101
|
Goth CK, Tuhkanen HE, Khan H, Lackman JJ, Wang S, Narimatsu Y, Hansen LH, Overall CM, Clausen H, Schjoldager KT, Petäjä-Repo UE. Site-specific O-Glycosylation by Polypeptide N-Acetylgalactosaminyltransferase 2 (GalNAc-transferase T2) Co-regulates β 1-Adrenergic Receptor N-terminal Cleavage. J Biol Chem 2017; 292:4714-4726. [PMID: 28167537 PMCID: PMC5377785 DOI: 10.1074/jbc.m116.730614] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 01/29/2017] [Indexed: 01/08/2023] Open
Abstract
The β1-adrenergic receptor (β1AR) is a G protein-coupled receptor (GPCR) and the predominant adrenergic receptor subtype in the heart, where it mediates cardiac contractility and the force of contraction. Although it is the most important target for β-adrenergic antagonists, such as β-blockers, relatively little is yet known about its regulation. We have shown previously that β1AR undergoes constitutive and regulated N-terminal cleavage participating in receptor down-regulation and, moreover, that the receptor is modified by O-glycosylation. Here we demonstrate that the polypeptide GalNAc-transferase 2 (GalNAc-T2) specifically O-glycosylates β1AR at five residues in the extracellular N terminus, including the Ser-49 residue at the location of the common S49G single-nucleotide polymorphism. Using in vitro O-glycosylation and proteolytic cleavage assays, a cell line deficient in O-glycosylation, GalNAc-T-edited cell line model systems, and a GalNAc-T2 knock-out rat model, we show that GalNAc-T2 co-regulates the metalloproteinase-mediated limited proteolysis of β1AR. Furthermore, we demonstrate that impaired O-glycosylation and enhanced proteolysis lead to attenuated receptor signaling, because the maximal response elicited by the βAR agonist isoproterenol and its potency in a cAMP accumulation assay were decreased in HEK293 cells lacking GalNAc-T2. Our findings reveal, for the first time, a GPCR as a target for co-regulatory functions of site-specific O-glycosylation mediated by a unique GalNAc-T isoform. The results provide a new level of β1AR regulation that may open up possibilities for new therapeutic strategies for cardiovascular diseases.
Collapse
Affiliation(s)
- Christoffer K Goth
- From the Copenhagen Center for Glycomics, Department of Cellular and Molecular Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen N, Denmark
| | - Hanna E Tuhkanen
- the Medical Research Center Oulu, Research Unit of Biomedicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
| | - Hamayun Khan
- the Medical Research Center Oulu, Research Unit of Biomedicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
| | - Jarkko J Lackman
- the Medical Research Center Oulu, Research Unit of Biomedicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
| | - Shengjun Wang
- From the Copenhagen Center for Glycomics, Department of Cellular and Molecular Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen N, Denmark
| | - Yoshiki Narimatsu
- From the Copenhagen Center for Glycomics, Department of Cellular and Molecular Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen N, Denmark
| | - Lasse H Hansen
- the Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, DK-2100 Copenhagen Ø, Denmark and
| | - Christopher M Overall
- the Centre for Blood Research, Department of Oral Biological and Medical Sciences, and Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Henrik Clausen
- From the Copenhagen Center for Glycomics, Department of Cellular and Molecular Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen N, Denmark
| | - Katrine T Schjoldager
- From the Copenhagen Center for Glycomics, Department of Cellular and Molecular Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen N, Denmark,
| | - Ulla E Petäjä-Repo
- the Medical Research Center Oulu, Research Unit of Biomedicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland,
| |
Collapse
|
102
|
den Boer SL, Flipse DHK, van der Meulen MH, Backx APCM, du Marchie Sarvaas GJ, Ten Harkel ADJ, van Iperen GG, Rammeloo LAJ, Tanke RB, Helbing WA, Takken T, Dalinghaus M. Six-Minute Walk Test as a Predictor for Outcome in Children with Dilated Cardiomyopathy and Chronic Stable Heart Failure. Pediatr Cardiol 2017; 38:465-471. [PMID: 27909753 PMCID: PMC5355503 DOI: 10.1007/s00246-016-1536-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 11/12/2016] [Indexed: 11/24/2022]
Abstract
Cardiopulmonary exercise testing is an important tool to predict prognosis in children and adults with heart failure. A much less sophisticated exercise test is the 6 min walk test, which has been shown an independent predictor for morbidity and mortality in adults with heart failure. Therefore, we hypothesized that the 6 min walk test could be predictive for outcome in children with dilated cardiomyopathy. We prospectively included 49 children with dilated cardiomyopathy ≥6 years who performed a 6 min walk test. Median age was 11.9 years (interquartile range [IQR] 7.4-15.1), median time after diagnosis was 3.6 years (IQR 0.6-7.4). The 6 min walk distance was transformed to a percentage of predicted, using age- and gender-specific norm values (6MWD%). For all patients, mean 6MWD% was 70 ± 21%. Median follow-up was 33 months (IQR 14-50). Ten patients reached the combined endpoint of death or heart transplantation. Using univariable Cox regression, a higher 6MWD% resulted in a lower risk of death or transplantation (hazard ratio 0.95 per percentage increase, p = 0.006). A receiver operating characteristic curve was generated to define the optimal threshold to identify patients at highest risk for an endpoint. Patients with a 6MWD% < 63% had a 2 year transplant-free survival of 73%, in contrast to a transplant-free survival of 92% in patients with a 6MWD% ≥ 63% (p = 0.003). In children with dilated cardiomyopathy, the 6 min walk test is a simple and feasible tool to identify children with a higher risk of death or heart transplantation.
Collapse
Affiliation(s)
- Susanna L. den Boer
- Division of Pediatric Cardiology, Sophia Children’s Hospital, Erasmus University Medical Center, Dr. Molewaterplein 60, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands
| | - Daniël H. K. Flipse
- Division of Pediatric Cardiology, Sophia Children’s Hospital, Erasmus University Medical Center, Dr. Molewaterplein 60, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands
| | - Marijke H. van der Meulen
- Division of Pediatric Cardiology, Sophia Children’s Hospital, Erasmus University Medical Center, Dr. Molewaterplein 60, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands
| | - Ad P. C. M. Backx
- Division of Pediatric Cardiology, Emma Children’s Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Gideon J. du Marchie Sarvaas
- Division of Pediatric Cardiology, Beatrix Children’s Hospital, University of Groningen, Groningen, The Netherlands
| | - Arend D. J. Ten Harkel
- Division of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Gabriëlle G. van Iperen
- Division of Pediatric Cardiology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lukas A. J. Rammeloo
- Division of Pediatric Cardiology, Department of Pediatrics, Free University Medical Center, Amsterdam, The Netherlands
| | - Ronald B. Tanke
- Division of Pediatric Cardiology, Department of Pediatrics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Willem A. Helbing
- Division of Pediatric Cardiology, Sophia Children’s Hospital, Erasmus University Medical Center, Dr. Molewaterplein 60, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands
| | - Tim Takken
- Child Development and Exercise Center, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Michiel Dalinghaus
- Division of Pediatric Cardiology, Sophia Children’s Hospital, Erasmus University Medical Center, Dr. Molewaterplein 60, P.O. Box 2060, 3000 CB Rotterdam, The Netherlands
| |
Collapse
|
103
|
Nielsen EE, Feinberg J, Safi S, Sethi NJ, Gluud C, Jakobsen JC. Beta-blockers for non-acute treatment after myocardial infarction. Hippokratia 2017. [DOI: 10.1002/14651858.cd012565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Emil Eik Nielsen
- Department 7812, Rigshospitalet, Copenhagen University Hospital; Copenhagen Trial Unit, Centre for Clinical Intervention Research; Blegdamsvej 9 Copenhagen Denmark 2100
| | - Joshua Feinberg
- Department 7812, Rigshospitalet, Copenhagen University Hospital; Copenhagen Trial Unit, Centre for Clinical Intervention Research; Blegdamsvej 9 Copenhagen Denmark 2100
| | - Sanam Safi
- Department 7812, Rigshospitalet, Copenhagen University Hospital; Copenhagen Trial Unit, Centre for Clinical Intervention Research; Blegdamsvej 9 Copenhagen Denmark 2100
| | - Naqash J Sethi
- Department 7812, Rigshospitalet, Copenhagen University Hospital; Copenhagen Trial Unit, Centre for Clinical Intervention Research; Blegdamsvej 9 Copenhagen Denmark 2100
| | - Christian Gluud
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital; The Cochrane Hepato-Biliary Group; Blegdamsvej 9 Copenhagen Denmark DK-2100
| | - Janus C Jakobsen
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital; The Cochrane Hepato-Biliary Group; Blegdamsvej 9 Copenhagen Denmark DK-2100
- Holbaek Hospital; Department of Cardiology; Holbaek Denmark 4300
| |
Collapse
|
104
|
Rosa GM, Meliota G, Brunelli C, Ferrero S. Pharmacokinetic drug evaluation of bucindolol for the treatment of atrial fibrillation in heart failure patients. Expert Opin Drug Metab Toxicol 2017; 13:473-481. [DOI: 10.1080/17425255.2017.1291631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Gian Marco Rosa
- Department of Internal Medicine, Cardiology, IRCCS AOU San Martino – IST, University of Genoa, Genova, Italy
| | - Giovanni Meliota
- Department of Internal Medicine, Cardiology, IRCCS AOU San Martino – IST, University of Genoa, Genova, Italy
| | - Claudio Brunelli
- Department of Internal Medicine, Cardiology, IRCCS AOU San Martino – IST, University of Genoa, Genova, Italy
| | - Simone Ferrero
- Department of Obstetrics and Gynaecology, IRCCS AOU San Martino – IST, University of Genoa, Genova, Italy
| |
Collapse
|
105
|
Kim W, Gandhi RT, Peña CS, Herrera RE, Schernthaner MB, Tsoukas A, Acuña JM, Katzen BT. Effect of β-blocker on aneurysm sac behavior after endovascular abdominal aortic repair. J Vasc Surg 2017; 65:337-345. [PMID: 28126172 DOI: 10.1016/j.jvs.2016.06.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 06/25/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study was conducted to determine whether β-blocker (BB) therapy is associated with abdominal aortic aneurysm (AAA) sac regression after endovascular abdominal aortic repair (EVAR). METHODS A total of 198 patients (mean age, 76 years) who underwent EVAR were analyzed (104 in the BB group and 94 in the non-BB group). The primary end point was the incidence of AAA sac regression at 1 and 2 years. RESULTS Hypertension, coronary artery disease, and hyperlipidemia were more common in the BB group. The BB group was also more likely to have been prescribed an aspirin and a statin than the non-BB group. The length of proximal neck was significantly longer in the non-BB group than in the BB group. All study patients were monitored for at least 1 year after EVAR, and 2-year follow-up was available in 104 patients (52.5%). There was no statistically significant difference in the incidence of aneurysm sac regression in either group at 1 year (52.1% in the non-BB group vs 45.2% in the BB group; P = .330) and 2 years (58.5% in the non-BB group vs 64.7% in the BB group; P = .515). The difference of the change of AAA maximum diameter between two groups did not reach statistical significance at 1 year (-6.0 ± 7.0 mm in the non-BB group vs -5.5 ± 8.1 mm in the BB group; P = .644) and 2 years (-9.0 ± 10.5 mm in the non-BB group vs -9.0 ± 10.0 mm in the BB group; P = .977). BB therapy was not associated with increased odds of AAA sac regression. The effect of third-generation BBs on AAA sac regression was not significant. CONCLUSIONS BB therapy had no effect on AAA sac regression. At the present time, there is insufficient evidence to recommend BB therapy for the purpose of AAA sac regression.
Collapse
Affiliation(s)
- Wonho Kim
- Division of Interventional Radiology, Miami Cardiac and Vascular Institute, Miami, Fla; Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Fla; Division of Cardiology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea
| | - Ripal T Gandhi
- Division of Interventional Radiology, Miami Cardiac and Vascular Institute, Miami, Fla
| | - Constantino S Peña
- Division of Interventional Radiology, Miami Cardiac and Vascular Institute, Miami, Fla
| | - Raul E Herrera
- Division of Interventional Radiology, Miami Cardiac and Vascular Institute, Miami, Fla
| | | | - Athanassios Tsoukas
- Division of Vascular Surgery, Miami Cardiac and Vascular Institute, Miami, Fla
| | - Juan M Acuña
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Fla
| | - Barry T Katzen
- Division of Interventional Radiology, Miami Cardiac and Vascular Institute, Miami, Fla.
| |
Collapse
|
106
|
Targeting GPCR-Gβγ-GRK2 signaling as a novel strategy for treating cardiorenal pathologies. Biochim Biophys Acta Mol Basis Dis 2017; 1863:1883-1892. [PMID: 28130200 DOI: 10.1016/j.bbadis.2017.01.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 01/13/2017] [Accepted: 01/18/2017] [Indexed: 02/06/2023]
Abstract
The pathologic crosstalk between the heart and kidney is known as cardiorenal syndrome (CRS). While the specific mechanisms underlying this crosstalk remain poorly understood, CRS is associated with exacerbated dysfunction of either or both organs and reduced survival. Maladaptive fibrotic remodeling is a key component of both heart and kidney failure pathogenesis and progression. G-protein coupled receptor (GPCR) signaling is a crucial regulator of cardiovascular and renal function. Chronic/pathologic GPCR signaling elicits the interaction of the G-protein Gβγ subunit with GPCR kinase 2 (GRK2), targeting the receptor for internalization, scaffolding to pathologic signals, and receptor degradation. Targeting this pathologic Gβγ-GRK2 interaction has been suggested as a possible strategy for the treatment of HF. In the current review, we discuss recent updates in understanding the role of GPCR-Gβγ-GRK2 signaling as a crucial mediator of maladaptive organ remodeling detected in HF and kidney dysfunction, with specific attention to small molecule-mediated inhibition of pathologic Gβγ-GRK2 interactions. Further, we explore the potential of GPCR-Gβγ-GRK2 signaling as a possible therapeutic target for cardiorenal pathologies.
Collapse
|
107
|
Tomková J, Ondra P, Kocianová E, Václavík J. Fast and sensitive analysis of beta blockers by ultra-high-performance liquid chromatography coupled with ultra-high-resolution TOF mass spectrometry. Biomed Chromatogr 2017; 31. [DOI: 10.1002/bmc.3911] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/25/2016] [Accepted: 11/29/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Jana Tomková
- Faculty of Medicine and Dentistry; Palacky University; Olomouc Czech Republic
- Department of Forensic Medicine and Medical Law; University Hospital Olomouc; Olomouc Czech Republic
| | - Peter Ondra
- Faculty of Medicine and Dentistry; Palacky University; Olomouc Czech Republic
- Department of Forensic Medicine and Medical Law; University Hospital Olomouc; Olomouc Czech Republic
| | - Eva Kocianová
- Department of Forensic Medicine and Medical Law; University Hospital Olomouc; Olomouc Czech Republic
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry; Palacky University Olomouc; Olomouc Czech Republic
| | - Jan Václavík
- Department of Forensic Medicine and Medical Law; University Hospital Olomouc; Olomouc Czech Republic
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry; Palacky University Olomouc; Olomouc Czech Republic
| |
Collapse
|
108
|
Abstract
While crucial for the acute physiologic response to stress, the adrenergic system may become maladaptive upon prolonged stimulation in the course of development of heart failure. This has been the basis for the development of beta-blocking therapies, targeting mainly beta1-2 adrenoreceptors (B1-2AR). The third isotype, B3AR, was more recently identified in cardiac myocytes and endothelial cells from human (and many other animal species), where its distinctive coupling to nitric oxide and antioxidant pathways suggested potential protective properties that were unexploited so far. The observation of beneficial effects of B3AR expression/activation on myocardial remodeling and the availability of specific agonists for clinical use now open the way for directly testing the hypothesis in heart failure patients. We will briefly review the specificities of B3AR signaling in the context of the cardiovascular adrenergic system, the evidence supporting its beneficial effects and outline an ongoing clinical trial using the B3AR agonist, mirabegron in patients with/at risk of developing heart failure with preserved ejection fraction (HFpEF).
Collapse
Affiliation(s)
- Lauriane Y M Michel
- Pole of Pharmacology and Therapeutics (FATH), Institut de Recherche Experimentale et Clinique (IREC), Université Catholique de Louvain, B1.53.09, 52 Ave. Mounier, 1200, Brussels, Belgium
| | - Jean-Luc Balligand
- Pole of Pharmacology and Therapeutics (FATH), Institut de Recherche Experimentale et Clinique (IREC), Université Catholique de Louvain, B1.53.09, 52 Ave. Mounier, 1200, Brussels, Belgium.
- Department of Medicine, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10 Ave. Hippocrate, 1200, Brussels, Belgium.
| |
Collapse
|
109
|
Prajapati H, Sharma R, Patel D. Carvedilol: a review of its use in the management of heart failure. DRUGS & THERAPY PERSPECTIVES 2016. [DOI: 10.1007/s40267-016-0370-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
110
|
Teixeira MZ. Biological therapies (immunomodulatory drugs), worsening of psoriasis and rebound effect: new evidence of similitude. HOMEOPATHY 2016; 105:344-355. [PMID: 27914574 DOI: 10.1016/j.homp.2016.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 04/25/2016] [Accepted: 09/14/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Employing the secondary action or adaptative reaction of the organism as therapeutic response, homeopathy uses the treatment by similitude (similia similibus curentur) administering to sick individuals the medicines that caused similar symptoms in healthy individuals. Such homeostatic or paradoxical reaction of the organism is scientifically explained through the rebound effect of drugs, which cause worsening of symptoms after withdrawal of several palliative treatments. Despite promoting an improvement in psoriasis at the beginning of the treatment, modern biological therapies provoke worsening of the psoriasis (rebound psoriasis) after discontinuation of drugs. METHOD Exploratory qualitative review of the literature on the occurrence of the rebound effect with the use of immunomodulatory drugs [T-cell modulating agents and tumor necrosis factor (TNF) inhibitors drugs] in the treatment of psoriasis. RESULTS Several researches indicate the rebound effect as the mechanism of worsening of psoriasis with the use of efalizumab causing the suspension of its marketing authorization in 2009, in view of some severe cases. Other studies also have demonstrated the occurrence of rebound psoriasis with the use of alefacept, etanercept and infliximab. CONCLUSION As well as studied in other classes of drugs, the rebound effect of biologic agents supports the principle of similitude (primary action of the drugs followed by secondary action and opposite of the organism).
Collapse
Affiliation(s)
- Marcus Zulian Teixeira
- Department of Internal Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
| |
Collapse
|
111
|
Loss of β-adrenergic-stimulated phosphorylation of CaV1.2 channels on Ser1700 leads to heart failure. Proc Natl Acad Sci U S A 2016; 113:E7976-E7985. [PMID: 27864509 DOI: 10.1073/pnas.1617116113] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
L-type Ca2+ currents conducted by voltage-gated calcium channel 1.2 (CaV1.2) initiate excitation-contraction coupling in the heart, and altered expression of CaV1.2 causes heart failure in mice. Here we show unexpectedly that reducing β-adrenergic regulation of CaV1.2 channels by mutation of a single PKA site, Ser1700, in the proximal C-terminal domain causes reduced contractile function, cardiac hypertrophy, and heart failure without changes in expression, localization, or function of the CaV1.2 protein in the mutant mice (SA mice). These deficits were aggravated with aging. Dual mutation of Ser1700 and a nearby casein-kinase II site (Thr1704) caused accelerated hypertrophy, heart failure, and death in mice with these mutations (STAA mice). Cardiac hypertrophy was increased by voluntary exercise and by persistent β-adrenergic stimulation. PKA expression was increased, and PKA sites Ser2808 in ryanodine receptor type-2, Ser16 in phospholamban, and Ser23/24 in troponin-I were hyperphosphorylated in SA mice, whereas phosphorylation of substrates for calcium/calmodulin-dependent protein kinase II was unchanged. The Ca2+ pool in the sarcoplasmic reticulum was increased, the activity of calcineurin was elevated, and calcineurin inhibitors improved contractility and ameliorated cardiac hypertrophy. Cardio-specific expression of the SA mutation also caused reduced contractility and hypertrophy. These results suggest engagement of compensatory mechanisms, which initially may enhance the contractility of individual myocytes but eventually contribute to an increased sensitivity to cardiovascular stress and to heart failure in vivo. Our results demonstrate that normal regulation of CaV1.2 channels by phosphorylation of Ser1700 in cardiomyocytes is required for cardiovascular homeostasis and normal physiological regulation in vivo.
Collapse
|
112
|
Meng Y, Liu X, Liu J, Cheng X. A prospective study on the impact of heart rate control achieved with metoprolol on cardiac performance, motor function and quality of life in Chinese chronic heart failure patients. Int J Cardiol 2016; 227:267-271. [PMID: 27843047 DOI: 10.1016/j.ijcard.2016.11.115] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 11/06/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND To prospectively evaluate the impact of metoprolol achieved heart rate (HR) on cardiac-motor function and quality of life (QoL) in chronic heart failure (CHF) patients. METHODS AND RESULTS Between February 2013 to April 2016, association of HR reduction with haemodynamic indices, motor function and QoL in CHF patients with HR>80bpm receiving metoprolol 23.75mg or 47.5mgq.d was studied. Overall, 154 patients (median age, 66.39years; males, n=101; females, n=53) were enrolled, whose average resting HR decreased significantly from baseline value of 82.72±6.73 to 69.38±3.57, 67.72±2.61, 66.50±3.14 and 64.86±3.21bpm in the 1st, 3rd, 6th and 12th months post metoprolol intervention, respectively (P<0.0001). Similarly, the ejection fraction (r=-0.6461, P<0.0001), cardiac output (r=-0.5238, P<0.0001), cardiac index (r=-0.5378, P<0.0001) and veterans specific activity questionnaire scores (r=-0.4088, P<0.0001) were significantly associated with the reduction in HR after 12months. The improvement in 6-min walk test was independent of HR reduction (P=0.005). Similarly, QoL as measured by short form-8 questionnaire (SF-8) but not Minnesota Living with Heart Failure was significantly improved at the 12th-month. However, this was not associated with the reductions in HR. CONCLUSION Metoprolol achieved HR control was associated with improvement in cardiac performance and motor function but not QoL in patients with CHF.
Collapse
Affiliation(s)
- Yong Meng
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan 650101, China.
| | - Xuelu Liu
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan 650101, China
| | - Juan Liu
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan 650101, China
| | - Xianliang Cheng
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan 650101, China
| |
Collapse
|
113
|
Nakamura T, Fujita T, Kishimura M, Suita K, Hidaka Y, Cai W, Umemura M, Yokoyama U, Uechi M, Ishikawa Y. Vidarabine, an Anti-Herpes Virus Agent, Protects Against the Development of Heart Failure With Relatively Mild Side-Effects on Cardiac Function in a Canine Model of Pacing-Induced Dilated Cardiomyopathy. Circ J 2016; 80:2496-2505. [PMID: 27818454 DOI: 10.1253/circj.cj-16-0736] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND In heart failure patients, chronic hyperactivation of sympathetic signaling is known to exacerbate cardiac dysfunction. In this study, the cardioprotective effect of vidarabine, an anti-herpes virus agent, which we identified as a cardiac adenylyl cyclase inhibitor, in dogs with pacing-induced dilated cardiomyopathy (DCM) was evaluated. In addition, the adverse effects of vidarabine on basal cardiac function was compared to those of the β-blocker, carvedilol.Methods and Results:Vidarabine and carvedilol attenuated the development of pacing-induced systolic dysfunction significantly and with equal effectiveness. Both agents also inhibited the development of cardiac apoptosis and fibrosis and reduced the Na+-Ca2+exchanger-1 protein level in the heart. Importantly, carvedilol significantly enlarged the left ventricle and atrium; vidarabine, in contrast, did not. Vidarabine-treated dogs maintained cardiac response to β-AR stimulation better than carvedilol-treated dogs did. CONCLUSIONS Vidarabine may protect against pacing-induced DCM with less suppression of basal cardiac function than carvedilol in a dog model. (Circ J 2016; 80: 2496-2505).
Collapse
Affiliation(s)
- Takashi Nakamura
- Cardiovascular Research Institute, Yokohama City University Graduate School of Medicine
| | | | | | | | | | | | | | | | | | | |
Collapse
|
114
|
|
115
|
Depressed Myocardial Contractility: Can It Be Rescued? Am J Med Sci 2016; 352:428-432. [PMID: 27776727 DOI: 10.1016/j.amjms.2016.05.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 05/24/2016] [Indexed: 11/20/2022]
Abstract
Current dogma suggests patients with advanced systolic heart failure have an irreversible depression in myocardial contractility. Recent experience with improved ventricular function during continuous flow ventricular assist devices used as destination therapy would suggest otherwise. Herein, cellular and molecular signaling involved in reversing depressed myocardial contractility would be addressed. This includes cardiomyocyte thyroid hormone signaling responsible for the reexpression of fetal gene program that preserves cell efficiency (work and energy consumed) and the rescue of an endogenous population of atrophic myocytes bordering on microdomains of fibrosis to improve contractile mass.
Collapse
|
116
|
cAMP-PKA-CaMKII signaling pathway is involved in aggravated cardiotoxicity during Fuzi and Beimu Combination Treatment of Experimental Pulmonary Hypertension. Sci Rep 2016; 6:34903. [PMID: 27739450 PMCID: PMC5064387 DOI: 10.1038/srep34903] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 09/20/2016] [Indexed: 01/03/2023] Open
Abstract
Aconiti Lateralis Radix Praeparata (Fuzi) and Fritillariae Thunbergii bulbus (Beimu) have been widely used clinically to treat cardiopulmonary related diseases in China. However, according to the classic rules of traditional Chinese medicine, Fuzi and Beimu should be prohibited to use as a combination for their incompatibility. Therefore, it is critical to elucidate the paradox on the use of Fuzi and Beimu combination therapy. Monocrotaline-induced pulmonary hypertension rats were treated with either Fuzi, Beimu, or their combination at different stages of PH. We demonstrated that at the early stage of PH, Fuzi and Beimu combination significantly improved lung function and reduced pulmonary histopathology. However, as the disease progressed, when Fuzi and Beimu combination were used at the late stage of PH, right ventricular chamber dilation was histologically apparent and myocardial apoptosis was significantly increased compared with each drug alone. Western-blotting results indicated that the main chemical ingredient of Beimu could down-regulate the protein phosphorylation levels of Akt and PDE4D, whereas the combination of Fuzi and Beimu could up-regulate PKA and CaMKII signaling pathways. Therefore, we concluded that Fuzi and Beimu combination potentially aggravated the heart injury due to the inhibition of PDK1/Akt/PDE4D axis and subsequent synergistic activation of βAR-Gs-PKA/CaMKII signaling pathway.
Collapse
|
117
|
Armenian SH, Hudson MM, Chen MH, Colan SD, Lindenfeld L, Mills G, Siyahian A, Gelehrter S, Dang H, Hein W, Green DM, Robison LL, Wong FL, Douglas PS, Bhatia S. Rationale and design of the Children's Oncology Group (COG) study ALTE1621: a randomized, placebo-controlled trial to determine if low-dose carvedilol can prevent anthracycline-related left ventricular remodeling in childhood cancer survivors at high risk for developing heart failure. BMC Cardiovasc Disord 2016; 16:187. [PMID: 27716152 PMCID: PMC5050602 DOI: 10.1186/s12872-016-0364-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 09/27/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Anthracyclines are widely used in the treatment of childhood cancer. One of the well-recognized side-effects of anthracycline therapy is dose-dependent cardiomyopathy that may progress to heart failure (HF) years after completion of cancer-directed therapy. This study will evaluate the efficacy of low-dose beta-blocker (carvedilol) for HF risk reduction in childhood cancer survivors at highest risk for HF. The proposed intervention has the potential to significantly reduce chronic cardiac injury via interruption of neurohormonal systems responsible for left ventricular (LV) remodeling, resulting in improved cardiac function and decreased risk of HF. The intervention is informed by previous studies demonstrating efficacy in pediatric and adult non-oncology populations, yet remains unstudied in the pediatric oncology population. METHODS/DESIGN The primary objective of the trial is to determine impact of the intervention on echocardiographic markers of cardiac remodeling and HF risk, including: LV wall thickness/ dimension ratio (LVWT/D; primary endpoint), as well as LV ejection fraction, volume, and blood biomarkers (natriuretic peptides, galectin-3) associated with HF risk. Secondary objectives are to establish safety and tolerability of the 2-year course of carvedilol using: 1) objective measures: hepatic and cardiovascular toxicity, treatment adherence, and 2) subjective measures: participant self-reported outcomes. Two hundred and fifty survivors of childhood cancer (diagnosed <21 years of age), and previously treated with high-dose (≥300 mg/m2) anthracyclines will be enrolled in a randomized, double-blind, placebo controlled trial. After baseline assessments, participants will be randomized in a 1:1 ratio to low-dose carvedilol (maximum dose: 12.5 mg/day) or placebo. Carvedilol or placebo is up-titrated (starting dose: 3.125 mg/day) according to tolerability. DISCUSSION When completed, this study will provide much-needed information regarding a physiologically plausible pharmacological risk-reduction strategy for childhood cancer survivors at high risk for developing anthracycline-related HF. TRIAL REGISTRATION ClinicalTrials.gov; NCT02717507.
Collapse
MESH Headings
- Adrenergic beta-Antagonists/administration & dosage
- Adrenergic beta-Antagonists/adverse effects
- Age Factors
- Anthracyclines/adverse effects
- Antibiotics, Antineoplastic/adverse effects
- Carbazoles/administration & dosage
- Carbazoles/adverse effects
- Cardiotoxicity
- Carvedilol
- Clinical Protocols
- Double-Blind Method
- Female
- Heart Failure/chemically induced
- Heart Failure/diagnosis
- Heart Failure/physiopathology
- Heart Failure/prevention & control
- Humans
- Hypertrophy, Left Ventricular/chemically induced
- Hypertrophy, Left Ventricular/diagnosis
- Hypertrophy, Left Ventricular/physiopathology
- Hypertrophy, Left Ventricular/prevention & control
- Male
- Propanolamines/administration & dosage
- Propanolamines/adverse effects
- Research Design
- Risk Assessment
- Risk Factors
- Time Factors
- Treatment Outcome
- Ventricular Dysfunction, Left/chemically induced
- Ventricular Dysfunction, Left/diagnosis
- Ventricular Dysfunction, Left/physiopathology
- Ventricular Dysfunction, Left/prevention & control
- Ventricular Function, Left/drug effects
- Ventricular Remodeling/drug effects
Collapse
Affiliation(s)
- Saro H. Armenian
- Department of Population Sciences, City of Hope, 1500, East Duarte Road, Duarte, CA 91010-3000 USA
| | - Melissa M. Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN USA
| | - Ming Hui Chen
- Department of Cardiology, Boston Children’s Hospital, Boston, MA USA
| | - Steven D. Colan
- Department of Cardiology, Boston Children’s Hospital, Boston, MA USA
| | - Lanie Lindenfeld
- Department of Population Sciences, City of Hope, 1500, East Duarte Road, Duarte, CA 91010-3000 USA
| | - George Mills
- Department of Population Sciences, City of Hope, 1500, East Duarte Road, Duarte, CA 91010-3000 USA
| | - Aida Siyahian
- Department of Population Sciences, City of Hope, 1500, East Duarte Road, Duarte, CA 91010-3000 USA
| | - Sarah Gelehrter
- Pediatric Cardiology, C.S. Mott Children’s Hospital, Ann Arbor, MI USA
| | - Ha Dang
- Children’s Oncology Group, Arcadia, CA USA
| | - Wendy Hein
- Survive & Thrive Long-term Follow-up Program, Children’s Mercy Hospital, Kansas City, USA
| | - Daniel M. Green
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN USA
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN USA
| | - F. Lennie Wong
- Department of Population Sciences, City of Hope, 1500, East Duarte Road, Duarte, CA 91010-3000 USA
| | | | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL USA
| |
Collapse
|
118
|
Bradley SJ, Tobin AB. Design of Next-Generation G Protein-Coupled Receptor Drugs: Linking Novel Pharmacology and In Vivo Animal Models. Annu Rev Pharmacol Toxicol 2016; 56:535-59. [PMID: 26738479 DOI: 10.1146/annurev-pharmtox-011613-140012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Despite the fact that G protein-coupled receptors (GPCRs) are the most successful drug targets in history, this supergene family of cell surface receptors has yet to be fully exploited as targets in the treatment of human disease. Here, we present optimism that this may change in the future by reviewing the substantial progress made in the understanding of GPCR molecular pharmacology that has generated an extensive toolbox of ligand types that include orthosteric, allosteric, and bitopic ligands, many of which show signaling bias. We discuss how combining these advances with recently described transgenic, chemical genetic, and optogenetic animal models will provide the framework to allow for the rational design of next-generation GPCR drugs that possess increased therapeutic efficacy and decreased adverse/toxic responses.
Collapse
Affiliation(s)
- Sophie J Bradley
- MRC Toxicology Unit, University of Leicester, Leicester LE1 9HN United Kingdom; ,
| | - Andrew B Tobin
- MRC Toxicology Unit, University of Leicester, Leicester LE1 9HN United Kingdom; ,
| |
Collapse
|
119
|
Weber S, Meyer-Roxlau S, El-Armouche A. Role of protein phosphatase inhibitor-1 in cardiac beta adrenergic pathway. J Mol Cell Cardiol 2016; 101:116-126. [PMID: 27639308 DOI: 10.1016/j.yjmcc.2016.09.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 09/05/2016] [Accepted: 09/13/2016] [Indexed: 01/08/2023]
Abstract
Phosphoproteomic studies have shown that about one third of all cardiac proteins are reversibly phosphorylated, affecting virtually every cellular signaling pathway. The reversibility of this process is orchestrated by the opposing enzymatic activity of kinases and phosphatases. Conversely, imbalances in subcellular protein phosphorylation patterns are a hallmark of many cardiovascular diseases including heart failure and cardiac arrhythmias. While numerous studies have revealed excessive beta-adrenergic signaling followed by deregulated kinase expression or activity as a major driver of the latter cardiac pathologies, far less is known about the beta-adrenergic regulation of their phosphatase counterparts. In fact, most of the limited knowledge stems from the detailed analysis of the endogenous inhibitor of the protein phosphatase 1 (I-1) in cellular and animal models. I-1 acts as a nodal point between adrenergic and putatively non-adrenergic cardiac signaling pathways and is able to influence widespread cellular functions of protein phosphatase 1 which are contributing to cardiac health and disease, e.g. Ca2+ handling, sarcomere contractility and glucose metabolism. Finally, nearly all of these studies agree that I-1 is a promising drug target on the one hand but the outcome of its pharmacological regulation maybe extremely context-dependent on the other hand, thus warranting for careful interpretation of past and future experimental results. In this respect we will: 1) comprehensively review the current knowledge about structural, functional and regulatory properties of I-1 within the heart 2) highlight current working hypothesis and potential I-1 mediated disease mechanisms 3) discuss state-of-the-art knowledge and future prospects of a potential therapeutic strategy targeting I-1 by restoring the balance of cardiac protein phosphorylation.
Collapse
Affiliation(s)
- Silvio Weber
- Department of Pharmacology and Toxicology, Medical Faculty, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany.
| | - Stefanie Meyer-Roxlau
- Department of Pharmacology and Toxicology, Medical Faculty, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany
| | - Ali El-Armouche
- Department of Pharmacology and Toxicology, Medical Faculty, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany.
| |
Collapse
|
120
|
Hamid T, Xu Y, Ismahil MA, Li Q, Jones SP, Bhatnagar A, Bolli R, Prabhu SD. TNF receptor signaling inhibits cardiomyogenic differentiation of cardiac stem cells and promotes a neuroadrenergic-like fate. Am J Physiol Heart Circ Physiol 2016; 311:H1189-H1201. [PMID: 27591224 DOI: 10.1152/ajpheart.00904.2015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 08/25/2016] [Indexed: 01/23/2023]
Abstract
Despite expansion of resident cardiac stem cells (CSCs; c-kit+Lin-) after myocardial infarction, endogenous repair processes are insufficient to prevent adverse cardiac remodeling and heart failure (HF). This suggests that the microenvironment in post-ischemic and failing hearts compromises CSC regenerative potential. Inflammatory cytokines, such as tumor necrosis factor-α (TNF), are increased after infarction and in HF; whether they modulate CSC function is unknown. As the effects of TNF are specific to its two receptors (TNFRs), we tested the hypothesis that TNF differentially modulates CSC function in a TNFR-specific manner. CSCs were isolated from wild-type (WT), TNFR1-/-, and TNFR2-/- adult mouse hearts, expanded and evaluated for cell competence and differentiation in vitro in the absence and presence of TNF. Our results indicate that TNF signaling in murine CSCs is constitutively related primarily to TNFR1, with TNFR2 inducible after stress. TNFR1 signaling modestly diminished CSC proliferation, but, along with TNFR2, augmented CSC resistance to oxidant stress. Deficiency of either TNFR1 or TNFR2 did not impact CSC telomerase activity. Importantly, TNF, primarily via TNFR1, inhibited cardiomyogenic commitment during CSC differentiation, and instead promoted smooth muscle and endothelial fates. Moreover, TNF, via both TNFR1 and TNFR2, channeled an alternate CSC neuroadrenergic-like fate (capable of catecholamine synthesis) during differentiation. Our results suggest that elevated TNF in the heart restrains cardiomyocyte differentiation of resident CSCs and may enhance adrenergic activation, both effects that would reduce the effectiveness of endogenous cardiac repair and the response to exogenous stem cell therapy, while promoting adverse cardiac remodeling.
Collapse
Affiliation(s)
- Tariq Hamid
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; and
| | - Yuanyuan Xu
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; and
| | - Mohamed Ameen Ismahil
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; and
| | - Qianhong Li
- Department of Medicine, Institute of Molecular Cardiology, Diabetes and Obesity Center, University of Louisville, Louisville, Kentucky
| | - Steven P Jones
- Department of Medicine, Institute of Molecular Cardiology, Diabetes and Obesity Center, University of Louisville, Louisville, Kentucky
| | - Aruni Bhatnagar
- Department of Medicine, Institute of Molecular Cardiology, Diabetes and Obesity Center, University of Louisville, Louisville, Kentucky
| | - Roberto Bolli
- Department of Medicine, Institute of Molecular Cardiology, Diabetes and Obesity Center, University of Louisville, Louisville, Kentucky
| | - Sumanth D Prabhu
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; and
| |
Collapse
|
121
|
Protective effects of Astragalus polysaccharides against endothelial dysfunction in hypertrophic rats induced by isoproterenol. Int Immunopharmacol 2016; 38:306-12. [DOI: 10.1016/j.intimp.2016.06.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 05/22/2016] [Accepted: 06/17/2016] [Indexed: 11/21/2022]
|
122
|
Tashakori-Sabzevar F, Razavi BM, Imenshahidi M, Daneshmandi M, Fatehi H, Entezari Sarkarizi Y, Mohajeri SA. Evaluation of mechanism for antihypertensive and vasorelaxant effects of hexanic and hydroalcoholic extracts of celery seed in normotensive and hypertensive rats. REVISTA BRASILEIRA DE FARMACOGNOSIA-BRAZILIAN JOURNAL OF PHARMACOGNOSY 2016. [DOI: 10.1016/j.bjp.2016.05.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
123
|
Teixeira MZ, Podgaec S, Baracat EC. Protocol of randomized controlled trial of potentized estrogen in homeopathic treatment of chronic pelvic pain associated with endometriosis. HOMEOPATHY 2016; 105:240-249. [PMID: 27473545 DOI: 10.1016/j.homp.2016.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 03/01/2016] [Accepted: 03/09/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Endometriosis is a chronic inflammatory disease that causes difficult-to-treat pelvic pain. Thus being, many patients seek help in complementary and alternative medicine, including homeopathy. The effectiveness of homeopathic treatment for endometriosis is controversial due to the lack of evidences in the literature. The aim of the present randomized controlled trial is to assess the efficacy of potentized estrogen compared to placebo in the treatment of chronic pelvic pain associated with endometriosis. METHODS/DESIGN The present is a randomized, double-blind, placebo-controlled trial of a homeopathic medicine individualized according to program 'New Homeopathic Medicines: use of modern drugs according to the principle of similitude' (http://newhomeopathicmedicines.com). Women with endometriosis, chronic pelvic pain and a set of signs and symptoms similar to the adverse events caused by estrogen were recruited at the Endometriosis Unit of Division of Clinical Gynecology, Clinical Hospital, School of Medicine, University of São Paulo (Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - HCFMUSP). The participants were selected based on the analysis of their medical records and the application of self-report structured questionnaires. A total of 50 women meeting the eligibility criteria will be randomly allocated to receive potentized estrogen or placebo. The primary clinical outcome measure will be severity of chronic pelvic pain. Statistical analysis will be performed on the intention-to-treat and per-protocol approaches comparing the effect of the homeopathic medicine versus placebo after 24 weeks of intervention. DISCUSSION The present study was approved by the research ethics committee of HCFMUSP and the results are expected in 2016. TRIAL REGISTRATION ClinicalTrials.gov Identifier: https://clinicaltrials.gov/ct2/show/NCT02427386.
Collapse
Affiliation(s)
- Marcus Zulian Teixeira
- Department of Obstetrics and Gynecology, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
| | - Sérgio Podgaec
- Department of Obstetrics and Gynecology, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Edmund Chada Baracat
- Department of Obstetrics and Gynecology, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| |
Collapse
|
124
|
Bauman JL, Talbert RL. Pharmacodynamics ofβ-Blockers in Heart Failure: Lessons from the Carvedilol Or Metoprolol European Trial. J Cardiovasc Pharmacol Ther 2016; 9:117-28. [PMID: 15309248 DOI: 10.1177/107424840400900207] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Heart failure is a growing public health problem in the United States, and the approach to the treatment of heart failure has undergone a radical transformation in the past decade. The use of β-blocker therapy in heart failure patients is now widely recommended, based on evidence from large-scale clinical trials demonstrating that bisoprolol, carvedilol, and extended-release metoprolol succinate significantly reduce morbidity and mortality in patients with heart failure. Although these agents appear to provide similar benefits, the question remains whether pharmacologic differences among them could translate to differences in clinical outcomes. The Carvedilol Or Metoprolol European Trial (COMET) compared nonselective blockade of the β1-/β2-/α1-adrenergic receptors with carvedilol versus selective β1-blockade with immediate-release metoprolol tartrate in patients with chronic heart failure. The trial found that carvedilol significantly reduced all-cause mortality compared with immediate-release metoprolol tartrate, although there were no differences in hospitalizations. Herein we review the pharmacokinetics and pharmacodynamics of metoprolol and carvedilol. In doing so, several issues regarding the design of COMET are identified that could alter the interpretation of the results of this trial. These include the choice of dose and dosage regimen of immediate-release metoprolol tartrate, a dosage form that has never been shown to reduce mortality in patients with heart failure. Additional studies are needed to fully understand whether there are any advantages of selective versus nonselective adrenergic blockade and whether there are any clinically meaningful differences in effectiveness between β-blockers with proven benefit in the management of chronic heart failure. The results of COMET demonstrate that all β-blockers and dosage forms are not interchangeable when prescribed for heart failure. Clinicians should choose only those agents (and dosage forms) that have been proven to reduce mortality in this patient population.
Collapse
Affiliation(s)
- Jerry L Bauman
- Departments of Pharmacy Practice and Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA.
| | | |
Collapse
|
125
|
Schlager O, Gajdosova Kovacicova L, Senn O, Amann-Vesti B, Wilkinson IB, Jacomella V, Husmann M. β-Blockers and Vascular Hemodynamics in Patients With Peripheral Arterial Disease. J Clin Hypertens (Greenwich) 2016; 18:1244-1249. [PMID: 27279251 DOI: 10.1111/jch.12854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 04/11/2016] [Accepted: 04/13/2016] [Indexed: 11/30/2022]
Abstract
Aortic augmentation index (AIx) is a marker of central aortic pressure burden and is modulated by antihypertensive drugs. In patients with peripheral arterial disease (PAD) undergoing antihypertensive treatment, aortic pressures parameters, heart rate-adjusted augmentation index (AIx75), and unadjusted AIx were determined. The (aortic) systolic and diastolic blood pressure did not differ between PAD patients who were taking β-blockers (n=61) and those who were not taking β-blockers (n=80). In patients taking β-blockers, augmentation pressure and pulse pressure were higher than in patients who did not take β-blockers (augmentation pressure, P=.02; pulse pressure, P=.005). AIx75 was lower in PAD patients taking β-blockers than in patients not taking β-blockers (P=.04), while the AIx did not differ between PAD patients taking and not taking β-blockers. The present study demonstrates that β-blockers potentially affect markers of vascular hemodynamics in patients with PAD. Because these markers are surrogates of cardiovascular risk, further studies are warranted to clarify the impact of selective β-blocker treatment on clinical outcome in patients with PAD.
Collapse
Affiliation(s)
- Oliver Schlager
- Division of Angiology, Department of Medicine II, Medical University of Vienna, Wien, Austria
| | | | - Oliver Senn
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | | | - Ian B Wilkinson
- Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK
| | | | - Marc Husmann
- Division of Angiology, University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
126
|
Gardner RT, Ripplinger CM, Myles RC, Habecker BA. Molecular Mechanisms of Sympathetic Remodeling and Arrhythmias. Circ Arrhythm Electrophysiol 2016; 9:e001359. [PMID: 26810594 DOI: 10.1161/circep.115.001359] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Ryan T Gardner
- From the Department of Physiology and Pharmacology and Knight Cardiovascular Institute, Oregon Health and Science University, Portland (R.T.G., B.A.H.); Department of Pharmacology, School of Medicine, University of California, Davis (C.M.R.); and Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (R.C.M.)
| | - Crystal M Ripplinger
- From the Department of Physiology and Pharmacology and Knight Cardiovascular Institute, Oregon Health and Science University, Portland (R.T.G., B.A.H.); Department of Pharmacology, School of Medicine, University of California, Davis (C.M.R.); and Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (R.C.M.)
| | - Rachel C Myles
- From the Department of Physiology and Pharmacology and Knight Cardiovascular Institute, Oregon Health and Science University, Portland (R.T.G., B.A.H.); Department of Pharmacology, School of Medicine, University of California, Davis (C.M.R.); and Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (R.C.M.)
| | - Beth A Habecker
- From the Department of Physiology and Pharmacology and Knight Cardiovascular Institute, Oregon Health and Science University, Portland (R.T.G., B.A.H.); Department of Pharmacology, School of Medicine, University of California, Davis (C.M.R.); and Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (R.C.M.).
| |
Collapse
|
127
|
Li T, Cheng HJ, Ohte N, Hasegawa H, Morimoto A, Herrington DM, Little WC, Li W, Cheng CP. C-Type Natriuretic Peptide Improves Left Ventricular Functional Performance at Rest and Restores Normal Exercise Responses after Heart Failure. J Pharmacol Exp Ther 2016; 357:545-53. [PMID: 27026682 PMCID: PMC4885509 DOI: 10.1124/jpet.115.231696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 03/28/2016] [Indexed: 01/20/2023] Open
Abstract
In heart failure (HF), the impaired left ventricular (LV) arterial coupling and diastolic dysfunction present at rest are exacerbated during exercise. C-type natriuretic peptide (CNP) is elevated in HF; however, its functional effects are unclear. We tested the hypotheses that CNP with vasodilating, natriuretic, and positive inotropic and lusitropic actions may prevent this abnormal exercise response after HF. We determined the effects of CNP (2 μg/kg plus 0.4 μg/kg per minute, i.v., 20 minutes) on plasma levels of cGMP before and after HF and assessed LV dynamics during exercise in 10 chronically instrumented dogs with pacing-induced HF. Compared with the levels before HF, CNP infusion caused significantly greater increases in cGMP levels after HF. After HF, at rest, CNP administration significantly reduced LV end-systolic pressure (PES), arterial elastance (EA), and end-diastolic pressure. The peak mitral flow (dV/dtmax) was also increased owing to decreased minimum LVP (LVPmin) and the time constant of LV relaxation (τ) (P < 0.05). In addition, LV contractility (EES) was increased. The LV-arterial coupling (EES/EA) was improved. The beneficial effects persisted during exercise. Compared with exercise in HF preparation, treatment with CNP caused significantly less important increases in PES but significantly decreased τ (34.2 vs. 42.6 ms) and minimum left ventricular pressure with further augmented dV/dtmax Both EES, EES/EA (0.87 vs. 0.32) were increased. LV mechanical efficiency improved from 0.38 to 0.57 (P < 0.05). After HF, exogenous CNP produces arterial vasodilatation and augments LV contraction, relaxation, diastolic filling, and LV arterial coupling, thus improving LV performance at rest and restoring normal exercise responses after HF.
Collapse
Affiliation(s)
- Tiankai Li
- Wake Forest School of Medicine, Winston-Salem, North Carolina (H.J.C., N.O., H.H., A.M., D.M.H., W.C.L., C.P.C.), and the First Affiliated Hospital of Harbin Medical University, Harbin, China (T.L., H.J.C, W.L., C.P.C)
| | - Heng-Jie Cheng
- Wake Forest School of Medicine, Winston-Salem, North Carolina (H.J.C., N.O., H.H., A.M., D.M.H., W.C.L., C.P.C.), and the First Affiliated Hospital of Harbin Medical University, Harbin, China (T.L., H.J.C, W.L., C.P.C)
| | - Nobuyuki Ohte
- Wake Forest School of Medicine, Winston-Salem, North Carolina (H.J.C., N.O., H.H., A.M., D.M.H., W.C.L., C.P.C.), and the First Affiliated Hospital of Harbin Medical University, Harbin, China (T.L., H.J.C, W.L., C.P.C)
| | - Hiroshi Hasegawa
- Wake Forest School of Medicine, Winston-Salem, North Carolina (H.J.C., N.O., H.H., A.M., D.M.H., W.C.L., C.P.C.), and the First Affiliated Hospital of Harbin Medical University, Harbin, China (T.L., H.J.C, W.L., C.P.C)
| | - Atsushi Morimoto
- Wake Forest School of Medicine, Winston-Salem, North Carolina (H.J.C., N.O., H.H., A.M., D.M.H., W.C.L., C.P.C.), and the First Affiliated Hospital of Harbin Medical University, Harbin, China (T.L., H.J.C, W.L., C.P.C)
| | - David M Herrington
- Wake Forest School of Medicine, Winston-Salem, North Carolina (H.J.C., N.O., H.H., A.M., D.M.H., W.C.L., C.P.C.), and the First Affiliated Hospital of Harbin Medical University, Harbin, China (T.L., H.J.C, W.L., C.P.C)
| | - William C Little
- Wake Forest School of Medicine, Winston-Salem, North Carolina (H.J.C., N.O., H.H., A.M., D.M.H., W.C.L., C.P.C.), and the First Affiliated Hospital of Harbin Medical University, Harbin, China (T.L., H.J.C, W.L., C.P.C)
| | - Weimin Li
- Wake Forest School of Medicine, Winston-Salem, North Carolina (H.J.C., N.O., H.H., A.M., D.M.H., W.C.L., C.P.C.), and the First Affiliated Hospital of Harbin Medical University, Harbin, China (T.L., H.J.C, W.L., C.P.C)
| | - Che Ping Cheng
- Wake Forest School of Medicine, Winston-Salem, North Carolina (H.J.C., N.O., H.H., A.M., D.M.H., W.C.L., C.P.C.), and the First Affiliated Hospital of Harbin Medical University, Harbin, China (T.L., H.J.C, W.L., C.P.C)
| |
Collapse
|
128
|
Joyner MJ. Preclinical and clinical evaluation of autonomic function in humans. J Physiol 2016; 594:4009-13. [PMID: 27098282 DOI: 10.1113/jp271875] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 03/22/2016] [Indexed: 01/06/2023] Open
Abstract
This review focuses on how to assess autonomic function in humans including various ways to measure heart rate, catecholamines, and sympathetic neural activity. The need to assess autonomic function is paramount in many experimental paradigms because of the following. (1) Autonomic dysfunction is present in common diseases like hypertension, diabetes and heart failure, and the magnitude of this dysfunction is broadly related to morbidity and mortality in these disorders. (2) The relationship between autonomic dysfunction and morbidity and mortality can be causal. (3) Interventions that modulate or reverse autonomic dysfunction can improve outcomes in the affected patients. The techniques discussed are also frequently used to understand the autonomic response to sympathoexcitatory manoeuvres like exercise, the cold pressor test or mental stress. Because these manoeuvres can engage a variety of sensory and efferent pathways, under some circumstances the physiological responses measured by many of the techniques are directionally similar, in others they are divergent. Thus any investigator seeking to study the autonomic nervous system or its contribution to either normal physiology or pathophysiological conditions must carefully balance a number of considerations to ensure that the right technique is used to address the question of interest.
Collapse
Affiliation(s)
- Michael J Joyner
- Department of Anaesthesiology, Mayo Clinic, Rochester, MN, 55902, USA
| |
Collapse
|
129
|
Abstract
We present a case of acute clenbuterol toxicity following ingestion of 20 μg of clenbuterol, resulting in symptoms of sympathetic activation, sinus tachycardia and electrolyte derangement. The patient was managed conservatively with fluid resuscitation, electrolyte replacement and monitoring, and discharged following a 5-day stay in hospital.
Collapse
|
130
|
Waight M, McGuinness W. Case of low dose clenbuterol toxicity. BMJ Case Rep 2016; 2016:10.1136/bcr-2016-215157. [PMID: 27084902 DOI: 10.1136/bcr-2016-215157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present a case of acute clenbuterol toxicity following ingestion of 20 μg of clenbuterol, resulting in symptoms of sympathetic activation, sinus tachycardia and electrolyte derangement. The patient was managed conservatively with fluid resuscitation, electrolyte replacement and monitoring, and discharged following a 5-day stay in hospital.
Collapse
|
131
|
Rossi F, Mascolo A, Mollace V. The pathophysiological role of natriuretic peptide-RAAS cross talk in heart failure. Int J Cardiol 2016; 226:121-125. [PMID: 27062428 DOI: 10.1016/j.ijcard.2016.03.080] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 03/19/2016] [Indexed: 12/22/2022]
Abstract
Chronic Heart Failure (HF) is still a disease state characterized by elevated morbidity and mortality and represents an unresolved problem for its socio-economic impact. Besides many of the pathophysiological events leading to advanced HF have been widely disclosed in the past decades, the role of neuro-hormonal dysregulation accompanying HF has to be clearly assessed with the objective of better therapeutic approaches in treating such a disease. In the present review article, alongside with a brief re-evaluation of general aspects of HF physiopathology, we summarize recent advances in the cross talk between renin-angiotensin-aldosterone system (RAAS) with natriuretic peptides (NPs) which have been shown to play a relevant role in the development of severe HF. The role of RAAS-NPs interplay has been shown to be crucial in both hemodynamic and tissue remodeling associated to cardiomyocyte dysfunction, leading to advanced impairment of left ventricular performance. On the basis of these results, the development of drugs resetting both RAAS and NPs system seems to be promising for a successful long term treatment of chronic HF.
Collapse
Affiliation(s)
- Francesco Rossi
- Second University of Naples, Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Department of Experimental Medicine, Section of Pharmacology L. Donatelli, Napoli, Italy
| | - Annamaria Mascolo
- Second University of Naples, Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Department of Experimental Medicine, Section of Pharmacology L. Donatelli, Napoli, Italy.
| | - Vincenzo Mollace
- Institute of Research for Food Safety & Health (IRC-FSH), University "Magna Graecia" of Catanzaro, Italy
| |
Collapse
|
132
|
Nicotinic Acid Adenine Dinucleotide Phosphate (NAADP) and Cyclic ADP-Ribose (cADPR) Mediate Ca2+ Signaling in Cardiac Hypertrophy Induced by β-Adrenergic Stimulation. PLoS One 2016; 11:e0149125. [PMID: 26959359 PMCID: PMC4784992 DOI: 10.1371/journal.pone.0149125] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/27/2016] [Indexed: 01/19/2023] Open
Abstract
Ca2+ signaling plays a fundamental role in cardiac hypertrophic remodeling, but the underlying mechanisms remain poorly understood. We investigated the role of Ca2+-mobilizing second messengers, NAADP and cADPR, in the cardiac hypertrophy induced by β-adrenergic stimulation by isoproterenol. Isoproterenol induced an initial Ca2+ transients followed by sustained Ca2+ rises. Inhibition of the cADPR pathway with 8-Br-cADPR abolished only the sustained Ca2+ increase, whereas inhibition of the NAADP pathway with bafilomycin-A1 abolished both rapid and sustained phases of the isoproterenol-mediated signal, indicating that the Ca2+ signal is mediated by a sequential action of NAADP and cADPR. The sequential production of NAADP and cADPR was confirmed biochemically. The isoproterenol-mediated Ca2+ increase and cADPR production, but not NAADP production, were markedly reduced in cardiomyocytes obtained from CD38 knockout mice. CD38 knockout mice were rescued from chronic isoproterenol infusion-induced myocardial hypertrophy, interstitial fibrosis, and decrease in fractional shortening and ejection fraction. Thus, our findings indicate that β-adrenergic stimulation contributes to the development of maladaptive cardiac hypertrophy via Ca2+ signaling mediated by NAADP-synthesizing enzyme and CD38 that produce NAADP and cADPR, respectively.
Collapse
|
133
|
Elmongy H, Ahmed H, Wahbi AA, Amini A, Colmsjö A, Abdel-Rehim M. Determination of metoprolol enantiomers in human plasma and saliva samples utilizing microextraction by packed sorbent and liquid chromatography-tandem mass spectrometry. Biomed Chromatogr 2016; 30:1309-17. [DOI: 10.1002/bmc.3685] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 01/04/2016] [Accepted: 01/08/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Hatem Elmongy
- Department of Environmental Science and Analytical Chemistry; Stockholm University; SE10691 Stockholm Sweden
- Pharmaceutical Analysis Department, Faculty of Pharmacy; Damanhour University; Damanhour 22511 Egypt
| | - Hytham Ahmed
- Pharmaceutical Analysis Department, Faculty of Pharmacy; Damanhour University; Damanhour 22511 Egypt
| | - Abdel-Aziz Wahbi
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy; University of Alexandria; Alexandria 21521 Egypt
| | | | - Anders Colmsjö
- Department of Environmental Science and Analytical Chemistry; Stockholm University; SE10691 Stockholm Sweden
| | - Mohamed Abdel-Rehim
- Department of Environmental Science and Analytical Chemistry; Stockholm University; SE10691 Stockholm Sweden
| |
Collapse
|
134
|
Rengo G, Pagano G, Filardi PP, Femminella GD, Parisi V, Cannavo A, Liccardo D, Komici K, Gambino G, D'Amico ML, de Lucia C, Paolillo S, Trimarco B, Vitale DF, Ferrara N, Koch WJ, Leosco D. Prognostic Value of Lymphocyte G Protein-Coupled Receptor Kinase-2 Protein Levels in Patients With Heart Failure. Circ Res 2016; 118:1116-24. [PMID: 26884616 DOI: 10.1161/circresaha.115.308207] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 02/16/2016] [Indexed: 01/08/2023]
Abstract
RATIONALE Sympathetic nervous system hyperactivity is associated with poor prognosis in patients with heart failure (HF), yet routine assessment of sympathetic nervous system activation is not recommended for clinical practice. Myocardial G protein-coupled receptor kinase-2 (GRK2) is upregulated in HF patients, causing dysfunctional β-adrenergic receptor signaling. Importantly, myocardial GRK2 levels correlate with levels found in peripheral lymphocytes of HF patients. OBJECTIVE The independent prognostic value of blood GRK2 measurements in HF patients has never been investigated; thus, the purpose of this study was to evaluate whether lymphocyte GRK2 levels predict clinical outcome in HF patients. METHODS AND RESULTS We prospectively studied 257 HF patients with mean left ventricular ejection fraction of 31.4±8.5%. At the time of enrollment, plasma norepinephrine, serum NT-proBNP, and lymphocyte GRK2 levels, as well as clinical and instrumental variables were measured. The prognostic value of GRK2 to predict cardiovascular (CV) death and all-cause mortality was assessed using the Cox proportional hazard model including demographic, clinical, instrumental, and laboratory data. Over a mean follow-up period of 37.5±20.2 months (range, 3-60 months), there were 102 CV deaths. Age, left ventricular ejection fraction, New York Heart Association class, chronic obstructive pulmonary disease, chronic kidney disease, N-terminal-pro brain natriuretic peptide, and lymphocyte GRK2 protein levels were independent predictors of CV mortality in HF patients. GRK2 levels showed an additional prognostic and clinical value over demographic and clinical variables. The independent prognostic value of lymphocyte GRK2 levels was also confirmed for all-cause mortality. CONCLUSIONS Lymphocyte GRK2 protein levels can independently predict prognosis in patients with HF.
Collapse
Affiliation(s)
- Giuseppe Rengo
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.)
| | - Gennaro Pagano
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.)
| | - Pasquale Perrone Filardi
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.)
| | - Grazia Daniela Femminella
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.)
| | - Valentina Parisi
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.)
| | - Alessandro Cannavo
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.)
| | - Daniela Liccardo
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.)
| | - Klara Komici
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.)
| | - Giuseppina Gambino
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.)
| | - Maria Loreta D'Amico
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.)
| | - Claudio de Lucia
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.)
| | - Stefania Paolillo
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.)
| | - Bruno Trimarco
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.)
| | - Dino Franco Vitale
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.)
| | - Nicola Ferrara
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.)
| | - Walter J Koch
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.).
| | - Dario Leosco
- From the Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.R., G.G., D.F.V., N.F.); Division of Geriatrics, Department of Translational Medical Sciences (G.R., G.P., G.D.F., V.P., A.C., D. Liccardo, K.K., G.G., M.L.D.'A., C.d.L., N.F., D. Leosco), Division of Cardiology, Department of Advanced Biomedical Sciences (P.P.F., B.T.), Federico II University of Naples, Naples, Italy; SDN Foundation IRCCS, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); and Department of Pharmacology, Center of Translational Medicine, Temple University, Philadelphia, PA (A.C., D. Liccardo, W.J.K.).
| |
Collapse
|
135
|
Nánási P, Váczi K, Papp Z. The myosin activator omecamtiv mecarbil: a promising new inotropic agent. Can J Physiol Pharmacol 2016; 94:1033-1039. [PMID: 27322915 DOI: 10.1139/cjpp-2015-0573] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Heart failure became a leading cause of mortality in the past few decades with a progressively increasing prevalence. Its current therapy is restricted largely to the suppression of the sympathetic activity and the renin-angiotensin system in combination with diuretics. This restrictive strategy is due to the potential long-term adverse effects of inotropic agents despite their effective influence on cardiac function when employed for short durations. Positive inotropes include inhibitors of the Na+/K+ pump, β-receptor agonists, and phosphodiesterase inhibitors. Theoretically, Ca2+ sensitizers may also increase cardiac contractility without resulting in Ca2+ overload; nevertheless, their mechanism of action is frequently complicated by other pleiotropic effects. Recently, a new positive inotropic agent, the myosin activator omecamtiv mecarbil, has been developed. Omecamtiv mecarbil binds directly to β-myosin heavy chain and enhances cardiac contractility by increasing the number of the active force-generating cross-bridges, presumably without major off-target effects. This review focuses on recent in vivo and in vitro results obtained with omecamtiv mecarbil, and discusses its mechanism of action at a molecular level. Based on clinical data, omecamtiv mecarbil is a promising new tool in the treatment of systolic heart failure.
Collapse
Affiliation(s)
- Péter Nánási
- a Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Krisztina Váczi
- b Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zoltán Papp
- c Division of Clinical Physiology, Department of Cardiology, Research Center for Molecular Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| |
Collapse
|
136
|
Su VYF, Chang YS, Hu YW, Hung MH, Ou SM, Lee FY, Chou KT, Yang KY, Perng DW, Chen TJ, Liu CJ. Carvedilol, Bisoprolol, and Metoprolol Use in Patients With Coexistent Heart Failure and Chronic Obstructive Pulmonary Disease. Medicine (Baltimore) 2016; 95:e2427. [PMID: 26844454 PMCID: PMC4748871 DOI: 10.1097/md.0000000000002427] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 11/10/2015] [Accepted: 12/10/2015] [Indexed: 01/11/2023] Open
Abstract
Beta (β)-blockers are under-prescribed in patients with heart failure (HF) and concurrent chronic obstructive pulmonary disease (COPD) due to concerns about adverse pulmonary effects and a poor understanding of the effects of these drugs. We aimed to evaluate the survival effects of β-blockers in patients with coexistent HF and COPD. Using the Taiwan National Health Insurance Research Database, we conducted a nationwide population-based study. Patients with coexistent HF and COPD diagnosed between 2000 and 2009 were enrolled. Doses of the 3 β-blockers proven to be beneficial to HF (carvedilol, bisoprolol, and metoprolol) during the study period were extracted. The primary endpoint was cumulative survival. Patients were followed until December 31, 2009. The study included 11,558 subjects, with a mean follow-up period of 4.07 years. After adjustment for age, sex, comorbidities, and severity of HF and COPD, bisoprolol use showed a dose-response survival benefit [low dose: adjusted hazard ratio (HR) = 0.76, 95% confidence interval (CI) = 0.59-0.97, P = 0.030; high dose: adjusted HR = 0.40, 95% CI = 0.26-0.63, P < 0.001] compared with nonusers, whereas no survival difference was observed for carvedilol or metoprolol. Compared with patients with HF alone, this special HF + COPD cohort received significantly fewer targeted β-blockers (108.8 vs 137.3 defined daily doses (DDDs)/person-year, P < 0.001) and bisoprolol (57.9 vs 70.8 DDDs/person-year, P < 0.001). In patients with coexisting HF and COPD, this study demonstrated a dose-response survival benefit of bisoprolol use, but not of carvedilol or metoprolol use.
Collapse
Affiliation(s)
- Vincent Yi-Fong Su
- From the Department of Chest Medicine (VY-FS, K-TC, K-YY, D-WP); Cancer Center (Y-WH); Division of Hematology and Oncology (M-HH, C-JL); Division of Nephrology (S-MO); Division of Gastroenterology, Department of Medicine (F-YL); Department of Family Medicine, Taipei Veterans General Hospital, Taipei (T-JC); Division of Allergy, Immunology & Rheumatology, Department of Medicine, Taipei Medical University Shuang Ho Hospital, New Taipei City (Y-SC); School of Medicine (VY-FS, Y-SC, Y-WH, M-HH, S-MO, F-YL, K-TC, K-YY, D-WP, T-JC, C-JL); Institute of Public Health (M-HH, C-JL); and Institute of Clinical Medicine VY-FS, K-TC, National Yang-Ming University, Taipei, Taiwan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
137
|
Malenfant S, Perros F. β-blockers in pulmonary arterial hypertension: generation might matter. Eur Respir J 2016; 47:682-4. [DOI: 10.1183/13993003.01244-2015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
138
|
Daniels D. Angiotensin II (de)sensitization: Fluid intake studies with implications for cardiovascular control. Physiol Behav 2016; 162:141-6. [PMID: 26801390 DOI: 10.1016/j.physbeh.2016.01.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 01/14/2016] [Accepted: 01/18/2016] [Indexed: 02/07/2023]
Abstract
Cardiovascular disease is the leading cause of death worldwide and hypertension is the most common risk factor for death. Although many anti-hypertensive pharmacotherapies are approved for use in the United States, rates of hypertension have increased over the past decade. This review article summarizes a presentation given at the 2015 meeting of the Society for the Study of Ingestive Behavior. The presentation described work performed in our laboratory that uses angiotensin II-induced drinking as a model system to study behavioral and cardiovascular effects of the renin-angiotensin system, a key component of blood pressure regulation, and a common target of anti-hypertensives. Angiotensin II (AngII) is a potent dipsogen, but the drinking response shows a rapid desensitization after repeated injections of AngII. This desensitization appears to be dependent upon the timing of the injections, requires activation of the AngII type 1 (AT1) receptor, requires activation of mitogen-activated protein (MAP) kinase family members, and involves the anteroventral third ventricle (AV3V) region as a critical site of action. Moreover, the response does not appear to be the result of a more general suppression of behavior, a sensitized pressor response to AngII, or an aversive state generated by the treatment. More recent studies suggest that the treatment regimen used to produce desensitization in our laboratory also prevents the sensitization that occurs after daily bolus injections of AngII. Our hope is that these findings can be used to support future basic research on the topic that could lead to new developments in treatments for hypertension.
Collapse
Affiliation(s)
- Derek Daniels
- Department of Psychology, Behavioral Neuroscience Program, University at Buffalo, The State University of New York, Buffalo, NY 14260, USA.
| |
Collapse
|
139
|
Itani N, Skeffington KL, Beck C, Niu Y, Giussani DA. Melatonin rescues cardiovascular dysfunction during hypoxic development in the chick embryo. J Pineal Res 2016; 60:16-26. [PMID: 26444711 PMCID: PMC4832387 DOI: 10.1111/jpi.12283] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 10/02/2015] [Indexed: 01/08/2023]
Abstract
There is a search for rescue therapy against fetal origins of cardiovascular disease in pregnancy complicated by chronic fetal hypoxia, particularly following clinical diagnosis of fetal growth restriction (FGR). Melatonin protects the placenta in adverse pregnancy; however, whether melatonin protects the fetal heart and vasculature in hypoxic pregnancy independent of effects on the placenta is unknown. Whether melatonin can rescue fetal cardiovascular dysfunction when treatment commences following FGR diagnosis is also unknown. We isolated the effects of melatonin on the developing cardiovascular system of the chick embryo during hypoxic incubation. We tested the hypothesis that melatonin directly protects the fetal cardiovascular system in adverse development and that it can rescue dysfunction following FGR diagnosis. Chick embryos were incubated under normoxia or hypoxia (14% O2) from day 1 ± melatonin treatment (1 mg/kg/day) from day 13 of incubation (term ~21 days). Melatonin in hypoxic chick embryos rescued cardiac systolic dysfunction, impaired cardiac contractility and relaxability, increased cardiac sympathetic dominance, and endothelial dysfunction in peripheral circulations. The mechanisms involved included reduced oxidative stress, enhanced antioxidant capacity and restored vascular endothelial growth factor expression, and NO bioavailability. Melatonin treatment of the chick embryo starting at day 13 of incubation, equivalent to ca. 25 wk of gestation in human pregnancy, rescues early origins of cardiovascular dysfunction during hypoxic development. Melatonin may be a suitable antioxidant candidate for translation to human therapy to protect the fetal cardiovascular system in adverse pregnancy.
Collapse
Affiliation(s)
- Nozomi Itani
- Department of Physiology, Development and NeuroscienceUniversity of CambridgeCambridgeUK
| | - Katie L. Skeffington
- Department of Physiology, Development and NeuroscienceUniversity of CambridgeCambridgeUK
| | - Christian Beck
- Department of Physiology, Development and NeuroscienceUniversity of CambridgeCambridgeUK
| | - Youguo Niu
- Department of Physiology, Development and NeuroscienceUniversity of CambridgeCambridgeUK
| | - Dino A. Giussani
- Department of Physiology, Development and NeuroscienceUniversity of CambridgeCambridgeUK
| |
Collapse
|
140
|
Jung G, Fajardo G, Ribeiro AJS, Kooiker KB, Coronado M, Zhao M, Hu DQ, Reddy S, Kodo K, Sriram K, Insel PA, Wu JC, Pruitt BL, Bernstein D. Time-dependent evolution of functional vs. remodeling signaling in induced pluripotent stem cell-derived cardiomyocytes and induced maturation with biomechanical stimulation. FASEB J 2015; 30:1464-79. [PMID: 26675706 DOI: 10.1096/fj.15-280982] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 11/30/2015] [Indexed: 01/13/2023]
Abstract
Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) are a powerful platform for uncovering disease mechanisms and assessing drugs for efficacy/toxicity. However, the accuracy with which hiPSC-CMs recapitulate the contractile and remodeling signaling of adult cardiomyocytes is not fully known. We used β-adrenergic receptor (β-AR) signaling as a prototype to determine the evolution of signaling component expression and function during hiPSC-CM maturation. In "early" hiPSC-CMs (less than or equal to d 30), β2-ARs are a primary source of cAMP/PKA signaling. With longer culture, β1-AR signaling increases: from 0% of cAMP generation at d 30 to 56.8 ± 6.6% by d 60. PKA signaling shows a similar increase: 15.7 ± 5.2% (d 30), 49.8 ± 0.5% (d 60), and 71.0 ± 6.1% (d 90). cAMP generation increases 9-fold from d 30 to 60, with enhanced coupling to remodeling pathways (e.g., Akt and Ca(2+)/calmodulin-dependent protein kinase type II) and development of caveolin-mediated signaling compartmentalization. By contrast, cardiotoxicity induced by chronic β-AR stimulation, a major component of heart failure, develops much later: 5% cell death at d 30vs 55% at d 90. Moreover, β-AR maturation can be accelerated by biomechanical stimulation. The differential maturation of β-AR functionalvs remodeling signaling in hiPSC-CMs has important implications for their use in disease modeling and drug testing. We propose that assessment of signaling be added to the indices of phenotypic maturation of hiPSC-CMs.-Jung, G., Fajardo, G., Ribeiro, A. J. S., Kooiker, K. B., Coronado, M., Zhao, M., Hu, D.-Q., Reddy, S., Kodo, K., Sriram, K., Insel, P. A., Wu, J. C., Pruitt, B. L., Bernstein, D. Time-dependent evolution of functionalvs remodeling signaling in induced pluripotent stem cell-derived cardiomyocytes and induced maturation with biomechanical stimulation.
Collapse
Affiliation(s)
- Gwanghyun Jung
- *Division of Cardiology, Department of Pediatrics, Stanford Cardiovascular Institute, Division of Cardiovascular Medicine, Department of Medicine, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, USA; and Departments of Pharmacology and Medicine, University of California, San Diego, San Diego, California, USA
| | - Giovanni Fajardo
- *Division of Cardiology, Department of Pediatrics, Stanford Cardiovascular Institute, Division of Cardiovascular Medicine, Department of Medicine, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, USA; and Departments of Pharmacology and Medicine, University of California, San Diego, San Diego, California, USA
| | - Alexandre J S Ribeiro
- *Division of Cardiology, Department of Pediatrics, Stanford Cardiovascular Institute, Division of Cardiovascular Medicine, Department of Medicine, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, USA; and Departments of Pharmacology and Medicine, University of California, San Diego, San Diego, California, USA
| | - Kristina Bezold Kooiker
- *Division of Cardiology, Department of Pediatrics, Stanford Cardiovascular Institute, Division of Cardiovascular Medicine, Department of Medicine, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, USA; and Departments of Pharmacology and Medicine, University of California, San Diego, San Diego, California, USA
| | - Michael Coronado
- *Division of Cardiology, Department of Pediatrics, Stanford Cardiovascular Institute, Division of Cardiovascular Medicine, Department of Medicine, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, USA; and Departments of Pharmacology and Medicine, University of California, San Diego, San Diego, California, USA
| | - Mingming Zhao
- *Division of Cardiology, Department of Pediatrics, Stanford Cardiovascular Institute, Division of Cardiovascular Medicine, Department of Medicine, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, USA; and Departments of Pharmacology and Medicine, University of California, San Diego, San Diego, California, USA
| | - Dong-Qing Hu
- *Division of Cardiology, Department of Pediatrics, Stanford Cardiovascular Institute, Division of Cardiovascular Medicine, Department of Medicine, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, USA; and Departments of Pharmacology and Medicine, University of California, San Diego, San Diego, California, USA
| | - Sushma Reddy
- *Division of Cardiology, Department of Pediatrics, Stanford Cardiovascular Institute, Division of Cardiovascular Medicine, Department of Medicine, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, USA; and Departments of Pharmacology and Medicine, University of California, San Diego, San Diego, California, USA
| | - Kazuki Kodo
- *Division of Cardiology, Department of Pediatrics, Stanford Cardiovascular Institute, Division of Cardiovascular Medicine, Department of Medicine, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, USA; and Departments of Pharmacology and Medicine, University of California, San Diego, San Diego, California, USA
| | - Krishna Sriram
- *Division of Cardiology, Department of Pediatrics, Stanford Cardiovascular Institute, Division of Cardiovascular Medicine, Department of Medicine, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, USA; and Departments of Pharmacology and Medicine, University of California, San Diego, San Diego, California, USA
| | - Paul A Insel
- *Division of Cardiology, Department of Pediatrics, Stanford Cardiovascular Institute, Division of Cardiovascular Medicine, Department of Medicine, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, USA; and Departments of Pharmacology and Medicine, University of California, San Diego, San Diego, California, USA
| | - Joseph C Wu
- *Division of Cardiology, Department of Pediatrics, Stanford Cardiovascular Institute, Division of Cardiovascular Medicine, Department of Medicine, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, USA; and Departments of Pharmacology and Medicine, University of California, San Diego, San Diego, California, USA
| | - Beth L Pruitt
- *Division of Cardiology, Department of Pediatrics, Stanford Cardiovascular Institute, Division of Cardiovascular Medicine, Department of Medicine, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, USA; and Departments of Pharmacology and Medicine, University of California, San Diego, San Diego, California, USA
| | - Daniel Bernstein
- *Division of Cardiology, Department of Pediatrics, Stanford Cardiovascular Institute, Division of Cardiovascular Medicine, Department of Medicine, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Mechanical Engineering, Stanford University School of Engineering, Stanford, California, USA; and Departments of Pharmacology and Medicine, University of California, San Diego, San Diego, California, USA
| |
Collapse
|
141
|
Sacchi S, Perini AP, Attanà P, Grifoni G, Chiostri M, Ricciardi G, Pieragnoli P, Padeletti L. Assessment of Myocardial Contractility by SonR Sensor in Patients Undergoing Cardiac Resynchronization Therapy. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2015; 39:268-74. [PMID: 26644068 DOI: 10.1111/pace.12795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 11/06/2015] [Accepted: 12/01/2015] [Indexed: 01/25/2023]
Abstract
BACKGROUND SonR sensor signal correlates well with myocardial contractility expressed in terms of left ventricular (LV) dP/dt max. The aim of our study was to evaluate the changes in myocardial contractility during isometric effort in heart failure patients undergoing cardiac resynchronization therapy (CRT) with right atrial SonR sensor. METHODS Thirty-one patients (19 men, 65 ± 7 years, LV ejection fraction [LVEF] 28% ± 5%, in sinus rhythm) were implanted with a CRT-defibrillator (CRT-D) device equipped with SonR sensor, which was programmed in VVI mode at 40 beats/min. Twenty-four hours after implantation, each patient underwent a noninvasive hemodynamic evaluation at rest and during isometric effort, including: (1) measurement of beat-to-beat endocavitary SonR signal; (2) echocardiographic assessment; and (3) continuous measurement of blood pressure with Nexfin method (BMEYE, Amsterdam, the Netherlands). The following contractility parameters were considered: (1) mean value of beat-to-beat SonR signal; (2) mean value of LV dP/dt by Nexfin system; and (3) fractional shortening (FS) by echocardiography. RESULTS At the third minute of the isometric effort, mean value of SonR signal significantly increased from baseline (P < 0.001). Similarly, mean value of both LV dP/dt by Nexfin and FS significantly increased compared to the resting condition (P < 0.001; P < 0.001). While in 27 (88%) patients SonR signal increased at the third minute of the isometric effort, in four (12%) patients SonR signal decreased. In these patients, both LV dP/dt by Nexfin and FS consensually decreased. CONCLUSIONS In CRT patients, SonR sensor is able to detect changes in myocardial contractility in a consensual way like noninvasive methods such as Nexfin system and echocardiography.
Collapse
Affiliation(s)
- Stefania Sacchi
- Institute of Internal Medicine and Cardiology, University of Florence, Florence, Italy.,International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College, London, UK
| | | | - Paola Attanà
- Institute of Internal Medicine and Cardiology, University of Florence, Florence, Italy
| | - Gino Grifoni
- Institute of Internal Medicine and Cardiology, University of Florence, Florence, Italy
| | - Marco Chiostri
- Institute of Internal Medicine and Cardiology, University of Florence, Florence, Italy
| | - Giuseppe Ricciardi
- Institute of Internal Medicine and Cardiology, University of Florence, Florence, Italy
| | - Paolo Pieragnoli
- Institute of Internal Medicine and Cardiology, University of Florence, Florence, Italy
| | - Luigi Padeletti
- Institute of Internal Medicine and Cardiology, University of Florence, Florence, Italy.,IRCCS, Multimedica, Sesto San Giovanni, Milan, Italy
| |
Collapse
|
142
|
Vascular nitric oxide: Beyond eNOS. J Pharmacol Sci 2015; 129:83-94. [PMID: 26499181 DOI: 10.1016/j.jphs.2015.09.002] [Citation(s) in RCA: 490] [Impact Index Per Article: 54.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 09/11/2015] [Accepted: 09/16/2015] [Indexed: 02/06/2023] Open
Abstract
As the first discovered gaseous signaling molecule, nitric oxide (NO) affects a number of cellular processes, including those involving vascular cells. This brief review summarizes the contribution of NO to the regulation of vascular tone and its sources in the blood vessel wall. NO regulates the degree of contraction of vascular smooth muscle cells mainly by stimulating soluble guanylyl cyclase (sGC) to produce cyclic guanosine monophosphate (cGMP), although cGMP-independent signaling [S-nitrosylation of target proteins, activation of sarco/endoplasmic reticulum calcium ATPase (SERCA) or production of cyclic inosine monophosphate (cIMP)] also can be involved. In the blood vessel wall, NO is produced mainly from l-arginine by the enzyme endothelial nitric oxide synthase (eNOS) but it can also be released non-enzymatically from S-nitrosothiols or from nitrate/nitrite. Dysfunction in the production and/or the bioavailability of NO characterizes endothelial dysfunction, which is associated with cardiovascular diseases such as hypertension and atherosclerosis.
Collapse
|
143
|
Rørth R, Fosbøl EL, Mogensen UM, Iversen K, Iversen M, Kelbæk H, Pedersen F, Engstrøm T, Torp-Pedersen C, Gislason G, Køber L. The importance of β2-agonists in myocardial infarction: Findings from the Eastern Danish Heart Registry. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2015; 5:551-559. [PMID: 26385900 DOI: 10.1177/2048872615606599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 08/21/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE β2-Agonists are widely used for relief of respiratory symptoms. Studies so far have reported conflicting results regarding use of β2-agonists and risk of myocardial infarction (MI). Yet, coronary angiographical data and longitudinal outcomes data are sparse and could help explain if there is an association between use of β2-agonists and MI. METHODS Using a novel data-linkage of the Eastern Danish Heart Registry and nationwide administrative registries we identified a cohort of patients referred for acute coronary angiography due to ST-elevation MI (STEMI). Clinical and angiographical findings were compared between β2-agonist users and non-users. RESULTS Among 66,234 patients undergoing coronary angiography, 9857 patients had STEMI. Of these, 933 (9%) patients used β2-agonists. β2-Agonist users were more often without significant coronary stenosis (15% in β2-agonist users vs 9% in non-users; p<0.0001), odds ratio (OR) 1.68 (95% confidence interval (CI) 1.37-2.07; p<0.0001). The association was correlated to the number of filled prescriptions. One prescription: OR=1.00 (CI 95% 0.66-1.50; p=1.00)), 2-5 prescriptions: OR= 2.02 (CI 95% 1.47-2.78; p<0.0001), more than five prescriptions: OR=2.30 (CI 95% 1.69-3.12; p<0.0001). All-cause mortality during up to 14 years of follow-up was significantly higher among the β2-agonist-user group compared to the non-user group (34% vs 23%; p<0.0001), hazard ratio 1.36, 95% CI 1.18-1.56; p<0.0001). CONCLUSION Among patients referred to urgent coronary angiography for STEMI, use of β2-agonists was associated with a lower frequency of significant coronary stenosis and a higher mortality compared with non-users.
Collapse
Affiliation(s)
- Rasmus Rørth
- Department of Cardiology, Copenhagen University Hospital, Denmark
| | - Emil L Fosbøl
- Department of Cardiology, Copenhagen University Hospital, Denmark
| | - Ulrik M Mogensen
- Department of Cardiology, Copenhagen University Hospital, Denmark
| | - Kasper Iversen
- Department of Cardiology, Nephrology and Endocrinology, North Zealand University Hospital, Denmark
| | - Martin Iversen
- Department of Cardiology, Copenhagen University Hospital, Denmark
| | - Henning Kelbæk
- Department of Cardiology, Copenhagen University Hospital, Denmark
| | - Frants Pedersen
- Department of Cardiology, Copenhagen University Hospital, Denmark
| | - Thomas Engstrøm
- Department of Cardiology, Copenhagen University Hospital, Denmark
| | | | - Gunnar Gislason
- Department of Cardiology, Gentofte University Hospital, Denmark.,The National Institute of Public Health, University of Southern Denmark, Denmark
| | - Lars Køber
- Department of Cardiology, Copenhagen University Hospital, Denmark
| |
Collapse
|
144
|
Xia N, Wang H, Nie X. Inhaled Long-Acting β2-Agonists Do Not Increase Fatal Cardiovascular Adverse Events in COPD: A Meta-Analysis. PLoS One 2015; 10:e0137904. [PMID: 26378450 PMCID: PMC4574772 DOI: 10.1371/journal.pone.0137904] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 08/22/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The cardiovascular safety of inhaled long-acting β2-agonists (LABAs) in patients with chronic obstructive pulmonary disease (COPD) is a controversial problem. Certain studies have suggested that inhaled LABAs lead to an increased risk of cardiovascular events in patients with COPD. This meta-analysis aimed to assess the cardiovascular safety of inhaled LABAs in COPD. METHODS A meta-analysis of randomized, double-blind, parallel-group, placebo-controlled trials for LABA treatment of COPD with at least 3 months of follow-up was performed. The fixed-effects model was used to evaluate the effects of LABAs on fatal cardiovascular adverse events. Adverse events were collected for each trial, and the relative risk (RR) and 95% confidence intervals (CI) for LABA/placebo were estimated. RESULTS There were 24 trials included in this meta-analysis. Compared with placebo, inhaled LABAs significantly decreased fatal cardiovascular adverse events in COPD patients (RR 0.65, 95% CI 0.50 to 0.86, P = 0.002). In sensitivity analysis, there was still no increased risk of fatal cardiovascular events (RR 0.68, 95%CI 0.46 to 1.01, P = 0.06) after excluding the trial with the largest weight. Among the different types of LABAs, only salmeterol had a significant effect (RR 0.64, 95% CI 0.46 to 0.90). In subgroup analyses, inhaled LABAs were able to significantly decrease fatal cardiovascular events in long-term trials (RR 0.64, 95% CI 0.47 to 0.87) and in trials with severe COPD patients (RR 0.69, 95% CI 0.50 to 0.96). CONCLUSION Inhaled LABAs do not increase the risk of fatal cardiovascular events in COPD patients.
Collapse
Affiliation(s)
- Ning Xia
- Department of Respiratory Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hao Wang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiuhong Nie
- Department of Respiratory Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China
- * E-mail:
| |
Collapse
|
145
|
Hashemi S, Salma J, Wales S, McDermott JC. Pro-survival function of MEF2 in cardiomyocytes is enhanced by β-blockers. Cell Death Discov 2015; 1:15019. [PMID: 27551452 PMCID: PMC4979494 DOI: 10.1038/cddiscovery.2015.19] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 07/10/2015] [Accepted: 07/13/2015] [Indexed: 12/18/2022] Open
Abstract
β1-Adrenergic receptor (β1-AR) stimulation increases apoptosis in cardiomyocytes through activation of cAMP/protein kinase A (PKA) signaling. The myocyte enhancer factor 2 (MEF2) proteins function as important regulators of myocardial gene expression. Previously, we reported that PKA signaling directly represses MEF2 activity. We determined whether (a) MEF2 has a pro-survival function in cardiomyocytes, and (b) whether β-adrenergic/PKA signaling modulates MEF2 function in cardiomyocytes. Initially, we observed that siRNA-mediated gene silencing of MEF2 induces cardiomyocyte apoptosis as indicated by flow cytometry. β1-AR activation by isoproterenol represses MEF2 activity and promotes apoptosis in cultured neonatal cardiomyocytes. Importantly, β1-AR mediated apoptosis was abrogated in cardiomyocytes expressing a PKA-resistant form of MEF2D (S121/190A). We also observed that a β1-blocker, Atenolol, antagonizes isoproterenol-induced apoptosis while concomitantly enhancing MEF2 transcriptional activity. β-AR stimulation modulated MEF2 cellular localization in cardiomyocytes and this effect was reversed by β-blocker treatment. Furthermore, Kruppel-like factor 6, a MEF2 target gene in the heart, functions as a downstream pro-survival factor in cardiomyocytes. Collectively, these data indicate that (a) MEF2 has an important pro-survival role in cardiomyocytes, and (b) β-adrenergic signaling antagonizes the pro-survival function of MEF2 in cardiomyocytes and β-blockers promote it. These observations have important clinical implications that may contribute to novel strategies for preventing cardiomyocyte apoptosis associated with heart pathology.
Collapse
Affiliation(s)
- S Hashemi
- Department of Biology, York University, Toronto, Canada; Muscle Health Research Centre (MHRC), York University, Toronto, Canada; Centre for Research in Biomolecular Interactions (CRBI), York University, Toronto, Canada
| | - J Salma
- Department of Biology, York University, Toronto, Canada; Muscle Health Research Centre (MHRC), York University, Toronto, Canada; Centre for Research in Biomolecular Interactions (CRBI), York University, Toronto, Canada
| | - S Wales
- Department of Biology, York University, Toronto, Canada; Muscle Health Research Centre (MHRC), York University, Toronto, Canada; Centre for Research in Biomolecular Interactions (CRBI), York University, Toronto, Canada
| | - J C McDermott
- Department of Biology, York University, Toronto, Canada; Muscle Health Research Centre (MHRC), York University, Toronto, Canada; Centre for Research in Biomolecular Interactions (CRBI), York University, Toronto, Canada; Centre for Research in Mass Spectrometry (CRMS), York University, Toronto, Canada
| |
Collapse
|
146
|
Bani-Yaseen AD. Synchronous spectrofluorimetric study of the supramolecular host-guest interaction of β-cyclodextrin with propranolol: A comparative study. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2015; 148:93-98. [PMID: 25875030 DOI: 10.1016/j.saa.2015.03.128] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/21/2015] [Accepted: 03/30/2015] [Indexed: 06/04/2023]
Abstract
The objective of this work is to assess the use of constant-wavelength synchronous fluorescence spectroscopy (SFS) in comparison to conventional fluorescence spectroscopy (CFS) for the investigation of the supramolecular host-guest interaction of β-CD with propranolol (PPL) in aqueous solutions. Scanning for the optimal Δλ at which the SFS can be performed in the presence of β-CD was examined. The results obtained revealed three distinguishable shapes for PPL using SFS that can be represented by three different Δλ values, namely 10, 40, and 100 nm. However, the effect of the β-CD concentration on the fluorescence intensity of PPL was examined using CFS and SFS of PPL at a Δλ of 10 and 100 nm. The change in the fluorescence intensity was used to calculate the equilibrium constant (Keq) for the formation of the β-CD:PPL inclusion complex by applying the Benesi-Hildebrand method. Keq values of 108, 112, and 117 M(-1) were obtained using SFS with a Δλ of 10 and 100 nm, and CFS, respectively. Further, the SFS method was successfully employed to examine the iodide quenching effect on the fluorescence intensity of PPL, where the results obtained revealed a Stern-Volmer quenching constant of 42.8 M(-1), which is in good agreement with results obtained using CFS. All results obtained using the SFS method were compared with the results obtained using the CFS method.
Collapse
Affiliation(s)
- Abdulilah Dawoud Bani-Yaseen
- Department of Chemistry & Earth Sciences, College of Arts & Sciences, Qatar University, P.O. Box 2713, Doha, Qatar.
| |
Collapse
|
147
|
Abstract
OPINION STATEMENT Despite major advances that have led to effective therapeutic modalities for the treatment of heart failure (HF), this syndrome has continued to be a staggering health problem associated with significant mortality and morbidity. The increasing number of hospital admissions and readmissions related to acute HF continues to pose a fiscal challenge leading to constant interest in development of novel approaches. These point to multiple areas of unmet needs especially in acute HF, thus, necessitating further efforts to develop novel strategies for prevention and treatment of acute HF. One area of continuing focus is targeting the role of autonomic imbalance associated with the development of HF. Autonomic dysregulation, manifested by increased sympathetic drive and reduced parasympathetic activity, has been recognized as a mediator of increased mortality and morbidity in HF and myocardial infarction. Furthermore, vagal withdrawal has been shown to precede acute decompensation, though whether this represents cause or effect is unknown. This review discusses the potential role of autonomic dysregulation as a therapeutic modality for patients with acute decompensated HF.
Collapse
|
148
|
Mason D, Chen YZ, Krishnan HV, Sant S. Cardiac gene therapy: Recent advances and future directions. J Control Release 2015; 215:101-11. [PMID: 26254712 DOI: 10.1016/j.jconrel.2015.08.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 07/31/2015] [Accepted: 08/01/2015] [Indexed: 11/15/2022]
Abstract
Gene therapy has the potential to serve as an adaptable platform technology for treating various diseases. Cardiovascular disease is a major cause of mortality in the developed world and genetic modification is steadily becoming a more plausible method to repair and regenerate heart tissue. Recently, new gene targets to treat cardiovascular disease have been identified and developed into therapies that have shown promise in animal models. Some of these therapies have advanced to clinical testing. Despite these recent successes, several barriers must be overcome for gene therapy to become a widely used treatment of cardiovascular diseases. In this review, we evaluate specific genetic targets that can be exploited to treat cardiovascular diseases, list the important delivery barriers for the gene carriers, assess the most promising methods of delivering the genetic information, and discuss the current status of clinical trials involving gene therapies targeted to the heart.
Collapse
Affiliation(s)
- Daniel Mason
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Yu-Zhe Chen
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Harini Venkata Krishnan
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Shilpa Sant
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, 15261, USA; Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, 15261, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, 15219, USA.
| |
Collapse
|
149
|
Longo VD, Antebi A, Bartke A, Barzilai N, Brown‐Borg HM, Caruso C, Curiel TJ, Cabo R, Franceschi C, Gems D, Ingram DK, Johnson TE, Kennedy BK, Kenyon C, Klein S, Kopchick JJ, Lepperdinger G, Madeo F, Mirisola MG, Mitchell JR, Passarino G, Rudolph KL, Sedivy JM, Shadel GS, Sinclair DA, Spindler SR, Suh Y, Vijg J, Vinciguerra M, Fontana L. Interventions to Slow Aging in Humans: Are We Ready? Aging Cell 2015; 14:497-510. [PMID: 25902704 PMCID: PMC4531065 DOI: 10.1111/acel.12338] [Citation(s) in RCA: 370] [Impact Index Per Article: 41.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2015] [Indexed: 12/17/2022] Open
Abstract
The workshop entitled ‘Interventions to Slow Aging in Humans: Are We Ready?’ was held in Erice, Italy, on October 8–13, 2013, to bring together leading experts in the biology and genetics of aging and obtain a consensus related to the discovery and development of safe interventions to slow aging and increase healthy lifespan in humans. There was consensus that there is sufficient evidence that aging interventions will delay and prevent disease onset for many chronic conditions of adult and old age. Essential pathways have been identified, and behavioral, dietary, and pharmacologic approaches have emerged. Although many gene targets and drugs were discussed and there was not complete consensus about all interventions, the participants selected a subset of the most promising strategies that could be tested in humans for their effects on healthspan. These were: (i) dietary interventions mimicking chronic dietary restriction (periodic fasting mimicking diets, protein restriction, etc.); (ii) drugs that inhibit the growth hormone/IGF-I axis; (iii) drugs that inhibit the mTOR–S6K pathway; or (iv) drugs that activate AMPK or specific sirtuins. These choices were based in part on consistent evidence for the pro-longevity effects and ability of these interventions to prevent or delay multiple age-related diseases and improve healthspan in simple model organisms and rodents and their potential to be safe and effective in extending human healthspan. The authors of this manuscript were speakers and discussants invited to the workshop. The following summary highlights the major points addressed and the conclusions of the meeting.
Collapse
|
150
|
Spaich S, Katus HA, Backs J. Ongoing controversies surrounding cardiac remodeling: is it black and white-or rather fifty shades of gray? Front Physiol 2015; 6:202. [PMID: 26257654 PMCID: PMC4510775 DOI: 10.3389/fphys.2015.00202] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 07/03/2015] [Indexed: 01/02/2023] Open
Abstract
Cardiac remodeling describes the heart's multimodal response to a myriad of external or intrinsic stimuli and stressors most of which are probably only incompletely elucidated to date. Over many years the signaling molecules involved in these remodeling processes have been dichotomized according to a classic antagonistic view of black and white, i.e., attributed either a solely maladaptive or entirely beneficial character. By dissecting controversies, recent developments and shifts in perspective surrounding the three major cardiac signaling molecules calcineurin (Cn), protein kinase A (PKA) and calcium/calmodulin-dependent kinase II (CaMKII), this review challenges this dualistic view and advocates the nature and dignity of each of these key mediators of cardiac remodeling as a multilayered, highly context-sensitive and sophisticated continuum that can be markedly swayed and influenced by a multitude of environmental factors and crosstalk mechanisms. Furthermore this review delineates the importance and essential contributions of degradation and proteolysis to cardiac plasticity and homeostasis and finally aims to integrate the various aspects of protein synthesis and turnover into a comprehensive picture.
Collapse
Affiliation(s)
- Sebastian Spaich
- Research Unit Cardiac Epigenetics, Department of Cardiology, Angiology and Pneumology, University of HeidelbergHeidelberg, Germany
- German Centre for Cardiovascular Research, Partner Site Heidelberg/MannheimHeidelberg, Germany
- Department of Cardiology, Angiology and Pneumology, University of HeidelbergHeidelberg, Germany
| | - Hugo A. Katus
- Research Unit Cardiac Epigenetics, Department of Cardiology, Angiology and Pneumology, University of HeidelbergHeidelberg, Germany
- German Centre for Cardiovascular Research, Partner Site Heidelberg/MannheimHeidelberg, Germany
- Department of Cardiology, Angiology and Pneumology, University of HeidelbergHeidelberg, Germany
| | - Johannes Backs
- Research Unit Cardiac Epigenetics, Department of Cardiology, Angiology and Pneumology, University of HeidelbergHeidelberg, Germany
- German Centre for Cardiovascular Research, Partner Site Heidelberg/MannheimHeidelberg, Germany
| |
Collapse
|