiology, Silesian Center for Heart Disease, Zabrze, Poland
| | - Mathias Rauchhaus
- Department of Cardiology, Centre for Internal Medicine, University of Rostock, Rostock, Germany
| | - Rostislav Karpov
- Institute of Cardiology, Tomsk Research Centre of the Russian Academy of Medical Science, Tomsk, Russian Federation
| | - Vsevolod Tkachuk
- Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russian Federation
| | | | - Andrey Y. Zaritskey
- Almazov Federal Centre for Heart, Blood and Endocrinology, St. Petersburg, Russian Federation
| | - Eugeniy V. Shlyakhto
- Almazov Federal Centre for Heart, Blood and Endocrinology, St. Petersburg, Russian Federation
| | - John G. Cleland
- Department of Cardiology, Castle Hill Hospital, Hull York Medical School, University of Hull, Hull, United Kingdom
| | - Stefan D. Anker
- Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
- Centre for Clinical and Basic Research, IRCCS San Raffaele, Rome, Italy
| |
Collapse
|
74
|
Affiliation(s)
- Faisal M. Merchant
- From the Cardiology Division (F.M.M.), Emory University School of Medicine, Atlanta, Ga; and the Cardiology Division (G.W.D., J.P.S.), Massachusetts General Hospital Heart Center, Harvard Medical School, Boston, Mass
| | - G. William Dec
- From the Cardiology Division (F.M.M.), Emory University School of Medicine, Atlanta, Ga; and the Cardiology Division (G.W.D., J.P.S.), Massachusetts General Hospital Heart Center, Harvard Medical School, Boston, Mass
| | - Jagmeet P. Singh
- From the Cardiology Division (F.M.M.), Emory University School of Medicine, Atlanta, Ga; and the Cardiology Division (G.W.D., J.P.S.), Massachusetts General Hospital Heart Center, Harvard Medical School, Boston, Mass
| |
Collapse
|
75
|
Alehagen U, Dahlström U, Rehfeld JF, Goetze JP. Prognostic Assessment of Elderly Patients with Symptoms of Heart Failure by Combining High-Sensitivity Troponin T and N-Terminal Pro–B-Type Natriuretic Peptide Measurements. Clin Chem 2010; 56:1718-24. [DOI: 10.1373/clinchem.2009.141341] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND
N-terminal pro–B-type natriuretic peptide (NT-proBNP) is a useful biomarker in heart failure assessment, whereas measurement of cardiac troponin is central in the diagnosis of patients with acute coronary syndromes. This report examined the prognostic use of combining high-sensitivity cardiac troponin T (hs-cTnT) and NT-proBNP measurements in elderly patients presenting to a primary care center with symptoms associated with heart failure.
METHODS
A total of 470 elderly patients (age range 65–86 years) presenting with symptoms of heart failure were recruited from primary healthcare. In addition to clinical examination and echocardiography, hs-cTnT and NT-proBNP plasma concentrations were measured. All patients were followed for 10 years, and cardiovascular mortality was registered.
RESULTS
By use of the hs-cTnT assay, 80.4% of the population had plasma concentrations above the lower detection limit of the assay. Of those displaying a plasma concentration of hs-cTnT >99th percentile of a healthy population, 43% also had an NT-proBNP concentration in the fourth quartile (>507 ng/L). In the multivariate analysis, we observed a 2.5-fold increased risk for cardiovascular mortality in individuals with a plasma NT-proBNP concentration >507 ng/L (P < 0.0001). Conversely, patients with hs-cTnT >99th percentile displayed an approximately 2-fold increased risk for cardiovascular mortality (P = 0.0002). Combining the 2 biomarkers, NT-proBNP concentrations >507 ng/L with hs-cTnT >99th percentile increased the risk 3-fold, even after adjustment for clinical variables such as age, sex, impaired estimated glomerular filtration rate, and anemia (P < 0.0001).
CONCLUSIONS
hs-cTnT and NT-proBNP measurements combined provide better prognostic information than using either biomarker separately in elderly patients with symptoms associated with heart failure.
Collapse
Affiliation(s)
- Urban Alehagen
- Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden
| | - Ulf Dahlström
- Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden
| | - Jens F Rehfeld
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jens P Goetze
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
76
|
Reddy VS, Prabhu SD, Mummidi S, Valente AJ, Venkatesan B, Shanmugam P, Delafontaine P, Chandrasekar B. Interleukin-18 induces EMMPRIN expression in primary cardiomyocytes via JNK/Sp1 signaling and MMP-9 in part via EMMPRIN and through AP-1 and NF-kappaB activation. Am J Physiol Heart Circ Physiol 2010; 299:H1242-54. [PMID: 20693392 DOI: 10.1152/ajpheart.00451.2010] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IL-18 and the extracellular matrix metalloproteinase (MMP) inducer (EMMPRIN) stimulate the expression of proinflammatory cytokines and MMPs and are elevated in myocardial hypertrophy, remodeling, and failure. Here, we report several novel findings in primary cardiomyocytes treated with IL-18. First, IL-18 activated multiple transcription factors, including NF-κB (p50 and p65), activator protein (AP)-1 (cFos, cJun, and JunD), GATA, CCAAT/enhancer-binding protein, myocyte-specific enhancer-binding factor, interferon regulatory factor-1, p53, and specific protein (Sp)-1. Second, IL-18 induced EMMPRIN expression via myeloid differentiation primary response gene 88/IL-1 receptor-associated kinase/TNF receptor-associated factor-6/JNK-dependent Sp1 activation. Third, IL-18 induced a number of MMP genes, particularly MMP-9, at a rapid rate as well as tissue inhibitor of metalloproteinase (TIMP)-1 and TIMP-3 at a slower rate. Finally, the IL-18 induction of MMP-9 was mediated in part via EMMPRIN and through JNK- and ERK-dependent AP-1 activation and p38 MAPK-dependent NF-κB activation. These results suggest that the elevated expression of IL-18 during myocardial injury and inflammation may favor EMMPRIN and MMP induction and extracellular matrix degradation. Therefore, targeting IL-18 or its signaling pathways may be of potential therapeutic benefit in adverse remodeling.
Collapse
|
77
|
Prevalence and prognostic implications of active cytomegalovirus infection in patients with acute heart failure. Clin Sci (Lond) 2010; 119:443-52. [DOI: 10.1042/cs20100162] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AHF (acute heart failure) causes significant morbidity and mortality. Recent studies have postulated that the expression of inflammatory mediators, such as cytokines and chemokines, plays an important role in the development and progression of heart failure. A pro-inflammatory state has been postulated as a key factor in triggering CMV (cytomegalovirus) reactivation. Therefore we sought to determine the prevalence of active CMV infection in immunocompetent patients admitted for AHF and to quantify the association with the risk of the combined end point of death or AHF readmission. A total of 132 consecutive patients admitted for AHF were enrolled in the present study. Plasma CMV DNAaemia was assessed by qRT-PCR (quantitative real-time PCR), and cytokine measurements in plasma were performed by ELISA. Clinical data were evaluated by personnel blinded to CMV results. The independent association between active CMV infection and the end point was determined by Cox regression analysis. During a median follow-up of 120 [IQR (interquartile range), 60–240] days, 23 (17.4%) deaths, 34 (24.2%) readmissions for AHF and 45 (34.1%) deaths/readmissions for AHF were identified. Plasma CMV DNAaemia occurred in 11 (8.3%) patients, albeit at a low level (<100 copies/ml). The cumulative rate of the composite end point was higher in patients with CMV DNAaemia (81.8 compared with 29.8%; P<0.001). After adjusting for established risk factors, the occurrence of CMV DNAaemia was strongly associated with the clinical end point [hazard ratio = 4.39 (95% confidence interval, 2.02–9.52); P<0.001]. In conclusion, active CMV infection occurs, although uncommonly, in patients with AHF, and may be a marker of disease severity.
Collapse
|
78
|
Li W, Olshansky B. Inflammatory cytokines and nitric oxide in heart failure and potential modulation by vagus nerve stimulation. Heart Fail Rev 2010; 16:137-45. [DOI: 10.1007/s10741-010-9184-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
|
79
|
Ahmad S, Rai TS, Khullar M, Bahl A, Saikia UN, Thungapathra M, Kumar RM, Mahajan R, Talwar KK. Decreased myocardial expression of dystrophin and titin mRNA and protein in dilated cardiomyopathy: possibly an adverse effect of TNF-alpha. J Clin Immunol 2010; 30:520-30. [PMID: 20373002 DOI: 10.1007/s10875-010-9388-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Accepted: 03/12/2010] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS While the molecular basis of dilated cardiomyopathy (DCM) remains uncertain, concrete evidence is emerging that sarcomeric and cytoskeleton gene expression of myocardium isolated from failing versus non-failing patients differ dramatically. The central aim to this work was to find out the possible role of dystrophin and titin along with the TNF-alpha in the pathogenesis of cardiomyopathy. PATIENTS AND METHODS mRNA levels and protein expression of a cytoskeletal protein, dystrophin and a sarcomeric protein, titin in endomyocardial biopsies of DCM patients were examined using RT-PCR and immunohistochemistry, respectively. Further, we examined the effect of TNF-alpha on myocardial expression of titin and dystrophin in vitro in rat cardiac myoblast cell line (H9c2). RESULTS We observed significantly decreased mRNA and protein levels of dystrophin and titin in endomyocardial biopsy of DCM patients as compared to control group. The decreased levels of these proteins correlated with the severity of the disease. Plasma levels of both TNF-alpha and its soluble receptors TNFR1 and TNFR2 were found to be significantly higher in patients as compared to control group. Treatment of H9c2 cells with TNF-alpha resulted in a dose- and time-dependent decrease in mRNA levels of dystrophin and titin. Pretreatment of these cells with MG132, an inhibitor of nuclear factor kappa B (NF-kappaB) pathway, abolished TNF-alpha-induced reduction in mRNA levels of dystrophin and titin. CONCLUSION Our results suggest that reduced expression of dystrophin and titin is associated with the pathophysiology of DCM, and TNF-alpha may modulate the expression of these proteins via NF-kappaB pathway.
Collapse
Affiliation(s)
- Shamim Ahmad
- Department of Cardiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | | | | | | | | | | |
Collapse
|
80
|
Noutsias M, Pankuweit S, Maisch B. Biomarkers in Inflammatory and Noninflammatory Cardiomyopathy. Herz 2010; 34:614-23. [DOI: 10.1007/s00059-009-3318-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
81
|
Mikirova NA, Jackson JA, Hunninghake R, Kenyon J, Chan KWH, Swindlehurst CA, Minev B, Patel AN, Murphy MP, Smith L, Alexandrescu DT, Ichim TE, Riordan NH. Circulating endothelial progenitor cells: a new approach to anti-aging medicine? J Transl Med 2009; 7:106. [PMID: 20003528 PMCID: PMC2804590 DOI: 10.1186/1479-5876-7-106] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Accepted: 12/15/2009] [Indexed: 12/17/2022] Open
Abstract
Endothelial dysfunction is associated with major causes of morbidity and mortality, as well as numerous age-related conditions. The possibility of preserving or even rejuvenating endothelial function offers a potent means of preventing/treating some of the most fearful aspects of aging such as loss of mental, cardiovascular, and sexual function. Endothelial precursor cells (EPC) provide a continual source of replenishment for damaged or senescent blood vessels. In this review we discuss the biological relevance of circulating EPC in a variety of pathologies in order to build the case that these cells act as an endogenous mechanism of regeneration. Factors controlling EPC mobilization, migration, and function, as well as therapeutic interventions based on mobilization of EPC will be reviewed. We conclude by discussing several clinically-relevant approaches to EPC mobilization and provide preliminary data on a food supplement, Stem-Kine, which enhanced EPC mobilization in human subjects.
Collapse
Affiliation(s)
- Nina A Mikirova
- Bio-Communications Research Institute, Wichita, Kansas, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|