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LaRock DL, Sands JS, Ettouati E, Richard M, Bushway PJ, Adler ED, Nizet V, LaRock CN. Inflammasome inhibition blocks cardiac glycoside cell toxicity. J Biol Chem 2019; 294:12846-12854. [PMID: 31300552 PMCID: PMC6709640 DOI: 10.1074/jbc.ra119.008330] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/17/2019] [Indexed: 12/27/2022] Open
Abstract
Chronic heart failure and cardiac arrhythmias have high morbidity and mortality, and drugs for the prevention and management of these diseases are a large part of the pharmaceutical market. Among these drugs are plant-derived cardiac glycosides, which have been used by various cultures over millennia as both medicines and poisons. We report that digoxin and related compounds activate the NLRP3 inflammasome in macrophages and cardiomyocytes at concentrations achievable during clinical use. Inflammasome activation initiates the maturation and release of the inflammatory cytokine IL-1β and the programmed cell death pathway pyroptosis in a caspase-1–dependent manner. Notably, the same fluxes of potassium and calcium cations that affect heart contraction also induce inflammasome activation in human but not murine cells. Pharmaceuticals that antagonize these fluxes, including glyburide and verapamil, also inhibit inflammasome activation by cardiac glycosides. Cardiac glycoside–induced cellular cytotoxicity and IL-1β signaling are likewise antagonized by inhibitors of the NLRP3 inflammasome or the IL-1 receptor–targeting biological agent anakinra. Our results inform on the molecular mechanism by which the inflammasome integrates the diverse signals that activate it through secondary signals like cation flux. Furthermore, this mechanism suggests a contribution of the inflammasome to the toxicity and adverse events associated with cardiac glycosides use in humans and that targeted anti-inflammatories could provide an additional adjunct therapeutic countermeasure.
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Affiliation(s)
- Doris L LaRock
- Department of Pediatrics, University of California San Diego, La Jolla, California 92093.,Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, California 92093.,Department of Microbiology and Immunology, Emory School of Medicine, Atlanta, Georgia.,Department of Medicine, Emory School of Medicine, Atlanta, Georgia 30322
| | - Jenna S Sands
- Department of Microbiology and Immunology, Emory School of Medicine, Atlanta, Georgia.,Department of Medicine, Emory School of Medicine, Atlanta, Georgia 30322
| | - Ethan Ettouati
- Department of Pediatrics, University of California San Diego, La Jolla, California 92093.,Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, California 92093
| | - Marine Richard
- Department of Pediatrics, University of California San Diego, La Jolla, California 92093.,Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, California 92093.,Institut Supérieur de la Santé et des Bioproduits, Angers, France 49000
| | - Paul J Bushway
- Department of Cardiovascular Medicine, University of California San Diego, La Jolla, California 92093
| | - Eric D Adler
- Department of Cardiovascular Medicine, University of California San Diego, La Jolla, California 92093
| | - Victor Nizet
- Department of Pediatrics, University of California San Diego, La Jolla, California 92093 .,Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, California 92093
| | - Christopher N LaRock
- Department of Pediatrics, University of California San Diego, La Jolla, California 92093 .,Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, California 92093.,Department of Microbiology and Immunology, Emory School of Medicine, Atlanta, Georgia.,Department of Medicine, Emory School of Medicine, Atlanta, Georgia 30322
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102
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Marchio P, Guerra-Ojeda S, Vila JM, Aldasoro M, Victor VM, Mauricio MD. Targeting Early Atherosclerosis: A Focus on Oxidative Stress and Inflammation. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:8563845. [PMID: 31354915 PMCID: PMC6636482 DOI: 10.1155/2019/8563845] [Citation(s) in RCA: 352] [Impact Index Per Article: 70.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/10/2019] [Accepted: 05/19/2019] [Indexed: 02/07/2023]
Abstract
Atherosclerosis is a chronic vascular inflammatory disease associated to oxidative stress and endothelial dysfunction. Oxidation of low-density lipoprotein (LDL) cholesterol is one of the key factors for the development of atherosclerosis. Nonoxidized LDL have a low affinity for macrophages, so they are not themselves a risk factor. However, lowering LDL levels is a common clinical practice to reduce oxidation and the risk of major events in patients with cardiovascular diseases (CVD). Atherosclerosis starts with dysfunctional changes in the endothelium induced by disturbed shear stress which can lead to endothelial and platelet activation, adhesion of monocytes on the activated endothelium, and differentiation into proinflammatory macrophages, which increase the uptake of oxidized LDL (oxLDL) and turn into foam cells, exacerbating the inflammatory signalling. The atherosclerotic process is accelerated by a myriad of factors, such as the release of inflammatory chemokines and cytokines, the generation of reactive oxygen species (ROS), growth factors, and the proliferation of vascular smooth muscle cells. Inflammation and immunity are key factors for the development and complications of atherosclerosis, and therefore, the whole atherosclerotic process is a target for diagnosis and treatment. In this review, we focus on early stages of the disease and we address both biomarkers and therapeutic approaches currently available and under research.
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Affiliation(s)
- Patricia Marchio
- Department of Physiology, Faculty of Medicine and Odontology, Universitat de Valencia and Institute of Health Research INCLIVA, Valencia, Spain
| | - Sol Guerra-Ojeda
- Department of Physiology, Faculty of Medicine and Odontology, Universitat de Valencia and Institute of Health Research INCLIVA, Valencia, Spain
| | - José M. Vila
- Department of Physiology, Faculty of Medicine and Odontology, Universitat de Valencia and Institute of Health Research INCLIVA, Valencia, Spain
| | - Martín Aldasoro
- Department of Physiology, Faculty of Medicine and Odontology, Universitat de Valencia and Institute of Health Research INCLIVA, Valencia, Spain
| | - Victor M. Victor
- Department of Physiology, Faculty of Medicine and Odontology, Universitat de Valencia and Institute of Health Research INCLIVA, Valencia, Spain
- Service of Endocrinology, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
| | - Maria D. Mauricio
- Department of Physiology, Faculty of Medicine and Odontology, Universitat de Valencia and Institute of Health Research INCLIVA, Valencia, Spain
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Intracardiac administration of neutrophil protease cathepsin G activates noncanonical inflammasome pathway and promotes inflammation and pathological remodeling in non-injured heart. J Mol Cell Cardiol 2019; 134:29-39. [PMID: 31252040 DOI: 10.1016/j.yjmcc.2019.06.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 06/21/2019] [Accepted: 06/23/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Inflammatory serine proteases (ISPs) play an important role in cardiac repair after injury through hydrolysis of dead cells and extracellular matrix (ECM) debris. Evidence also suggests an important role of ISPs in the coordination of the inflammatory response. However, the effect of ISPs on inflammation is obfuscated by the confounding factors associated with cell death and inflammatory cell infiltration induced after cardiac injury. This study investigated whether neutrophil-derived cathepsin G (Cat.G) influences inflammation and remodeling in the absence of prior cardiac injury and cell death. METHODS AND RESULTS Intracardiac catheter delivery of Cat.G (1 mg/kg) in rats induced significant left ventricular (LV) dilatation and cardiac contractile dysfunction at day 5, but not at day 2, post-delivery compared to vehicle-treated animals. Cat.G delivery also significantly increased matrix metalloprotease activity and collagen and fibronectin degradation at day 5 compared to vehicle-treated rats and these changes were associated with increased death signaling pathways and myocyte apoptosis. Mechanistic analysis shows that Cat.G-treatment induced potent chemotactic activity in hearts at day 2 and 5 post-delivery, characterized by processing and activation of interleukin (IL)-1β and IL-18, stimulation of inflammatory signaling pathways and accumulation of myeloid cells when compared to vehicle-treated rats. Cat.G-induced processing of IL-1β and IL-18 was independent of the canonical NLRP-3 inflammasome pathway and treatment of isolated cardiomyocytes with inhibitors of NLRP-3 or caspase-1 failed to reduce Cat.G-induced cardiomyocyte death. Notably, rats treated with IL-1 receptor antagonist (IL-1Ra) show reduced inflammation and improved cardiac remodeling and function following Cat.G delivery. CONCLUSIONS Cat.G exerts potent chemoattractant and pro-inflammatory effects in non-stressed or injured heart in part through processing and activation of IL-1 family cytokines, subsequently leading to adverse cardiac remodeling and function. Thus, targeting ISPs could be a novel therapeutic strategy to reduce cardiac inflammation and improve cardiac remodeling and function after injury or stress.
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104
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Fenofibrate attenuates cardiac and renal alterations in young salt-loaded spontaneously hypertensive stroke-prone rats through mitochondrial protection. J Hypertens 2019; 36:1129-1146. [PMID: 29278547 DOI: 10.1097/hjh.0000000000001651] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The simultaneous presence of cardiac and renal diseases is a pathological condition that leads to increased morbidity and mortality. Several lines of evidence have suggested that lipid dysmetabolism and mitochondrial dysfunction are pathways involved in the pathological processes affecting the heart and kidney. In the salt-loaded spontaneously hypertensive stroke-prone rat (SHRSP), a model of cardiac hypertrophy and nephropathy that shows mitochondrial alterations in the myocardium, we evaluated the cardiorenal effects of fenofibrate, a peroxisome proliferator-activated receptor alpha (PPARα) agonist that acts by modulating mitochondrial and peroxisomal fatty acid oxidation. METHODS Male SHRSPs aged 6-7 weeks were divided in three groups: standard diet (n = 6), Japanese diet with vehicle (n = 6), and Japanese diet with fenofibrate 150 mg/kg/day (n = 6) for 5 weeks. Cardiac and renal functions were assessed in vivo by MRI, ultrasonography, and biochemical assays. Mitochondria were investigated by transmission electron microscopy, succinate dehydrogenase (SDH) activity, and gene expression analysis. RESULTS Fenofibrate attenuated cardiac hypertrophy, as evidenced by histological and MRI analyses, and protected the kidneys, preventing morphological alterations, changes in arterial blood flow velocity, and increases in 24-h proteinuria. Cardiorenal inflammation, oxidative stress, and cellular senescence were also inhibited by fenofibrate. In salt-loaded SHRSPs, we observed severe morphological mitochondrial alterations, reduced SDH activity, and down-regulation of genes regulating mitochondrial fatty-acid oxidation (i.e. PPARα, SIRT3, and Acadm). These changes were counteracted by fenofibrate. In vitro, a direct protective effect of fenofibrate on mitochondrial membrane potential was observed in albumin-stimulated NRK-52E renal tubular epithelial cells. CONCLUSION The results suggest that the cardiorenal protective effects of fenofibrate in young male salt-loaded SHRSPs are explained by its capacity to preserve mitochondrial function.
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105
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An Orally Available NLRP3 Inflammasome Inhibitor Prevents Western Diet-Induced Cardiac Dysfunction in Mice. J Cardiovasc Pharmacol 2019; 72:303-307. [PMID: 30422890 DOI: 10.1097/fjc.0000000000000628] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND A diet rich in saturated fat and sugars (Western diet, WD) induces myocardial expression of the NLRP3 inflammasome and dysfunction in mice. We therefore hypothesized that a diet enriched with an orally available NLRP3 inflammasome inhibitor could prevent WD-induced cardiac dysfunction in mice. METHODS Ten-week-old CD-1 male mice were fed WD or standard diet (SD) for 8 weeks. The compound 16673-34-0, an orally active NLRP3 inhibitor, was added to the diet at a concentration of 100 mg/Kg. The plasmatic levels of the NLRP3 inflammasome inhibitor were measured. Food intake, body weight, and glucose tolerance were assessed. Cardiac systolic and diastolic functions were measured by Doppler echocardiography at baseline, 4 weeks, and 8 weeks. RESULTS WD induced a significant increase in body weight (+14%, P = 0.02), impaired glucose tolerance (+34%, P = 0.03), and a significant increase in isovolumetric relaxation time (+129%, P = 0.03) and reduction in left ventricular ejection fraction (-10%, P = 0.03), as compared to standard chow diet (SD). The treatment with NLRP3 inhibitor in the diet prevented cardiac systolic and diastolic dysfunction (P < 0.05 for left ventricular ejection fraction, isovolumetric relaxation time, and myocardial performance index in WD with drug vs. WD without drug), without significant changes in heart rate and metabolic parameters. CONCLUSIONS An orally available NLRP3 inhibitor prevented WD-induced cardiac dysfunction in obese mice.
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106
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Vascular Inflammation and Oxidative Stress: Major Triggers for Cardiovascular Disease. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:7092151. [PMID: 31341533 PMCID: PMC6612399 DOI: 10.1155/2019/7092151] [Citation(s) in RCA: 376] [Impact Index Per Article: 75.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 05/20/2019] [Indexed: 02/08/2023]
Abstract
Cardiovascular disease is a leading cause of death and reduced quality of life, proven by the latest data of the Global Burden of Disease Study, and is only gaining in prevalence worldwide. Clinical trials have identified chronic inflammatory disorders as cardiovascular risks, and recent research has revealed a contribution by various inflammatory cells to vascular oxidative stress. Atherosclerosis and cardiovascular disease are closely associated with inflammation, probably due to the close interaction of inflammation with oxidative stress. Classical therapies for inflammatory disorders have demonstrated protective effects in various models of cardiovascular disease; especially established drugs with pleiotropic immunomodulatory properties have proven beneficial cardiovascular effects; normalization of oxidative stress seems to be a common feature of these therapies. The close link between inflammation and redox balance was also supported by reports on aggravated inflammatory phenotype in the absence of antioxidant defense proteins (e.g., superoxide dismutases, heme oxygenase-1, and glutathione peroxidases) or overexpression of reactive oxygen species producing enzymes (e.g., NADPH oxidases). The value of immunomodulation for the treatment of cardiovascular disease was recently supported by large-scale clinical trials demonstrating reduced cardiovascular mortality in patients with established atherosclerotic disease when treated by highly specific anti-inflammatory therapies (e.g., using monoclonal antibodies against cytokines). Modern antidiabetic cardiovascular drugs (e.g., SGLT2 inhibitors, DPP-4 inhibitors, and GLP-1 analogs) seem to share these immunomodulatory properties and display potent antioxidant effects, all of which may explain their successful lowering of cardiovascular risk.
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107
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Affiliation(s)
- Helge Wiig
- Department of Biomedicine, University of Bergen, Norway.
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108
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Ebrahimi F, Urwyler SA, Schuetz P, Mueller B, Bernasconi L, Neyer P, Donath MY, Christ-Crain M. Effects of interleukin-1 antagonism on cortisol levels in individuals with obesity: a randomized clinical trial. Endocr Connect 2019; 8:701-708. [PMID: 31042669 PMCID: PMC6547405 DOI: 10.1530/ec-19-0201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 05/01/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Anti-inflammatory treatment with interleukin-1 (IL-1) antagonism decreases both cortisol and adrenocorticotropin hormone (ACTH) levels in individuals with obesity in short term. However, it remains unknown whether these effects persist upon prolonged treatment. METHODS In this double-blind, parallel-group trial involving patients with features of the metabolic syndrome, 33 patients were randomly assigned to receive 100 mg of anakinra (recombinant human IL-1 receptor antagonist) subcutaneously twice-daily and 34 patients to receive placebo for 4 weeks. For this analysis, change in cortisol and ACTH levels from baseline to 4 weeks were predefined end points of the trial. RESULTS The mean age was 54 years, baseline cortisol levels were 314 nmol/L (IQR 241-385) and C-reactive protein (CRP) levels were 3.4 mg/L (IQR 1.7-4.8). Treatment with anakinra led to a significant decrease in cortisol levels at day 1 when compared to placebo with an adjusted between-group difference of 28 nmol/L (95% CI, -7 to -43; P = 0.03). After 4 weeks, the cortisol-lowering effect of anakinra was attenuated and overall was statistically not significant (P = 0.72). Injection-site reactions occurred in 21 patients receiving anakinra and were associated with higher CRP and cortisol levels. CONCLUSIONS IL-1 antagonism decreases cortisol levels in male patients with obesity and chronic low-grade inflammation on the short term. After prolonged treatment, this effect is attenuated, probably due to injection-site reactions (ClinicalTrials.gov, NCT02672592).
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Affiliation(s)
- Fahim Ebrahimi
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, University of Basel Hospital, Basel, Switzerland
- Department of Clinical Research, University of Basel Hospital, Basel, Switzerland
| | - Sandrine A Urwyler
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, University of Basel Hospital, Basel, Switzerland
- Department of Clinical Research, University of Basel Hospital, Basel, Switzerland
| | - Philipp Schuetz
- Department of Clinical Research, University of Basel Hospital, Basel, Switzerland
- Division of Endocrinology, Diabetes and Metabolism, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Beat Mueller
- Department of Clinical Research, University of Basel Hospital, Basel, Switzerland
- Division of Endocrinology, Diabetes and Metabolism, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Luca Bernasconi
- Department of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Peter Neyer
- Department of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Marc Y Donath
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, University of Basel Hospital, Basel, Switzerland
- Department of Clinical Research, University of Basel Hospital, Basel, Switzerland
| | - Mirjam Christ-Crain
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, University of Basel Hospital, Basel, Switzerland
- Department of Clinical Research, University of Basel Hospital, Basel, Switzerland
- Correspondence should be addressed to M Christ-Crain:
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Abstract
Advances in the treatment of heart failure with reduced ejection fraction due to systolic dysfunction are engaging an ever-expanding compendium of molecular signaling targets. Well established approaches modifying hemodynamics and cell biology by neurohumoral receptor blockade are evolving, exploring the role and impact of modulating intracellular signaling pathways with more direct myocardial effects. Even well-tread avenues are being reconsidered with new insights into the signaling engaged and thus opportunity to treat underlying myocardial disease. This review explores therapies that have proven successful, those that have not, those that are moving into the clinic but whose utility remains to be confirmed, and those that remain in the experimental realm. The emphasis is on signaling pathways that are tractable for therapeutic manipulation. Of the approaches yet to be tested in humans, we chose those with a well-established experimental history, where clinical translation may be around the corner. The breadth of opportunities bodes well for the next generation of heart failure therapeutics.
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Affiliation(s)
| | | | - David A. Kass
- Division of Cardiology, Department of Medicine
- Department of Pharmacology and Molecular Sciences, The Johns Hopkins University, Baltimore Maryland, 21205
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110
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Effects of Curcumin Nanoparticles in Isoproterenol-Induced Myocardial Infarction. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:7847142. [PMID: 31205590 PMCID: PMC6530192 DOI: 10.1155/2019/7847142] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 03/15/2019] [Accepted: 03/21/2019] [Indexed: 12/30/2022]
Abstract
Curcumin has anti-inflammatory, antioxidative, anticarcinogenic, and cardiovascular protective effects. Our study is aimed at evaluating the effects of pretreatment with curcumin nanoparticles (CCNP) compared to conventional curcumin (CC) on isoproterenol (ISO) induced myocardial infarction (MI) in rats. Fifty-six Wistar-Bratislava white rats were randomly divided into eight groups of seven rats each. Curcumin and curcumin nanoparticles were given by gavage in three different doses (100 mg/kg body weight (bw), 150 mg/kg bw, and 200 mg/kg bw) for 15 days. The MI was induced on day 13 using 100 mg/kg bw ISO administered twice, with the second dose 24 h after the initial dose. The blood samples were taken 24 h after the last dose of ISO. The antioxidant, anti-inflammatory, and cardioprotective effects were evaluated in all groups. All doses of CC and CCNP offered a cardioprotective effect by preventing creatine kinase-MB leakage from cardiomyocytes, with the best result for CCNP. All the oxidative stress parameters were significantly improved after CCNP compared to CC pretreatment. CCNP was more efficient than CC in limiting the increase in inflammatory cytokine levels (such as TNF-α, IL-6, IL-1α, IL-1β, MCP-1, and RANTES) after MI. MMP-2 and MMP-9 levels decreased more after pretreatment with CCNP than with CC. CCNP better prevented myocardial necrosis and reduced interstitial edema and neutrophil infiltration than CC, on histopathological examination. Therefore, improving the bioactivity of curcumin by nanotechnology may help limit cardiac injury after myocardial infarction.
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111
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Carbone S, Canada JM, Billingsley HE, Siddiqui MS, Elagizi A, Lavie CJ. Obesity paradox in cardiovascular disease: where do we stand? Vasc Health Risk Manag 2019; 15:89-100. [PMID: 31118651 PMCID: PMC6503652 DOI: 10.2147/vhrm.s168946] [Citation(s) in RCA: 216] [Impact Index Per Article: 43.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 02/27/2019] [Indexed: 12/11/2022] Open
Abstract
Obesity is associated with an increased risk of developing cardiovascular disease (CVD), particularly heart failure (HF) and coronary heart disease (CHD). The mechanisms through which obesity increases CVD risk involve changes in body composition that can affect hemodynamics and alters heart structure. Pro-inflammatory cytokines produced by the adipose tissue itself which can induce cardiac dysfunction and can promote the formation of atherosclerotic plaques. When obesity and HF or CHD coexist, individuals with class I obesity present a more favorable prognosis compared to individuals who are normal or underweight. This phenomenon has been termed the “obesity paradox.” Obesity is defined as an excess fat mass (FM), but individuals with obesity typically also present with an increased amount of lean mass (LM). The increase in LM may explain part of the obesity paradox as it is associated with improved cardiorespiratory fitness (CRF), a major determinant of clinical outcomes in the general population, but particularly in those with CVD, including HF. While increased LM is a stronger prognosticator in HF compared to FM, in patients with CHD excess FM can exert protective effects particularly when not associated with increased systemic inflammation. In the present review, we discuss the mechanisms through which obesity may increase the risk for CVD, and how it may exert protective effects in the setting of established CVD, with a focus on body composition. We also highlight the importance of measuring or estimating CRF, including body composition-adjusted measures of CRF (ie, lean peak oxygen consumption) for an improved risk status stratification in patients with CVD and finally, we discuss the potential non-pharmacologic therapeutics, such as exercise training and dietary interventions, aimed at improving CRF and perhaps clinical outcomes.
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Affiliation(s)
- Salvatore Carbone
- VCU Pauley Heart Center, Department of Internal Medicine, Richmond, VA, USA
| | - Justin M Canada
- VCU Pauley Heart Center, Department of Internal Medicine, Richmond, VA, USA
| | - Hayley E Billingsley
- VCU Pauley Heart Center, Department of Internal Medicine, Richmond, VA, USA.,Kinesiology and Health Sciences, College of Humanities & Science, Richmond, VA, USA
| | - Mohammad S Siddiqui
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, USA
| | - Andrew Elagizi
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA, USA
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA, USA
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112
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Potere N, Del Buono MG, Mauro AG, Abbate A, Toldo S. Low Density Lipoprotein Receptor-Related Protein-1 in Cardiac Inflammation and Infarct Healing. Front Cardiovasc Med 2019; 6:51. [PMID: 31080804 PMCID: PMC6497734 DOI: 10.3389/fcvm.2019.00051] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/09/2019] [Indexed: 01/07/2023] Open
Abstract
Acute myocardial infarction (AMI) leads to myocardial cell death and ensuing sterile inflammatory response, which represents an attempt to clear cellular debris and promote cardiac repair. However, an overwhelming, unopposed or unresolved inflammatory response following AMI leads to further injury, worse remodeling and heart failure (HF). Additional therapies are therefore warranted to blunt the inflammatory response associated with ischemia and reperfusion and prevent long-term adverse events. Low-density lipoprotein receptor-related protein 1 (LRP1) is a ubiquitous endocytic cell surface receptor with the ability to recognize a wide range of structurally and functionally diverse ligands. LRP1 transduces multiple intracellular signal pathways regulating the inflammatory reaction, tissue remodeling and cell survival after organ injury. In preclinical studies, activation of LRP1-mediated signaling in the heart with non-selective and selective LRP1 agonists is linked with a powerful cardioprotective effect, reducing infarct size and cardiac dysfunction after AMI. The data from early phase clinical studies with plasma-derived α1-antitrypsin (AAT), an endogenous LRP1 agonist, and SP16 peptide, a synthetic LRP1 agonist, support the translational value of LRP1 as a novel therapeutic target in AMI. In this review, we will summarize the cellular and molecular bases of LRP1 functions in modulating the inflammatory reaction and the reparative process after injury in various peripheral tissues, and discuss recent evidences implicating LRP1 in myocardial inflammation and infarct healing.
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Affiliation(s)
- Nicola Potere
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, United States
| | - Marco Giuseppe Del Buono
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, United States
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Adolfo Gabriele Mauro
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, United States
| | - Antonio Abbate
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, United States
| | - Stefano Toldo
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, United States
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113
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Abstract
The recognition that atherosclerosis is a complex chronic inflammatory disorder mediated through both adaptive and innate immunity has led to the hypothesis that anticytokine therapies targeting specific IL (interleukin) signaling pathways could serve as powerful adjuncts to lipid lowering in the prevention and treatment of cardiovascular disease. Cytokines involved in human atherosclerosis can be broadly classified as proinflammatory and proatherogenic (such as IL-1, IL-6, and TNF [tumor necrosis factor]) or as anti-inflammatory and antiatherogenic (such as IL-10 and IL-1rA). The recent CANTOS (Canakinumab Anti-Inflammatory Thrombosis Outcomes Study) has shown that specific targeting of IL-1β can significantly reduce cardiovascular event rates without lipid or blood pressure lowering. In CANTOS, the magnitude of benefit of this cytokine-targeted approach to atherosclerosis treatment was associated to the magnitude of reduction of the central signaling cytokine IL-6 and the downstream clinical biomarker high-sensitivity CRP (C-reactive protein). By contrast, in the recent CIRT (Cardiovascular Inflammation Reduction Trial), low-dose methotrexate neither reduced IL-1β, IL-6, or high-sensitivity CRP nor lowered cardiovascular event rates. Taken together, these 2 contemporary trials provide proof of principle that focused cytokine inhibition, not broad-spectrum anti-inflammatory therapy, is likely to be crucial for atheroprotection. This review provides an overview of cytokines in atherosclerosis, the potential benefits and risks associated with targeted anticytokine therapies, and a look to the future of clinical practices addressing residual inflammatory risk.
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Affiliation(s)
- Paul M Ridker
- From the Center for Cardiovascular Disease Prevention, Divisions of Cardiovascular Medicine and Preventive Medicine, Brigham and Women's Hospital, Boston, MA
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114
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Dyball D, Evans S, Boos CJ, Stevelink SAM, Fear NT. The association between PTSD and cardiovascular disease and its risk factors in male veterans of the Iraq/Afghanistan conflicts: a systematic review. Int Rev Psychiatry 2019; 31:34-48. [PMID: 31041877 DOI: 10.1080/09540261.2019.1580686] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Military personnel with Post-Traumatic Stress Disorder (PTSD) can experience high levels of mental and physical health comorbidity, potentially indicating a high level of functional impairment that can impact on both military readiness and later ill-health. There is strong evidence to implicate PTSD as a contributory factor to Cardiovascular Disease (CVD) among serving personnel and veterans. This systematic review focusses on the association between PTSD and cardiovascular disease/risk factors in male, military serving and ex-serving personnel who served in the Iraq/Afghanistan conflicts. PUBMED, MEDLINE, PILOTS, EMBASE, PSYCINFO, and PSYCARTICLES were searched using PRISMA guidelines. Three hundred and forty-three records were identified, of which 20 articles were selected. PTSD was positively associated with the development of CVD, specifically circulatory diseases, including hypertension. PTSD was also positively associated with the following risk factors: elevated heart rate, tobacco use, dyslipidaemia, and obesity. Conflicting data is presented regarding heart rate variability and inflammatory markers. Future studies would benefit from a standardized methodological approach to investigating PTSD and physical health manifestations. It is suggested that clinicians offer health advice for CVD at an earlier age for ex-/serving personnel with PTSD.
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Affiliation(s)
- Daniel Dyball
- a King's Centre for Military Health Research, Psychological Medicine , King's College London , London , UK.,b ADVANCE study, Academic Department of Military Rehabilitation , Defence Medical Rehabilitation Centre Stanford Hall , Loughborough , UK
| | - Sarah Evans
- a King's Centre for Military Health Research, Psychological Medicine , King's College London , London , UK.,b ADVANCE study, Academic Department of Military Rehabilitation , Defence Medical Rehabilitation Centre Stanford Hall , Loughborough , UK
| | - Christopher J Boos
- b ADVANCE study, Academic Department of Military Rehabilitation , Defence Medical Rehabilitation Centre Stanford Hall , Loughborough , UK.,c Department of Postgraduate Medical Education , Bournemouth University , Poole , UK
| | - Sharon A M Stevelink
- a King's Centre for Military Health Research, Psychological Medicine , King's College London , London , UK.,d Department of Psychological Medicine , King's College London , London , UK
| | - Nicola T Fear
- a King's Centre for Military Health Research, Psychological Medicine , King's College London , London , UK.,b ADVANCE study, Academic Department of Military Rehabilitation , Defence Medical Rehabilitation Centre Stanford Hall , Loughborough , UK.,e Academic Department for Military Mental Health , King's College London , London , UK
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Moriya J. Critical roles of inflammation in atherosclerosis. J Cardiol 2019; 73:22-27. [DOI: 10.1016/j.jjcc.2018.05.010] [Citation(s) in RCA: 151] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 05/17/2018] [Indexed: 01/02/2023]
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Li W, Chen M, Xu L, Lv Z, Chen L, Li Y, He W. Morroniside alleviates coxsackievirus B3-induced myocardial damage apoptosis via restraining NLRP3 inflammasome activation. RSC Adv 2019; 9:1222-1229. [PMID: 35518014 PMCID: PMC9059572 DOI: 10.1039/c8ra08662a] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 12/19/2018] [Indexed: 02/05/2023] Open
Abstract
Coxsackievirus B3 (CVB3)-induced myocardial damage always leads to serious heart failure by inducing cardiac injury. NLRP3 inflammasome activation has been identified as a central player in the pathogenesis of CVB3-induced viral myocarditis. Therefore, restraining NLRP3 inflammasome activation has been supposed to significantly alleviate the severity of myocardial damage and improve cardiac function. Morroniside (MR), one of the main iridoid glycosides, has the ability to depress the production of reactive oxygen species (ROS) and restrain the expression of caspase-3 and -9. Of importance, ROS and caspase are essential for NLRP3 inflammasome activation in response to CVB3 infection. Therefore, in the present study, MR was selected as a model drug to alleviate CVB3-induced myocardial damage. The results of cardiac function index determination showed that abnormal indexes including mean arterial pressure, heart rate, and left ventricular systolic pressure of myocardial damage rats could be recovered by treating with MR. Such results can be further verified by histopathological evaluation, with the heart tissues of CVB3-infected rats displaying the most amount of H&E and TUNEL positive cells. The underlying mechanism by which MR improves the cardiac function was subsequently investigated. The detection of various gene levels indicated that NLRP3 inflammasome activation was inhibited by MR through down-regulating the expression of pro-inflammatory cytokines: interleukin (IL)-β and IL-18, the pivotal factors that lead to inflammatory responses. More importantly, the related genes, cardiac function indexes, and various myocardial damage markers of normal rats treated with MR did not exhibit any obvious changes compared with the control group, indicating a satisfactory biocompatibility of MR. In summary, MR holds a great potential in the alleviation of CVB3-induced myocardial damage with a negligible cytotoxicity to normal heart tissues. Coxsackievirus B3 (CVB3)-induced myocardial damage always leads to serious heart failure by inducing cardiac injury.![]()
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Affiliation(s)
- Weidong Li
- Department of Cardiology
- Sichuan University
- West China Hospital
- Chengdu
- China
| | - Mao Chen
- Department of Cardiology
- Sichuan University
- West China Hospital
- Chengdu
- China
| | - Lishuai Xu
- Department of Ophthalmology
- Affiliated Hospital of North Sichuan Medical College
- China
| | - Zhan Lv
- Department of Cardiology
- Affiliated Hospital of North Sichuan Medical College
- China
| | - Li Chen
- Department of Cardiology
- Affiliated Hospital of North Sichuan Medical College
- China
| | - Yiling Li
- Department of Cardiology
- Second Affiliated Hospital of North Sichuan Medical College
- China
| | - WenFen He
- Department of Cardiology
- Affiliated Hospital of North Sichuan Medical College
- China
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Du Y, Gu X, Meng H, Aa N, Liu S, Peng C, Ge Y, Yang Z. Muscone improves cardiac function in mice after myocardial infarction by alleviating cardiac macrophage-mediated chronic inflammation through inhibition of NF-κB and NLRP3 inflammasome. Am J Transl Res 2018; 10:4235-4246. [PMID: 30662666 PMCID: PMC6325512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/19/2018] [Indexed: 06/09/2023]
Abstract
Muscone is the main active monomer of traditional Chinese medicine musk. Previous studies have reported a variety of beneficial effects of muscone. However, the effects of muscone on chronic inflammation after myocardial infarction (MI) are rarely reported. This study evaluated the anti-inflammatory effects of muscone on myocardial infarction by establishing a MI model in mice. We found that muscone remarkably decreased the levels of inflammatory cytokines (IL-1β, TNF-α and IL-6), and ultimately improved cardiac function and survival rate. Furthermore, the main anti-inflammatory effect of muscone was alleviating cardiac macrophage-mediated inflammatory response in heart tissues after MI. Bone marrow-derived macrophages (BMDMs) induced with lipopolysaccharide (LPS) were used as an in vitro inflammation model to further clarify anti-inflammatory mechanisms of muscone. Muscone significantly downregulated the levels of LPS-induced inflammatory cytokines and inhibited NF-κB and NLRP3 inflammasome activation in BMDMs. Moreover, ROS and antioxidant indices in LPS-induced BMDMs were also ameliorated after muscone treatment. To sum up, our study found that muscone alleviated cardiac macrophage-mediated chronic inflammation by inhibiting NF-κB and NLRP3 inflammasome activation, thereby improving cardiac function in MI mice. Besides, the inhibitory effect of muscone on inflammation may be related to the scavenging of ROS. It is suggested that muscone may serve as a promising and effective drug for post-MI treatment.
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Affiliation(s)
- Yingqiang Du
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityNanjing, China
| | - Xin Gu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityNanjing, China
| | - Haoyu Meng
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityNanjing, China
| | - Nan Aa
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityNanjing, China
| | - Shuiyuan Liu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityNanjing, China
| | - Chengyi Peng
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityNanjing, China
| | - Yingbin Ge
- Department of Physiology, Nanjing Medical UniversityNanjing, China
| | - Zhijian Yang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical UniversityNanjing, China
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Clinician’s Guide to Reducing Inflammation to Reduce Atherothrombotic Risk. J Am Coll Cardiol 2018; 72:3320-3331. [DOI: 10.1016/j.jacc.2018.06.082] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 06/22/2018] [Accepted: 06/25/2018] [Indexed: 02/06/2023]
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Fang X, Dorcely B, Ding XP, Yin S, Son NH, Hu SL, Goldberg IJ. Glycemic reduction alters white blood cell counts and inflammatory gene expression in diabetes. J Diabetes Complications 2018; 32:1027-1034. [PMID: 30197161 PMCID: PMC6174091 DOI: 10.1016/j.jdiacomp.2018.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/30/2018] [Accepted: 08/01/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Systemic inflammation contributes to cardiovascular disease in patients with type 2 diabetes, and elevated white blood cell (WBC) counts are an established risk factor. Our goal is to describe changes in WBCs and inflammatory markers after glycemic reductions in diabetes. RESEARCH DESIGN AND METHODS This study enrolled 63 subjects with poorly controlled diabetes, defined as hemoglobin A1c (HbA1c) ≥8% [64 mmol/mol]. Circulating granulocytes and mononuclear cells were separated by histopaque double-density protocol. Inflammatory markers from these isolated WBCs were assessed at baseline and after 3 months of medical management. RESULTS After 3 months, significant glycemic reduction, defined as a decrease in HbA1c ≥ 1.5%, occurred in 42 subjects. Fasting plasma glucose decreased by 47% (165.6 mg/dL), and HbA1c decreased from 10.2 ± 1.8 to 6.8 ± 0.9. Glycemic reductions were associated with a 9.4% decrease in total WBC counts, 10.96% decrease in neutrophils, and 21.74% decrease in monocytes. The mRNA levels of inflammatory markers from granulocytes and mononuclear cells decreased, including receptor for advanced glycation endproducts; S100 calcium binding proteins A8, A9, A12; krüppel-like factor 5; and IL-1. Also, circulating levels of IL-1β and C-reactive protein decreased. Insulin dose was a mediator between HbA1c and both total WBC and neutrophil counts, but not changes in WBC inflammatory markers. In contrast, the 17 subjects without significant glycemic reductions showed no significant differences in their WBC counts and proteins of inflammatory genes. CONCLUSION Significant glycemic reduction in subjects with poorly controlled diabetes led to reduced circulating WBC counts and inflammatory gene expression.
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Affiliation(s)
- Xiang Fang
- Department of Geriatrics, Affiliated Provincial Hospital of Anhui Medical University, No. 17, Lujiang Road, Hefei City 230001, Anhui Province, China; Gerontology Institute of Anhui Province, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Tumor Immunotherapy and Nutrition Therapy, Hefei, Anhui, China
| | - Brenda Dorcely
- Division of Endocrinology, Diabetes and Metabolism, NYU Langone Health, New York, NY 10016, United States of America
| | - Xi-Ping Ding
- Department of Geriatrics, Affiliated Provincial Hospital of Anhui Medical University, No. 17, Lujiang Road, Hefei City 230001, Anhui Province, China
| | - Shi Yin
- Department of Geriatrics, Affiliated Provincial Hospital of Anhui Medical University, No. 17, Lujiang Road, Hefei City 230001, Anhui Province, China
| | - Ni-Huiping Son
- Division of Endocrinology, Diabetes and Metabolism, NYU Langone Health, New York, NY 10016, United States of America
| | - Shi-Lian Hu
- Department of Geriatrics, Affiliated Provincial Hospital of Anhui Medical University, No. 17, Lujiang Road, Hefei City 230001, Anhui Province, China; Gerontology Institute of Anhui Province, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Tumor Immunotherapy and Nutrition Therapy, Hefei, Anhui, China
| | - Ira J Goldberg
- Division of Endocrinology, Diabetes and Metabolism, NYU Langone Health, New York, NY 10016, United States of America.
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Trankle CR, Canada JM, Cei L, Abouzaki N, Oddi-Erdle C, Kadariya D, Christopher S, Viscusi M, Del Buono M, Kontos MC, Arena R, Van Tassell B, Abbate A. Usefulness of Canakinumab to Improve Exercise Capacity in Patients With Long-Term Systolic Heart Failure and Elevated C-Reactive Protein. Am J Cardiol 2018; 122:1366-1370. [PMID: 30244844 DOI: 10.1016/j.amjcard.2018.07.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 07/03/2018] [Accepted: 07/10/2018] [Indexed: 11/16/2022]
Abstract
Interleukin-1β (IL-1β) is a cytokine involved in atherothrombosis and is known to depress cardiac function. We hypothesized that blocking IL-1β in patients with symptomatic systolic heart failure (HF) would improve their cardiorespiratory fitness. The purpose of the study was to measure changes in peak oxygen consumption (VO2) in 30 patients with prior myocardial infarction, high-sensitivity C-reactive protein ≥ 2 mg/l and HF with left ventricular ejection fraction (LVEF) < 50% enrolled in the Canakinumab Anti-inflammatory Thrombosis Outcome Study (CANTOS) in an independent single center substudy. We measured peak VO2 before and after 3 and 12 months of treatment with Canakinumab every 3 months (50, 150, or 300mg subcutaneously) or placebo, and measured LVEF before and after 12 months. In December 2013, the CANTOS study announced early termination of enrollment, halting enrollment for this substudy after only 15 patients, of which 3 were assigned to placebo and 12 to Canakinumab (50mg [1; 7%], 150mg [5; 33%], 300mg [6; 40%]). Patients treated with Canakinumab had a significant improvement in peak VO2, from 19.2 to 22.8 ml/kg/min at 3 months (p = 0.023 within-group changes, p = 0.026 for time_x_group interaction versus placebo [primary end point]), and an improvement in LVEF 38% (33-43) to 44% (38-52) at 12 months (p = 0.012 for within-group changes). No significant changes were seen in the placebo group. In conclusion, the findings of this small prespecified secondary analysis of the CANTOS trial support the positive results of the overall study, and confirm IL-1 as a potential therapeutic target in HF. https://clinicaltrials.gov/ct2/show/NCT01900600.
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Affiliation(s)
- Cory R Trankle
- VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Richmond, VA
| | - Justin M Canada
- VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Richmond, VA; Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA
| | - Laura Cei
- VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Richmond, VA
| | - Nayef Abouzaki
- VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Richmond, VA
| | - Claudia Oddi-Erdle
- VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Richmond, VA
| | - Dinesh Kadariya
- VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Richmond, VA
| | - Sanah Christopher
- VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Richmond, VA
| | - Michele Viscusi
- VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Richmond, VA
| | - Marco Del Buono
- VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Richmond, VA
| | - Michael C Kontos
- VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Richmond, VA
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, IL
| | - Benjamin Van Tassell
- VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Richmond, VA; Department of Pharmacotherapy and Outcome Sciences, Virginia Commonwealth University, Richmond, VA
| | - Antonio Abbate
- VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Richmond, VA.
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Impact of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio on 5-Year Clinical Outcomes of Patients with Stable Coronary Artery Disease Undergoing Elective Percutaneous Coronary Intervention. J Cardiovasc Transl Res 2018; 11:517-523. [DOI: 10.1007/s12265-018-9829-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 08/22/2018] [Indexed: 01/05/2023]
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Abstract
Interleukin-1 (IL-1) is the prototypical pro-inflammatory cytokine that occupies an apical place in the inflammatory cascade and also modulates cardiac function, functioning as a soluble cardiodepressant factor. Preclinical research over the past 4 decades has shown that blocking IL-1 processing or activity favorably affects cardiomyocyte survival and cardiac function in experimental animal models, paving the way for clinical studies in patients with heart disease. The promising results of phase II clinical trials of IL-1 blockade in patients with acute myocardial infarction and heart failure have been followed by a successful phase III trial in patients with prior acute myocardial infarction. Three IL-1 blockers with different mechanism of action are currently available for clinical use, although currently none have an indication for heart disease. We herein review the bench-to-bedside clinical translation of IL-1 targeting strategies and discuss the potential use of IL-1 blockade in patients with heart disease.
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Interleukin-12p35 Knock Out Aggravates Doxorubicin-Induced Cardiac Injury and Dysfunction by Aggravating the Inflammatory Response, Oxidative Stress, Apoptosis and Autophagy in Mice. EBioMedicine 2018; 35:29-39. [PMID: 30228093 PMCID: PMC6154773 DOI: 10.1016/j.ebiom.2018.06.009] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 06/07/2018] [Accepted: 06/08/2018] [Indexed: 02/06/2023] Open
Abstract
Background Recent evidence has demonstrated that interleukin 12p35 knockout (IL-12p35 KO) is involved in cardiac diseases by regulating the inflammatory response. The involvement of inflammatory cells has also been observed in doxorubicin (DOX)-induced cardiac injury. This study aimed to investigate whether IL-12p35 KO affects DOX-induced cardiac injury and the underlying mechanisms. Methods First, the effect of DOX treatment on cardiac IL-12p35 expression was assessed. In addition, to investigate the effect of IL-12p35 KO on DOX-induced cardiac injury, IL-12p35 KO mice were treated with DOX. Because IL-12p35 is the mutual subunit of IL-12 and IL-35, to determine the cytokine that mediates the effect of IL-12p35 KO on DOX-induced cardiac injury, mice were given phosphate-buffered saline (PBS), mouse recombinant IL-12 (rIL-12) or rIL-35 before treatment with DOX. Results DOX treatment significantly increased the level of cardiac IL-12p35 expression. In addition, IL-12p35 KO mice exhibited higher serum and heart lactate dehydrogenase levels, higher serum and heart creatine kinase myocardial bound levels, and greater cardiac dysfunction than DOX-treated mice. Furthermore, IL-12p35 KO further increased M1 macrophage and decreased M2 macrophage differentiation, aggravated the imbalance of oxidants and antioxidants, and further activated the mitochondrial apoptotic pathway and endoplasmic reticulum stress autophagy pathway. Both rIL-12 and rIL-35 protected against DOX-induced cardiac injury by alleviating the inflammatory response, oxidative stress, apoptosis and autophagy. Conclusions IL-12p35 KO aggravated DOX-induced cardiac injury by amplifying the levels of inflammation, oxidative stress, apoptosis and autophagy. (234 words). IL-12p35 KO aggravates DOX-induced cardiac injury and dysfunction. IL-12p35 further increases the DOX-induced imbalance in inflammation, oxidative stress, apoptosis and autophagy. Both exogenous rIL-12 and rIL-35 relieved cardiac injury mediated by DOX.
CD4+ T helper (Th) cells are closely related to cardiac injury; regulatory T cells (Tregs) are a new subset of Th cells, and IL-35 is the functional cytokine of Tregs. Cardiac injury mediated by DOX is the most serious complication during chemotherapy, and there are no good preventive measures. This study aimed to investigate whether IL-35 can reduce cardiac injury induced by DOX during chemotherapy. In addition to IL-35, IL-12p35 KO can cancel the biological effect of IL-12; therefore, we also determined whether IL-12 participates in DOX-induced cardiac injury and the underlying mechanisms.
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Khan R, Rheaume E, Tardif JC. Examining the Role of and Treatment Directed at IL-1β in Atherosclerosis. Curr Atheroscler Rep 2018; 20:53. [DOI: 10.1007/s11883-018-0754-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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126
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Cardioprotective Effects of Nanoemulsions Loaded with Anti-Inflammatory Nutraceuticals against Doxorubicin-Induced Cardiotoxicity. Nutrients 2018; 10:nu10091304. [PMID: 30223482 PMCID: PMC6164259 DOI: 10.3390/nu10091304] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 02/07/2023] Open
Abstract
Doxorubicin is a highly active antineoplastic agent, but its clinical use is limited because of its cardiotoxicity. Although nutraceuticals endowed with anti-inflammatory properties exert cardioprotective activity, their bioavailability and stability are inconsistent. In an attempt to address this issue, we evaluated whether bioavailable nanoemulsions loaded with nutraceuticals (curcumin and fresh and dry tomato extracts rich in lycopene) protect cardiomyoblasts (H9C2 cells) from doxorubicin-induced toxicity. Nanoemulsions were produced with a high-pressure homogenizer. H9C2 cells were incubated with nanoemulsions loaded with different nutraceuticals alone or in combination with doxorubicin. Cell viability was evaluated with a modified MTT method. The levels of the lipid peroxidation products malondialdehyde (MDA) and 4-hydroxy-2-butanone (4-HNA), and of the cardiotoxic-related interleukins IL-6, IL-8, IL-1β and IL-10, tumor necrosis factor-alpha (TNF-α), and nitric oxide were analyzed in cardiomyoblasts. The hydrodynamic size of nanoemulsions was around 100 nm. Cell viability enhancement was 35–40% higher in cardiomyoblasts treated with nanoemulsion + doxorubicin than in cardiomyoblasts treated with doxorubicin alone. Nanoemulsions also protected against oxidative stress as witnessed by a reduction of MDA and 4-HNA. Notably, nanoemulsions inhibited the release of IL-6, IL-8, IL-1β, TNF-α and nitric oxide by around 35–40% and increased IL-10 production by 25–27% versus cells not treated with emulsions. Of the nutraceuticals evaluated, lycopene-rich nanoemulsions had the best cardioprotective profile. In conclusion, nanoemulsions loaded with the nutraceuticals described herein protect against cardiotoxicity, by reducing inflammation and lipid oxidative stress. These results set the stage for studies in preclinical models.
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127
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Free fatty acids may be involved in the pathogenesis of oral-related and cardiovascular diseases. J Oral Biosci 2018. [DOI: 10.1016/j.job.2018.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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128
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Van Tassell BW, Lipinski MJ, Appleton D, Roberts CS, Kontos MC, Abouzaki N, Melchior R, Mueller G, Garnett J, Canada J, Carbone S, Buckley LF, Wohlford G, Kadariya D, Trankle CR, Oddi Erdle C, Sculthorpe R, Puckett L, DeWilde C, Shah K, Angiolillo DJ, Vetrovec G, Biondi-Zoccai G, Arena R, Abbate A. Rationale and design of the Virginia Commonwealth University-Anakinra Remodeling Trial-3 (VCU-ART3): A randomized, placebo-controlled, double-blinded, multicenter study. Clin Cardiol 2018; 41:1004-1008. [PMID: 30033595 DOI: 10.1002/clc.22988] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 05/25/2018] [Accepted: 05/29/2018] [Indexed: 02/05/2023] Open
Abstract
There is clear association between the intensity of the acute inflammatory response during acute myocardial infarction (AMI) and adverse prognosis after AMI. Interleukin-1 (IL-1) is a pro-inflammatory cytokine released during AMI and involved in adverse remodeling and heart failure (HF). We describe a study to evaluate the safety and efficacy of IL-1 blockade using an IL-1 receptor antagonist (anakinra) during the acute phase of ST-segment elevation myocardial infarction (STEMI). The Virginia Commonwealth University-Anakinra Remodeling Trial-3 (VCU-ART3; http://www.ClinicalTrials.gov NCT01950299) is a phase 2, multicenter, double-blinded, randomized, placebo-controlled clinical trial comparing anakinra 100 mg once or twice daily vs matching placebo (1:1:1) for 14 days in 99 patients with STEMI. Patients who present to the hospital with STEMI within 12 hours of symptom onset will be eligible for enrollment. Patients will be excluded for a history of HF (functional class III-IV), severe valvular disease, severe kidney disease (stage 4-5), active infection, recent use of immunosuppressive drugs, active malignancy, or chronic autoimmune/auto-inflammatory diseases. We will measure the difference in the area under the curve for C-reactive protein between admission and day 14, separately comparing each of the anakinra groups with the placebo group. The P value will be considered significant if <0.025 to adjust for multiple comparisons. Patients will also be followed for up to 12 months from enrollment to evaluate cardiac remodeling (echocardiography), cardiac function (echocardiography), and major adverse cardiovascular outcomes (cardiovascular death, MI, revascularization, and new onset of HF).
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Affiliation(s)
- Benjamin W Van Tassell
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
- Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University, Richmond, Virginia
- VCU Johnson Center for Pulmonary and Critical Care Research, Virginia Commonwealth University, Richmond, Virginia
| | - Michael J Lipinski
- Medstar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia
| | | | - Charlotte S Roberts
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
| | - Michael C Kontos
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
| | - Nayef Abouzaki
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
| | - Ryan Melchior
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
- Virginia Cardiovascular Specialists, Richmond, Virginia
| | - George Mueller
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
- Virginia Cardiovascular Specialists, Richmond, Virginia
| | - James Garnett
- Virginia Cardiovascular Specialists, Richmond, Virginia
| | - Justin Canada
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Salvatore Carbone
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
| | - Leo F Buckley
- Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University, Richmond, Virginia
| | - George Wohlford
- Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University, Richmond, Virginia
| | - Dinesh Kadariya
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
| | - Cory R Trankle
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
| | - Claudia Oddi Erdle
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
| | - Robin Sculthorpe
- Investigational Pharmacy, Virginia Commonwealth University, Richmond, Virginia
| | - Laura Puckett
- VCU Johnson Center for Pulmonary and Critical Care Research, Virginia Commonwealth University, Richmond, Virginia
- Virginia Cardiovascular Specialists, Richmond, Virginia
| | - Christine DeWilde
- VCU Johnson Center for Pulmonary and Critical Care Research, Virginia Commonwealth University, Richmond, Virginia
| | - Keyur Shah
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
| | | | - George Vetrovec
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
| | - Giuseppe Biondi-Zoccai
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, and Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois
| | - Antonio Abbate
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
- VCU Johnson Center for Pulmonary and Critical Care Research, Virginia Commonwealth University, Richmond, Virginia
- Kenneth and Dianne Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, Virginia
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129
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Regulation of IL-1 signaling by the decoy receptor IL-1R2. J Mol Med (Berl) 2018; 96:983-992. [PMID: 30109367 DOI: 10.1007/s00109-018-1684-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/11/2018] [Accepted: 08/06/2018] [Indexed: 12/21/2022]
Abstract
The pleiotropic cytokine IL-1 mediates its biological functions via association with the signaling receptor IL-1R1. Despite an apparent simplicity in IL-1 signaling activation, multiple negative regulators have been identified. The decoy receptor IL-1R2 (also known as CD121b) can suppress IL-1 maturation, sequester its active forms or hinder the signaling complex assembly. IL-1R2 is differentially expressed among numerous cell types and displays cis- and trans- modes of action. In this review, we link different forms of IL-1R2 (membrane-bound (mIL-1R2), secreted (sIL-1R2), shedded (shIL-1R2), cytoplasmic, and intracellular domain (IL-1R2ICD) restricted) with their ability to interfere with IL-1, thereby regulating immune responses. We also discuss the intriguing possible function of IL-1R2 as a transcriptional regulator. Finally, we summarize the known impact of IL-1R2 in disease pathogenesis and discuss its potential role in treatment of inflammatory conditions.
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130
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Hegner B, Schaub T, Janke D, Zickler D, Lange C, Girndt M, Jankowski J, Schindler R, Dragun D. Targeting proinflammatory cytokines ameliorates calcifying phenotype conversion of vascular progenitors under uremic conditions in vitro. Sci Rep 2018; 8:12087. [PMID: 30108259 PMCID: PMC6092400 DOI: 10.1038/s41598-018-30626-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 07/06/2018] [Indexed: 11/09/2022] Open
Abstract
Severe vascular calcification develops almost invariably in chronic kidney patients posing a substantial risk to quality of life and survival. This unmet medical need demands identification of novel therapeutic modalities. We aimed to pinpoint components of the uremic microenvironment triggering differentiation of vascular progenitors to calcifying osteoblast-like cells. In an unbiased approach, assessing the individual potency of 63 uremic retention solutes to enhance calcific phenotype conversion of vascular progenitor cells, the pro-inflammatory cytokines IL-1β and TNF-α were identified as the strongest inducers followed by FGF-2, and PTH. Pharmacologic targeting of these molecules alone or in combination additively antagonized pro-calcifying properties of sera from uremic patients. Our findings stress the importance of pro-inflammatory cytokines above other characteristic components of the uremic microenvironment as key mediators of calcifying osteoblastic differentiation in vascular progenitors. Belonging to the group of "middle-sized molecules", they are neither effectively removed by conventional dialysis nor influenced by established supportive therapies. Specific pharmacologic interventions or novel extracorporeal approaches may help preserve regenerative capacity and control vascular calcification due to uremic environment.
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Affiliation(s)
- Björn Hegner
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Clinic for Nephrology and Intensive Care Medicine, Campus Virchow-Clinic, Berlin, Germany. .,Berlin-Brandenburg School for Regenerative Therapies (BSRT), Berlin, Germany. .,Center for Cardiovascular Research (CCR), Charité University Hospital, Berlin, Germany. .,Vivantes Ida Wolff Hospital for Geriatric Medicine, Berlin, Germany.
| | - Theres Schaub
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Clinic for Nephrology and Intensive Care Medicine, Campus Virchow-Clinic, Berlin, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Chemistry and Biochemistry, Berlin, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Cell- and Neurobiology, Campus Mitte, Berlin, Germany
| | - Daniel Janke
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Clinic for Nephrology and Intensive Care Medicine, Campus Virchow-Clinic, Berlin, Germany
| | - Daniel Zickler
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Clinic for Nephrology and Intensive Care Medicine, Campus Virchow-Clinic, Berlin, Germany
| | - Claudia Lange
- Clinic for Stem Cell Transplantation, Department of Cell and Gene Therapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias Girndt
- Department of Internal Medicine II, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Joachim Jankowski
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Clinic for Nephrology, Charité University Hospital Campus Benjamin Franklin, Berlin, Germany.,Institute for Molecular Cardiovascular Research, University Hospital RWTH, Aachen, Germany.,School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Ralf Schindler
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Clinic for Nephrology and Intensive Care Medicine, Campus Virchow-Clinic, Berlin, Germany
| | - Duska Dragun
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Clinic for Nephrology and Intensive Care Medicine, Campus Virchow-Clinic, Berlin, Germany.,Berlin-Brandenburg School for Regenerative Therapies (BSRT), Berlin, Germany.,Center for Cardiovascular Research (CCR), Charité University Hospital, Berlin, Germany
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131
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Elagizi A, Kachur S, Lavie CJ, Carbone S, Pandey A, Ortega FB, Milani RV. An Overview and Update on Obesity and the Obesity Paradox in Cardiovascular Diseases. Prog Cardiovasc Dis 2018; 61:142-150. [PMID: 29981771 DOI: 10.1016/j.pcad.2018.07.003] [Citation(s) in RCA: 426] [Impact Index Per Article: 71.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 07/01/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Andrew Elagizi
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA, United States of America
| | - Sergey Kachur
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA, United States of America
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA, United States of America.
| | - Salvatore Carbone
- Pauley Heart Center, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Ambarish Pandey
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Francisco B Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Richard V Milani
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA, United States of America
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De Luca G, Cavalli G, Campochiaro C, Tresoldi M, Dagna L. Myocarditis: An Interleukin-1-Mediated Disease? Front Immunol 2018; 9:1335. [PMID: 29951067 PMCID: PMC6008311 DOI: 10.3389/fimmu.2018.01335] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 05/29/2018] [Indexed: 12/20/2022] Open
Affiliation(s)
- Giacomo De Luca
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Giulio Cavalli
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.,Department of Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Corrado Campochiaro
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Moreno Tresoldi
- Unit of General Medicine and Advanced Care, IRCCS San Raffaele Hospital and Scientific Institute, Milan, Italy
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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Orrem HL, Shetelig C, Ueland T, Limalanathan S, Nilsson PH, Husebye T, Aukrust P, Seljeflot I, Hoffmann P, Eritsland J, Mollnes TE, Andersen GØ, Yndestad A. Soluble IL-1 receptor 2 is associated with left ventricular remodelling in patients with ST-elevation myocardial infarction. Int J Cardiol 2018; 268:187-192. [PMID: 29853279 DOI: 10.1016/j.ijcard.2018.05.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 04/24/2018] [Accepted: 05/10/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND The inflammatory response following myocardial infarction (MI) is prerequisite for proper healing of infarcted tissue, but can also have detrimental effects on cardiac function. Interleukin (IL)-1α and IL-1β are potent inflammatory mediators and their bioactivity is tightly regulated by IL-1 receptor antagonist (IL-1ra) and soluble (s) IL-1 receptors (R). We aimed to examine whether levels of soluble regulators of IL-1 signalling are changed during ST-elevation MI (STEMI) and their associations with parameters of cardiac injury and ventricular remodelling. METHODS Plasma levels of IL-1Ra, sIL-1R1, sIL-1R2 and sIL-1R accessory protein (sIL-1RAcP) were measured by immunoassays in repeated samples from patients with STEMI (n = 255) and compared to healthy controls (n = 65). RESULTS IL-1Ra, sIL-1R1 and sIL-1R2 levels were all significantly elevated after STEMI, while levels of sIL-1RAcP were lower compared to controls. sIL-1R2 levels (at different time points) correlated positively with C-reactive protein, myocardial infarct size and change in indexed left ventricular end-diastolic and end-systolic volume (LVEDVi and LVESVi) measured by cardiac MR acutely and after 4 months, and negatively with LV ejection fraction. Patients with >median levels of sIL-1R2 in the acute phase were more likely to have increased change in LVEDVi and LVESVi. Importantly, sIL-1R2 remained significantly associated with change in LVEDVi and LVESVi also after adjustment for clinical covariates. CONCLUSION Levels of sIL-1R2 are independently associated with parameters of LV adverse remodelling following STEMI.
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Affiliation(s)
- Hilde L Orrem
- Department of Immunology, Oslo University Hospital Rikshospitalet, Norway; Department of Anesthesiology, Oslo University Hospital Rikshospitalet, Norway; Institute of Clinical Medicine, University of Oslo, Norway
| | - Christian Shetelig
- Institute of Clinical Medicine, University of Oslo, Norway; Department of Cardiology, Oslo University Hospital Ullevål, Norway; Center for Clinical Heart Research, Oslo University Hospital Ullevål, Norway
| | - Thor Ueland
- Institute of Clinical Medicine, University of Oslo, Norway; Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Norway; K.G. Jebsen TREC, University of Tromsø, Tromsø, Norway
| | - Shanmuganathan Limalanathan
- Department of Cardiology, Oslo University Hospital Ullevål, Norway; Center for Clinical Heart Research, Oslo University Hospital Ullevål, Norway; Feiring Heart Clinic, Feiring, Norway
| | - Per H Nilsson
- K.G. Jebsen Inflammatory Research Centre, University of Oslo, Norway; Linnaeus Centre for Biomaterials Chemistry, Linnaeus University, Kalmar, Sweden
| | - Trygve Husebye
- Department of Cardiology, Oslo University Hospital Ullevål, Norway; Center of Heart Failure Research, University of Oslo, Norway
| | - Pål Aukrust
- Institute of Clinical Medicine, University of Oslo, Norway; Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Norway; K.G. Jebsen Inflammatory Research Centre, University of Oslo, Norway; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Norway
| | - Ingebjørg Seljeflot
- Institute of Clinical Medicine, University of Oslo, Norway; Department of Cardiology, Oslo University Hospital Ullevål, Norway; Center for Clinical Heart Research, Oslo University Hospital Ullevål, Norway; Center of Heart Failure Research, University of Oslo, Norway
| | - Pavel Hoffmann
- Institute of Clinical Medicine, University of Oslo, Norway; Section of Interventional Cardiology, Oslo University Hospital Ullevål, Norway
| | - Jan Eritsland
- Department of Cardiology, Oslo University Hospital Ullevål, Norway; Center for Clinical Heart Research, Oslo University Hospital Ullevål, Norway
| | - Tom E Mollnes
- Department of Immunology, Oslo University Hospital Rikshospitalet, Norway; K.G. Jebsen TREC, University of Tromsø, Tromsø, Norway; K.G. Jebsen Inflammatory Research Centre, University of Oslo, Norway; Research Laboratory, Nordland Hospital, Bodø, Norway; Centre of Molecular Inflammation Research, Norwegian University of Science, Trondheim, Norway
| | - Geir Øystein Andersen
- Department of Cardiology, Oslo University Hospital Ullevål, Norway; Center for Clinical Heart Research, Oslo University Hospital Ullevål, Norway; Center of Heart Failure Research, University of Oslo, Norway
| | - Arne Yndestad
- Institute of Clinical Medicine, University of Oslo, Norway; Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Norway; K.G. Jebsen Inflammatory Research Centre, University of Oslo, Norway; Center of Heart Failure Research, University of Oslo, Norway.
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134
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Pironti G, Bersellini-Farinotti A, Agalave NM, Sandor K, Fernandez-Zafra T, Jurczak A, Lund LH, Svensson CI, Andersson DC. Cardiomyopathy, oxidative stress and impaired contractility in a rheumatoid arthritis mouse model. Heart 2018; 104:2026-2034. [DOI: 10.1136/heartjnl-2018-312979] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 04/15/2018] [Accepted: 04/17/2018] [Indexed: 11/04/2022] Open
Abstract
ObjectivesPatients with rheumatoid arthritis (RA) display an increased risk of heart failure independent of traditional cardiovascular risk factors. To elucidate myocardial disease in RA, we have investigated molecular and cellular remodelling of the heart in an established mouse model of RA.MethodsThe collagen antibody-induced arthritis (CAIA) RA mouse model is characterised by joint inflammation and increased inflammatory markers in the serum. We used CAIA mice in the postinflammatory phase that resembles medically controlled RA or RA in remission. Hearts were collected for cardiomyocyte isolation, biochemistry and histology analysis.ResultsHearts from mice subjected to CAIA displayed hypertrophy (heart/body weight, mean±SD: 5.9±0.8vs 5.1±0.7 mg/g, p<0.05), fibrosis and reduced left ventricular fractional shortening compared with control. Cardiomyocytes from CAIA mice showed reduced cytosolic [Ca2+]i transient amplitudes (F/F0, mean±SD: 3.0±1.2vs 3.6±1.5, p<0.05) that was linked to reductions in sarcoplasmic reticulum (SR) Ca2+ store (F/F0, mean±SD: 3.5±1.3vs 4.4±1.3, p<0.01) measured with Ca2+ imaging. This was associated to lower fractional shortening in the cardiomyocytes from the CAIA mice (%FS, mean±SD: 3.4±2.2 vs 4.6%±2.3%, p<0.05). Ca2+ handling proteins displayed oxidation-dependent posttranslational modifications that together with an increase in superoxide dismutase expression indicate a cell environment with oxidative stress.ConclusionsThis study shows that inflammation during active RA has long-term consequences on molecular remodelling and contractile function of the heart, which further supports that rheumatology patients should be followed for development of heart failure.
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Brinchmann BC, Skuland T, Rambøl MH, Szoke K, Brinchmann JE, Gutleb AC, Moschini E, Kubátová A, Kukowski K, Le Ferrec E, Lagadic-Gossmann D, Schwarze PE, Låg M, Refsnes M, Øvrevik J, Holme JA. Lipophilic components of diesel exhaust particles induce pro-inflammatory responses in human endothelial cells through AhR dependent pathway(s). Part Fibre Toxicol 2018; 15:21. [PMID: 29751765 PMCID: PMC5948689 DOI: 10.1186/s12989-018-0257-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 05/01/2018] [Indexed: 12/31/2022] Open
Abstract
Background Exposure to traffic-derived particulate matter (PM), such as diesel exhaust particles (DEP), is a leading environmental cause of cardiovascular disease (CVD), and may contribute to endothelial dysfunction and development of atherosclerosis. It is still debated how DEP and other inhaled PM can contribute to CVD. However, organic chemicals (OC) adhered to the particle surface, are considered central to many of the biological effects. In the present study, we have explored the ability of OC from DEP to reach the endothelium and trigger pro-inflammatory reactions, a central step on the path to atherosclerosis. Results Exposure-relevant concentrations of DEP (0.12 μg/cm2) applied on the epithelial side of an alveolar 3D tri-culture, rapidly induced pro-inflammatory and aryl hydrocarbon receptor (AhR)-regulated genes in the basolateral endothelial cells. These effects seem to be due to soluble lipophilic constituents rather than particle translocation. Extractable organic material of DEP (DEP-EOM) was next fractionated with increasing polarity, chemically characterized, and examined for direct effects on pro-inflammatory and AhR-regulated genes in human microvascular endothelial (HMEC-1) cells and primary human endothelial cells (PHEC) from four healthy donors. Exposure-relevant concentrations of lipophilic DEP-EOM (0.15 μg/cm2) induced low to moderate increases in IL-1α, IL-1β, COX2 and MMP-1 gene expression, and the MMP-1 secretion was increased. By contrast, the more polar EOM had negligible effects, even at higher concentrations. Use of pharmacological inhibitors indicated that AhR and protease-activated receptor-2 (PAR-2) were central in regulation of EOM-induced gene expression. Some effects also seemed to be attributed to redox-responses, at least at the highest exposure concentrations tested. Although the most lipophilic EOM, that contained the majority of PAHs and aliphatics, had the clearest low-concentration effects, there was no straight-forward link between chemical composition and biological effects. Conclusion Lipophilic and semi-lipophilic chemicals seemed to detach from DEP, translocate through alveolar epithelial cells and trigger pro-inflammatory reactions in endothelial cells at exposure-relevant concentrations. These effects appeared to be triggered by AhR agonists, and involve PAR-2 signaling. Electronic supplementary material The online version of this article (10.1186/s12989-018-0257-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bendik C Brinchmann
- Department of Air Pollution and Noise, Domain of Infection Control, Environment and Health, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403, Oslo, Norway.,Division of Laboratory Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Tonje Skuland
- Department of Air Pollution and Noise, Domain of Infection Control, Environment and Health, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403, Oslo, Norway
| | - Mia H Rambøl
- Norwegian Center for Stem Cell Research, Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Krisztina Szoke
- Norwegian Center for Stem Cell Research, Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Jan E Brinchmann
- Norwegian Center for Stem Cell Research, Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Arno C Gutleb
- Luxembourg Institute of Science and Technology (LIST), Environmental Research and Innovation (ERIN) Department, Belvaux, Grand Duchy of Luxembourg
| | - Elisa Moschini
- Luxembourg Institute of Science and Technology (LIST), Environmental Research and Innovation (ERIN) Department, Belvaux, Grand Duchy of Luxembourg
| | - Alena Kubátová
- Department of Chemistry, University of North Dakota, Grand Forks, ND, USA
| | - Klara Kukowski
- Department of Chemistry, University of North Dakota, Grand Forks, ND, USA
| | - Eric Le Ferrec
- Inserm U1085, Institut de Recherche en Santé, Environnement, Travail (IRSET), Rennes, France.,Université de Rennes 1, Faculté des Sciences pharmaceutiques et biologiques, Rennes, France
| | - Dominique Lagadic-Gossmann
- Inserm U1085, Institut de Recherche en Santé, Environnement, Travail (IRSET), Rennes, France.,Université de Rennes 1, Faculté des Sciences pharmaceutiques et biologiques, Rennes, France
| | - Per E Schwarze
- Department of Air Pollution and Noise, Domain of Infection Control, Environment and Health, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403, Oslo, Norway
| | - Marit Låg
- Department of Air Pollution and Noise, Domain of Infection Control, Environment and Health, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403, Oslo, Norway
| | - Magne Refsnes
- Department of Air Pollution and Noise, Domain of Infection Control, Environment and Health, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403, Oslo, Norway
| | - Johan Øvrevik
- Department of Air Pollution and Noise, Domain of Infection Control, Environment and Health, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403, Oslo, Norway
| | - Jørn A Holme
- Department of Air Pollution and Noise, Domain of Infection Control, Environment and Health, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403, Oslo, Norway.
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Bakhta O, Blanchard S, Guihot AL, Tamareille S, Mirebeau-Prunier D, Jeannin P, Prunier F. Cardioprotective Role of Colchicine Against Inflammatory Injury in a Rat Model of Acute Myocardial Infarction. J Cardiovasc Pharmacol Ther 2018; 23:446-455. [PMID: 29658326 DOI: 10.1177/1074248418763611] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Inflammation plays a crucial role in the pathophysiology of myocardial ischemia/reperfusion (I/R) injury. A clinical trial has recently reported a smaller infarct size in a cohort of patients with ST-segment elevation myocardial infarction (MI) treated with a short colchicine course. The mechanism underlying colchicine-induced cardioprotection in the early MI phase remains unclear. We hypothesized that a short pretreatment with colchicine could induce acute beneficial effects by protecting the heart against inflammation in myocardial I/R injury. METHODS AND RESULTS Rats were subjected to 40-minute left anterior descending coronary occlusion, followed by 120-minute reperfusion. Colchicine (0.3 mg/kg) or a vehicle was administered per os 24 hours and immediately before surgery. Infarct size was significantly reduced in the colchicine group (35.6% ± 3.0% vs 46.6% ± 3.3%, P < .05). The beneficial effects of colchicine were associated with an increased systemic interleukin-10 (IL-10) level and decreased cardiac transforming growth factor-β level. Interleukin-1β was found to increase in a "time of reperfusion"-dependent manner. Colchicine inhibited messenger RNA expression of caspase-1 and pro-IL-18. Interleukin-1β injected 10 minutes prior to myocardial ischemia induced greater infarct size (58.0% ± 2.0%, P < .05) as compared to the vehicle. Colchicine combined to IL-1β injection significantly decreased infarct size (47.1% ± 2.2%, P < .05) as compared to IL-1β alone, while colchicine alone exhibited a significantly more marked cardioprotective effect than the colchicine-IL-1β association. CONCLUSION The cardioprotection induced by a short colchicine pretreatment was associated with an anti-inflammatory effect in the early reperfusion phase in our rat MI model.
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Affiliation(s)
- Oussama Bakhta
- 1 Université Angers, Angers, France.,2 Institut MITOVASC, UMR INSERM U1083 and CNRS 6015, Angers, France
| | - Simon Blanchard
- 1 Université Angers, Angers, France.,3 CHU Angers, Angers, France.,4 U1232, Immunology and Allergology Laboratory, Center of Immunology and Cancer Research Nantes Angers, Angers, France
| | - Anne-Laure Guihot
- 1 Université Angers, Angers, France.,2 Institut MITOVASC, UMR INSERM U1083 and CNRS 6015, Angers, France
| | - Sophie Tamareille
- 1 Université Angers, Angers, France.,2 Institut MITOVASC, UMR INSERM U1083 and CNRS 6015, Angers, France
| | - Delphine Mirebeau-Prunier
- 1 Université Angers, Angers, France.,2 Institut MITOVASC, UMR INSERM U1083 and CNRS 6015, Angers, France.,3 CHU Angers, Angers, France
| | - Pascale Jeannin
- 1 Université Angers, Angers, France.,3 CHU Angers, Angers, France.,4 U1232, Immunology and Allergology Laboratory, Center of Immunology and Cancer Research Nantes Angers, Angers, France
| | - Fabrice Prunier
- 1 Université Angers, Angers, France.,2 Institut MITOVASC, UMR INSERM U1083 and CNRS 6015, Angers, France.,3 CHU Angers, Angers, France
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Wallet SM, Puri V, Gibson FC. Linkage of Infection to Adverse Systemic Complications: Periodontal Disease, Toll-Like Receptors, and Other Pattern Recognition Systems. Vaccines (Basel) 2018; 6:E21. [PMID: 29621153 PMCID: PMC6027258 DOI: 10.3390/vaccines6020021] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 03/25/2018] [Accepted: 03/30/2018] [Indexed: 12/13/2022] Open
Abstract
Toll-like receptors (TLRs) are a group of pattern recognition receptors (PRRs) that provide innate immune sensing of conserved pathogen-associated molecular patterns (PAMPs) to engage early immune recognition of bacteria, viruses, and protozoa. Furthermore, TLRs provide a conduit for initiation of non-infectious inflammation following the sensing of danger-associated molecular patterns (DAMPs) generated as a consequence of cellular injury. Due to their essential role as DAMP and PAMP sensors, TLR signaling also contributes importantly to several systemic diseases including cardiovascular disease, diabetes, and others. The overlapping participation of TLRs in the control of infection, and pathogenesis of systemic diseases, has served as a starting point for research delving into the poorly defined area of infection leading to increased risk of various systemic diseases. Although conflicting studies exist, cardiovascular disease, diabetes, cancer, rheumatoid arthritis, and obesity/metabolic dysfunction have been associated with differing degrees of strength to infectious diseases. Here we will discuss elements of these connections focusing on the contributions of TLR signaling as a consequence of bacterial exposure in the context of the oral infections leading to periodontal disease, and associations with metabolic diseases including atherosclerosis and type 2 diabetes.
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Affiliation(s)
- Shannon M Wallet
- Department of Oral Biology, College of Dental Medicine, University of Florida, Gainesville, FL 32610, USA.
| | - Vishwajeet Puri
- Department of Biomedical Sciences and Diabetes Institute, Ohio University, Athens, OH 45701, USA.
| | - Frank C Gibson
- Department of Oral Biology, College of Dental Medicine, University of Florida, Gainesville, FL 32610, USA.
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Billingsley HE, Carbone S. The antioxidant potential of the Mediterranean diet in patients at high cardiovascular risk: an in-depth review of the PREDIMED. Nutr Diabetes 2018; 8:13. [PMID: 29549354 PMCID: PMC5856841 DOI: 10.1038/s41387-018-0025-1] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 02/02/2018] [Accepted: 02/07/2018] [Indexed: 12/11/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading global cause of death. Diet is known to be important in the prevention of CVD. The PREDIMED trial tested a relatively low-fat diet versus a high-fat Mediterranean diet (MedDiet) for the primary prevention of CVD. The resulting reduction of the CV composite outcome resulted in a paradigm shift in CV nutrition. Though many dietary factors likely contributed to this effect, this review focuses on the influence of the MedDiet on endogenous antioxidant systems and the effect of dietary polyphenols. Subgroup analysis of the PREDIMED trial revealed increased endogenous antioxidant and decreased pro-oxidant activity in the MedDiet groups. Moreover, higher polyphenol intake was associated with lower incidence of the primary outcome, overall mortality, blood pressure, inflammatory biomarkers, onset of new-onset type 2 diabetes mellitus (T2DM), and obesity. This suggests that polyphenols likely contributed to the lower incidence of the primary event in the MedDiet groups. In this article, we summarize the potential benefits of polyphenols found in the MedDiet, specifically the PREDIMED cohort. We also discuss the need for further research to confirm and expand the findings of the PREDIMED in a non-Mediterranean population and to determine the exact mechanisms of action of polyphenols.
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Affiliation(s)
| | - Salvatore Carbone
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA. .,Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
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139
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Aleksova A, Beltrami AP, Carriere C, Barbati G, Lesizza P, Perrieri-Montanino M, Isola M, Gentile P, Salvioni E, Not T, Agostoni P, Sinagra G. Interleukin-1β levels predict long-term mortality and need for heart transplantation in ambulatory patients affected by idiopathic dilated cardiomyopathy. Oncotarget 2018; 8:25131-25140. [PMID: 28212578 PMCID: PMC5421915 DOI: 10.18632/oncotarget.15349] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 01/09/2017] [Indexed: 01/19/2023] Open
Abstract
Aims The prognostic stratification of patients with Idiopathic Dilated Cardiomyopathy (iDCM) is a difficult task. Here, we assessed the additive value of the evaluation of biomarkers of inflammasome activation and systemic inflammation for the long-term risk stratification of iDCM patients. Methods and Results We studied 156 ambulatory iDCM patients (mean age 58 years, 77% men, 79% in NYHA class 1-2, median Left Ventricular Ejection Fraction (LVEF) 35%, mean sodium 139 mEq/L, median BNP 189 pg/mL, median IL-1 beta (IL-1β) 1.08 pg/mL, median IL-6 1.7 pg/mL and median IL-10 2.7 pg/mL). During the follow-up period of 89.6 months, 35 patients (22%) died/underwent heart transplantation. Patients who died/underwent heart transplantation were more likely to be male, to be in NYHA class III, to have atrial fibrillation, to have lower LVEF and higher BNP levels. IL-1β, IL-6 and IL-10 levels did not differ significantly between the groups of patients with good or bad prognosis. IL-1β levels did not vary significantly among either the different NYHA classes or the quartiles of LVEF. In a multivariable model, however, IL-1β was a strong and independent predictor of all-cause mortality (HR 1.193, 95% CI 1.056 – 1.349, p=0.005 for log squared transformed values). Other factors associated with the outcome were: male gender, presence of atrial fibrillation and sodium concentration. The estimated time-dependent ROC curve of the multivariable model showed an AUC 0.74 (95% CI 0.65-0.86). Conclusions Serum levels of IL-1β could be useful to predict the long-term outcome of patients with iDCM.
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Affiliation(s)
- Aneta Aleksova
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
| | | | - Cosimo Carriere
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
| | - Giulia Barbati
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
| | - Pierluigi Lesizza
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
| | - Martina Perrieri-Montanino
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
| | - Miriam Isola
- Department of Medical and Biological Sciences, University of Udine, Italy
| | - Piero Gentile
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
| | - Elisabetta Salvioni
- Centro Cardiologico Monzino, IRCCS, Milan, Italy, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Tarcisio Not
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo" Trieste and University of Trieste, Trieste, Italy
| | - Piergiuseppe Agostoni
- Centro Cardiologico Monzino, IRCCS, Milan, Italy, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Gianfranco Sinagra
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
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140
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Guo X, Bai Y, Zhang L, Zhang B, Zagidullin N, Carvalho K, Du Z, Cai B. Cardiomyocyte differentiation of mesenchymal stem cells from bone marrow: new regulators and its implications. Stem Cell Res Ther 2018; 9:44. [PMID: 29482607 PMCID: PMC5828435 DOI: 10.1186/s13287-018-0773-9] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
In the past years, cardiac mortality has decreased, but cardiac diseases are still responsible for millions of deaths every year worldwide. Bone-marrow mesenchymal stem cells (BMSCs) transplantation may be a promising therapeutic strategy because of its capacity to differentiate into cardiac cells. Current research indicates that chemical substances, microRNAs, and cytokines have biological functions that regulate the cardiomyocytes differentiation of BMSCs. In this review, we chiefly summarize the regulatory factors that induce BMSCs to differentiate into cardiomyocytes.
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Affiliation(s)
- Xiaofei Guo
- Department of Pharmacy, the Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Harbin, Heilongjiang Province, 150081, People's Republic of China
| | - Yan Bai
- Department of Pharmacy, the Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Harbin, Heilongjiang Province, 150081, People's Republic of China
| | - Li Zhang
- Department of Pharmacy, the Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Harbin, Heilongjiang Province, 150081, People's Republic of China
| | - Bo Zhang
- Department of Pharmacy, the Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Harbin, Heilongjiang Province, 150081, People's Republic of China
| | - Naufal Zagidullin
- Department of Internal Diseases, Bashkir State Medical University, Ufa, Russia
| | - Katherine Carvalho
- Cell Therapy and Biotechnology in Regenerative Medicine Research Group, Pequeno Príncipe Faculty, Pelé Pequeno Príncipe Institute, Curitiba, Brazil
| | - Zhimin Du
- Department of Pharmacy, the Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Harbin, Heilongjiang Province, 150081, People's Republic of China
| | - Benzhi Cai
- Department of Pharmacy, the Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Harbin, Heilongjiang Province, 150081, People's Republic of China.
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141
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Epstein SE, Lipinski MJ, Luger D. Persistent Inflammation, Stem Cell-Induced Systemic Anti-Inflammatory Effects, and Need for Repeated Stem Cell Injections: Critical Concepts Influencing Optimal Stem Cell Strategies for Treating Acute Myocardial Infarction and Heart Failure. J Am Heart Assoc 2018; 7:JAHA.118.008524. [PMID: 29440037 PMCID: PMC5850210 DOI: 10.1161/jaha.118.008524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Stephen E Epstein
- MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, DC
| | - Michael J Lipinski
- MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, DC
| | - Dror Luger
- MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, DC
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142
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Miteva K, Pappritz K, Sosnowski M, El-Shafeey M, Müller I, Dong F, Savvatis K, Ringe J, Tschöpe C, Van Linthout S. Mesenchymal stromal cells inhibit NLRP3 inflammasome activation in a model of Coxsackievirus B3-induced inflammatory cardiomyopathy. Sci Rep 2018; 8:2820. [PMID: 29434214 PMCID: PMC5809634 DOI: 10.1038/s41598-018-20686-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 01/16/2018] [Indexed: 12/20/2022] Open
Abstract
Inflammation in myocarditis induces cardiac injury and triggers disease progression to heart failure. NLRP3 inflammasome activation is a newly identified amplifying step in the pathogenesis of myocarditis. We previously have demonstrated that mesenchymal stromal cells (MSC) are cardioprotective in Coxsackievirus B3 (CVB3)-induced myocarditis. In this study, MSC markedly inhibited left ventricular (LV) NOD2, NLRP3, ASC, caspase-1, IL-1β, and IL-18 mRNA expression in CVB3-infected mice. ASC protein expression, essential for NLRP3 inflammasome assembly, increased upon CVB3 infection and was abrogated in MSC-treated mice. Concomitantly, CVB3 infection in vitro induced NOD2 expression, NLRP3 inflammasome activation and IL-1β secretion in HL-1 cells, which was abolished after MSC supplementation. The inhibitory effect of MSC on NLRP3 inflammasome activity in HL-1 cells was partly mediated via secretion of the anti-oxidative protein stanniocalcin-1. Furthermore, MSC application in CVB3-infected mice reduced the percentage of NOD2-, ASC-, p10- and/or IL-1β-positive splenic macrophages, natural killer cells, and dendritic cells. The suppressive effect of MSC on inflammasome activation was associated with normalized expression of prominent regulators of myocardial contractility and fibrosis to levels comparable to control mice. In conclusion, MSC treatment in myocarditis could be a promising strategy limiting the adverse consequences of cardiac and systemic NLRP3 inflammasome activation.
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Affiliation(s)
- Kapka Miteva
- Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Berlin, Germany.,DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Kathleen Pappritz
- Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Berlin, Germany.,DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Marzena Sosnowski
- Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Berlin, Germany
| | - Muhammad El-Shafeey
- Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Berlin, Germany.,Medical Biotechnology Research Department, Genetic Engineering and Biotechnology Research Institute (GEBRI), City of Scientific Research and Technological Applications, Alexandria, Egypt
| | - Irene Müller
- Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Berlin, Germany.,DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Fengquan Dong
- Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Berlin, Germany
| | - Konstantinos Savvatis
- Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Berlin, Germany
| | - Jochen Ringe
- Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Berlin, Germany.,Laboratory for Tissue Engineering, Charité, University Medicine Berlin, Berlin, Germany
| | - Carsten Tschöpe
- Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Berlin, Germany.,DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany.,Charité-University-Medicine Berlin, Campus Rudolf Virchow, Department of Cardiology, Berlin, Germany
| | - Sophie Van Linthout
- Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Berlin, Germany. .,DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany. .,Charité-University-Medicine Berlin, Campus Rudolf Virchow, Department of Cardiology, Berlin, Germany.
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143
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Szekely Y, Arbel Y. A Review of Interleukin-1 in Heart Disease: Where Do We Stand Today? Cardiol Ther 2018; 7:25-44. [PMID: 29417406 PMCID: PMC5986669 DOI: 10.1007/s40119-018-0104-3] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Indexed: 12/16/2022] Open
Abstract
Cardiovascular diseases are the leading cause of death worldwide. Research in the last two decades has emphasized the inflammatory process as a key component in the pathogenesis of many of them. The Interleukin-1 family is a pivotal element of inflammation and has been well studied as a therapeutic target in various inflammatory states. Recent trials have explored the effect of Interleukin-1 blockade in cardiovascular diseases and initial evidence of the relevance of such treatment in this field of medicine accumulate. This review will describe the role of Interleukin-1 in heart diseases and the potential therapeutic effect of its blockade in such diseases.
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Affiliation(s)
- Yishay Szekely
- Department of Cardiology, Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Yaron Arbel
- Department of Cardiology, Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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144
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Frangogiannis NG. Cell biological mechanisms in regulation of the post-infarction inflammatory response. CURRENT OPINION IN PHYSIOLOGY 2018; 1:7-13. [PMID: 29552674 PMCID: PMC5851468 DOI: 10.1016/j.cophys.2017.09.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Inflammation plays a crucial role in cardiac repair, but may also extend ischemic injury and contribute to post-infarction remodeling. This review manuscript discusses recent advances in our understanding of the cell biology of the post-infarction inflammatory response. Recently published studies demonstrated that the functional repertoire of inflammatory and reparative cells may extend beyond the roles suggested by traditional teachings. Neutrophils may play an important role in cardiac repair by driving macrophages toward a reparative phenotype. Subsets of activated fibroblasts have been implicated in protection of ischemic cardiomyocytes, in phagocytosis of apoptotic cells, and in regulation of inflammation. Dissection of the cellular effectors of cardiac repair is critical in order to develop new therapeutic strategies for patients with acute myocardial infarction.
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Affiliation(s)
- Nikolaos G Frangogiannis
- The Wilf Family Cardiovascular Research Institute, Department of Medicine (Cardiology), Albert Einstein College of Medicine, Bronx, NY, United States
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145
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Buckley LF, Viscusi MM, Van Tassell BW, Abbate A. Interleukin-1 blockade for the treatment of pericarditis. EUROPEAN HEART JOURNAL. CARDIOVASCULAR PHARMACOTHERAPY 2018; 4:46-53. [PMID: 28633474 PMCID: PMC5843129 DOI: 10.1093/ehjcvp/pvx018] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 05/18/2017] [Accepted: 06/09/2017] [Indexed: 01/08/2023]
Abstract
Pericarditis is a debilitating condition that results from profound inflammation of the pericardial tissue. Between 10 and 15% of first episodes of acute pericarditis will be followed by several episodes refractory to conventional treatment. Current standard of care for pericarditis treatment includes high-dose non-steroidal anti-inflammatory drugs, colchicine, and systemic corticosteroids, each associated with potentially severe toxicities and nominal efficacy. Interleukin-1 (IL-1), an apical pro-inflammatory cytokine, plays an important role as an autocrine magnifier of systemic inflammation in pericarditis. Interruption of the IL-1 circuit has been shown to have a favourable risk profile in several disease states. In this review, we discuss the growing body of evidence which supports the use of IL-1 blockade in the treatment of recurrent pericarditis as well as provide practical considerations for the use of IL-1 blockade in clinical practice.
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Affiliation(s)
- Leo F Buckley
- Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University, Richmond, VA, USA USA
| | - Michele M Viscusi
- VCU Pauley Heart Center, Virginia Commonwealth University, 1200 E Broad Street, 5th Floor Rm 520, Richmond, VA 23298, USA
| | - Benjamin W Van Tassell
- Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University, Richmond, VA, USA USA
| | - Antonio Abbate
- VCU Pauley Heart Center, Virginia Commonwealth University, 1200 E Broad Street, 5th Floor Rm 520, Richmond, VA 23298, USA
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146
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Abstract
Cardiovascular disease (CVD) is the number one cause of death worldwide. The pathogenesis of various disease entities that comprise the area of CVD is complex and multifactorial. Inflammation serves a central role in these complex aetiologies. The inflammasomes are intracellular protein complexes activated by danger-associated molecular patterns (DAMPs) present in CVD such as atherosclerosis and myocardial infarction (MI). After a two-step process of priming and activation, inflammasomes are responsible for the formation of pro-inflammatory cytokines interleukin-1β and interleukin-18, inducing a signal transduction cascade resulting in a strong immune response that culminates in disease progression. In the past few years, increased interest has been raised regarding the inflammasomes in CVD. Inflammasome activation is thought to be involved in the pathogenesis of various disease entities such as atherosclerosis, MI and heart failure (HF). Interference with inflammasome-mediated signalling could reduce inflammation and attenuate the severity of disease. In this chapter we provide an overview of the current literature available on the role of inflammasome inhibition as a therapeutic intervention and the possible clinical implications for CVD.
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Affiliation(s)
- Gerardus P J van Hout
- Department of Cardiology, Utrecht University Medical Center, Utrecht, The Netherlands.
| | - Lena Bosch
- Department of Experimental Cardiology, Utrecht University Medical Center, Utrecht, The Netherlands
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147
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Significant Cytokine mRNA Expression Changes Immediately after Initiation of Cardiopulmonary Resuscitation. Mediators Inflamm 2017; 2017:8473171. [PMID: 29445259 PMCID: PMC5763133 DOI: 10.1155/2017/8473171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 11/23/2017] [Indexed: 12/17/2022] Open
Abstract
Introduction The purpose of this study was to evaluate immediate immunological changes following cardiopulmonary resuscitation (CPR). mRNA expression levels of selected immunomodulatory cytokines in out-of-hospital cardiac arrest (OHCA) survivors were detected and correlated to clinical parameter. Methods OHCA survivors with sustained unconsciousness after return of spontaneous circulation (ROSC) were included. PAXgene whole blood samples were drawn immediately after initiation of CPR and subsequently after 6 h, 12 h, 24 h, 48 h, and 72 h. TNF-alpha, IL-8, IL-10, and IL-1ra mRNA levels were quantified by RT-qPCR and compared to multiple organ failure, 30-day survival, and the induction of therapeutic hypothermia (TH). Results 25 patients (63 ± 15 years) were enrolled presenting a characteristic time-dependent cytokine profile in the early postresuscitation period. High initial TNF-alpha and IL-8 mRNA levels were followed by a significant decrease. IL-1ra mRNA levels significantly increased beginning after 6 h. Nonsurvivors showed significantly higher IL-8 mRNA levels immediately after CPR. TH induced significantly higher IL-1ra mRNA levels compared to normothermia. Conclusion Significant mRNA cytokine expression changes are already detectable immediately after initiation of CPR. These expressional changes are significantly different depending on 30-day survival. TH seems to attenuate proinflammatory immune reaction by a significant increase of IL-1ra mRNA levels. This trial is registered with DRKS00012940.
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148
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Uhle F, Castrup C, Necaev AM, Grieshaber P, Lichtenstern C, Weigand MA, Böning A. Inflammation and Its Consequences After Surgical Versus Transcatheter Aortic Valve Replacement. Artif Organs 2017; 42:E1-E12. [PMID: 29226341 DOI: 10.1111/aor.13051] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/12/2017] [Accepted: 09/14/2017] [Indexed: 12/20/2022]
Abstract
Symptomatic aortic stenosis can be treated by surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR), the latter of which is regarded as a minimally invasive procedure. Differences between these procedures regarding immune responses or changes in coagulation and neurocognitive function have thus far been evaluated only sparsely. We carried out a prospective, single-center, nonrandomized explorative study with 38 patients. Thirteen patients were subjected to either SAVR or transfemoral (TF-) TAVR, and 12 patients underwent transapical (TA-) TAVR. Plasma cytokines (IL-6, -8, -18, presepsin) and acute-phase proteins (C-reactive protein, procalcitonin), markers of coagulation and platelet function, and neurocognitive function (via various standard tests) were assessed before and at five-time points during a 72-h follow-up after surgery. SAVR and TA-TAVR patients responded similarly to the procedure in terms of C-reactive protein, leukocyte numbers, and IL-6, whereas these responses were substantially lower in TF-TAVR patients. Only SAVR patients showed measurable IL-10 levels. SAVR patients without prior anticoagulation experienced a robust and transient restoration of platelet function after surgery, with no hypercoagulation observable in functional coagulation assays. None of the procedures led to an immediate improvement of hand and leg coordination, but patients after TA-TAVR had decreased neurocognitive function. Patients after SAVR or TA-TAVR exhibit a robust pro-inflammatory response, which is-on the cytokine level-counterbalanced only in SAVR patients. Our results point toward a greater impact of TA-TAVR on neurocognitive function and indicate a potentially detrimental activation of platelets in some patients after SAVR.
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Affiliation(s)
- Florian Uhle
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Castrup
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Giessen and Marburg, Giessen, Germany
| | - Anna-Maria Necaev
- Department of Cardiovascular Surgery, University Hospital Giessen and Marburg, Giessen, Germany
| | - Philippe Grieshaber
- Department of Cardiovascular Surgery, University Hospital Giessen and Marburg, Giessen, Germany
| | | | | | - Andreas Böning
- Department of Cardiovascular Surgery, University Hospital Giessen and Marburg, Giessen, Germany
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149
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Liu D, Zeng X, Li X, Mehta JL, Wang X. Role of NLRP3 inflammasome in the pathogenesis of cardiovascular diseases. Basic Res Cardiol 2017; 113:5. [PMID: 29224086 DOI: 10.1007/s00395-017-0663-9] [Citation(s) in RCA: 172] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 12/04/2017] [Indexed: 12/21/2022]
Abstract
NLRP3 inflammasome is a key multiprotein signaling platform that tightly controls inflammatory responses and coordinates antimicrobial host defenses by activating caspase-1 for the subsequent maturation of pro-inflammatory cytokines, IL-1β and IL-18, and induces pyroptosis. The assembly and activation of NLRP3 inflammasome are linked to the pathogenesis of several cardiovascular disease risk factors, such as hypertension and diabetes, and their major consequences-myocardial remodeling. The study of the NLRP3 inflammasome in these cardiovascular disease states may uncover important triggers and endogenous modulators of the disease, and lead to new treatment strategies. This review outlines current insights into NLRP3 inflammasome research associated with cardiovascular diseases and discusses the questions that remain in this field.
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Affiliation(s)
- Dongling Liu
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang, 453003, China
| | - Xiang Zeng
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China
| | - Xiao Li
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang, 453003, China
| | - Jawahar L Mehta
- Central Arkansas Veterans Healthcare System and the Division of Cardiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Xianwei Wang
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang, 453003, China.
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150
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Van Tassell BW, Canada J, Carbone S, Trankle C, Buckley L, Oddi Erdle C, Abouzaki NA, Dixon D, Kadariya D, Christopher S, Schatz A, Regan J, Viscusi M, Del Buono M, Melchior R, Mankad P, Lu J, Sculthorpe R, Biondi-Zoccai G, Lesnefsky E, Arena R, Abbate A. Interleukin-1 Blockade in Recently Decompensated Systolic Heart Failure: Results From REDHART (Recently Decompensated Heart Failure Anakinra Response Trial). Circ Heart Fail 2017; 10:CIRCHEARTFAILURE.117.004373. [PMID: 29141858 DOI: 10.1161/circheartfailure.117.004373] [Citation(s) in RCA: 165] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/18/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND An enhanced inflammatory response predicts worse outcomes in heart failure (HF). We hypothesized that administration of IL-1 (interleukin-1) receptor antagonist (anakinra) could inhibit the inflammatory response and improve peak aerobic exercise capacity in patients with recently decompensated systolic HF. METHODS AND RESULTS We randomly assigned 60 patients with reduced left ventricular ejection fraction (<50%) and elevated C-reactive protein levels (>2 mg/L), within 14 days of hospital discharge, to daily subcutaneous injections with anakinra 100 mg for 2 weeks, 12 weeks, or placebo. Patients underwent measurement of peak oxygen consumption (Vo2 [mL/kg per minute]) and ventilatory efficiency (the VE/Vco2 slope). Treatment with anakinra did not affect peak Vo2 or VE/Vco2 slope at 2 weeks. At 12 weeks, patients continued on anakinra showed an improvement in peak Vo2 from 14.5 (10.5-16.6) mL/kg per minute to 16.1 (13.2-18.6) mL/kg per minute (P=0.009 for within-group changes), whereas no significant changes occurred within the anakinra 2-week or placebo groups. The between-groups differences, however, were not statistically significant. The incidence of death or rehospitalization for HF at 24 weeks was 6%, 31%, and 30%, in the anakinra 12-week, anakinra 2-week, and placebo groups, respectively (log-rank test P=0.10). CONCLUSIONS No change in peak Vo2 occurred at 2 weeks in patients with recently decompensated systolic HF treated with anakinra, whereas an improvement was seen in those patients in whom anakinra was continued for 12 weeks. Additional larger studies are needed to validate the effects of prolonged anakinra on peak Vo2 and rehospitalization for HF. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01936909.
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Affiliation(s)
- Benjamin W Van Tassell
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Justin Canada
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Salvatore Carbone
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Cory Trankle
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Leo Buckley
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Claudia Oddi Erdle
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Nayef A Abouzaki
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Dave Dixon
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Dinesh Kadariya
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Sanah Christopher
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Aaron Schatz
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Jessica Regan
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Michele Viscusi
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Marco Del Buono
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Ryan Melchior
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Pranav Mankad
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Juan Lu
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Robin Sculthorpe
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Giuseppe Biondi-Zoccai
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Edward Lesnefsky
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Ross Arena
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.)
| | - Antonio Abbate
- From the Department of Pharmacotherapy and Outcomes Science (B.W.V.T., L.F.B., D.L.D.), VCU Pauley Heart Center (B.W.V.T, J.M.C., S.C., C.T., C.O.E., N.A.A., D.L.D., D.K., S.C., A.S., J.R., M.V., M.D.B., R.M., P.M., E.L., A.A.), Department of Family Medicine and Population Health (J.L.), and Investigational Pharmacy (R.S.), Virginia Commonwealth University, Richmond; Department of Experimental Medicine, Sapienza University of Rome, Italy (S.C.); Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (G.B.-Z.); Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy (G.B.-Z.); Division of Cardiology, Hunter Holmes McGuire Veterans Administration Hospital, Richmond, VA (E.L.); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (R.A.).
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