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Lopez-Jaramillo P, Barajas J, Rueda-Quijano SM, Lopez-Lopez C, Felix C. Obesity and Preeclampsia: Common Pathophysiological Mechanisms. Front Physiol 2018; 9:1838. [PMID: 30618843 PMCID: PMC6305943 DOI: 10.3389/fphys.2018.01838] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 12/06/2018] [Indexed: 01/25/2023] Open
Abstract
Preeclampsia is a disorder specific of the human being that appears after 20 weeks of pregnancy, characterized by new onset of hypertension and proteinuria. Abnormal placentation and reduced placental perfusion associated to impaired trophoblast invasion and alteration in the compliance of uterine spiral arteries are the early pathological findings that are present before the clinical manifestations of preeclampsia. Later on, the endothelial and vascular dysfunction responsible of the characteristic vasoconstriction of preeclampsia appear. Different nutritional risk factors such as a maternal deficit in the intake of calcium, protein, vitamins and essential fatty acids, have been shown to play a role in the genesis of preeclampsia, but also an excess of weight gain during pregnancy or a pre-pregnancy state of obesity and overweight, which are associated to hyperinsulinism, insulin resistance and maternal systemic inflammation, are proposed as one of the mechanism that conduce to endothelial dysfunction, hypertension, proteinuria, thrombotic responses, multi-organ damage, and high maternal mortality and morbidity. Moreover, it has been demonstrated that pregnant women that suffer preeclampsia will have an increased risk of future cardiovascular disease and related mortality in their later life. In this article we will discuss the results of studies performed in different populations that have shown an interrelationship between obesity and overweight with the presence of preeclampsia. Moreover, we will review some of the common mechanisms that explain this interrelationship, particularly the alterations in the L-arginine/nitric oxide pathway as a crucial mechanism that is common to obesity, preeclampsia and cardiovascular diseases.
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Affiliation(s)
- Patricio Lopez-Jaramillo
- Clinic of Metabolic Syndrome, Prediabetes, and Diabetes, Research Department, FOSCAL, Floridablanca, Colombia.,Masira Institute, Medical School, Universidad de Santander, Bucaramanga, Colombia.,Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnologica Equinoccial, Quito, Ecuador
| | - Juan Barajas
- Clinic of Metabolic Syndrome, Prediabetes, and Diabetes, Research Department, FOSCAL, Floridablanca, Colombia
| | - Sandra M Rueda-Quijano
- Clinic of Metabolic Syndrome, Prediabetes, and Diabetes, Research Department, FOSCAL, Floridablanca, Colombia
| | | | - Camilo Felix
- Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnologica Equinoccial, Quito, Ecuador
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Sibuyi NRS, Meyer M, Onani MO, Skepu A, Madiehe AM. Vascular targeted nanotherapeutic approach for obesity treatment. Int J Nanomedicine 2018; 13:7915-7929. [PMID: 30538468 PMCID: PMC6260142 DOI: 10.2147/ijn.s173424] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Obesity is a global epidemic that poses a serious health concern due to it being a risk factor for life-threatening chronic diseases, such as type 2 diabetes, cancer, and cardiovascular diseases. Pharmacotherapy remains the mainstay for the management of obesity; however, its usefulness is limited due to poor drug efficacy, non-specificity and toxic side effects. Therefore, novel approaches that could provide insights into obesity and obesity-associated diseases as well as development of novel anti-obesity treatment modalities or improvement on the existing drugs are necessary. While the ideal treatment of obesity should involve early intervention in susceptible individuals, targeted nanotherapy potentially provides a fresh perspective that might be better than the current conventional therapies. Independent studies have shown improved drug efficacy by using prohibitin (PHB)-targeted therapy in obese rodents and non-human primates, thus providing a proof of concept that targeted nanotherapy can be a feasible treatment for obesity. This review presents a brief global survey of obesity, its impact on human health, its current treatment and their limitations, and the role of angiogenesis and PHB in the development of obesity. Finally, the role and potential use of nanotechnology coupled with targeted drug delivery in the treatment of obesity are discussed.
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Affiliation(s)
- Nicole Remaliah Samantha Sibuyi
- Department of Science and Technology/Mintek Nanotechnology Innovation Centre, Biolabels Unit, Department of Biotechnology, University of the Western Cape, Bellville, South Africa,
| | - Mervin Meyer
- Department of Science and Technology/Mintek Nanotechnology Innovation Centre, Biolabels Unit, Department of Biotechnology, University of the Western Cape, Bellville, South Africa,
| | - Martin Opiyo Onani
- Organometallics and Nanomaterials, Department of Chemistry, University of the Western Cape, Bellville, South Africa
| | - Amanda Skepu
- Department of Science and Technology/Mintek Nanotechnology Innovation Centre, Biolabels Unit, Advanced Materials Division, Mintek, Johannesburg, South Africa
| | - Abram Madimabe Madiehe
- Department of Science and Technology/Mintek Nanotechnology Innovation Centre, Biolabels Unit, Department of Biotechnology, University of the Western Cape, Bellville, South Africa,
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Contreras-Duarte S, Carvajal L, Fuenzalida B, Cantin C, Sobrevia L, Leiva A. Maternal Dyslipidaemia in Pregnancy with Gestational Diabetes Mellitus: Possible Impact on Foetoplacental Vascular Function and Lipoproteins in the Neonatal Circulation. Curr Vasc Pharmacol 2018; 17:52-71. [DOI: 10.2174/1570161115666171116154247] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 10/30/2017] [Accepted: 11/04/2017] [Indexed: 01/06/2023]
Abstract
Dyslipidaemia occurs in pregnancy to secure foetal development. The mother shows a physiological
increase in plasma total cholesterol and Triglycerides (TG) as pregnancy progresses (i.e. maternal
physiological dyslipidaemia in pregnancy). However, in some women pregnancy-associated dyslipidaemia
exceeds this physiological adaptation. The consequences of this condition on the developing
fetus include endothelial dysfunction of the foetoplacental vasculature and development of foetal aortic
atherosclerosis. Gestational Diabetes Mellitus (GDM) associates with abnormal function of the foetoplacental
vasculature due to foetal hyperglycaemia and hyperinsulinaemia, and associates with development
of cardiovascular disease in adulthood. Supraphysiological dyslipidaemia is also detected in
GDM pregnancies. Although there are several studies showing the alteration in the maternal and neonatal
lipid profile in GDM pregnancies, there are no studies addressing the effect of dyslipidaemia in the
maternal and foetal vasculature. The literature reviewed suggests that dyslipidaemia in GDM pregnancy
should be an additional factor contributing to worsen GDM-associated endothelial dysfunction by altering
signalling pathways involving nitric oxide bioavailability and neonatal lipoproteins.
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Affiliation(s)
- Susana Contreras-Duarte
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago 8330024, Chile
| | - Lorena Carvajal
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago 8330024, Chile
| | - Bárbara Fuenzalida
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago 8330024, Chile
| | - Claudette Cantin
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago 8330024, Chile
| | - Luis Sobrevia
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago 8330024, Chile
| | - Andrea Leiva
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago 8330024, Chile
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Lu Y, Chen Y, Li R, Liu Q, Wang N, Zhang Y, Li B, Fang Z. Protective effects of Danzhi jiangtang capsule on vascular endothelial damages induced by high-fat diet and palmitic acid. Biomed Pharmacother 2018; 107:1631-1640. [DOI: 10.1016/j.biopha.2018.08.129] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 08/09/2018] [Accepted: 08/24/2018] [Indexed: 02/07/2023] Open
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Frydrych LM, Bian G, O'Lone DE, Ward PA, Delano MJ. Obesity and type 2 diabetes mellitus drive immune dysfunction, infection development, and sepsis mortality. J Leukoc Biol 2018; 104:525-534. [PMID: 30066958 DOI: 10.1002/jlb.5vmr0118-021rr] [Citation(s) in RCA: 155] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 12/14/2022] Open
Abstract
Obesity and type 2 diabetes mellitus (T2D) are global pandemics. Worldwide, the prevalence of obesity has nearly tripled since 1975 and the prevalence of T2D has almost doubled since 1980. Both obesity and T2D are indolent and chronic diseases that develop gradually, with cellular physiologic changes occurring before the clinical signs and symptoms of the diseases become apparent. Individuals with obesity and T2D are physiologically frail and have an increased risk of infections and mortality from sepsis. Improvement in the morbidity and mortality of these at-risk populations would provide a great societal benefit. We believe that the worsened outcomes observed in these patient populations is due to immune system dysfunction that is triggered by the chronic low-grade inflammation present in both diseases. As immune modulatory therapies have been utilized in other chronic inflammatory diseases, there is an emerging role for immune modulatory therapies that target the chronically affected immune pathways in obese and T2D patients. Additionally, bariatric surgery is currently the most successful treatment for obesity and is the only weight loss method that also causes a sustained, substantial improvement of T2D. Consequently, bariatric surgery may also have a role in improving immunity in these patient populations.
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Affiliation(s)
- Lynn M Frydrych
- Department of Surgery, Division of Acute Care Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Guowu Bian
- Department of Surgery, Division of Acute Care Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - David E O'Lone
- Department of Surgery, Division of Acute Care Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Peter A Ward
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Matthew J Delano
- Department of Surgery, Division of Acute Care Surgery, University of Michigan, Ann Arbor, Michigan, USA
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Townsend DK, McGregor K, Wu E, Cialkowski K, Haub MD, Barstow TJ. Insulin resistance and metabolic syndrome criteria in lean, normoglycemic college-age subjects. Diabetes Metab Syndr 2018; 12:609-616. [PMID: 29655623 DOI: 10.1016/j.dsx.2018.03.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 03/26/2018] [Indexed: 11/21/2022]
Abstract
AIMS The goal of this study was to determine insulin sensitivity in a fasted state and during an oral glucose tolerance test (OGTT), in normoglycemic (NGT), lean (L) (n = 35) and, for comparison, overweight/obese (OW/O) (n = 9) college-aged subjects. MATERIALS AND METHODS Insulin sensitivity for 44 NGT, normotensive subjects, age 18-26 yrs., was determined by homeostasis model assessment (HOMA-IR) and from Matsuda index (ISI Matsuda). RESULTS Subjects were normoglycemic fasted (4.59 + 0.35 mmol/L) and at two hours post OGTT (4.52 + 1.35 mmol/L). Besides anthropometric measures, there were significant differences between OW/O and L for fasting insulin (P < 0.001) and both measures of insulin sensitivity (P < 0.05). All subjects exhibited a 9-fold range in HOMA-IR (0.88 + 0.51, range 0.3-2.7) and an 8-fold range in ISI Matsuda (11.9 + 4.7, range 3.0-24.2). The latter was inversely correlated with systolic blood pressure (r = 0.35, P = 0.04) even though subjects were normotensive. In lean subjects, 2.3% were IR by HOMA-IR > 2.1, 5.7% by ISI Matsuda < 5.9, and 22.9% had >one criteria for metabolic syndrome (MetS); 28.6% had some negative metabolic biomarker. CONCLUSIONS Insulin resistance is present in lean, NGT college-age subjects even without MetS criteria and is discernable with an easily applicable OGTT-derived index.
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Affiliation(s)
- Dana K Townsend
- Applied Health Science, Wheaton College, Wheaton, Il, United States.
| | - Katheryn McGregor
- Kansas University School of Medicine, Kansas City, KS, United States
| | - Esther Wu
- Washington University in St. Louis School of Occupational Therapy, St. Louis., MO, United States
| | | | - Mark D Haub
- Rush University College of Nursing, Chicago, Il, United States
| | - Thomas J Barstow
- Department of Kinesiology, Kansas State University, Manhattan, KS, United States
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Tang Y, Zhong ZY, Liu YF, Sheng GT. Obtusifolin inhibits high glucose‑induced mitochondrial apoptosis in human umbilical vein endothelial cells. Mol Med Rep 2018; 18:3011-3019. [PMID: 30015829 DOI: 10.3892/mmr.2018.9251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 09/28/2017] [Indexed: 11/06/2022] Open
Abstract
DM is often accompanied by macrovascular complications. Obtusifolin, which is an anthraquinone‑based compound with antioxidant activity, is obtained from the seeds of Cassia obtusifolia. In this study, the potential effect of obtusifolin was investigated in human umbilical vein endothelial cells. The results from flow cytometry analysis revealed that pretreatment with obtusifolin depressed the production of cellular reactive oxygen species that was induced by high glucose content. Moreover, the results showed that pretreatment with obtusifolin reduced the level of malondialdehyde, as well as recovered the activities of mitochondrial complex I/III, catalase and superoxide dismutase. Furthermore, flow cytometry analysis also revealed that mitochondrial membrane potential and cell apoptosis were recovered, and inhibited by obtusifolin, respectively. The expression of X chromosome‑linked IAP was upregulated, whereas the expressions of poly ADP‑ribose polymerase and cysteinyl aspartate specific proteinase‑3/9 were downregulated by the pretreatment with obtusifolin. Notably, the western blot analyses showed that the release of Omi/HtrA2 into the cytosol was prevented by the pretreatment with obtusifolin. Conclusively, it was suggested that obtusifolin may provide protection against mitochondrial apoptosis largely through inhibition of the release of Omi/HtrA2 from mitochondria into cytosol.
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Affiliation(s)
- Yu Tang
- Department of Cardiology, People's Hospital of Jiangxi, Nanchang, Jiangxi 330006, P.R. China
| | - Zhi-Ying Zhong
- Department of Cardiology, The Fourth Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330003, P.R. China
| | - Yan-Feng Liu
- Department of Cardiology, People's Hospital of Jiangxi, Nanchang, Jiangxi 330006, P.R. China
| | - Gou-Tai Sheng
- Department of Cardiology, People's Hospital of Jiangxi, Nanchang, Jiangxi 330006, P.R. China
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Non-invasive Markers of Portal Hypertension: Appraisal of Adult Experience and Potential Utilisation in Children. J Pediatr Gastroenterol Nutr 2018; 66:559-569. [PMID: 29287004 DOI: 10.1097/mpg.0000000000001882] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Portal hypertension (PHT) is a significant cause of morbidity and mortality in children with chronic liver disease and portal vein obstruction. Increased portal pressure results in variceal formation along the gastrointestinal (GI) tract resulting in major bleeding. Identifying children with significant PHT who are more likely to suffer GI bleeding has been challenging and the role of surveillance upper GI endoscopy has been debated. This review analyses research done on serum biomarkers and imaging techniques as possible predictors of significant PHT. We evaluated the research performed on adult population, as well as the limited work done on children, to identify promising areas for future research. A literature search was conducted on "PubMed." Several search terms were used including "portal hypertension," "paediatric portal hypertension," "non-invasive markers of portal hypertension," "spleen stiffness," "liver stiffness," "elastography," and "endothelial damage." The articles included were selected based on their relevance to the purpose of our review. The research suggests a combination of several biomarkers, in addition to an imaging technique such as transient elastography or magnetic resonance elastography, would allow for the best prediction of significant varices. The most promising indicators would be those that are applicable in both intra- and extra-hepatic causes of PHT. Further research on these predictors in children with PHT is required to determine their potential role as selection criteria for PHT and stratification of surveillance GI endoscopies.
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Abstract
Prehypertension (pHTN) and metabolic syndrome (MetS) are both lifestyle diseases that are potentiated by increased adiposity, as both disease processes are closely related to weight. In the case of pHTN, increased adiposity causes dysregulation of the renin-angiotensin-aldosterone-system (RAAS) as well as adipokine- and leptin-associated increases in adrenergic tone. In MetS, excess weight potentiates hyperglycemia and insulin resistance which causes positive feedback into the RAAS system, activates an inflammatory cascade that potentiates atherosclerosis, and causes lipid dysregulation which together contribute to cardiovascular disease, especially coronary heart disease (CHD) and heart failure (HF). The relationship with all-cause mortality is not as clear-cut in part because of some protective effects associated with the obesity paradox in chronic diseases such as CHD and HF. However, in healthy populations, the absence of excess weight and its associated effects on prehypertension and MetS are associated with a longer absolute and disease-free lifespan.
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Yeary KHCK, Moore P, Turner J, Dawson L, Heo S, Greene P. Feasibility Test of a Community-Relevant Intervention Designed to Promote African American Participation in Translational, Breast Cancer Disparities Research: Know About Health Options for Women (Know HOW). JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:29-36. [PMID: 27085550 PMCID: PMC5065933 DOI: 10.1007/s13187-016-1032-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
There are marked racial differences in breast cancer, the second leading cause of death among US women. Understanding the causes of these differences is essential to eliminate breast cancer inequities. More prevalent in African American than in Caucasian women, metabolic syndrome has been associated with breast cancer outcomes. Further research is needed to understand metabolic syndrome's role in breast cancer disparities, thus novel strategies to increase minority participation in research are important. We embedded two approaches (comprehensive, focused) to increase African American participation in breast cancer research in a state-wide service program and pilot tested both approaches in rural African American women. We conducted three comprehensive and three focused outreach programs (n = 48) and assessed research participation through consent and actual provision of data for four types of data: survey, anthropometric, blood, and mammography records. The majority of participants provided written consent for all data collection procedures (96 % survey; 92 % anthropometric; 94 %, blood; 100 % mammography). There were no between group differences in consent rates. There was variation in the overall proportion of participants who provided data (96 % survey; 92 % anthropometric; 73 % blood; 40 % mammography). Women in the comprehensive approach were less likely to return for a scheduled mammogram than women in the focused approach (19 % vs 64 %, p = 0.0236). Both outreach programs promoted African American engagement in research. Differences in the provision of data by type may have been due to participant burden (i.e., time required to provide data). Study designs that embed research in service programs have promise to increase minority research participation.
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Affiliation(s)
| | - Page Moore
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jerome Turner
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Leah Dawson
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Seongkum Heo
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Paul Greene
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Mohd Nor NS, Saimin H, Rahman T, Abdul Razak S, Mohd Nasir N, Ismail Z, Mohd Nawawi H. Comparable Enhanced Prothrombogenesis in Simple Central Obesity and Metabolic Syndrome. J Obes 2018; 2018:8508549. [PMID: 29785305 PMCID: PMC5892226 DOI: 10.1155/2018/8508549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 02/27/2018] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE There is limited data comparing prothrombogenic or fibrinolysis biomarkers (tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1)) simultaneously in subjects with Metabolic Syndrome (MS), simple central obesity without MS (COB) and normal controls (NC). We investigated the concentrations of fibrinolysis biomarkers in subjects with MS, COB and NC. METHODS A cross-sectional study involving 503 drug naive subjects (163 males, aged 30-65 years old (mean age ± SD = 47.4 ± 8.3 years)) divided into MS, COB and NC groups. COB was defined as central obesity (waist circumference (WC) males ≥90 cm, females ≥80 cm) in the absence of MS according to the International Diabetes Federation 2006. Fasting blood levels of tPA and PAI-1were analyzed. RESULTS MS and COB had significantly higher concentration of all biomarkers compared to NC. The MS group had significantly higher concentration of tPA and PAI-1 compared to COB. WC and HDL-c had significant correlation with all biomarkers (tPA p < 0.001, PAI-1 p < 0.001). Fasting plasma glucose and diastolic blood pressure were independent predictors after correcting for confounding factors. CONCLUSION Central obesity with or without MS both demonstrated enhanced prothrombogenesis. This suggests that simple obesity possibly increases the risk of coronary artery disease in part, via increased susceptibility to thrombogenesis.
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Affiliation(s)
- Noor Shafina Mohd Nor
- Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA (UiTM), 47000 Sungai Buloh, Selangor, Malaysia
- Faculty of Medicine, Universiti Teknologi MARA (UiTM), 47000 Sungai Buloh, Selangor, Malaysia
| | - Hanis Saimin
- Faculty of Medicine, Universiti Teknologi MARA (UiTM), 47000 Sungai Buloh, Selangor, Malaysia
| | - Thuhairah Rahman
- Faculty of Medicine, Universiti Teknologi MARA (UiTM), 47000 Sungai Buloh, Selangor, Malaysia
| | - Suraya Abdul Razak
- Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA (UiTM), 47000 Sungai Buloh, Selangor, Malaysia
- Faculty of Medicine, Universiti Teknologi MARA (UiTM), 47000 Sungai Buloh, Selangor, Malaysia
| | - Nadzimah Mohd Nasir
- Faculty of Medicine, Universiti Teknologi MARA (UiTM), 47000 Sungai Buloh, Selangor, Malaysia
| | - Zaliha Ismail
- Faculty of Medicine, Universiti Teknologi MARA (UiTM), 47000 Sungai Buloh, Selangor, Malaysia
| | - Hapizah Mohd Nawawi
- Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA (UiTM), 47000 Sungai Buloh, Selangor, Malaysia
- Faculty of Medicine, Universiti Teknologi MARA (UiTM), 47000 Sungai Buloh, Selangor, Malaysia
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Lee J, Lee S, Zhang H, Hill MA, Zhang C, Park Y. Interaction of IL-6 and TNF-α contributes to endothelial dysfunction in type 2 diabetic mouse hearts. PLoS One 2017; 12:e0187189. [PMID: 29095915 PMCID: PMC5667841 DOI: 10.1371/journal.pone.0187189] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 10/16/2017] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Inflammatory cytokines, such as tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), are individually considered as important contributors to endothelial dysfunction in obesity and type 2 diabetes (T2D). However, their interactions in coronary arteriole endothelial dysfunction are uncertain. Therefore, this study aimed to determine the effects of TNF-α and IL-6 interactions on coronary endothelial dysfunction in experimental T2D. METHODS The studies used wild type (WT), diabetic mice (db/db), db/db null for TNF (dbTNF-/dbTNF-), and db/db mice treated with neutralizing antibody to IL-6 (anti-IL-6). Endothelium-dependent (acetylcholine [ACh], or luminal flow-induced shear stress) and endothelium-independent (sodium nitroprusside [SNP]) vasodilation of isolated and pressurized coronary arterioles were determined. Quantitative PCR, Western blot, and immunofluorescence staining were utilized for mechanistic studies. RESULTS Relative to WT, arteriolar dilation to both ACh and flow was attenuated in db/db mice and dbTNF-/dbTNF-. Treatment of dbTNF-/dbTNF- and db/db mice with anti-IL-6 improved arteriolar dilation compared to db/db mice. Immunofluorescence staining illustrated localization of IL-6 within the endothelial cells of coronary arterioles. In db/db mice, mRNA and protein expression of IL-6 and superoxide (O2-) production were higher, but reduced by anti-IL-6 treatment. Also, in db/db mice, mRNA and protein expression of TNF-α suppressed by the anti-IL-6 treatment and the reduced expression of mRNA and protein expression of IL-6 by the genetic deletion of TNF-α both supported a reciprocal regulation between TNF-α and IL-6. Superoxide dismutase 2 (SOD2) expression and phosphorylation of eNOS (p-eNOS/eNOS) were lower in db/db mice coronary arterioles and were restored in db/db+Anti-IL-6 and dbTNF-/dbTNF- mice. CONCLUSION The interactions between TNF-α and IL-6 exacerbate oxidative stress and reduce phosphorylation of eNOS, thereby contributing to coronary endothelial dysfunction in T2D mice.
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Affiliation(s)
- Jonghae Lee
- Department of Health and Human Performance, University of Houston, Houston, Texas, United States of America
| | - Sewon Lee
- Dalton Cardiovascular Research Center, University of Missouri-Columbia, Columbia, Missouri, United States of America
- Medical Pharmacology, University of Missouri-Columbia, Columbia, Missouri, United States of America
- Division of Sport Science and Sport Science Institute, Incheon National University, Incheon, South Korea
| | - Hanrui Zhang
- Dalton Cardiovascular Research Center, University of Missouri-Columbia, Columbia, Missouri, United States of America
- Medical Pharmacology, University of Missouri-Columbia, Columbia, Missouri, United States of America
- Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, United States of America
| | - Michael A. Hill
- Dalton Cardiovascular Research Center, University of Missouri-Columbia, Columbia, Missouri, United States of America
- Medical Pharmacology, University of Missouri-Columbia, Columbia, Missouri, United States of America
| | - Cuihua Zhang
- Dalton Cardiovascular Research Center, University of Missouri-Columbia, Columbia, Missouri, United States of America
- Medical Pharmacology, University of Missouri-Columbia, Columbia, Missouri, United States of America
- Departments of Internal Medicine, University of Missouri-Columbia, Columbia, Missouri, United States of America
- Physiology and Nutritional Sciences, University of Missouri-Columbia, Columbia, Missouri, United States of America
| | - Yoonjung Park
- Department of Health and Human Performance, University of Houston, Houston, Texas, United States of America
- Dalton Cardiovascular Research Center, University of Missouri-Columbia, Columbia, Missouri, United States of America
- * E-mail:
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The relationship between obesity and hypertension: an updated comprehensive overview on vicious twins. Hypertens Res 2017; 40:947-963. [DOI: 10.1038/hr.2017.75] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/07/2017] [Accepted: 04/14/2017] [Indexed: 02/07/2023]
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Gram AS, Bladbjerg EM, Quist JS, Petersen MB, Rosenkilde M, Stallknecht B. Anti-inflammatory effects of active commuting and leisure time exercise in overweight and obese women and men: A randomized controlled trial. Atherosclerosis 2017; 265:318-324. [DOI: 10.1016/j.atherosclerosis.2017.06.923] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/12/2017] [Accepted: 06/27/2017] [Indexed: 10/19/2022]
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Wilner B, Garg S, Ayers CR, Maroules CD, McColl R, Matulevicius SA, de Lemos JA, Drazner MH, Peshock R, Neeland IJ. Dynamic Relation of Changes in Weight and Indices of Fat Distribution With Cardiac Structure and Function: The Dallas Heart Study. J Am Heart Assoc 2017; 6:JAHA.117.005897. [PMID: 28724650 PMCID: PMC5586303 DOI: 10.1161/jaha.117.005897] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Obesity may increase heart failure risk through cardiac remodeling. Cross-sectional associations between adiposity and cardiac structure and function have been elucidated, but the impact of longitudinal changes in adiposity on cardiac remodeling is less well understood. METHODS AND RESULTS Participants in the Dallas Heart Study without cardiovascular disease or left ventricular dysfunction underwent assessment of body weight, anthropometrics, and cardiac magnetic resonance imaging at baseline and 7 years later. Associations between changes in indices of generalized and central adiposity with changes in left ventricular mass, volume, mass/volume ratio (concentricity), wall thickness, and ejection fraction were assessed using multivariable linear regression. The study cohort (n=1262) mean age was 44 years with 57% women, 44% black, and 36% obese participants. At follow-up, 41% had ≥5% weight gain, and 15% had ≥5% weight loss. Greater weight gain was associated with younger age, lower risk factor burden, and lower body mass index at baseline. In multivariable models adjusting for age, sex, race, comorbid conditions at baseline and follow-up, baseline adiposity, and cardiac measurement, increasing weight was associated with increases in left ventricular mass (β=0.10, P<0.0001), wall thickness (β=0.10, P<0.0001), and concentricity (β=0.06, P=0.002), with modest effects on end-diastolic volume (β=0.04, P=0.044) and ejection fraction (β=0.05, P=0.046). Similar results were seen with other adiposity indices. CONCLUSIONS Concentric left ventricular remodeling is the predominant phenotype linked to increasing adiposity in middle age. Our findings support the importance of weight management to prevent secular changes in adiposity, concentric remodeling, and eventual heart failure over time.
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Affiliation(s)
- Bryan Wilner
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Sonia Garg
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Colby R Ayers
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Roderick McColl
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Susan A Matulevicius
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - James A de Lemos
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Mark H Drazner
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Ronald Peshock
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX.,Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Ian J Neeland
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX
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S1PR2 antagonist protects endothelial cells against high glucose-induced mitochondrial apoptosis through the Akt/GSK-3β signaling pathway. Biochem Biophys Res Commun 2017; 490:1119-1124. [PMID: 28676392 DOI: 10.1016/j.bbrc.2017.06.189] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 06/30/2017] [Indexed: 11/23/2022]
Abstract
Vascular complications are the main cause of morbidity and mortality associated with type 2 diabetes mellitus. An early hallmark of the onset of vascular complications is endothelial dysfunction and apoptosis. We aimed to explore the role of sphingosine-1-phosphatereceptor 2 (S1PR2) in high glucose-induced endothelial cells apoptosis and to elaborate the underlying mechanism. Human umbilical vein endothelial cells (HUVECs) were cultured in a high glucose with or without S1PR2 antagonist. The apoptosis of the cells was measured by flow cytometry and mitochondrial membrane permeability was detected by the fluorescent probe JC-1. The expression of the related protein was determined by western blot. Cell apoptosis and the loss of mitochondrial membrane permeability were induced under high glucose conditions in HUVECs. The expression of mitochondrial apoptosis related protein bax increased and bcl-2 decreased in high glucose-induced HUVECs. The level of cytochrome c released into the cytoplasm increased when cells were exposed to high glucose. In addition, the expression of p-AKT and p-GSK3β was reduced when HUVECs were treated with high glucose. However, these effects were reversed in HUVECs when cells treated with S1PR2 antagonist. In conclusion, S1PR2 antagonist protects endothelial cells against high glucose-induced mitochondrial apoptosis through the Akt/GSK-3β signaling pathway.
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Villalpando Sánchez DC, Alvarez Aguilar C, Gómez García A. Advanced oxidation protein products and their relationship with cardiovascular risk factors in young apparently healthy people. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2017; 29:209-215. [PMID: 28619393 DOI: 10.1016/j.arteri.2017.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/07/2017] [Accepted: 04/12/2017] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Advanced oxidation protein products (AOPPs) are used as a marker to estimate oxidative stress in plasma proteins. Oxidative stress is considered a factor of cardiovascular risk (CVRF) related to increased blood pressure, and dyslipidaemia. The aim of this study was to evaluate the association between plasma AOPPs and CVRF in apparently healthy young adults. METHODS A prospective cross-sectional study was conducted on 120 students of the Faculty of Chemical-Pharmacobiology of the UMSNH. Body mass index (BMI) and blood pressure were determined. A blood specimen was also collected to quantify AOPPs, glucose, total cholesterol, lipoproteins (high, low, and very low density), and triglycerides. RESULTS Differences were observed in the groups with and without CVRF, with significant differences in BMI, waist, body fat (P<.05), and lipid profile (P<.0001). AOPPs were higher in the group of young people with three and four CVRF (F: 4.651; P=.002). A negatively correlation was found between AOPPs and LDL cholesterol (r=-0.364; P=.0001). CONCLUSIONS It was observed that AOPPs concentrations are increased as CVRF increase in young adults. Thus, this could be considered an important risk factor, because their deposition in the atherosclerotic plaque favours the atherogenic process, and thus the development of cardiovascular disease. Quantification of AOPPs contributes to the indirect determination of oxidative status in the body. The study of metabolic and oxidative state of apparently healthy young adults is important in the prevention of cardiovascular disease in later life. More longitudinal studies are required to study its evolution.
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Affiliation(s)
- Diana Carolina Villalpando Sánchez
- División de Investigación Clínica, Centro de Investigación Biomédica de Michoacán, Instituto Mexicano del Seguro Social, Morelia, Michoacán, México
| | - Cleto Alvarez Aguilar
- Coordinación Auxiliar de Investigación en Salud, Instituto Mexicano del Seguro Social, Morelia, Michoacán, México
| | - Anel Gómez García
- División de Investigación Clínica, Centro de Investigación Biomédica de Michoacán, Instituto Mexicano del Seguro Social, Morelia, Michoacán, México.
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Kohlgrüber S, Upadhye A, Dyballa-Rukes N, McNamara CA, Altschmied J. Regulation of Transcription Factors by Reactive Oxygen Species and Nitric Oxide in Vascular Physiology and Pathology. Antioxid Redox Signal 2017; 26:679-699. [PMID: 27841660 PMCID: PMC5421514 DOI: 10.1089/ars.2016.6946] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
SIGNIFICANCE Cardiovascular diseases are the main cause of death worldwide and pose an immense economical burden. In most cases, the underlying problem is vascular occlusion by atherosclerotic plaques. Importantly, different cell types of the vascular wall and the immune system play crucial roles in atherosclerosis at different stages of the disease. Furthermore, atherosclerosis and conditions recognized as risk factors are characterized by a reduced availability of the vasoprotective molecule nitric oxide and an increase in reactive oxygen species, so-called oxidative stress. Transcription factors function as intracellular signal integrators and relays and thus, play a central role in cellular responses to changing conditions. Recent Advances: Work on specific transcriptional regulators has uncovered many of their functions and the upstream pathways modulating their activity in response to reactive oxygen and nitrogen species. Here, we have reviewed for a few selected examples how this can contribute not only to protection against atherosclerosis development but also to disease progression and the occurrence of clinical manifestations, such as plaque rupture. CRITICAL ISSUES Transcription factors have pleiotropic outputs and often also divergent functions in different cell types and tissues. Thus, in light of potential severe adverse side effects, a global activation or inhibition of particular transcriptions factors does not seem a feasible therapeutic option. FUTURE DIRECTIONS A further in-depth characterization of the cell- and stage-specific actions and regulation of transcription factors in atherosclerosis with respect to protein-protein interactions and target genes could open up new avenues for prevention or therapeutic interventions in this vascular disease. Antioxid. Redox Signal. 26, 679-699.
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Affiliation(s)
- Stefanie Kohlgrüber
- 1 IUF-Leibniz Research Institute for Environmental Medicine , Düsseldorf, Germany
| | - Aditi Upadhye
- 2 Department of Microbiology, Immunology, Cancer Biology, University of Virginia , Charlottesville, Virginia
| | - Nadine Dyballa-Rukes
- 1 IUF-Leibniz Research Institute for Environmental Medicine , Düsseldorf, Germany
| | - Coleen A McNamara
- 3 Cardiovascular Division, Department of Medicine and Robert M. Berne Cardiovascular Research Center, University of Virginia-School of Medicine , Charlottesville, Virginia
| | - Joachim Altschmied
- 1 IUF-Leibniz Research Institute for Environmental Medicine , Düsseldorf, Germany
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Bond V, Curry BH, Kumar K, Pemminati S, Gorantla VR, Kadur K, Millis RM. Restricted Blood Flow Exercise in Sedentary, Overweight African-American Females May Increase Muscle Strength and Decrease Endothelial Function and Vascular Autoregulation. J Pharmacopuncture 2017; 20:23-28. [PMID: 28392959 PMCID: PMC5374335 DOI: 10.3831/kpi.2017.20.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objectives: Exercise with partially restricted blood flow is a low-load, low-intensity resistance training regimen which may have the potential to increase muscle strength in the obese, elderly and frail who are unable to do high-load training. Restricted blood flow exercise has also been shown to affect blood vessel function variably and can, therefore, contribute to blood vessel dysfunction. This pilot study tests the hypothesis that unilateral resistance training of the leg extensors with partially restricted blood flow increases muscle strength and decreases vascular autoregulation. Methods: The subjects were nine normotensive, overweight, young adult African-Americans with low cardiorespiratory fitness who underwent unilateral training of the quadriceps’ femoris muscles with partially restricted blood flow at 30% of the 1-repetition maximum (1-RM) load for 3 weeks. The 1-RM load and post-occlusion blood flow to the lower leg (calf) were measured during reactive hyperemia. Results: The 1-RM load increased in the trained legs from 77 ± 3 to 84 ± 4 kg (P < 0.05) in the absence of a significant effect on the 1-RM load in the contralateral untrained legs (P > 0.1). Post-occlusion blood flow decreased significantly in the trained legs from 19 ± 2 to 13 ± 2 mL· min-1· dL-1 (P < 0.05) and marginally in the contralateral untrained legs from 18 ± 2 to 16 ± 1 mL· min-1· dL-1 (P = 0.09). Changes in post-occlusion blood flow to the skin overlying the trained and the contralateral untrained muscles were not significant. Conclusion: These results demonstrate that restricted blood flow exercise, which results in significant gains in muscle strength, may produce decrements in endothelial dysfunction and vascular autoregulation. Future studies should determine whether pharmacopuncture plays a role in treatments for such blood vessel dysfunction.
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Affiliation(s)
- Vernon Bond
- Department of Recreation, Human Performance & Leisure Studies and Exercise Science & Human Nutrition Laboratory, Howard University Cancer Centre, Washington DC, United States of America
| | - Bryan Heath Curry
- Department of Medicine, Division of Cardiology, Howard College of Medicine & Howard University Hospital, Washington DC, United States of America
| | - Krishna Kumar
- Department of Pharmaceutical Sciences, Howard University Hospital, Washington DC, United States of America
| | - Sudhakar Pemminati
- Department of Medical Pharmacology, AUA College of Medicine & Manipal University, Antigua and Barbuda
| | - Vasavi Rakesh Gorantla
- Department of Behavioural Sciences and Neuroscience, AUA College of Medicine, Antigua and Barbuda
| | - Kishan Kadur
- Department of Medical Physiology, AUA College of Medicine, Antigua and Barbuda
| | - Richard Mark Millis
- Department of Medical Physiology, AUA College of Medicine, Antigua and Barbuda
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Gopal K, Ussher JR. Sugar-sweetened beverages and vascular function: food for thought. Am J Physiol Heart Circ Physiol 2017; 312:H285-H288. [DOI: 10.1152/ajpheart.00783.2016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Keshav Gopal
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
- Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada; and
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - John R. Ussher
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
- Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada; and
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
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Dong Y, Fernandes C, Liu Y, Wu Y, Wu H, Brophy ML, Deng L, Song K, Wen A, Wong S, Yan D, Towner R, Chen H. Role of endoplasmic reticulum stress signalling in diabetic endothelial dysfunction and atherosclerosis. Diab Vasc Dis Res 2017; 14:14-23. [PMID: 27941052 PMCID: PMC5161113 DOI: 10.1177/1479164116666762] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
It is well established that diabetes mellitus accelerates atherosclerotic vascular disease. Endothelial injury has been proposed to be the initial event in the pathogenesis of atherosclerosis. Endothelium not only acts as a semi-selective barrier but also serves physiological and metabolic functions. Diabetes or high glucose in circulation triggers a series of intracellular responses and organ damage such as endothelial dysfunction and apoptosis. One such response is high glucose-induced chronic endoplasmic reticulum stress in the endothelium. The unfolded protein response is an acute reaction that enables cells to overcome endoplasmic reticulum stress. However, when chronically persistent, endoplasmic reticulum stress response could ultimately lead to endothelial dysfunction and atherosclerosis. Herein, we discuss the scientific advances in understanding endoplasmic reticulum stress-induced endothelial dysfunction, the pathogenesis of diabetes-accelerated atherosclerosis and endoplasmic reticulum stress as a potential target in therapies for diabetic atherosclerosis.
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Affiliation(s)
- Yunzhou Dong
- Vascular Biology Program, Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Yanjun Liu
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science, University of California-Los Angeles School of Medicine, Los Angeles, CA, USA
| | - Yong Wu
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science, University of California-Los Angeles School of Medicine, Los Angeles, CA, USA
| | - Hao Wu
- Vascular Biology Program, Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Megan L Brophy
- Vascular Biology Program, Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Lin Deng
- Department of Biological Chemistry & Molecular Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Kai Song
- Vascular Biology Program, Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Aiyun Wen
- Vascular Biology Program, Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Scott Wong
- Vascular Biology Program, Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Daoguang Yan
- Department of Biology, Jinan University, Guangzhou, China
| | - Rheal Towner
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, Oklahoma, OK, USA
| | - Hong Chen
- Vascular Biology Program, Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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Evaluation the effect of 50 and 100 mg doses of Cuminum cyminum essential oil on glycemic indices, insulin resistance and serum inflammatory factors on patients with diabetes type II: A double-blind randomized placebo-controlled clinical trial. J Tradit Complement Med 2016; 7:332-338. [PMID: 28725629 PMCID: PMC5506625 DOI: 10.1016/j.jtcme.2016.08.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 08/08/2016] [Accepted: 08/15/2016] [Indexed: 11/21/2022] Open
Abstract
Aim The purpose of this study was to evaluate the effect of 50 and 100 mg doses of green cumin essential oil on glycemic and inflammatory indices in patients with diabetes type II. Method In this randomized double-blind placebo-controlled clinical trial, subjects were divided into three groups after selecting them randomly according to the inclusion criteria: 1 – Cuminum cyminum capsule (100 mg/day,n = 33), 2 – C. cyminum capsule (50 mg/day, n = 33), and 3 – placebo (n = 33). Before and after 8 weeks of intervention, a blood sample was taken. Findings The findings demonstrated that the mean of the FBS, glycosylated hemoglobin (HgA1c) and the serum levels of insulin were significantly decreased and insulin sensitivity (HOMA-IR) was significantly increased in the groups receiving the 100 mg supplement (P < 0.001) and 50 mg supplement, but these indices were increased in the placebo group. The mean serum levels of TNF-α and hsCRP were significantly decreased, and serum levels of adiponectin was significantly increased at the end of the study in the groups receiving 100 mg (P < 0.001) and 50 mg (P = 0.008) supplement as well as in the group who received the placebo. There were no significant change in HOMA-B and QUICKI as insulin resistance parameters. Discussion and conclusion Administering C. cyminum supplement in patients with diabetes type II may decrease the serum levels of insulin, FBS, and glycosylated hemoglobin and also the inflammatory indices of TNF-α and hsCRP and increased the serum levels of adiponectin. In addition it may control the complications of diabetes type II in these patients.
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73
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Islam MA, Chowdhury RI, Sultan KS. Analyzing dependence in incidence of diabetes and heart problem using generalized bivariate geometric models with covariates. J Appl Stat 2016. [DOI: 10.1080/02664763.2016.1266467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M. Ataharul Islam
- Department of Applied Statistics, East West University, Dhaka, Bangladesh
| | | | - K. S. Sultan
- Department of Statistics and Operations Research, College of Science, King Saud University, Riyadh, Saudi Arabia
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Pan Y, Liu B, Deng Z, Fan Y, Li J, Li H. Lipid Rafts Promote trans Fatty Acid-Induced Inflammation in Human Umbilical Vein Endothelial Cells. Lipids 2016; 52:27-35. [DOI: 10.1007/s11745-016-4213-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 11/03/2016] [Indexed: 01/08/2023]
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Spillmann F, De Geest B, Muthuramu I, Amin R, Miteva K, Pieske B, Tschöpe C, Van Linthout S. Apolipoprotein A-I gene transfer exerts immunomodulatory effects and reduces vascular inflammation and fibrosis in ob/ob mice. JOURNAL OF INFLAMMATION-LONDON 2016; 13:25. [PMID: 27486384 PMCID: PMC4969975 DOI: 10.1186/s12950-016-0131-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 07/19/2016] [Indexed: 12/31/2022]
Abstract
Background Obesity is associated with vascular inflammation, fibrosis and reduced high-density lipoproteins (HDL)-cholesterol. We aimed to investigate whether adenoviral gene transfer with human apolipoprotein (apo) A-I (Ad.A-I), the main apo of HDL, could exert immunomodulatory effects and counteract vascular inflammation and fibrosis in ob/ob mice. Methods Ad.A-I transfer was performed in 8 weeks (w) old ob/ob mice, which were sacrificed 7 w later. The aorta was excised for mRNA analysis and the spleen for splenocyte isolation for subsequent flow cytometry and co-culture with murine fibroblasts. HDL was added to mononuclear cells (MNC) and fibroblasts to assess their impact on adhesion capacity and collagen deposition, respectively. Results Ad.A-I led to a 1.8-fold (p < 0.05) increase in HDL-cholesterol versus control ob/ob mice at the day of sacrifice, which was paralleled by a decrease in aortic TNF-α and VCAM-1 mRNA expression. Pre-culture of MNC with HDL decreased their adhesion to TNF-α-activated HAEC. Ad.A-I exerted immunomodulatory effects as evidenced by a downregulation of aortic NOD2 and NLRP3 mRNA expression and by a 12 %, 6.9 %, and 15 % decrease of the induced proliferation/activity of total splenic MNC, CD4+, and CD8+ cells in ob/ob Ad.A-I versus control ob/ob mice, respectively (p < 0.05). Ad.A-I further reduced aortic collagen I and III mRNA expression by 62 % and 66 %, respectively (p < 0.0005), and abrogated the potential of ob/ob splenocytes to induce the collagen content in murine fibroblasts upon co-culture. Finally, HDL decreased the TGF-ß1-induced collagen deposition of murine fibroblasts in vitro. Conclusions Apo A-I transfer counteracts vascular inflammation and fibrosis in ob/ob mice. Electronic supplementary material The online version of this article (doi:10.1186/s12950-016-0131-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Frank Spillmann
- Department of Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), Berlin, Germany
| | - Bart De Geest
- Catholic University of Leuven, Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Leuven, Belgium
| | - Ilayaraja Muthuramu
- Catholic University of Leuven, Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Leuven, Belgium
| | - Ruhul Amin
- Catholic University of Leuven, Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Leuven, Belgium
| | - Kapka Miteva
- Berlin-Brandenburg Center for Regenerative Therapy (BCRT), Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), Südstrasse 2, 13353 Berlin, Germany
| | - Burkert Pieske
- Department of Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), Berlin, Germany ; Deutsches Zentrum für Herz Kreislaufforschung (DZHK), Standort Berlin/Charité, Berlin, Germany ; Department of Cardiology, Deutsches Herzzentrum Berlin (DHZB), Berlin, Germany
| | - Carsten Tschöpe
- Department of Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), Berlin, Germany ; Berlin-Brandenburg Center for Regenerative Therapy (BCRT), Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), Südstrasse 2, 13353 Berlin, Germany ; Deutsches Zentrum für Herz Kreislaufforschung (DZHK), Standort Berlin/Charité, Berlin, Germany
| | - Sophie Van Linthout
- Department of Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), Berlin, Germany ; Berlin-Brandenburg Center for Regenerative Therapy (BCRT), Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), Südstrasse 2, 13353 Berlin, Germany ; Deutsches Zentrum für Herz Kreislaufforschung (DZHK), Standort Berlin/Charité, Berlin, Germany
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Tabur S, Oztuzcu S, Oguz E, Demiryürek S, Dagli H, Alasehirli B, Ozkaya M, Demiryürek AT. Evidence for elevated (LIMK2 and CFL1) and suppressed (ICAM1, EZR, MAP2K2, and NOS3) gene expressions in metabolic syndrome. Endocrine 2016; 53:465-70. [PMID: 26956845 DOI: 10.1007/s12020-016-0910-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 02/25/2016] [Indexed: 12/12/2022]
Abstract
The metabolic syndrome (MetS) is a common multicomponent condition including abdominal obesity, dyslipidemia, hypertension, and hyperglycaemia. The aim of this study was to investigate the associations of the expression of a panel of signalling genes with the MetS in a Turkish population. A total of 54 MetS patients and 42 healthy controls with similar age and sex were included to this study. mRNA from blood samples was extracted, and real-time polymerase chain reaction was performed for gene expressions using a BioMark 96.96 dynamic array system. We observed marked increases in LIM kinase 2 (LIMK2) and cofilin 1 (CFL1) gene expressions in MetS patients. However, there were significant decreases in intercellular adhesion molecules 1 (ICAM1), ezrin (EZR), mitogen-activated protein kinase kinase 2 (MAP2K2), and nitric oxide synthase 3 (NOS3) gene expressions in MetS patients. Additionally, no marked changes were noted in other 15 genes studied. This is the first study to provide evidence that activation of LIMK2/CFL1 pathway may play an important role in MetS.
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Affiliation(s)
- Suzan Tabur
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Gaziantep, 27310, Gaziantep, Turkey.
| | - Serdar Oztuzcu
- Department of Medical Biology, Faculty of Medicine, University of Gaziantep, 27310, Gaziantep, Turkey
| | - Elif Oguz
- Department of Medical Pharmacology, Faculty of Medicine, Harran University, 63300, Sanliurfa, Turkey
| | - Seniz Demiryürek
- Department of Physiology, Faculty of Medicine, University of Gaziantep, 27310, Gaziantep, Turkey
| | - Hasan Dagli
- Department of Medical Biology, Faculty of Medicine, University of Gaziantep, 27310, Gaziantep, Turkey
| | - Belgin Alasehirli
- Department of Medical Pharmacology, Faculty of Medicine, University of Gaziantep, 27310, Gaziantep, Turkey
| | - Mesut Ozkaya
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Gaziantep, 27310, Gaziantep, Turkey
| | - Abdullah T Demiryürek
- Department of Medical Pharmacology, Faculty of Medicine, University of Gaziantep, 27310, Gaziantep, Turkey
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Acree LS, Montgomery PS, Gardner AW. The influence of obesity on arterial compliance in adult men and women. Vasc Med 2016; 12:183-8. [PMID: 17848474 DOI: 10.1177/1358863x07079323] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of this study was to determine whether differences in large and small arterial compliance existed among normal weight, overweight, and obese older men and women, and whether large and small arterial compliance were associated with abdominal, hip, and subcutaneous fat distribution. A total of 134 individuals who were 40 years of age and older (age = 62 ± 11 years; mean ± SD) were grouped into normal weight (BMI: 18.5—24.9 kg/m2; n = 33), overweight (BMI: 25.0—29.9 kg/m2; n = 48), or obese (BMI: ≥30.0 kg/m2; n = 53) categories. The hemodynamic and arterial compliance measurements were obtained using the HDI/PulseWave CR-2000 CardioVascular Profiling System (Hypertension Diagnostics, Inc). Body mass index, nine-site sum of skinfolds, and circumference measures around the hip and waist were used for analysis. Large and small arterial compliance was lower (p < 0.001) in the obese group (12.4 ± 4.8 ml/mmHg × 10 vs 4.6 ± 2.5 ml/mmHg × 100, respectively) than the normal weight (16.2 ± 4.9 ml/mmHg × 10 vs 5.5 ± 2.7 ml/mmHg × 100) and overweight (15.2 ± 4.3 ml/mmHg × 10 vs 5.0 ± 2.2 ml/mmHg × 100) groups. This difference remained (p < 0.001) after adjusting for body surface area, sex, hyperlipidemia, and hypertension. Additionally, large arterial compliance correlated (p < 0.05) with sum of skinfolds (r = — 0.209), while small arterial compliance correlated with hip circumference (r = — 0.189). Arterial compliance measures were not related (p > 0.05) to waist circumference or waist-to-hip ratio. In conclusion, obesity was associated with a decrease in large and small arterial compliance independent of conventional risk factors. Additionally, subcutaneous fat and fat around the hips were inversely related to arterial compliance.
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Affiliation(s)
- Luke S Acree
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
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Withaferin A protects against palmitic acid-induced endothelial insulin resistance and dysfunction through suppression of oxidative stress and inflammation. Sci Rep 2016; 6:27236. [PMID: 27250532 PMCID: PMC4890118 DOI: 10.1038/srep27236] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 05/13/2016] [Indexed: 01/01/2023] Open
Abstract
Activation of inflammatory pathways via reactive oxygen species (ROS) by free fatty acids (FFA) in obesity gives rise to insulin resistance and endothelial dysfunction. Withaferin A (WA), possesses both antioxidant and anti-inflammatory properties and therefore would be a good strategy to suppress palmitic acid (PA)-induced oxidative stress and inflammation and hence, insulin resistance and dysfunction in the endothelium. Effect of WA on PA-induced insulin resistance in human umbilical vein endothelial cells (HUVECs) was determined by evaluating insulin signaling mechanisms whilst effect of this drug on PA-induced endothelial dysfunction was determined in acetylcholine-mediated relaxation in isolated rat aortic preparations. WA significantly inhibited ROS production and inflammation induced by PA. Furthermore, WA significantly decreased TNF-α and IL-6 production in endothelial cells by specifically suppressing IKKβ/NF-κβ phosphorylation. WA inhibited inflammation-stimulated IRS-1 serine phosphorylation and improved the impaired insulin PI3-K signaling, and restored the decreased nitric oxide (NO) production triggered by PA. WA also decreased endothelin-1 and plasminogen activator inhibitor type-1 levels, and restored the impaired endothelium-mediated vasodilation in isolated aortic preparations. These findings suggest that WA inhibited both ROS production and inflammation to restore impaired insulin resistance in cultured endothelial cells and improve endothelial dysfunction in rat aortic rings.
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79
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Catry E, Neyrinck AM, Lobysheva I, Pachikian BD, Van Hul M, Cani PD, Dessy C, Delzenne NM. Nutritional depletion in n-3 PUFA in apoE knock-out mice: A new model of endothelial dysfunction associated with fatty liver disease. Mol Nutr Food Res 2016; 60:2198-2207. [PMID: 27136390 DOI: 10.1002/mnfr.201500930] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 03/04/2016] [Accepted: 04/04/2016] [Indexed: 12/18/2022]
Abstract
SCOPE Western diets are characterized by low intake of n-3 PUFA compensated by constant amounts of n-6 PUFA. Reduced intake of n-3 PUFA is associated with increased cardiovascular risk, as observed in nonalcoholic fatty liver disease patients. The study aimed to evaluating the impact of dietary n-3 PUFA depletion on endothelial function, an early key event of cardiovascular diseases. METHODS AND RESULTS C57Bl/6J or apolipoprotein E knock-out (apoE-/- ) were fed control (CT) or n-3 PUFA-depleted diets (DEF) for 12 wks. Mice fed n-3 DEF diet developed a hepatic steatosis, linked to changes in hepatic expression of genes controlled by Sterol Regulatory Element Binding Protein-1 and -2. Vascular function was assessed on second- and third-order mesenteric arteries and n-3 PUFA-depleted apoE-/- mice presented endothelial dysfunction characterized by decreased vasorelaxation in response of acetylcholine. The presence of a nitric oxide synthase (NOS) inhibitor blunted the relaxation in each groups and heme-nitrosylated hemoglobin blood (Hb-NO) level was significantly lower in n-3 PUFA-depleted apoE-/- mice. CONCLUSION Twelve weeks of n-3 DEF diet promote steatosis and accelerate the process of endothelial dysfunction in apoE-/- mice by a mechanism involving the NOS/NO pathway. We propose n-3 PUFA-depleted apoE-/- mice as a new model to study endothelial dysfunction related to hepatic steatosis independently of obesity.
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Affiliation(s)
- Emilie Catry
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium
| | - Audrey M Neyrinck
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium
| | - Irina Lobysheva
- Pôle de Pharmacologie et Thérapeutique, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium
| | - Barbara D Pachikian
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium
| | - Matthias Van Hul
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium.,Walloon Excellence in Life sciences and Biotechnology (WELBIO), Wavre, Belgium
| | - Patrice D Cani
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium.,Walloon Excellence in Life sciences and Biotechnology (WELBIO), Wavre, Belgium
| | - Chantal Dessy
- Pôle de Pharmacologie et Thérapeutique, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium
| | - Nathalie M Delzenne
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium.
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Liu Y, Tian X, Li Y, Liu D, Liu M, Zhang X, Zhang Q, Yan C, Han Y. Up-Regulation of CREG Expression by the Transcription Factor GATA1 Inhibits High Glucose- and High Palmitate-Induced Apoptosis in Human Umbilical Vein Endothelial Cells. PLoS One 2016; 11:e0154861. [PMID: 27139506 PMCID: PMC4854376 DOI: 10.1371/journal.pone.0154861] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 04/20/2016] [Indexed: 01/14/2023] Open
Abstract
Background Endothelial cell (EC) apoptosis plays a vital role in the pathogenesis of atherosclerosis in patients with diabetes mellitus (DM), but the underlying mechanism remains unclear. Cellular repressor of E1A-stimulated genes (CREG) is a novel gene reported to be involved in maintaining the homeostasis of ECs. Therefore, in the present study, we investigated the role of CREG in high glucose/high palmitate-induced EC apoptosis and to decipher the upstream regulatory mechanism underlying the transcriptional regulation of CREG. Methods The expression of CREG and the rate of apoptosis were assessed in lower-limb atherosclerotic lesions from patients with type 2 DM (T2DM). Primary human umbilical vein endothelial cells (HUVECs) were isolated and cultured in a high glucose/high palmitate medium (25 mmol/L D-glucose, 0.4 mmol/L palmitate), and the over-expression and knock-down of CREG were performed in HUVECs to determine the role of CREG in EC apoptosis. The upstream regulatory mechanism of CREG was identified using a promoter-binding transcription-factor profiling array, chromatin immunoprecipitation (ChIP) assay and a mutation analysis. Results Compared with normal arteries from non-diabetic patients, reduced CREG expression and increased apoptosis were found in the endothelium of atherosclerotic lesions from patients with T2DM. In vitro treatment of HUVECs with a high glucose/high palmitate medium also resulted in decreased CREG expression and increased apoptosis. Moreover, high glucose/high palmitate induced-HUVEC apoptosis was increased by the knock-down of CREG and rescued by the over-expression of CREG. We also demonstrated that GATA1 was able to bind to the promoter of the human CREG gene. A deletion mutation at -297/-292 in the CREG promoter disrupted GATA1 binding and reduced the activation of CREG transcription by approximately 83.3%. Finally, the overexpression of GATA1 abrogated the high glucose/high palmitate-induced apoptosis in HUVECs. Conclusions The over-expression of CREG inhibits high glucose/high palmitate-induced apoptosis in HUVECs. CREG is transcriptionally upregulated by GATA1. Thus, CREG might be a potential therapeutic target for intervention of vascular complications related to diabetes.
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Affiliation(s)
- Yanxia Liu
- Graduate School of Third Military Medical University, Chongqing, China
- Department of Cardiology and Cardiovascular Research Institute, General Hospital of Shenyang Military Region, Shenyang, China
| | - Xiaoxiang Tian
- Department of Cardiology and Cardiovascular Research Institute, General Hospital of Shenyang Military Region, Shenyang, China
| | - Yang Li
- Department of Cardiology and Cardiovascular Research Institute, General Hospital of Shenyang Military Region, Shenyang, China
| | - Dan Liu
- Department of Cardiology and Cardiovascular Research Institute, General Hospital of Shenyang Military Region, Shenyang, China
| | - Meili Liu
- Department of Cardiology and Cardiovascular Research Institute, General Hospital of Shenyang Military Region, Shenyang, China
| | - Xiaolin Zhang
- Department of Cardiology and Cardiovascular Research Institute, General Hospital of Shenyang Military Region, Shenyang, China
| | - Quanyu Zhang
- Department of Cardiology and Cardiovascular Research Institute, General Hospital of Shenyang Military Region, Shenyang, China
| | - Chenghui Yan
- Department of Cardiology and Cardiovascular Research Institute, General Hospital of Shenyang Military Region, Shenyang, China
| | - Yaling Han
- Department of Cardiology and Cardiovascular Research Institute, General Hospital of Shenyang Military Region, Shenyang, China
- * E-mail:
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Abstract
OBJECTIVES Although critical care physicians view obesity as an independent poor prognostic marker, growing evidence suggests that obesity is, instead, associated with improved mortality following ICU admission. However, this prior empirical work may be biased by preferential admission of obese patients to ICUs, and little is known about other patient-centered outcomes following critical illness. We sought to determine whether 1-year mortality, healthcare utilization, and functional outcomes following a severe sepsis hospitalization differ by body mass index. DESIGN Observational cohort study. SETTING U.S. hospitals. PATIENTS We analyzed 1,404 severe sepsis hospitalizations (1999-2005) among Medicare beneficiaries enrolled in the nationally representative Health and Retirement Study, of which 597 (42.5%) were normal weight, 473 (33.7%) were overweight, and 334 (23.8%) were obese or severely obese, as assessed at their survey prior to acute illness. Underweight patients were excluded a priori. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Using Medicare claims, we identified severe sepsis hospitalizations and measured inpatient healthcare facility use and calculated total and itemized Medicare spending in the year following hospital discharge. Using the National Death Index, we determined mortality. We ascertained pre- and postmorbid functional status from survey data. Patients with greater body mass indexes experienced lower 1-year mortality compared with nonobese patients, and there was a dose-response relationship such that obese (odds ratio = 0.59; 95% CI, 0.39-0.88) and severely obese patients (odds ratio = 0.46; 95% CI, 0.26-0.80) had the lowest mortality. Total days in a healthcare facility and Medicare expenditures were greater for obese patients (p < 0.01 for both comparisons), but average daily utilization (p = 0.44) and Medicare spending were similar (p = 0.65) among normal, overweight, and obese survivors. Total function limitations following severe sepsis did not differ by body mass index category (p = 0.64). CONCLUSIONS Obesity is associated with improved mortality among severe sepsis patients. Due to longer survival, obese sepsis survivors use more healthcare and result in higher Medicare spending in the year following hospitalization. Median daily healthcare utilization was similar across body mass index categories.
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Obesity Related Coronary Microvascular Dysfunction: From Basic to Clinical Practice. Cardiol Res Pract 2016; 2016:8173816. [PMID: 27092288 PMCID: PMC4820617 DOI: 10.1155/2016/8173816] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 03/06/2016] [Indexed: 11/30/2022] Open
Abstract
Obesity related coronary microvascular disease is a medical entity which is not yet fully elucidated. The pathophysiological basis of coronary microcirculatory dysfunction consists of a heterogeneous group of disorders with individual morphologic/functional/clinical presentation and prognosis. Coronary microcirculatory changes include mechanisms connected with vascular dysfunction, as well as extravascular and vasostructural changes in responses to neural, mechanical, and metabolic factors. Cardiometabolic changes that include obesity, dyslipidemia, diabetes mellitus type II, and hypertension are associated with atherosclerosis of epicardial coronary arteries and/or microvascular coronary dysfunction, with incompletely understood underlying mechanisms. In obesity, microvascular disease is mediated via adipokines/cytokines causing chronic, subclinical inflammation with (a) reduced NO-mediated dilatation, (b) changed endothelial- and smooth muscle-dependent vasoregulating mechanisms, (c) altered vasomotor control with increased sympathetic activity, and (d) obesity related hypertension with cardiomyocytes hypertrophy and impaired cardiac vascular adaptation to metabolic needs. From a clinical point of view it can present itself in acute or chronic form with different prognosis, as a practice problem for real-life diagnosis and treatment.
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Avilés-Santa L, Salinas K, Adams-Huet B, Raskin P. Insulin Therapy, Glycemic Control, and Cardiovascular Risk Factors in Young Latin Americans with Type 2 Diabetes Mellitus. J Investig Med 2016; 54:20-31. [PMID: 16409887 DOI: 10.2310/6650.2005.05012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Type 2 diabetes has been linked to an increased risk of cardiovascular (CV) disease, but this risk has not been well documented in young patients, especially of Latin American descent. Also, the potential CV benefits of insulin therapy have not been evaluated in young patients with type 2 diabetes. The objectives of this study were to determine any gender-related difference in the presence of CV risk factors in young Latin Americans with poorly controlled type 2 diabetes and the effect of intensive insulin therapy on these CV risk factors. METHODS AND RESULTS Fifty-seven Latin American patients with type 2 diabetes between the ages 18 and 45 years were evaluated at baseline. All women were premenopausal and had regular menstrual periods. The mean body mass index (BMI) was > 30 kg/m2 in both genders. Percent body fat, percent hemoglobin A1c, and lipoprotein profiles were similar between genders. Highly sensitive C-reactive protein (CRP) levels were elevated and similar between genders (p = .4). Leukocyte adhesion molecules (intercellular adhesion molecule 1, vascular adhesion molecule 1, E-selectin) and monocyte chemoattractant protein 1 were elevated, whereas adiponectin levels were below normal in both gender groups. Urinary albumin excretion was similar between genders and did not show any relationship with any of the variables. In women, there was a direct relationship between waist circumference and high-sensitivity CRP levels (rho = .53, p = .01). No other significant relationships were observed. Eighteen Latin American patients with type 2 diabetes completed up to 104 weeks of post-intervention with insulin monotherapy. In these patients, glycemic, lipoprotein, and anthropometric measurements were obtained every 12 weeks. Highly sensitive CRP, leukocyte adhesion molecules, and urinary albumin excretion, among other tests, were obtained every 52 weeks. At 52 and 104 weeks, body weight, BMI, waist circumference, and percent body fat increased in a parallel and significant manner. Despite a significant decrease in percent hemoglobin A1c (22.2%; p = < .0001), lipid and lipoprotein profiles, highly sensitive CRP, leukocyte adhesion molecules, and other nontraditional CV risk factors did not change significantly. CONCLUSIONS In young, obese, Latino type 2 diabetic patients, improvement in glycemic control with insulin monotherapy was not associated with a parallel improvement in markers of vascular inflammation. Premenopausal Latino women with uncontrolled type 2 diabetes have CV risks comparable to Latino diabetic men of the same age. Obesity and underlying insulin resistance may counteract the potential CV benefits associated with insulin therapy in lean diabetic patients. Weight loss could be a potential therapeutic modality to improve CV risk in Latino type 2 diabetic patients, especially women.
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Affiliation(s)
- Larissa Avilés-Santa
- Department of Internal Medicine, The University of Texas Southwestern Medical Center at Dallas, 75390-8858, USA.
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Chiang TI, Chang IC, Lee HH, Hsieh KH, Chiu YW, Lai TJ, Liu JY, Hsu LS, Kao SH. Amelioration of estrogen deficiency-induced obesity by collagen hydrolysate. Int J Med Sci 2016; 13:853-857. [PMID: 27877077 PMCID: PMC5118756 DOI: 10.7150/ijms.16706] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 09/01/2016] [Indexed: 11/29/2022] Open
Abstract
Objectives: Menopausal transition with declining estrogen levels significantly affects the physiological properties of women and consequently contributes to a series of medical conditions, including obesity. Obesity is a crucial risk factor associated with cardiovascular diseases, diabetes mellitus, and breast cancer. Increasing dietary protein content improves satiety and energy expenditure. Thus, we hypothesize that supplementing with collagen, a common dietary protein, may alleviate menopause-induced obesity. Methods: We used ovariectomized (OVX) rats to mimic a menopausal human. The body weight of OVX rats significantly increased compared with that of sham-operated rats (P<0.05), but uterus weight was decreased. Adipocyte size in perigonadal adipose tissue also increased (P<0.05). Results: By contrast, OVX rats supplemented with aqueous collagen hydrolysate (2.5 mg/mL) exhibited significant attenuation in body weight gain and adipocyte enlargement (P<0.05), but insignificant change in uterus weight. Further investigation indicated that collagen hydrolysate supplementation insignificantly affected the levels of dorsal fat, serum total cholesterol, and serum triacylglycerol. Levels of serum biochemical factors, calcium, phosphorus, and glucose were also insignificantly altered by collagen hydrolysate supplementation. Conclusion: Collagen hydrolysate supplementation reduced body weight gain and adipocyte enlargement in response to ovariectomy but slightly affected blood lipids, calcium, and glucose in both sham-operated and OVX rats. Collagen hydrolysate supplementation is beneficial in ameliorating estrogen deficiency-induced obesity and its associated risk factors.
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Affiliation(s)
- Tsay-I Chiang
- Department of Nursing, College of Medicine & Nursing, Hung Kuang University, Taichung, Taiwan;; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - I-Chang Chang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan;; Department of Orthopedic Surgery, Chung Shan Medical University, Taichung 402, Taiwan
| | - Hsueh-Hui Lee
- Department of Laboratory Medicine, Kuang Tien General Hospital, Taichung, Taiwan
| | - Kuang Hui Hsieh
- Department of Laboratory Medicine, Kuang Tien General Hospital, Taichung, Taiwan
| | - Yung-Wei Chiu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan;; Emergency department and center of Hyperbaric Oxygen Therapy, Tungs' Taichung MetroHarbor Hospital, Taichung Taiwan
| | - Te-Jen Lai
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan;; Department of Psychiatry, Chung Shan Medical Hospital, Taichung,Taiwan
| | - Jer-Yuh Liu
- Center for Molecular Medicine, China Medical University Hospital, Taichung, Taiwan;; Graduate Institute of Cancer Biology, China Medical University, Taichung, Taiwan
| | - Li-Sung Hsu
- Institute of Biochemistry, Microbiology and Immunology, Medical College, Chung-Shan Medical University, Taichung, Taiwan;; Clinical Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Shao-Hsuan Kao
- Institute of Biochemistry, Microbiology and Immunology, Medical College, Chung-Shan Medical University, Taichung, Taiwan;; Clinical Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan
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Chung BL, Toth MJ, Kamaly N, Sei YJ, Becraft J, Mulder WJM, Fayad ZA, Farokhzad OC, Kim Y, Langer R. Nanomedicines for Endothelial Disorders. NANO TODAY 2015; 10:759-776. [PMID: 26955397 PMCID: PMC4778260 DOI: 10.1016/j.nantod.2015.11.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The endothelium lines the internal surfaces of blood and lymphatic vessels and has a critical role in maintaining homeostasis. Endothelial dysfunction is involved in the pathology of many diseases and conditions, including disorders such as diabetes, cardiovascular diseases, and cancer. Given this common etiology in a range of diseases, medicines targeting an impaired endothelium can strengthen the arsenal of therapeutics. Nanomedicine - the application of nanotechnology to healthcare - presents novel opportunities and potential for the treatment of diseases associated with an impaired endothelium. This review discusses therapies currently available for the treatment of these disorders and highlights the application of nanomedicine for the therapy of these major disease complications.
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Affiliation(s)
- Bomy Lee Chung
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology
- Department of Chemical Engineering, Massachusetts Institute of Technology
| | - Michael J. Toth
- George W. Woodruff School of Mechanical Engineering, Wallace H. Coulter Department of Biomedical Engineering, Institute for Electronics and Nanotechnology (IEN), Parker H. Petit Institute for Bioengineering and Bioscience (IBB), Georgia Institute of Technology
| | - Nazila Kamaly
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology
- Laboratory of Nanomedicine and Biomaterials, Brigham and Women’s Hospital, Harvard Medical School
| | - Yoshitaka J. Sei
- George W. Woodruff School of Mechanical Engineering, Wallace H. Coulter Department of Biomedical Engineering, Institute for Electronics and Nanotechnology (IEN), Parker H. Petit Institute for Bioengineering and Bioscience (IBB), Georgia Institute of Technology
| | - Jacob Becraft
- Department of Biological Engineering, Massachusetts Institute of Technology
| | - Willem J. M. Mulder
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai
| | - Zahi A. Fayad
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai
| | - Omid C. Farokhzad
- Laboratory of Nanomedicine and Biomaterials, Brigham and Women’s Hospital, Harvard Medical School
- King Abdulaziz University, Jeddah, Saudi Arabia
| | - YongTae Kim
- George W. Woodruff School of Mechanical Engineering, Wallace H. Coulter Department of Biomedical Engineering, Institute for Electronics and Nanotechnology (IEN), Parker H. Petit Institute for Bioengineering and Bioscience (IBB), Georgia Institute of Technology
| | - Robert Langer
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology
- Department of Chemical Engineering, Massachusetts Institute of Technology
- Department of Biological Engineering, Massachusetts Institute of Technology
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology
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van Haare J, Kooi ME, Vink H, Post MJ, van Teeffelen JWGE, Slenter J, Munts C, Cobelens H, Strijkers GJ, Koehn D, van Bilsen M. Early impairment of coronary microvascular perfusion capacity in rats on a high fat diet. Cardiovasc Diabetol 2015; 14:150. [PMID: 26576929 PMCID: PMC4650915 DOI: 10.1186/s12933-015-0312-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 11/06/2015] [Indexed: 02/05/2023] Open
Abstract
Background It remains to be established if, and to what extent, the coronary microcirculation becomes compromised during the development of obesity and insulin resistance. Recent studies suggest that changes in endothelial glycocalyx properties contribute to microvascular dysfunction under (pre-)diabetic conditions. Accordingly, early effects of diet-induced obesity on myocardial perfusion and function were studied in rats under baseline and hyperaemic conditions. Methods Rats were fed a high fat diet (HFD) for 6 weeks and myocardial microvascular perfusion was determined using first-pass perfusion MRI before and after adenosine infusion. The effect of HFD on microcirculatory properties was also assessed by sidestream darkfield (SDF) imaging of the gastrocnemius muscle. Results HFD-fed rats developed central obesity and insulin sensitivity was reduced as evidenced by the marked reduction in insulin-induced phosphorylation of Akt in both cardiac and gastrocnemius muscle. Early diet-induced obesity did not lead to hypertension or cardiac hypertrophic remodeling. In chow-fed, control rats a robust increase in cardiac microvascular perfusion was observed upon adenosine infusion (+40 %; p < 0.05). In contrast, the adenosine response was abrogated in rats on a HFD (+8 %; N.S.). HFD neither resulted in rarefaction or loss of glycocalyx integrity in skeletal muscle, nor reduced staining intensity of the glycocalyx of cardiac capillaries. Conclusions Alterations in coronary microcirculatory function as assessed by first-pass perfusion MRI represent one of the earliest obesity-related cardiac adaptations that can be assessed non-invasively. In this early stage of insulin resistance, disturbances in glycocalyx barrier properties appeared not to contribute to the observed changes in coronary microvascular function.
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Affiliation(s)
- Judith van Haare
- Department of Physiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - M Eline Kooi
- Department of Radiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Hans Vink
- Department of Physiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Mark J Post
- Department of Physiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Jurgen W G E van Teeffelen
- Department of Physiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Jos Slenter
- Department of Radiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Chantal Munts
- Department of Physiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Hanneke Cobelens
- Department of Physiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Gustav J Strijkers
- Biomedical Engineering and Physics, Academic Medical Center, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands.
| | - Dennis Koehn
- Pie Medical Imaging, P.O. Box 1132, 6201 BC, Maastricht, The Netherlands.
| | - Marc van Bilsen
- Department of Physiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. .,Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
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Lupoli R, Di Minno MND, Guidone C, Cefalo C, Capaldo B, Riccardi G, Mingrone G. Effects of bariatric surgery on markers of subclinical atherosclerosis and endothelial function: a meta-analysis of literature studies. Int J Obes (Lond) 2015; 40:395-402. [PMID: 26388348 DOI: 10.1038/ijo.2015.187] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 07/21/2015] [Accepted: 08/13/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND/OBJECTIVES Several studies confirmed a significantly increased carotid intima-media thickness (IMT) and impaired flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD) in obese subjects, but few data are available on the effects of bariatric surgery on these markers of cardiovascular (CV) risk. We performed a meta-analysis of studies evaluating changes in IMT, FMD and NMD in obese patients after bariatric surgery. METHODS A systematic search was performed in the PubMed, Web of Science, Scopus and EMBASE databases without any language or publication year restriction. The last search was performed in January 2015. In addition, the reference lists of all retrieved articles were manually reviewed. Prospective studies evaluating the impact of bariatric surgery on the markers of CV risk were included. Changes in IMT, FMD and NMD after bariatric surgery were expressed as mean differences (MD) with pertinent 95% confidence intervals (95% CIs). IMT has been expressed in millimeters (mm); FMD and NMD as percentage (%). Impact of clinical and demographic features on effect size was assessed by meta-regression. RESULTS Ten articles (314 obese patients) were included in the analysis. Six studies contained data on IMT (7 data sets; 206 patients), 8 studies on FMD (9 data sets; 269 patients) and 4 on NMD (4 data sets; 149 patients). After bariatric surgery, there was a significant reduction of IMT (MD: -0.17 mm; 95% CI: -0.290, -0.049; P=0.006) and a significant improvement in FMD (MD: 5.65%; 95% CI: 2.87, 8.03; P<0.001), whereas NMD did not change (MD: 2.173%; 95% CI: -0.796, 5.142; P=0.151). Interestingly, percentage of changes in the body mass index were associated with changes in IMT (Z=11.52, P<0.001), FMD (Z=-4.26, P<0.001) and NMD (Z=-3.81, P<0.001). CONCLUSIONS Despite heterogeneity among studies, bariatric surgery is associated with improvement of subclinical atherosclerosis and endothelial function. These effects may significantly contribute to the reduction of the CV risk after bariatric surgery.
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Affiliation(s)
- R Lupoli
- Department of Clinical Medicine and Surgery, Università Degli Studi Federico II, Naples, Italy
| | - M N D Di Minno
- Unit of Cell and Molecular Biology in Cardiovascular Diseases, Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - C Guidone
- Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C Cefalo
- Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | - B Capaldo
- Department of Clinical Medicine and Surgery, Università Degli Studi Federico II, Naples, Italy
| | - G Riccardi
- Department of Clinical Medicine and Surgery, Università Degli Studi Federico II, Naples, Italy
| | - G Mingrone
- Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
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88
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Inflammation-induced microvascular insulin resistance is an early event in diet-induced obesity. Clin Sci (Lond) 2015; 129:1025-36. [PMID: 26265791 PMCID: PMC4613534 DOI: 10.1042/cs20150143] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 08/11/2015] [Indexed: 01/04/2023]
Abstract
Obesity and diabetes are associated with inflammation, endothelial dysfunction and insulin resistance in the muscle microvasculature. Inflammation-induced microvascular insulin resistance is an early event and plays a causative role in the development of metabolic insulin resistance in diet-induced obesity. Endothelial dysfunction and vascular insulin resistance usually coexist and chronic inflammation engenders both. In the present study, we investigate the temporal relationship between vascular insulin resistance and metabolic insulin resistance. We assessed insulin responses in all arterial segments, including aorta, distal saphenous artery and the microvasculature, as well as the metabolic insulin responses in muscle in rats fed on a high-fat diet (HFD) for various durations ranging from 3 days to 4 weeks with or without sodium salicylate treatment. Compared with controls, HFD feeding significantly blunted insulin-mediated Akt (protein kinase B) and eNOS [endothelial nitric oxide (NO) synthase] phosphorylation in aorta in 1 week, blunted vasodilatory response in small resistance vessel in 4 weeks and microvascular recruitment in as early as 3 days. Insulin-stimulated whole body glucose disposal did not begin to progressively decrease until after 1 week. Salicylate treatment fully inhibited vascular inflammation, prevented microvascular insulin resistance and significantly improved muscle metabolic responses to insulin. We conclude that microvascular insulin resistance is an early event in diet-induced obesity and insulin resistance and inflammation plays an essential role in this process. Our data suggest microvascular insulin resistance contributes to the development of metabolic insulin resistance in muscle and muscle microvasculature is a potential therapeutic target in the prevention and treatment of diabetes and its related complications.
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89
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Ovadia-Blechman Z, Avrahami I, Weizman-Shammai E, Sharir T, Eldar M, Chouraqui P. Peripheral microcirculatory hemodynamic changes in patients with myocardial ischemia. Biomed Pharmacother 2015; 74:83-8. [PMID: 26349967 DOI: 10.1016/j.biopha.2015.07.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 07/20/2015] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Patients with coronary heart disease demonstrate changes in skin microcirculation and a decrease in cutaneous blood mass. OBJECTIVE The goal of this study was to assess the feasibility of diagnosing myocardial ischemia based on peripheral microcirculatory variables. METHODS The skin microcirculatory measurements were monitored using an LPT system comprising a Laser Doppler Flowmeter (LDF), a photoplethysmograph (PPG) and a transcutaneous oxygen tension device (tc-PO2). Concurrently, heart rate and blood pressure were monitored. Measurements were performed before and after exercise stress test. Subjects were divided into ischemic (20) and nonischemic (27) patients based on myocardial perfusion imaging (MPI). RESULTS The results indicate differences in LPT variables between ischemic and nonischemic patients following exercise, while no differences in the central variable values were observed between the two groups. CONCLUSIONS Peripheral microcirculatory variables may be useful for non-invasive assessment of myocardial ischemia. The system has clinical potential for sensitive and noninvasive monitoring of vital variables during medical procedures in clinics, as well as in home care for patients who suffer from ischemic cardiac diseases.
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Affiliation(s)
- Zehava Ovadia-Blechman
- Department of Medical Engineering, Afeka Tel Aviv Academic College of Engineering, 218 Bney-Efraim Rd., Tel Aviv, Israel; Neufeld Cardiac Research Institute, Tel Aviv University, Sheba Medical Center, Tel-Hashomer, Israel.
| | - Idit Avrahami
- Department of Mechanical Engineering and Mechatronics, Ariel University, Israel
| | - Einat Weizman-Shammai
- Neufeld Cardiac Research Institute, Tel Aviv University, Sheba Medical Center, Tel-Hashomer, Israel
| | - Tali Sharir
- Nuclear Cardiology Unit, Assuta Medical Centers, Israel
| | - Michael Eldar
- Neufeld Cardiac Research Institute, Tel Aviv University, Sheba Medical Center, Tel-Hashomer, Israel; Heart Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Pierre Chouraqui
- Nuclear Medicine Institute, Hillel Yaffe Medical Center, Hadera, affiliated to the Rappaport Medical School, The Technion Israel Institute of Technology, Haifa, Israel
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90
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Tallapragada DSP, Karpe PA, Tikoo K. Long-lasting partnership between insulin resistance and endothelial dysfunction: role of metabolic memory. Br J Pharmacol 2015; 172:4012-23. [PMID: 25825057 DOI: 10.1111/bph.13145] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 03/17/2015] [Accepted: 03/25/2015] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND AND PURPOSE The persistence of deleterious effects of hyperglycaemia even after glucose normalization is referred to as 'metabolic memory'. However, similar persistent effects of the metabolic consequences of a high fat diet (HFD) have not been described. EXPERIMENTAL APPROACH Rats were given a normal pellet diet (NPD) or a HFD for 3 months. The animals from the HFD group were then returned to the NPD to observe the long-term effects of insulin resistance. Endothelial dysfunction was assessed by carbachol-mediated vasorelaxation and eNOS phosphorylation. KEY RESULTS As expected, HFD consumption resulted in insulin resistance and endothelial dysfunction. Phosphorylation of eNOS at S1177 was decreased in HFD rats, compared with that in the NPD group. Rats on 3 months of HFD showed glucose intolerance and impaired insulin sensitivity and were then switched back to NPD (REV group) . Levels of cholesterol and triglyceride, and adiposity returned to normal in REV rats. However, endothelium-dependent vascular responses to carbachol which were impaired in HFD rats, continued to be impaired in REV rats. Similarly, decreased eNOS phosphorylation after HFD was not improved after 1 or 6 months of REV. CONCLUSIONS AND IMPLICATIONS Our data indicate that returning to NPD did not improve the insulin sensitivity or the endothelial dysfunction induced by HFD. Although some biochemical parameters responsible for insulin resistance and endothelial dysfunction were normalized, molecular and vascular abnormalities, involving NO, persisted for several months, highlighting the long-lasting effects of metabolic memory.
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Affiliation(s)
- Divya Sri Priyanka Tallapragada
- Laboratory of Epigenetics and Diseases, Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Mohali, Punjab, India
| | - Pinakin Arun Karpe
- Laboratory of Epigenetics and Diseases, Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Mohali, Punjab, India
| | - Kulbhushan Tikoo
- Laboratory of Epigenetics and Diseases, Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Mohali, Punjab, India
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91
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Abd-Elbaky AE, Abo-ElMatty DM, Mesbah NM, Ibrahim SM. Omentin and apelin concentrations in relation to obesity, diabetes mellitus type two, and cardiovascular diseases in Egyptian population. Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-015-0416-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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92
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Blaslov K, Bulum T, Duvnjak L. The role of endothelial dysfunction driven by adipocitokines in the development and progression of microvascular complications in patients with type 1 and type 2 diabetes. Med Hypotheses 2015; 84:593-5. [DOI: 10.1016/j.mehy.2015.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 03/02/2015] [Accepted: 03/04/2015] [Indexed: 11/24/2022]
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93
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Lott ME, Slocomb JE, Gao Z, Gabbay RA, Quillen D, Gardner TW, Bettermann K. Impaired coronary and retinal vasomotor function to hyperoxia in Individuals with Type 2 diabetes. Microvasc Res 2015; 101:1-7. [PMID: 26002545 DOI: 10.1016/j.mvr.2015.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 04/21/2015] [Accepted: 05/12/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE Adults with diabetes are at a high risk of developing coronary heart disease. The purpose of this study was to assess coronary artery vascular function non-invasively in individuals with and without Type 2 diabetes and to compare these coronary responses to another microvascular bed (i.e. retina). We hypothesized that individuals with diabetes would have impaired coronary reactivity and that these impairments would be associated with impairments in retinal reactivity. METHODS Coronary blood velocity (Transthoracic Doppler Echocardiography) and retinal diameters (Dynamic Vessel Analyzer) were measured continuously during five minutes of breathing 100% oxygen (i.e. hyperoxia) in 15 persons with Type 2 diabetes and 15 age-matched control subjects. Using fundus photographs, retinal vascular calibers were also measured (central retinal arteriole and venule equivalents). RESULTS Individuals with diabetes compared to controls had impaired coronary (-2.34±16.64% vs. -14.27±10.58%, P=0.03) and retinal (arteriole: -0.04±3.34% vs. -3.65±5.07%, P=0.03; venule: -1.65±3.68% vs. -5.23±5.47%, P=0.05) vasoconstrictor responses to hyperoxia, and smaller central arteriole-venule equivalent ratios (0.83±0.07 vs. 0.90±0.07, P=0.014). Coronary reactivity was associated with central retinal arteriole equivalents (r=-0.516, P=0.005) and retinal venular reactivity (r=0.387, P=0.034). CONCLUSION Diabetes impairs coronary and retinal microvascular function to hyperoxia. Impaired vasoconstrictor responses may be part of a systemic diabetic vasculopathy, which may contribute to adverse cardiovascular events in individuals with diabetes.
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Affiliation(s)
- Mary E Lott
- Penn State Hershey Medical Center, Heart and Vascular Institute, Hershey, PA 17033, USA.
| | - Julia E Slocomb
- John Hopkins University, Department of Biology, Baltimore, MD 21218, USA
| | - Zhaohui Gao
- Penn State Hershey Medical Center, Heart and Vascular Institute, Hershey, PA 17033, USA
| | - Robert A Gabbay
- Joslin Diabetes Center, Harvard Medical School, Boston, MA 02116, USA
| | - David Quillen
- Penn State Hershey Medical Center, Department of Ophthalmology, Hershey, PA 17033, USA
| | - Thomas W Gardner
- University of Michigan, Kellogg Eye Center, Ann Arbor, MI 48105, USA
| | - Kerstin Bettermann
- Penn State Hershey Medical Center, Department of Neurology, Hershey, PA 17033, USA
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94
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Cheng H, Harris RC. Renal endothelial dysfunction in diabetic nephropathy. Cardiovasc Hematol Disord Drug Targets 2015; 14:22-33. [PMID: 24720460 DOI: 10.2174/1871529x14666140401110841] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 03/21/2014] [Accepted: 03/26/2014] [Indexed: 12/24/2022]
Abstract
Endothelial dysfunction has been posited to play an important role in the pathogenesis of diabetic nephropathy (DN). Due to the heterogeneity of endothelial cells (ECs), it is difficult to generalize about endothelial responses to diabetic stimuli. At present, there are limited techniques fordirectly measuring EC function in vivo, so diagnosis of endothelial disorders still largely depends on indirect assessment of mediators arising from EC injury. In the kidney microcirculation, both afferent and efferent arteries, arterioles and glomerular endothelial cells (GEnC) have all been implicated as targets of diabetic injury. Both hyperglycemia per se, as well as the metabolic consequences of glucose dysregulation, are thought to lead to endothelial cell dysfunction. In this regard, endothelial nitric oxide synthase (eNOS) plays a central role in EC dysfunction. Impaired eNOS activity can occur at numerous levels, including enzyme uncoupling, post-translational modifications, internalization and decreased expression. Reduced nitric oxide (NO) bioavailability exacerbates oxidative stress, further promoting endothelial dysfunction and injury. The injured ECs may then function as active signal transducers of metabolic, hemodynamic and inflammatory factors that modify the function and morphology of the vessel wall and interact with adjacent cells, which may activate a cascade of inflammatory and proliferative and profibrotic responses in progressive DN. Both pharmacological approaches and potential regenerative therapies hold promise for restoration of impaired endothelial cells in diabetic nephropathy.
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Affiliation(s)
| | - Raymond C Harris
- Division of Nephrology, S3223 MCN, Vanderbilt University School of Medicine, and Nashville Veterans Affairs Hospital, Nashville, TN 37232, USA.
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95
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Balsan GA, Vieira JLDC, Oliveira AMD, Portal VL. Relationship between adiponectin, obesity and insulin resistance. Rev Assoc Med Bras (1992) 2015; 61:72-80. [DOI: 10.1590/1806-9282.61.01.072] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 06/03/2014] [Indexed: 11/21/2022] Open
Abstract
Objectives: the conditions of obesity and overweight pose a major risk for a number of comorbidities, including clinical syndromes resulting from atherosclerotic disease. Recent studies strongly indicate that adipose tissue is an active endocrine organ that secretes bioactive factors such as adipokines. Adiponectin appears to have a regulatory role in the mechanism of insulin resistance and in the development of atherosclerosis. This systematic review aims to evaluate the anti-atherogenic effects of adiponectin and its properties to improve and mimic metabolic and vascular actions of insulin and its influence on endothelial function. Methods: a qualitative, exploratory and literature review was performed in the PubMed, Portal Capes and Scielo databases using as key-words "adiponectin", "obesity", "insulin resistance", "anti-inflammatory", "therapeutic strategies" and "future prospects". Results: evidence suggests that adiponectin has anti-atherogenic properties with anti-inflammatory effects on the vascular wall. Moreover, it modifies the vascular intracellular signaling and has indirect antioxidant effects on the human myocardium. On the other hand, there are studies suggesting that increased levels of adiponectin are paradoxically associated with a worse prognosis in heart failure syndrome, although the mechanisms are not clear. Conclusion: it is not clear whether adiponectin levels have any clinical significance for risk stratification in cardiovascular disease or if they simply reflect the activation of complex underlying mechanisms. Changes in lifestyle and some drug treatments for hypertension and coronary heart disease have shown significant effect to increase adiponectin levels, and simultaneously decrease in insulin resistance and endothelial dysfunction.
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96
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Vascular function and cardiovascular risk factors in women with severe flushing. Maturitas 2015; 80:379-83. [PMID: 25704326 DOI: 10.1016/j.maturitas.2015.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 01/19/2015] [Indexed: 11/23/2022]
Abstract
Cardiovascular disease is the leading cause of death in women of postmenopausal age worldwide. It is a relatively rare occurrence before the menopause and the increase in incidence coincides with the most common symptom associated with menopausal transition, hot flushing. Interest in cardiovascular disease post-menopause has largely focused on the effect of hormone therapy on risk of coronary events and stroke, with vasomotor symptoms considered merely a nuisance symptom, but recent work suggests that the presence of flushing may be a marker of underlying cardiovascular disease.
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97
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Diehl KJ, Weil BR, Greiner JJ, Wright KP, Stauffer BL, DeSouza CA. Impaired endogenous fibrinolytic capacity in prehypertensive men. J Hum Hypertens 2015; 29:468-72. [PMID: 25566873 PMCID: PMC4762274 DOI: 10.1038/jhh.2014.120] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 10/29/2014] [Accepted: 11/04/2014] [Indexed: 12/14/2022]
Abstract
Prehypertension (BP 120–139/80–89 mmHg) is associated with an increased risk for future atherothrombotic events. Although the mechanisms underlying this elevated risk are not completely understood, one possibility is that prehypertension is associated with impaired endothelial fibrinolytic capacity. We tested the hypothesis that vascular endothelial release of t-PA is impaired in prehypertensive men. Net endothelial release of t-PA was determined, in vivo, in response to intrabrachial infusions of bradykinin (12.5, 25, 50 ng/100 mL tissue/min) and sodium nitroprusside at (1.0, 2.0, 4.0 µg/100 mL tissue/min) in 42 middle-age and older men: 16 normotensive (BP range: 100–119/57–79 mmHg); 16 prehypertensive (BP range: 120–139/76–89 mmHg); and 10 hypertensive (BP range: 140–150/74–100 mmHg). Net release of t-PA antigen was ~25% lower (P < 0.05) in the prehypertensive (−0.9 ± 0.8 to 42.4 ± 5.3 ng/100 mL tissue/min) compared with the normotensive (0.5 ± 1.0 to 53.9 ± 6.5 ng/100 mL tissue/min) men. There was no significant difference in t-PA release between the hypertensive (−1.8±1.6 to 40.8±6.6 ng/100 mL tissue/min) and prehypertensive groups. Sodium nitroprusside did not significantly alter t-PA release in any group. These data indicate that endothelial t-PA release is diminished in prehypertensive men. Further, the level of impairment in t-PA release seen with clinical hypertension is already apparent in the prehypertensive state. Impaired endothelial fibrinolytic function may underlie the increased atherothrombotic risk associated with blood pressure in the prehypertensive range.
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Affiliation(s)
- K J Diehl
- Department of Integrative Physiology, Integrative Vascular Biology Laboratory, University of Colorado, Boulder, CO, USA
| | - B R Weil
- Department of Integrative Physiology, Integrative Vascular Biology Laboratory, University of Colorado, Boulder, CO, USA
| | - J J Greiner
- Department of Integrative Physiology, Integrative Vascular Biology Laboratory, University of Colorado, Boulder, CO, USA
| | - K P Wright
- Department of Integrative Physiology, Integrative Vascular Biology Laboratory, University of Colorado, Boulder, CO, USA
| | - B L Stauffer
- 1] Department of Integrative Physiology, Integrative Vascular Biology Laboratory, University of Colorado, Boulder, CO, USA [2] Department of Medicine, University of Colorado, Denver, CO, USA [3] Denver Health Medical Center, Denver, CO, USA
| | - C A DeSouza
- 1] Department of Integrative Physiology, Integrative Vascular Biology Laboratory, University of Colorado, Boulder, CO, USA [2] Department of Medicine, University of Colorado, Denver, CO, USA
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98
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ŽÁKOVIČOVÁ E, KITTNAR O, SLAVÍČEK J, MEDOVÁ E, ŠVÁB P, CHARVÁT J. ECG Body Surface Mapping in Patients With Gestational Diabetes Mellitus and Optimal Metabolic Compensation. Physiol Res 2014; 63:S479-87. [DOI: 10.33549/physiolres.932921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Women with gestational diabetes mellitus (GDM) are at increased risk for cardiovascular diseases (CVD) events compared with women without GDM. The aim of the present study was to evaluate 200 parameters of the heart electric field in 35 women with GDM under optimal glycemic compensation compared to 32 healthy pregnant women. All examinations were performed in the 36th week of gestation. The parameters in ECG body surface mapping (BSM) were registered by the diagnostic system Cardiag 112.2. The absolute values of maximum and minimum in depolarization and repolarization isopotential, isointegral and isoarea maps were not significantly different between the groups. These findings correspond to the result of heart rate variability examination. However BSM revealed the significant prolongation of QRS complex (p=0.05), shortening of ventricular myocardial activation time (ICHVAT) (p=0.01), prolongation of mean QT duration (p=0.01) and increase of QT interval dispersion (p=0.01) in women with GDM. Duration of QRS and ICHVAT significantly correlated with interventricular septum and posterior wall thickness in GDM group, QTd interval correlated significantly with HbA1C level. We conclude that despite of optimal metabolic control several significant abnormalities detected by ECG BSM are still present in patients with GDM.
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Affiliation(s)
| | - O. KITTNAR
- Institute of Physiology of the First Faculty of Medicine, Charles University, Prague, Czech Republic
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99
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Gu M, Mordwinkin NM, Kooreman NG, Lee J, Wu H, Hu S, Churko JM, Diecke S, Burridge PW, He C, Barron FE, Ong SG, Gold JD, Wu JC. Pravastatin reverses obesity-induced dysfunction of induced pluripotent stem cell-derived endothelial cells via a nitric oxide-dependent mechanism. Eur Heart J 2014; 36:806-16. [PMID: 25368203 DOI: 10.1093/eurheartj/ehu411] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 09/23/2014] [Indexed: 12/11/2022] Open
Abstract
AIMS High-fat diet-induced obesity (DIO) is a major contributor to type II diabetes and micro- and macro-vascular complications leading to peripheral vascular disease (PVD). Metabolic abnormalities of induced pluripotent stem cell-derived endothelial cells (iPSC-ECs) from obese individuals could potentially limit their therapeutic efficacy for PVD. The aim of this study was to compare the function of iPSC-ECs from normal and DIO mice using comprehensive in vitro and in vivo assays. METHODS AND RESULTS Six-week-old C57Bl/6 mice were fed with a normal or high-fat diet. At 24 weeks, iPSCs were generated from tail tip fibroblasts and differentiated into iPSC-ECs using a directed monolayer approach. In vitro functional analysis revealed that iPSC-ECs from DIO mice had significantly decreased capacity to form capillary-like networks, diminished migration, and lower proliferation. Microarray and ELISA confirmed elevated apoptotic, inflammatory, and oxidative stress pathways in DIO iPSC-ECs. Following hindlimb ischaemia, mice receiving intramuscular injections of DIO iPSC-ECs had significantly decreased reperfusion compared with mice injected with control healthy iPSC-ECs. Hindlimb sections revealed increased muscle atrophy and presence of inflammatory cells in mice receiving DIO iPSC-ECs. When pravastatin was co-administered to mice receiving DIO iPSC-ECs, a significant increase in reperfusion was observed; however, this beneficial effect was blunted by co-administration of the nitric oxide synthase inhibitor, N(ω)-nitro-l-arginine methyl ester. CONCLUSION This is the first study to provide evidence that iPSC-ECs from DIO mice exhibit signs of endothelial dysfunction and have suboptimal efficacy following transplantation in a hindlimb ischaemia model. These findings may have important implications for future treatment of PVD using iPSC-ECs in the obese population.
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Affiliation(s)
- Mingxia Gu
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Nicholas M Mordwinkin
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Nigel G Kooreman
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA Department of Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Jaecheol Lee
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Haodi Wu
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Shijun Hu
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Jared M Churko
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Sebastian Diecke
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Paul W Burridge
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Chunjiang He
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Frances E Barron
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Sang-Ging Ong
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Joseph D Gold
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Joseph C Wu
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Ma S, Ma CCH. Recent developments in the effects of nitric oxide-donating statins on cardiovascular disease through regulation of tetrahydrobiopterin and nitric oxide. Vascul Pharmacol 2014; 63:63-70. [PMID: 25139660 DOI: 10.1016/j.vph.2014.08.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Revised: 08/01/2014] [Accepted: 08/04/2014] [Indexed: 10/24/2022]
Abstract
Since the discovery of the importance of nitric oxide (NO) to the human body three decades ago, numerous laboratory and clinical studies have been done to explore its potential therapeutic actions on many organs. In the cardiovascular system, NO works as a volatile signaling molecule regulating the vascular permeability and vascular tone, preventing thrombosis and inflammation, as well as inhibiting the smooth muscle hyperplasia. Thus, NO is important in the prevention and treatment of cardiovascular disease. NO is synthesized by NO synthase (NOS) with tetrahydrobiopterin (BH4) as the crucial cofactor. Many studies have been done to form nitric oxide donors so as to deliver NO directly to the vessel walls. In addition, NO moieties have been incorporated into existing therapeutic agents to enhance the NO bioavailability, including statins. Statins are inhibitors of 3-hydroxy-3-methylglutaryl-coenzyme (HMG-CoA), the rate-limiting enzyme of the mevalonate pathway. By inhibiting this pathway, statins lower blood cholesterol and exert their pleiotropic effects through activity in reaction cascades, such as Rho/ROCK and Rac 1/NADPH oxidase pathways. Statins have also been observed to implement their non-lipid effects by promoting BH4 synthesis with increase of NO bioavailability. Furthermore, NO-donating statins in laboratory studies have demonstrated to produce better therapeutic effects than their parent's drugs. They offer better anti-inflammatory, anti-proliferative and antithrombotic actions on cardiovascular system. They also cause better revascularization in peripheral ischemia and produce greater enhancement in limb reperfusion and salvage. In addition, it has been shown that NO-donating statin caused less myotoxicity, the most common side effect related to treatment with statins. The initial studies have demonstrated the superior therapeutic effects of NO-donating statins while producing fewer side effects.
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Affiliation(s)
- Sze Ma
- Hong Kong Baptist Hospital, Hong Kong; National University Ireland, Ireland; Royal College of Physicians of Ireland, Ireland
| | - Christopher Cheng-Hwa Ma
- NHS Dumfries & Galloway, GMC 7411692, United Kingdom; King's College London School of Medicine, United Kingdom.
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