151
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Caldentey G, García De Frutos P, Cristóbal H, Garabito M, Berruezo A, Bosch X, San Antonio R, Flores-Umanzor E, Perea RJ, De Caralt TM, Rodríguez J, Ortiz-Pérez JT. Serum levels of Growth Arrest-Specific 6 protein and soluble AXL in patients with ST-segment elevation myocardial infarction. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2017; 8:708-716. [PMID: 29119801 DOI: 10.1177/2048872617740833] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Serum soluble AXL (sAXL) and its ligand, Growth Arrest-Specific 6 protein (GAS6), intervene in tissue repair processes. AXL is increased in end-stage heart failure, but the role of GAS6 and sAXL in ST-segment elevation myocardial infarction (STEMI) is unknown. OBJECTIVES To study the association of sAXL and GAS6 acutely and six months following STEMI with heart failure and left ventricular remodelling. METHODS GAS6 and sAXL were measured by enzyme-linked immunosorbent assay at one day, seven days and six months in 227 STEMI patients and 20 controls. Contrast-enhanced magnetic resonance was performed during admission and at six months to measure infarct size and left ventricular function. RESULTS GAS6, but not sAXL, levels during admission were significantly lower in STEMI than in controls. AXL increased progressively over time (p<0.01), while GAS6 increased only from day 7. GAS6 or sAXL did not correlate with brain natriuretic peptide or infarct size. However, patients with heart failure (Killip >1) had higher values of sAXL at day 1 (48.9±11.9 vs. 44.0±10.7 ng/ml; p<0.05) and at six months (63.3±15.4 vs. 55.9±13.7 ng/ml; p<0.05). GAS6 levels were not different among subjects with heart failure or left ventricular remodelling. By multivariate analysis including infarct size, Killip class and sAXL at seven days, only the last two were independent predictors of left ventricular remodelling (odds ratio 2.24 (95% confidence interval: 1.08-4.63) and odds ratio 1.04 (95% confidence interval: 1.00-1.08) respectively). CONCLUSION sAXL levels increased following STEMI. Patients with heart failure and left ventricular remodelling have higher sAXL levels acutely and at six month follow-up. These findings suggest a potential role of the GAS6-AXL system in the pathophysiology of left ventricular remodelling following STEMI.
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Affiliation(s)
| | | | - Helena Cristóbal
- Department of Cell Death and Proliferation, IIBB-CSIC and IDIBAPS, Barcelona, Spain
| | - Manel Garabito
- Department of Cell Death and Proliferation, IIBB-CSIC and IDIBAPS, Barcelona, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, University of Barcelona, Spain
| | - Antonio Berruezo
- Institut Clínic Cardiovascular, Hospital Clínic Barcelona, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, University of Barcelona, Spain
| | - Xavier Bosch
- Institut Clínic Cardiovascular, Hospital Clínic Barcelona, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, University of Barcelona, Spain
| | | | | | - Rosario J Perea
- Institut d'investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, University of Barcelona, Spain.,Centre de Diagnòstic per la Imatge, Hospital Clínic Barcelona, Spain
| | - Teresa M De Caralt
- Institut d'investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, University of Barcelona, Spain.,Centre de Diagnòstic per la Imatge, Hospital Clínic Barcelona, Spain
| | - Jany Rodríguez
- Institut Clínic Cardiovascular, Hospital Clínic Barcelona, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, University of Barcelona, Spain
| | - José T Ortiz-Pérez
- Institut Clínic Cardiovascular, Hospital Clínic Barcelona, Spain.,Institut d'investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, University of Barcelona, Spain
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152
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Galuppo P, Vettorazzi S, Hövelmann J, Scholz CJ, Tuckermann JP, Bauersachs J, Fraccarollo D. The glucocorticoid receptor in monocyte-derived macrophages is critical for cardiac infarct repair and remodeling. FASEB J 2017; 31:5122-5132. [PMID: 28768721 PMCID: PMC5636710 DOI: 10.1096/fj.201700317r] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 07/25/2017] [Indexed: 01/10/2023]
Abstract
Cell- and tissue-specific actions of glucocorticoids are mediated by the glucocorticoid receptor. Here, we demonstrate that the glucocorticoid receptor (GR) in macrophages is essential for cardiac healing after myocardial infarction. Compared with GRflox (wild-type controls), GRLysMCre mice that lacked GR in myeloid cells showed increased acute mortality as a result of cardiac rupture. Seven days after left coronary artery ligation, GRLysMCre mice exhibited worse cardiac function and adverse remodeling associated with impaired scar formation and angiogenic response to ischemic injury. Inactivation of GR altered the functional differentiation/maturation of monocyte-derived macrophages in the infarcted myocardium. Mechanistically, CD45+/CD11b+/Ly6G-/F4/80+ macrophages isolated from GRLysMCre infarcts showed deregulation of factors that control inflammation, neovascularization, collagen degradation, and scar tissue formation. Moreover, we demonstrate that cardiac fibroblasts sorted from the ischemic myocardium of GRLysMCre mice compared with cells isolated from injured GRflox hearts displayed higher matrix metalloproteinase 2 expression, and we provide evidence that the macrophage GR regulates myofibroblast differentiation in the infarct microenvironment during the early phase of wound healing. In summary, GR signaling in macrophages, playing a crucial role in tissue-repairing mechanisms, could be a potential therapeutic target during wound healing after ischemic myocardial injury.-Galuppo, P., Vettorazzi, S., Hövelmann, J., Scholz, C.-J., Tuckermann, J. P., Bauersachs, J., Fraccarollo, D. The glucocorticoid receptor in monocyte-derived macrophages is critical for cardiac infarct repair and remodeling.
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Affiliation(s)
- Paolo Galuppo
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Sabine Vettorazzi
- Institute of Comparative Molecular Endocrinology, University of Ulm, Ulm, Germany
| | - Julian Hövelmann
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Claus-Jürgen Scholz
- Life and Medical Sciences Institute (LIMES), University of Bonn, Bonn, Germany
| | - Jan Peter Tuckermann
- Institute of Comparative Molecular Endocrinology, University of Ulm, Ulm, Germany
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Daniela Fraccarollo
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany;
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153
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Recombinant Human Alpha-1 Antitrypsin-Fc Fusion Protein Reduces Mouse Myocardial Inflammatory Injury After Ischemia-Reperfusion Independent of Elastase Inhibition. J Cardiovasc Pharmacol 2017; 68:27-32. [PMID: 26945157 DOI: 10.1097/fjc.0000000000000383] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Alpha-1-antitrypsin (AAT) is an abundant plasma protein with neutrophil elastase-inhibiting activity, and AAT is available as a plasma-derived therapeutic (pAAT). In experimental myocardial infarction, pAAT reduced acute inflammatory injury because of ischemia-reperfusion. The aim of the present study was to assess the properties of a recombinant protein composed of human AAT fused to the human immunoglobulin (Ig) G1 Fc fragment (rhAAT-Fc) in experimental myocardial infarction. METHODS Ten-week-old CD1 male mice underwent transient occlusion (30 minutes) of the left anterior coronary artery. rhAAT-Fc (2 mg/kg) or pAAT (60 mg/kg) were administered upon reperfusion. We used human plasma-derived Ig (2 mg/kg) or a matching volume of NaCl 0.9% as control solutions. After 24 hours, infarct size and caspase-1 activity were quantified. The left ventricular ejection fraction (LVEF) was measured by echocardiography at 24 hours and 7 days. A variant of rhAAT-Fc lacking elastase inhibition activity, rhAAT-Fc, was also tested. RESULTS The rhAAT-Fc induced a significant reduction in infarct size (P < 0.01 vs. all controls, P > 0.05 vs. pAAT). Caspase-1 activity was reduced to the same degree with rhAAT-Fc and pAAT (-70%; P < 0.05; P > 0.05 rhAAT-Fc vs. pAAT). The effects on infarct size after a single administration were reflected by preservation of LVEF at 24 hours and 7 days (all P < 0.05). rhAAT-Fc without elastase inhibiting activity, rhAAT-Fc, conferred comparable effects on infarct size, caspase-1 activity, and LVEF (P > 0.2 vs. rhAAT-Fc). CONCLUSIONS The pAAT and recombinant human AAT-Fc reduce the acute myocardial inflammatory injury after ischemia-reperfusion in the mouse leading to preservation of viable myocardium and systolic function, independent on the effects on neutrophil elastase.
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154
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Toldo S, Austin D, Mauro AG, Mezzaroma E, Van Tassell BW, Marchetti C, Carbone S, Mogelsvang S, Gelber C, Abbate A. Low-Density Lipoprotein Receptor-Related Protein-1 Is a Therapeutic Target in Acute Myocardial Infarction. JACC Basic Transl Sci 2017; 2:561-574. [PMID: 30062170 PMCID: PMC6058925 DOI: 10.1016/j.jacbts.2017.05.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 05/11/2017] [Accepted: 05/15/2017] [Indexed: 01/29/2023]
Abstract
Low-density lipoprotein receptor-related protein-1 (LRP1) is a ubiquitous membrane receptor functioning as a scavenger and regulatory receptor, inducing anti-inflammatory and prosurvival signals. Based on the known structure-activity of the LRP1 receptor binding site, the authors synthesized a small peptide (SP16). SP16 induced a >50% reduction in infarct size (p < 0.001) and preservation of left ventricular systolic function (p < 0.001), and treatment with an LRP1 blocking antibody eliminated the protective effects of SP16. In conclusion, LRP1 activation with SP16 given within 30 min of reperfusion during experimental acute myocardial infarction leads to a cardioprotective signal reducing infarct size and preservation of cardiac systolic function.
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Key Words
- A2MG, alpha-2 macroglobulin
- AAT, alpha-1 antitrypsin
- AMI, acute myocardial infarction
- ATIII, antithrombin III
- HRP, horseradish peroxidase
- IL, interleukin
- IV, intravenous
- LPS, lipopolysaccharide
- LRP1, low-density lipoprotein receptor–related protein-1
- LV, left ventricular
- LVFS, left ventricular fractional shortening
- PBS, phosphate-buffered saline
- SEC, serine protease inhibitor–enzyme complex
- SERPIN, serine protease inhibitor
- SERPINs
- TBS, tris-buffered saline
- TUNEL, terminal deoxynucleotidyl transferase dUTP nick end labeling
- ischemia reperfusion
- low-density lipoprotein receptor-related protein-1
- serine protease inhibitor
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Affiliation(s)
- Stefano Toldo
- Division of Cardiology, VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
- Johnson Research Center for Critical Care, Virginia Commonwealth University, Richmond, Virginia
| | | | - Adolfo G. Mauro
- Division of Cardiology, VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
- Johnson Research Center for Critical Care, Virginia Commonwealth University, Richmond, Virginia
| | - Eleonora Mezzaroma
- Johnson Research Center for Critical Care, Virginia Commonwealth University, Richmond, Virginia
- Department of Pharmacotherapy and Outcome Sciences, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia
| | - Benjamin W. Van Tassell
- Johnson Research Center for Critical Care, Virginia Commonwealth University, Richmond, Virginia
- Department of Pharmacotherapy and Outcome Sciences, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia
| | - Carlo Marchetti
- Division of Cardiology, VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
- Johnson Research Center for Critical Care, Virginia Commonwealth University, Richmond, Virginia
| | - Salvatore Carbone
- Division of Cardiology, VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
- Johnson Research Center for Critical Care, Virginia Commonwealth University, Richmond, Virginia
| | | | | | - Antonio Abbate
- Division of Cardiology, VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
- Johnson Research Center for Critical Care, Virginia Commonwealth University, Richmond, Virginia
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155
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Lin HJ, Wang TD. Profiling the Evolution of Inflammatory Response and Exploring Its Prognostic Significance in Acute Myocardial Infarction: The First Step to Establishing Anti-Inflammatory Strategy. ACTA CARDIOLOGICA SINICA 2017; 33:486-488. [PMID: 28959100 DOI: 10.6515/acs20170731a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Hung-Ju Lin
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Tzung-Dau Wang
- Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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156
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Yang YH, Fang HL, Zhao M, Wei XL, Zhang N, Wang S, Lu Y, Yu XJ, Sun L, He X, Li DL, Liu JJ, Zang WJ. Specific α7 nicotinic acetylcholine receptor agonist ameliorates isoproterenol-induced cardiac remodelling in mice through TGF-β1/Smad3 pathway. Clin Exp Pharmacol Physiol 2017; 44:1192-1200. [PMID: 28732106 DOI: 10.1111/1440-1681.12819] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 06/15/2017] [Accepted: 07/11/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Yong-Hua Yang
- Department of Paediatrics; the First Affiliated Hospital of Xi'an Jiaotong University; Xi'an China
- Department of Pharmacology; Xi'an Jiaotong University; Health Science Centre; Xi'an China
| | - Huan-Le Fang
- Department of Medicine; Medical College of Xi'an Pei Hua University; Xi'an China
| | - Ming Zhao
- Department of Pharmacology; Xi'an Jiaotong University; Health Science Centre; Xi'an China
| | - Xiang-Lan Wei
- Department of Pharmacy; Xi'an Chest and Tuberculosis Hospital; Xi'an China
| | - Ning Zhang
- Department of Clinical Laboratory; the First Affiliated Hospital of Xi'an Jiaotong University; Xi'an China
| | - Shun Wang
- Department of Cardiology; the First Affiliated Hospital of Xi'an Jiaotong University; Xi'an China
| | - Yi Lu
- Department of Pharmacology; Xi'an Jiaotong University; Health Science Centre; Xi'an China
| | - Xiao-Jiang Yu
- Department of Pharmacology; Xi'an Jiaotong University; Health Science Centre; Xi'an China
| | - Lei Sun
- Department of Pharmacology; Xi'an Jiaotong University; Health Science Centre; Xi'an China
| | - Xi He
- Department of Pharmacology; Xi'an Jiaotong University; Health Science Centre; Xi'an China
| | - Dong-Ling Li
- Department of Pharmacology; Xi'an Jiaotong University; Health Science Centre; Xi'an China
| | - Jin-Jun Liu
- Department of Pharmacology; Xi'an Jiaotong University; Health Science Centre; Xi'an China
| | - Wei-Jin Zang
- Department of Pharmacology; Xi'an Jiaotong University; Health Science Centre; Xi'an China
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157
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Toldo S, Van Tassell BW, Abbate A. Interleukin-1 Blockade in Acute Myocardial Infarction and Heart Failure: Getting Closer and Closer. JACC Basic Transl Sci 2017; 2:431-433. [PMID: 30062161 PMCID: PMC6034455 DOI: 10.1016/j.jacbts.2017.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Stefano Toldo
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
- Johnson Research Center for Critical Care, Virginia Commonwealth University, Richmond, Virginia
- Division of Cardiothoracic Surgery, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Benjamin W. Van Tassell
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
- Department of Pharmacotherapy, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia
| | - Antonio Abbate
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
- Johnson Research Center for Critical Care, Virginia Commonwealth University, Richmond, Virginia
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158
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Kawashima C, Matsuzawa Y, Akiyama E, Konishi M, Suzuki H, Hashiba K, Ebina T, Kosuge M, Hibi K, Tsukahara K, Iwahashi N, Maejima N, Sakamaki K, Umemura S, Kimura K, Tamura K. Prolonged Fever After ST-Segment Elevation Myocardial Infarction and Long-Term Cardiac Outcomes. J Am Heart Assoc 2017; 6:JAHA.116.005463. [PMID: 28735289 PMCID: PMC5586283 DOI: 10.1161/jaha.116.005463] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background The biphasic inflammation after ST‐segment elevation myocardial infarction (STEMI) plays an important role in myocardial healing and progression of systemic atherosclerosis. The purpose of this study is to investigate the impact of fever during the first and second phases of post‐STEMI inflammation on long‐term cardiac outcomes. Methods and Results A total of 550 patients with STEMI were enrolled in this study. Axillary body temperature (BT) was measured and maximum BTs were determined for the first (within 3 days: max‐BT1–3d) and second (from 4 to 10 days after admission: max‐BT4–10d) phases, respectively. Patients were followed for cardiac events (cardiovascular death, acute coronary syndrome, and rehospitalization for heart failure) for a median 5.3 years. During the follow‐up period, 80 patients experienced cardiac events. A high max‐BT4–10d was strongly associated with long‐term cardiac events (hazard ratio, 95% CI) for a 1°C increase in the max‐BT4–10d: 2.834 (2.017–3.828), P<0.0001, whereas the max‐BT1–3d was not associated with cardiac events (1.136 [0.731–1.742], P=0.57). Even after adjustment for coronary risk factors, estimated glomerular filtration rate, infarct size, pericardial effusion, and medications on discharge, fever during the second phase (max‐BT4–10d ≥37.1°C) was significantly associated with future cardiac events (hazard ratio [95% CI] 2.900 [1.710–5.143], P<0.0001). Conclusions Fever during the second phase but not the first phase of post‐STEMI inflammation was a strong associated factor with worse long‐term cardiac outcomes in patients after STEMI, suggesting the need to consider the optimal timing for anti‐inflammatory strategies after STEMI.
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Affiliation(s)
- Chika Kawashima
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yasushi Matsuzawa
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Eiichi Akiyama
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Masaaki Konishi
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Hiroyuki Suzuki
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Katsutaka Hashiba
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Toshiaki Ebina
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Masami Kosuge
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kiyoshi Hibi
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kengo Tsukahara
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Noriaki Iwahashi
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Nobuhiko Maejima
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kentaro Sakamaki
- Department of Biostatistics and Epidemiology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Satoshi Umemura
- Division of Cardiology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Kazuo Kimura
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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159
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Reinstadler SJ, Stiermaier T, Liebetrau J, Fuernau G, Eitel C, de Waha S, Desch S, Reil JC, Pöss J, Metzler B, Lücke C, Gutberlet M, Schuler G, Thiele H, Eitel I. Prognostic Significance of Remote Myocardium Alterations Assessed by Quantitative Noncontrast T1 Mapping in ST-Segment Elevation Myocardial Infarction. JACC Cardiovasc Imaging 2017. [PMID: 28624398 DOI: 10.1016/j.jcmg.2017.03.015] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study assessed the prognostic significance of remote zone native T1 alterations for the prediction of clinical events in a population with ST-segment elevation myocardial infarction (STEMI) who were treated by primary percutaneous coronary intervention (PPCI) and compared it with conventional markers of infarct severity. BACKGROUND The exact role and incremental prognostic relevance of remote myocardium native T1 mapping alterations assessed by cardiac magnetic resonance (CMR) after STEMI remains unclear. METHODS We included 255 consecutive patients with STEMI who were reperfused within 12 h after symptom onset. CMR core laboratory analysis was performed to assess left ventricular (LV) function, standard infarct characteristics, and native T1 values of the remote, noninfarcted myocardium. The primary endpoint was a composite of death, reinfarction, and new congestive heart failure within 6 months (major adverse cardiac events [MACE]). RESULTS Patients with increased remote zone native T1 values (>1,129 ms) had significantly larger infarcts (p = 0.012), less myocardial salvage (p = 0.002), and more pronounced LV dysfunction (p = 0.011). In multivariable analysis, remote zone native T1 was independently associated with MACE after adjusting for clinical risk factors (p = 0.001) or other CMR variables (p = 0.007). In C-statistics, native T1 of remote myocardium provided incremental prognostic information beyond clinical risk factors, LV ejection fraction, and other markers of infarct severity (all p < 0.05). The addition of remote zone native T1 to a model of prognostic CMR parameters (ejection fraction, infarct size, and myocardial salvage index) led to net reclassification improvement of 0.82 (95% confidence interval: 0.46 to 1.17; p < 0.001) and to an integrated discrimination improvement of 0.07 (95% confidence interval: 0.02 to 0.13; p = 0.01). CONCLUSIONS In STEMI patients treated by PPCI, evaluation of remote zone alterations by quantitative noncontrast T1 mapping provided independent and incremental prognostic information in addition to clinical risk factors and traditional CMR outcome markers. Remote zone alterations may thus represent a novel therapeutic target and a useful parameter for optimized risk stratification. (Effect of Conditioning on Myocardial Damage in STEMI [LIPSIA-COND]; NCT02158468).
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Affiliation(s)
- Sebastian J Reinstadler
- University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine, University of Lübeck, Lübeck, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany; University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Stiermaier
- University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine, University of Lübeck, Lübeck, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Johanna Liebetrau
- University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine, University of Lübeck, Lübeck, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Georg Fuernau
- University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine, University of Lübeck, Lübeck, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Charlotte Eitel
- University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine, University of Lübeck, Lübeck, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Suzanne de Waha
- University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine, University of Lübeck, Lübeck, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Steffen Desch
- University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine, University of Lübeck, Lübeck, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Jan-Christian Reil
- University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine, University of Lübeck, Lübeck, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Janine Pöss
- University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine, University of Lübeck, Lübeck, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Bernhard Metzler
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian Lücke
- Department of Diagnostic and Interventional Radiology, University of Leipzig-Heart Center, Leipzig, Germany
| | - Matthias Gutberlet
- Department of Diagnostic and Interventional Radiology, University of Leipzig-Heart Center, Leipzig, Germany
| | - Gerhard Schuler
- Department of Internal Medicine and Cardiology, University of Leipzig-Heart Center, Leipzig, Germany
| | - Holger Thiele
- University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine, University of Lübeck, Lübeck, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Ingo Eitel
- University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine, University of Lübeck, Lübeck, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany.
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160
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Meng X, Li J, Yu M, Yang J, Zheng M, Zhang J, Sun C, Liang H, Liu L. Transplantation of mesenchymal stem cells overexpressing IL10 attenuates cardiac impairments in rats with myocardial infarction. J Cell Physiol 2017; 233:587-595. [DOI: 10.1002/jcp.25919] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 03/17/2017] [Indexed: 01/14/2023]
Affiliation(s)
- Xin Meng
- Department of UltrasonographyXijing HospitalFourth Military Medical UniversityXi'anShaanxiChina
| | - Jianping Li
- Department of Radiation OncologyXijing HospitalFourth Military Medical UniversityXi'anShaanxiChina
| | - Ming Yu
- Department of UltrasonographyXijing HospitalFourth Military Medical UniversityXi'anShaanxiChina
| | - Jian Yang
- Department of Cardiovascular SurgeryXijing HospitalFourth Military Medical UniversityXi'anShaanxiChina
| | - Minjuan Zheng
- Department of UltrasonographyXijing HospitalFourth Military Medical UniversityXi'anShaanxiChina
| | - Jinzhou Zhang
- Department of Cardiovascular SurgeryXijing HospitalFourth Military Medical UniversityXi'anShaanxiChina
| | - Chao Sun
- Department of UltrasonographyXijing HospitalFourth Military Medical UniversityXi'anShaanxiChina
| | - Hongliang Liang
- Department of Cardiovascular SurgeryXijing HospitalFourth Military Medical UniversityXi'anShaanxiChina
| | - Liwen Liu
- Department of UltrasonographyXijing HospitalFourth Military Medical UniversityXi'anShaanxiChina
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161
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Bulluck H, Rosmini S, Abdel-Gadir A, White SK, Bhuva AN, Treibel TA, Fontana M, Ramlall M, Hamarneh A, Sirker A, Herrey AS, Manisty C, Yellon DM, Kellman P, Moon JC, Hausenloy DJ. Residual Myocardial Iron Following Intramyocardial Hemorrhage During the Convalescent Phase of Reperfused ST-Segment-Elevation Myocardial Infarction and Adverse Left Ventricular Remodeling. Circ Cardiovasc Imaging 2017; 9:CIRCIMAGING.116.004940. [PMID: 27894068 PMCID: PMC5068185 DOI: 10.1161/circimaging.116.004940] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 08/11/2016] [Indexed: 12/16/2022]
Abstract
Supplemental Digital Content is available in the text. Background— The presence of intramyocardial hemorrhage (IMH) in ST-segment–elevation myocardial infarction patients reperfused by primary percutaneous coronary intervention has been associated with residual myocardial iron at follow-up, and its impact on adverse left ventricular (LV) remodeling is incompletely understood and is investigated here. Methods and Results— Forty-eight ST-segment–elevation myocardial infarction patients underwent cardiovascular magnetic resonance at 4±2 days post primary percutaneous coronary intervention, of whom 40 had a follow-up scan at 5±2 months. Native T1, T2, and T2* maps were acquired. Eight out of 40 (20%) patients developed adverse LV remodeling. A subset of 28 patients had matching T2* maps, of which 15/28 patients (54%) had IMH. Eighteen of 28 (64%) patients had microvascular obstruction on the acute scan, of whom 15/18 (83%) patients had microvascular obstruction with IMH. On the follow-up scan, 13/15 patients (87%) had evidence of residual iron within the infarct zone. Patients with residual iron had higher T2 in the infarct zone surrounding the residual iron when compared with those without. In patients with adverse LV remodeling, T2 in the infarct zone surrounding the residual iron was also higher than in those without (60 [54–64] ms versus 53 [51–56] ms; P=0.025). Acute myocardial infarct size, extent of microvascular obstruction, and IMH correlated with the change in LV end-diastolic volume (Pearson’s rho of 0.64, 0.59, and 0.66, respectively; P=0.18 and 0.62, respectively, for correlation coefficient comparison) and performed equally well on receiver operating characteristic curve for predicting adverse LV remodeling (area under the curve: 0.99, 0.94, and 0.95, respectively; P=0.19 for receiver operating characteristic curve comparison). Conclusions— The majority of ST-segment–elevation myocardial infarction patients with IMH had residual myocardial iron at follow-up. This was associated with persistently elevated T2 values in the surrounding infarct tissue and adverse LV remodeling. IMH and residual myocardial iron may be potential therapeutic targets for preventing adverse LV remodeling in reperfused ST-segment–elevation myocardial infarction patients.
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Affiliation(s)
- Heerajnarain Bulluck
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Stefania Rosmini
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Amna Abdel-Gadir
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Steven K White
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Anish N Bhuva
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Thomas A Treibel
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Marianna Fontana
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Manish Ramlall
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Ashraf Hamarneh
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Alex Sirker
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Anna S Herrey
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Charlotte Manisty
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Derek M Yellon
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Peter Kellman
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - James C Moon
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.)
| | - Derek J Hausenloy
- From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., S.K.W., M.R., A.H., D.M.Y., D.J.H.); National Institute of Health Research, University College London Hospitals Biomedical Research Centre, United Kingdom (H.B., S.K.W., M.R., A.H., A.S., D.M.Y., J.C.M., D.J.H.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (H.B., S.R., A.A.-G., S.K.W., A.N.B., T.A.T., M.F., M.R., A.H., A.S., A.S.H., C.M., J.C.M., D.J.H.); National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (P.K.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (D.J.H.); and National Heart Research Institute Singapore, National Heart Centre Singapore (D.J.H.).
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Kali A, Cokic I, Tang R, Dohnalkova A, Kovarik L, Yang HJ, Kumar A, Prato FS, Wood JC, Underhill D, Marbán E, Dharmakumar R. Persistent Microvascular Obstruction After Myocardial Infarction Culminates in the Confluence of Ferric Iron Oxide Crystals, Proinflammatory Burden, and Adverse Remodeling. Circ Cardiovasc Imaging 2017; 9:CIRCIMAGING.115.004996. [PMID: 27903536 DOI: 10.1161/circimaging.115.004996] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 08/26/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Emerging evidence indicates that persistent microvascular obstruction (PMO) is more predictive of major adverse cardiovascular events than myocardial infarct (MI) size. But it remains unclear how PMO, a phenomenon limited to the acute/subacute period of MI, drives adverse remodeling in chronic MI setting. We hypothesized that PMO resolves into chronic iron crystals within MI territories, which in turn are proinflammatory and favor adverse remodeling post-MI. METHODS AND RESULTS Canines (n=40) were studied with cardiac magnetic resonance imaging to characterize the spatiotemporal relationships among PMO, iron deposition, infarct resorption, and left ventricular remodeling between day 7 (acute) and week 8 (chronic) post-MI. Histology was used to assess iron deposition and to examine relationships between iron content with macrophage infiltration, proinflammatory cytokine synthesis, and matrix metalloproteinase activation. Atomic resolution transmission electron microscopy was used to determine iron crystallinity, and energy-dispersive X-ray spectroscopy was used to identify the chemical composition of the iron composite. PMO with or without reperfusion hemorrhage led to chronic iron deposition, and the extent of this deposition was strongly related to PMO volume (r>0.8). Iron deposits were found within macrophages as aggregates of nanocrystals (≈2.5 nm diameter) in the ferric state. Extent of iron deposits was strongly correlated with proinflammatory burden, collagen-degrading enzyme activity, infarct resorption, and adverse structural remodeling (r>0.5). CONCLUSIONS Crystallized iron deposition from PMO is directly related to proinflammatory burden, infarct resorption, and adverse left ventricular remodeling in the chronic phase of MI in canines. Therapeutic strategies to combat adverse remodeling could potentially benefit from taking into account the chronic iron-driven inflammatory process.
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Affiliation(s)
- Avinash Kali
- From the Cedars-Sinai Medical Center, Los Angeles, CA (A.K., I.C., R.T., H.-J.Y., A.K., D.U., E.M., R.D.); University of California, Los Angeles (A.K., H.-J.Y., D.U., E.M., R.D.); Pacific Northwest National Laboratory, Environmental Molecular Sciences Laboratory, Richland, WA (A.D., L.K.); Lawson Health Research Institute, University of Western Ontario, London, Canada (F.S.P.); and Children's Hospital Los Angeles, CA (J.C.W.)
| | - Ivan Cokic
- From the Cedars-Sinai Medical Center, Los Angeles, CA (A.K., I.C., R.T., H.-J.Y., A.K., D.U., E.M., R.D.); University of California, Los Angeles (A.K., H.-J.Y., D.U., E.M., R.D.); Pacific Northwest National Laboratory, Environmental Molecular Sciences Laboratory, Richland, WA (A.D., L.K.); Lawson Health Research Institute, University of Western Ontario, London, Canada (F.S.P.); and Children's Hospital Los Angeles, CA (J.C.W.)
| | - Richard Tang
- From the Cedars-Sinai Medical Center, Los Angeles, CA (A.K., I.C., R.T., H.-J.Y., A.K., D.U., E.M., R.D.); University of California, Los Angeles (A.K., H.-J.Y., D.U., E.M., R.D.); Pacific Northwest National Laboratory, Environmental Molecular Sciences Laboratory, Richland, WA (A.D., L.K.); Lawson Health Research Institute, University of Western Ontario, London, Canada (F.S.P.); and Children's Hospital Los Angeles, CA (J.C.W.)
| | - Alice Dohnalkova
- From the Cedars-Sinai Medical Center, Los Angeles, CA (A.K., I.C., R.T., H.-J.Y., A.K., D.U., E.M., R.D.); University of California, Los Angeles (A.K., H.-J.Y., D.U., E.M., R.D.); Pacific Northwest National Laboratory, Environmental Molecular Sciences Laboratory, Richland, WA (A.D., L.K.); Lawson Health Research Institute, University of Western Ontario, London, Canada (F.S.P.); and Children's Hospital Los Angeles, CA (J.C.W.)
| | - Libor Kovarik
- From the Cedars-Sinai Medical Center, Los Angeles, CA (A.K., I.C., R.T., H.-J.Y., A.K., D.U., E.M., R.D.); University of California, Los Angeles (A.K., H.-J.Y., D.U., E.M., R.D.); Pacific Northwest National Laboratory, Environmental Molecular Sciences Laboratory, Richland, WA (A.D., L.K.); Lawson Health Research Institute, University of Western Ontario, London, Canada (F.S.P.); and Children's Hospital Los Angeles, CA (J.C.W.)
| | - Hsin-Jung Yang
- From the Cedars-Sinai Medical Center, Los Angeles, CA (A.K., I.C., R.T., H.-J.Y., A.K., D.U., E.M., R.D.); University of California, Los Angeles (A.K., H.-J.Y., D.U., E.M., R.D.); Pacific Northwest National Laboratory, Environmental Molecular Sciences Laboratory, Richland, WA (A.D., L.K.); Lawson Health Research Institute, University of Western Ontario, London, Canada (F.S.P.); and Children's Hospital Los Angeles, CA (J.C.W.)
| | - Andreas Kumar
- From the Cedars-Sinai Medical Center, Los Angeles, CA (A.K., I.C., R.T., H.-J.Y., A.K., D.U., E.M., R.D.); University of California, Los Angeles (A.K., H.-J.Y., D.U., E.M., R.D.); Pacific Northwest National Laboratory, Environmental Molecular Sciences Laboratory, Richland, WA (A.D., L.K.); Lawson Health Research Institute, University of Western Ontario, London, Canada (F.S.P.); and Children's Hospital Los Angeles, CA (J.C.W.)
| | - Frank S Prato
- From the Cedars-Sinai Medical Center, Los Angeles, CA (A.K., I.C., R.T., H.-J.Y., A.K., D.U., E.M., R.D.); University of California, Los Angeles (A.K., H.-J.Y., D.U., E.M., R.D.); Pacific Northwest National Laboratory, Environmental Molecular Sciences Laboratory, Richland, WA (A.D., L.K.); Lawson Health Research Institute, University of Western Ontario, London, Canada (F.S.P.); and Children's Hospital Los Angeles, CA (J.C.W.)
| | - John C Wood
- From the Cedars-Sinai Medical Center, Los Angeles, CA (A.K., I.C., R.T., H.-J.Y., A.K., D.U., E.M., R.D.); University of California, Los Angeles (A.K., H.-J.Y., D.U., E.M., R.D.); Pacific Northwest National Laboratory, Environmental Molecular Sciences Laboratory, Richland, WA (A.D., L.K.); Lawson Health Research Institute, University of Western Ontario, London, Canada (F.S.P.); and Children's Hospital Los Angeles, CA (J.C.W.)
| | - David Underhill
- From the Cedars-Sinai Medical Center, Los Angeles, CA (A.K., I.C., R.T., H.-J.Y., A.K., D.U., E.M., R.D.); University of California, Los Angeles (A.K., H.-J.Y., D.U., E.M., R.D.); Pacific Northwest National Laboratory, Environmental Molecular Sciences Laboratory, Richland, WA (A.D., L.K.); Lawson Health Research Institute, University of Western Ontario, London, Canada (F.S.P.); and Children's Hospital Los Angeles, CA (J.C.W.)
| | - Eduardo Marbán
- From the Cedars-Sinai Medical Center, Los Angeles, CA (A.K., I.C., R.T., H.-J.Y., A.K., D.U., E.M., R.D.); University of California, Los Angeles (A.K., H.-J.Y., D.U., E.M., R.D.); Pacific Northwest National Laboratory, Environmental Molecular Sciences Laboratory, Richland, WA (A.D., L.K.); Lawson Health Research Institute, University of Western Ontario, London, Canada (F.S.P.); and Children's Hospital Los Angeles, CA (J.C.W.)
| | - Rohan Dharmakumar
- From the Cedars-Sinai Medical Center, Los Angeles, CA (A.K., I.C., R.T., H.-J.Y., A.K., D.U., E.M., R.D.); University of California, Los Angeles (A.K., H.-J.Y., D.U., E.M., R.D.); Pacific Northwest National Laboratory, Environmental Molecular Sciences Laboratory, Richland, WA (A.D., L.K.); Lawson Health Research Institute, University of Western Ontario, London, Canada (F.S.P.); and Children's Hospital Los Angeles, CA (J.C.W.).
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Prabhu SD, Frangogiannis NG. The Biological Basis for Cardiac Repair After Myocardial Infarction: From Inflammation to Fibrosis. Circ Res 2017; 119:91-112. [PMID: 27340270 DOI: 10.1161/circresaha.116.303577] [Citation(s) in RCA: 1328] [Impact Index Per Article: 189.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 04/15/2016] [Indexed: 12/14/2022]
Abstract
In adult mammals, massive sudden loss of cardiomyocytes after infarction overwhelms the limited regenerative capacity of the myocardium, resulting in the formation of a collagen-based scar. Necrotic cells release danger signals, activating innate immune pathways and triggering an intense inflammatory response. Stimulation of toll-like receptor signaling and complement activation induces expression of proinflammatory cytokines (such as interleukin-1 and tumor necrosis factor-α) and chemokines (such as monocyte chemoattractant protein-1/ chemokine (C-C motif) ligand 2 [CCL2]). Inflammatory signals promote adhesive interactions between leukocytes and endothelial cells, leading to extravasation of neutrophils and monocytes. As infiltrating leukocytes clear the infarct from dead cells, mediators repressing inflammation are released, and anti-inflammatory mononuclear cell subsets predominate. Suppression of the inflammatory response is associated with activation of reparative cells. Fibroblasts proliferate, undergo myofibroblast transdifferentiation, and deposit large amounts of extracellular matrix proteins maintaining the structural integrity of the infarcted ventricle. The renin-angiotensin-aldosterone system and members of the transforming growth factor-β family play an important role in activation of infarct myofibroblasts. Maturation of the scar follows, as a network of cross-linked collagenous matrix is formed and granulation tissue cells become apoptotic. This review discusses the cellular effectors and molecular signals regulating the inflammatory and reparative response after myocardial infarction. Dysregulation of immune pathways, impaired suppression of postinfarction inflammation, perturbed spatial containment of the inflammatory response, and overactive fibrosis may cause adverse remodeling in patients with infarction contributing to the pathogenesis of heart failure. Therapeutic modulation of the inflammatory and reparative response may hold promise for the prevention of postinfarction heart failure.
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Affiliation(s)
- Sumanth D Prabhu
- From the Division of Cardiovascular Disease, University of Alabama at Birmingham, and Medical Service, Birmingham VAMC (S.D.P.); and Department of Medicine, The Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, Bronx, NY (N.G.F.)
| | - Nikolaos G Frangogiannis
- From the Division of Cardiovascular Disease, University of Alabama at Birmingham, and Medical Service, Birmingham VAMC (S.D.P.); and Department of Medicine, The Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, Bronx, NY (N.G.F.).
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Moreira DM, Lueneberg ME, da Silva RL, Fattah T, Gottschall CAM. MethotrexaTE THerapy in ST-Segment Elevation MYocardial InfarctionS. J Cardiovasc Pharmacol Ther 2017; 22:538-545. [DOI: 10.1177/1074248417699884] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: Methotrexate is an anti-inflammatory drug that has been shown to have anti-ischemic effects. Our aim was to evaluate if methotrexate could reduce infarct size in patients with ST-segment elevation myocardial infarction (STEMI). Methods: We randomly assigned patients with STEMI to receive either methotrexate or placebo. Primary outcome was infarct size determined by calculating the area under the curve (AUC) for creatine kinase (CK) release. Secondary outcomes were AUC of CK MB (CK-MB) and AUC of troponin I; peak CK, peak CK-MB, and troponin I; B-type natriuretic peptide (BNP) level, high-sensitivity C-reactive protein (hsCRP) result, and erythrocyte sedimentation rate (ESR); left ventricular ejection fraction (LVEF); thrombolysis in myocardial infarction (TIMI) frame count; Killip score; mortality and reinfarction incidence; and incidence of adverse reactions. Results: We included 84 patients. Median AUC of CK was 78 861.0 in the methotrexate group and 68 088.0 in the placebo group ( P = .10). Patients given methotrexate and placebo exhibited, respectively, median AUC for CK-MB of 9803.4 and 8037.0 ( P = .42); median AUC for troponin of 3691.1 and 2132.6 ( P = .09); peak CK of 2806.0 and 2147.0 ( P = .05); peak CK-MB of 516.0 and 462.3 ( P = .25); and peak troponin of 121.0 and 85.1 ( P = .06). At 3 months, LVEF was lower in patients who received methotrexate (49.0% ± 14.1%) than in patients given placebo (56.4% ± 10.0%; P = .01). There were no differences in hsCRP, ESR, BNP, Killip scores, TIMI frame count, reinfarction, and mortality rates. There was a higher median serum glutamic–pyruvic transaminase levels in the methotrexate group. Conclusion: Methotrexate did not reduce infarction size and worsened LVEF at 3 months ( Clinicaltrials.gov identifier NCT01741558).
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Affiliation(s)
- Daniel Medeiros Moreira
- Instituto de Cardiologia de Santa Catarina, São José, Santa Catarina, Brazil
- Instituto de Cardiologia do Rio Grande do Sul—FUC, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | - Tammuz Fattah
- Instituto de Cardiologia de Santa Catarina, São José, Santa Catarina, Brazil
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Liu ZH, Dai DP, Ding FH, Pan WQ, Fang YH, Zhang Q, Li M, Yang P, Wang XQ, Shen Y, Wang LJ, Yan XX, He YH, Yang K, Zhang RY, Shen WF, Chen Y, Lu L. Association of serum HMGB2 level with MACE at 1 mo of myocardial infarction: Aggravation of myocardial ischemic injury in rats by HMGB2 via ROS. Am J Physiol Heart Circ Physiol 2017; 312:H422-H436. [PMID: 28011583 DOI: 10.1152/ajpheart.00249.2016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 10/05/2016] [Accepted: 10/16/2016] [Indexed: 12/16/2022]
Abstract
High-mobility group box (HMGB) family is related to inflammatory diseases. We investigated whether serum HMGB2 levels are related to myocardial infarction (MI) severity and major adverse cardiac events (MACE) during MI. We included 432 consecutive patients with ST-segment elevation myocardial infarction and 312 controls. Serum HMGB2 levels were significantly higher in MI patients than in controls. Increased HMGB2 levels were associated with MACE and negatively with ejection fraction in MI patients. HMGB2 was an independent determinant of MACE in logistic regression analysis. HMGB2 protein (10 μg) or saline was injected intramyocardially in MI rats, with or without coadministration of the NADPH oxidase inhibitor apocynin. After 72 h, pathological, echocardiographic, and hemodynamic examinations showed that HMGB2 increased infarct size and worsened cardiac function in MI rats. Moreover, HMGB2 administration enhanced reactive oxygen species (ROS) production, cell apoptosis, inflammation, and autophagosome clearance impairment, which were attenuated by coadministration of apocynin or knock down of receptor for advanced glycation end products (RAGE). In conclusion, increased serum HMGB2 levels are associated with MI severity and MACE at 1 mo. HMGB2 promotes myocardial ischemic injury in rats and hypoxic H9C2 cell damage via ROS provoked by RAGE. NEW & NOTEWORTHY We demonstrate that serum high-mobility group box 2 is associated with major adverse cardiac events at 1 mo in myocardial infarction patients. Mechanistically, high-mobility group box 2 promotes reactive oxygen species production via receptor for advanced glycation end products signaling in ischemic myocardium, thereby aggravating cell apoptosis, inflammation, and autophagosome clearance impairment. This study reveals that high-mobility group box 2 is a novel factor enhancing ischemic injury in myocardial infarction.
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Affiliation(s)
- Zhu Hui Liu
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
| | - Dao Peng Dai
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
| | - Feng Hua Ding
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
| | - Wen Qi Pan
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
| | - Yue Hua Fang
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
| | - Qi Zhang
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
| | - Man Li
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
| | - Ping Yang
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
| | - Xiao Qun Wang
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
- Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China
| | - Ying Shen
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
| | - Ling Jie Wang
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
- Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China
| | - Xiao Xiang Yan
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
- Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China
| | - Yu Hu He
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
| | - Ke Yang
- Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China
| | - Rui Yan Zhang
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
| | - Wei Feng Shen
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
- Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China
| | - Ying Chen
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
| | - Lin Lu
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; and
- Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China
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Choo EH, Lee JH, Park EH, Park HE, Jung NC, Kim TH, Koh YS, Kim E, Seung KB, Park C, Hong KS, Kang K, Song JY, Seo HG, Lim DS, Chang K. Infarcted Myocardium-Primed Dendritic Cells Improve Remodeling and Cardiac Function After Myocardial Infarction by Modulating the Regulatory T Cell and Macrophage Polarization. Circulation 2017; 135:1444-1457. [PMID: 28174192 DOI: 10.1161/circulationaha.116.023106] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 01/20/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Inflammatory responses play a critical role in left ventricular remodeling after myocardial infarction (MI). Tolerogenic dendritic cells (tDCs) can modulate immune responses, inducing regulatory T cells in a number of inflammatory diseases. METHODS We generated tDCs by treating bone marrow-derived dendritic cells with tumor necrosis factor-α and cardiac lysate from MI mice. We injected MI mice, induced by a ligation of the left anterior descending coronary artery in C57BL/6 mice, twice with tDCs within 24 hours and at 7 days after the ligation. RESULTS In vivo cardiac magnetic resonance imaging and ex vivo histology confirmed the beneficial effect on postinfarct left ventricular remodeling in MI mice treated with tDCs. Subcutaneously administered infarct lysate-primed tDCs near the inguinal lymph node migrated to the regional lymph node and induced infarct tissue-specific regulatory T-cell populations in the inguinal and mediastinal lymph nodes, spleen, and infarcted myocardium, indicating that a local injection of tDCs induces a systemic activation of MI-specific regulatory T cells. These events elicited an inflammatory-to-reparative macrophage shift. The altered immune environment in the infarcted heart resulted in a better wound remodeling, preserved left ventricular systolic function after myocardial tissue damage, and improved survival. CONCLUSIONS This study showed that tDC therapy in a preclinical model of MI was potentially translatable into an antiremodeling therapy for ischemic tissue repair.
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Affiliation(s)
- Eun Ho Choo
- From Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea (E.H.C., E.-H.P., H.E.P., T.-H.K., Y.-S.K., E.K., K.-B.S., K.K., K.C.); Department of Biotechnology, CHA University, Seongnam-si, Gyeonggi-do, Korea (J.-H.L., D.-S.L.); Pharos Vaccine Inc, Seongnam-si, Gyeonggido, Korea (J.-H.L., N.-C.J.); Division of Magnetic Resonance Research, Korea Basic Science Institute, Cheongju-si, Chungcheongbuk- do, Korea (C.P., K.-S.H.); Department of Radiation Cancer Sciences, Korea Institute of Radiological and Medical Sciences, Seoul (J.-Y.S.); and Department of Animal Biotechnology, Konkuk University, Seoul, Korea (H.G.S.)
| | - Jun-Ho Lee
- From Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea (E.H.C., E.-H.P., H.E.P., T.-H.K., Y.-S.K., E.K., K.-B.S., K.K., K.C.); Department of Biotechnology, CHA University, Seongnam-si, Gyeonggi-do, Korea (J.-H.L., D.-S.L.); Pharos Vaccine Inc, Seongnam-si, Gyeonggido, Korea (J.-H.L., N.-C.J.); Division of Magnetic Resonance Research, Korea Basic Science Institute, Cheongju-si, Chungcheongbuk- do, Korea (C.P., K.-S.H.); Department of Radiation Cancer Sciences, Korea Institute of Radiological and Medical Sciences, Seoul (J.-Y.S.); and Department of Animal Biotechnology, Konkuk University, Seoul, Korea (H.G.S.)
| | - Eun-Hye Park
- From Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea (E.H.C., E.-H.P., H.E.P., T.-H.K., Y.-S.K., E.K., K.-B.S., K.K., K.C.); Department of Biotechnology, CHA University, Seongnam-si, Gyeonggi-do, Korea (J.-H.L., D.-S.L.); Pharos Vaccine Inc, Seongnam-si, Gyeonggido, Korea (J.-H.L., N.-C.J.); Division of Magnetic Resonance Research, Korea Basic Science Institute, Cheongju-si, Chungcheongbuk- do, Korea (C.P., K.-S.H.); Department of Radiation Cancer Sciences, Korea Institute of Radiological and Medical Sciences, Seoul (J.-Y.S.); and Department of Animal Biotechnology, Konkuk University, Seoul, Korea (H.G.S.)
| | - Hyo Eun Park
- From Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea (E.H.C., E.-H.P., H.E.P., T.-H.K., Y.-S.K., E.K., K.-B.S., K.K., K.C.); Department of Biotechnology, CHA University, Seongnam-si, Gyeonggi-do, Korea (J.-H.L., D.-S.L.); Pharos Vaccine Inc, Seongnam-si, Gyeonggido, Korea (J.-H.L., N.-C.J.); Division of Magnetic Resonance Research, Korea Basic Science Institute, Cheongju-si, Chungcheongbuk- do, Korea (C.P., K.-S.H.); Department of Radiation Cancer Sciences, Korea Institute of Radiological and Medical Sciences, Seoul (J.-Y.S.); and Department of Animal Biotechnology, Konkuk University, Seoul, Korea (H.G.S.)
| | - Nam-Chul Jung
- From Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea (E.H.C., E.-H.P., H.E.P., T.-H.K., Y.-S.K., E.K., K.-B.S., K.K., K.C.); Department of Biotechnology, CHA University, Seongnam-si, Gyeonggi-do, Korea (J.-H.L., D.-S.L.); Pharos Vaccine Inc, Seongnam-si, Gyeonggido, Korea (J.-H.L., N.-C.J.); Division of Magnetic Resonance Research, Korea Basic Science Institute, Cheongju-si, Chungcheongbuk- do, Korea (C.P., K.-S.H.); Department of Radiation Cancer Sciences, Korea Institute of Radiological and Medical Sciences, Seoul (J.-Y.S.); and Department of Animal Biotechnology, Konkuk University, Seoul, Korea (H.G.S.)
| | - Tae-Hoon Kim
- From Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea (E.H.C., E.-H.P., H.E.P., T.-H.K., Y.-S.K., E.K., K.-B.S., K.K., K.C.); Department of Biotechnology, CHA University, Seongnam-si, Gyeonggi-do, Korea (J.-H.L., D.-S.L.); Pharos Vaccine Inc, Seongnam-si, Gyeonggido, Korea (J.-H.L., N.-C.J.); Division of Magnetic Resonance Research, Korea Basic Science Institute, Cheongju-si, Chungcheongbuk- do, Korea (C.P., K.-S.H.); Department of Radiation Cancer Sciences, Korea Institute of Radiological and Medical Sciences, Seoul (J.-Y.S.); and Department of Animal Biotechnology, Konkuk University, Seoul, Korea (H.G.S.)
| | - Yoon-Seok Koh
- From Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea (E.H.C., E.-H.P., H.E.P., T.-H.K., Y.-S.K., E.K., K.-B.S., K.K., K.C.); Department of Biotechnology, CHA University, Seongnam-si, Gyeonggi-do, Korea (J.-H.L., D.-S.L.); Pharos Vaccine Inc, Seongnam-si, Gyeonggido, Korea (J.-H.L., N.-C.J.); Division of Magnetic Resonance Research, Korea Basic Science Institute, Cheongju-si, Chungcheongbuk- do, Korea (C.P., K.-S.H.); Department of Radiation Cancer Sciences, Korea Institute of Radiological and Medical Sciences, Seoul (J.-Y.S.); and Department of Animal Biotechnology, Konkuk University, Seoul, Korea (H.G.S.)
| | - Eunmin Kim
- From Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea (E.H.C., E.-H.P., H.E.P., T.-H.K., Y.-S.K., E.K., K.-B.S., K.K., K.C.); Department of Biotechnology, CHA University, Seongnam-si, Gyeonggi-do, Korea (J.-H.L., D.-S.L.); Pharos Vaccine Inc, Seongnam-si, Gyeonggido, Korea (J.-H.L., N.-C.J.); Division of Magnetic Resonance Research, Korea Basic Science Institute, Cheongju-si, Chungcheongbuk- do, Korea (C.P., K.-S.H.); Department of Radiation Cancer Sciences, Korea Institute of Radiological and Medical Sciences, Seoul (J.-Y.S.); and Department of Animal Biotechnology, Konkuk University, Seoul, Korea (H.G.S.)
| | - Ki-Bae Seung
- From Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea (E.H.C., E.-H.P., H.E.P., T.-H.K., Y.-S.K., E.K., K.-B.S., K.K., K.C.); Department of Biotechnology, CHA University, Seongnam-si, Gyeonggi-do, Korea (J.-H.L., D.-S.L.); Pharos Vaccine Inc, Seongnam-si, Gyeonggido, Korea (J.-H.L., N.-C.J.); Division of Magnetic Resonance Research, Korea Basic Science Institute, Cheongju-si, Chungcheongbuk- do, Korea (C.P., K.-S.H.); Department of Radiation Cancer Sciences, Korea Institute of Radiological and Medical Sciences, Seoul (J.-Y.S.); and Department of Animal Biotechnology, Konkuk University, Seoul, Korea (H.G.S.)
| | - Cheongsoo Park
- From Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea (E.H.C., E.-H.P., H.E.P., T.-H.K., Y.-S.K., E.K., K.-B.S., K.K., K.C.); Department of Biotechnology, CHA University, Seongnam-si, Gyeonggi-do, Korea (J.-H.L., D.-S.L.); Pharos Vaccine Inc, Seongnam-si, Gyeonggido, Korea (J.-H.L., N.-C.J.); Division of Magnetic Resonance Research, Korea Basic Science Institute, Cheongju-si, Chungcheongbuk- do, Korea (C.P., K.-S.H.); Department of Radiation Cancer Sciences, Korea Institute of Radiological and Medical Sciences, Seoul (J.-Y.S.); and Department of Animal Biotechnology, Konkuk University, Seoul, Korea (H.G.S.)
| | - Kwan-Soo Hong
- From Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea (E.H.C., E.-H.P., H.E.P., T.-H.K., Y.-S.K., E.K., K.-B.S., K.K., K.C.); Department of Biotechnology, CHA University, Seongnam-si, Gyeonggi-do, Korea (J.-H.L., D.-S.L.); Pharos Vaccine Inc, Seongnam-si, Gyeonggido, Korea (J.-H.L., N.-C.J.); Division of Magnetic Resonance Research, Korea Basic Science Institute, Cheongju-si, Chungcheongbuk- do, Korea (C.P., K.-S.H.); Department of Radiation Cancer Sciences, Korea Institute of Radiological and Medical Sciences, Seoul (J.-Y.S.); and Department of Animal Biotechnology, Konkuk University, Seoul, Korea (H.G.S.)
| | - Kwonyoon Kang
- From Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea (E.H.C., E.-H.P., H.E.P., T.-H.K., Y.-S.K., E.K., K.-B.S., K.K., K.C.); Department of Biotechnology, CHA University, Seongnam-si, Gyeonggi-do, Korea (J.-H.L., D.-S.L.); Pharos Vaccine Inc, Seongnam-si, Gyeonggido, Korea (J.-H.L., N.-C.J.); Division of Magnetic Resonance Research, Korea Basic Science Institute, Cheongju-si, Chungcheongbuk- do, Korea (C.P., K.-S.H.); Department of Radiation Cancer Sciences, Korea Institute of Radiological and Medical Sciences, Seoul (J.-Y.S.); and Department of Animal Biotechnology, Konkuk University, Seoul, Korea (H.G.S.)
| | - Jie-Young Song
- From Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea (E.H.C., E.-H.P., H.E.P., T.-H.K., Y.-S.K., E.K., K.-B.S., K.K., K.C.); Department of Biotechnology, CHA University, Seongnam-si, Gyeonggi-do, Korea (J.-H.L., D.-S.L.); Pharos Vaccine Inc, Seongnam-si, Gyeonggido, Korea (J.-H.L., N.-C.J.); Division of Magnetic Resonance Research, Korea Basic Science Institute, Cheongju-si, Chungcheongbuk- do, Korea (C.P., K.-S.H.); Department of Radiation Cancer Sciences, Korea Institute of Radiological and Medical Sciences, Seoul (J.-Y.S.); and Department of Animal Biotechnology, Konkuk University, Seoul, Korea (H.G.S.)
| | - Han Geuk Seo
- From Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea (E.H.C., E.-H.P., H.E.P., T.-H.K., Y.-S.K., E.K., K.-B.S., K.K., K.C.); Department of Biotechnology, CHA University, Seongnam-si, Gyeonggi-do, Korea (J.-H.L., D.-S.L.); Pharos Vaccine Inc, Seongnam-si, Gyeonggido, Korea (J.-H.L., N.-C.J.); Division of Magnetic Resonance Research, Korea Basic Science Institute, Cheongju-si, Chungcheongbuk- do, Korea (C.P., K.-S.H.); Department of Radiation Cancer Sciences, Korea Institute of Radiological and Medical Sciences, Seoul (J.-Y.S.); and Department of Animal Biotechnology, Konkuk University, Seoul, Korea (H.G.S.)
| | - Dae-Seog Lim
- From Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea (E.H.C., E.-H.P., H.E.P., T.-H.K., Y.-S.K., E.K., K.-B.S., K.K., K.C.); Department of Biotechnology, CHA University, Seongnam-si, Gyeonggi-do, Korea (J.-H.L., D.-S.L.); Pharos Vaccine Inc, Seongnam-si, Gyeonggido, Korea (J.-H.L., N.-C.J.); Division of Magnetic Resonance Research, Korea Basic Science Institute, Cheongju-si, Chungcheongbuk- do, Korea (C.P., K.-S.H.); Department of Radiation Cancer Sciences, Korea Institute of Radiological and Medical Sciences, Seoul (J.-Y.S.); and Department of Animal Biotechnology, Konkuk University, Seoul, Korea (H.G.S.)
| | - Kiyuk Chang
- From Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea (E.H.C., E.-H.P., H.E.P., T.-H.K., Y.-S.K., E.K., K.-B.S., K.K., K.C.); Department of Biotechnology, CHA University, Seongnam-si, Gyeonggi-do, Korea (J.-H.L., D.-S.L.); Pharos Vaccine Inc, Seongnam-si, Gyeonggido, Korea (J.-H.L., N.-C.J.); Division of Magnetic Resonance Research, Korea Basic Science Institute, Cheongju-si, Chungcheongbuk- do, Korea (C.P., K.-S.H.); Department of Radiation Cancer Sciences, Korea Institute of Radiological and Medical Sciences, Seoul (J.-Y.S.); and Department of Animal Biotechnology, Konkuk University, Seoul, Korea (H.G.S.).
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Veltman D, Laeremans T, Passante E, Huber HJ. Signal transduction analysis of the NLRP3-inflammasome pathway after cellular damage and its paracrine regulation. J Theor Biol 2016; 415:125-136. [PMID: 28017802 DOI: 10.1016/j.jtbi.2016.12.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 12/15/2016] [Accepted: 12/20/2016] [Indexed: 10/20/2022]
Abstract
Activation of the NLRP3-inflammasome pathway and production of the inflammatory cytokine IL-1B after cellular damage caused by infarct or infection is a key process in several diseases such as acute myocardial infarction and inflammatory bowel disease. However, while the molecular triggers of the NLRP3-pathway after cellular damage are well known, the mechanisms that sustain or confine its activity are currently under investigation. We present here an Ordinary Differential Equation-based model that investigates the mechanisms of inflammasome activation and regulation in monocytes to predict IL-1β activation kinetics upon a two-step activation by Damage-Associate-Molecular-Particles (DAMP) and extracellular ATP. Assuming both activation signals to be concomitantly present or present with a delay of 12h, the model predicted a transient IL-1β activation at different concentration levels dependent on signal synchronisation. Introducing a positive feedback loop mediated by active IL-1β resulted in a sustained IL-1β activation, hence arguing for a paracrine signalling between inflammatory cells to guarantee a temporally stable inflammatory response. We then investigate mechanisms that control termination of inflammation using two recently identified molecular intervention points in the inflammasome pathway. We found that a more upstream regulation, by attenuating production of the IL-1β-proform, was more potent in attenuating active IL-1β production than direct inhibition of the NLRP3-inflammasome. Interestingly, ablating this upstream negative feedback led to a high variability of IL-1β production in monocytes from different subjects, consistent with a recent pre-clinical study. We finally discuss the relevance and implications of our findings in disease models of acute myocardial infarction and spontaneous colitis.
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Affiliation(s)
- Denise Veltman
- Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Thessa Laeremans
- Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Egle Passante
- School of Pharmacy and Biomedical Sciences, Univ. of Central Lancashire, Preston, UK
| | - Heinrich J Huber
- Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium; Institute for Automation Engineering (IFAT), Laboratory for Systems Theory and Automatic Control, Otto-von-Guericke University Magdeburg, 39106 Magdeburg - Germany.
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Kang J, Jeon KH, Kim SW, Park JJ, Yoon CH, Suh JW, Cho YS, Youn TJ, Chae IH, Choi DJ. Evolution of nonculprit coronary atherosclerotic plaques assessed by serial virtual histology intravascular ultrasound in patients with ST-segment elevation myocardial infarction and chronic total occlusion. Coron Artery Dis 2016; 27:650-657. [PMID: 27501406 PMCID: PMC5087572 DOI: 10.1097/mca.0000000000000419] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 06/28/2016] [Accepted: 07/12/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The pathophysiology and natural course of coronary nonculprit plaques remain unclear. We investigated whether the short-term natural course of nonculprit plaques differs between ST-segment elevation myocardial infarction (STEMI) and chronic total occlusion (CTO) patients. METHODS We performed serial virtual histology intravascular ultrasound on nonculprit plaques in 26 STEMI and 11 CTO lesions at baseline and the 6-month follow-up. RESULTS At baseline, more lesions in the STEMI group were virtual histology intravascular ultrasound-derived thin-cap fibroatheromas (TCFA; 76.9 vs. 18.1%, P=0.002). During the follow-up period, the plaque composition changed dynamically in the STEMI group (fibrofatty: 9.8±1.9 to 17.3±2.9%, P=0.030; dense calcium: 12.7±1.8 to 8.1±1.7%, P=0.026; necrotic core: 21.1±1.8 to 15.4±2.2%, P=0.052), with a consistent plaque size. In the CTO group, the plaque composition and plaque size remained consistent without a significant change. Also, more lesions in the STEMI group remained as or progressed to TCFA, compared with the CTO group (67 vs. 11%, P=0.089). Factors associated with a persistent TCFA or with a new development of TCFA were a large necrotic core volume index and the diagnosis of STEMI, whereas new statin usage was a protective factor. CONCLUSION Nonculprit lesions in STEMI patients were more unstable at the baseline compared with those in CTO patients. During follow-up, nonculprit lesions in STEMI and CTO patients showed a distinct pattern of change; the former were stabilized in plaque composition, whereas the latter remained consistent. The diagnosis of STEMI and a large necrotic core volume were predictors of evolution to a TCFA, and new statin usage was a protective factor.
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Affiliation(s)
- Jeehoon Kang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Ki-Hyun Jeon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam
| | - Seong-Wook Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam
| | - Jin Joo Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam
| | - Chang-Hwan Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam
| | - Jung-Won Suh
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam
| | - Young-Seok Cho
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam
| | - Tae-Jin Youn
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam
| | - In-Ho Chae
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam
| | - Dong-Ju Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam
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169
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Osada-Oka M, Shiota M, Izumi Y, Nishiyama M, Tanaka M, Yamaguchi T, Sakurai E, Miura K, Iwao H. Macrophage-derived exosomes induce inflammatory factors in endothelial cells under hypertensive conditions. Hypertens Res 2016; 40:353-360. [PMID: 27881852 DOI: 10.1038/hr.2016.163] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 10/03/2016] [Accepted: 10/05/2016] [Indexed: 12/29/2022]
Abstract
Hypertension is one of the most important cardiovascular risk factors and results in macrophage infiltration of blood vessels. However, how macrophages coordinate inflammatory responses with endothelial cells (ECs) remains unclear. In this study, we investigated whether exosomes upregulate the expression of inflammatory factors in ECs under hypertensive conditions. Hypertension was induced in rats by continuous infusion of angiotensin II (Ang II). Exosomes were purified from rat serum by density gradient and ultracentrifugation and used to stimulate human coronary artery ECs (HCAECs). Moreover, the interactions between HCAECs and exosomes from human THP-1-derived macrophages were analyzed. Administration of Ang II enhanced the expression of CD68, a macrophage marker, in rat hearts, suggesting enhanced infiltration of macrophages. In addition, the expression of intracellular adhesion molecule-1 (ICAM1) and plasminogen activator inhibitor-1 (PAI-1), a proinflammatory factor, was increased in hypertensive rat hearts compared with control rats. CD68 protein expression and an increase in the expression of some exosome markers were detected in exosomes from hypertensive rat serum. Moreover, the exosomes upregulated the expression levels of ICAM1 and PAI-1 in HCAECs. The level of miR-17, a negative regulator of ICAM1 expression, was markedly decreased in exosomes from hypertensive rat serum compared with exosomes from control rats. Interestingly, Ang II-stimulated THP-1-derived exosomes also enhanced the expression of ICAM1 and PAI-1 and contained reduced levels of miR-17 compared with exosomes from unstimulated cells. These results suggest that inflammation of ECs under hypertensive conditions is caused, at least in part, by macrophage-derived exosomes.
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Affiliation(s)
- Mayuko Osada-Oka
- Food Hygiene and Environmental Health Division of Applied Life Science, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Kyoto, Japan.,Department of Pharmacology, Osaka City University Medical School, Osaka, Japan
| | - Masayuki Shiota
- Department of Pharmacology, Osaka City University Medical School, Osaka, Japan
| | - Yasukatsu Izumi
- Department of Pharmacology, Osaka City University Medical School, Osaka, Japan
| | - Masaki Nishiyama
- Department of Pharmacology, Osaka City University Medical School, Osaka, Japan
| | - Masako Tanaka
- Applied Pharmacology and Therapeutics, Osaka City University Medical School, Osaka, Japan
| | - Takehiro Yamaguchi
- Department of Bacteriology, Niigata University Graduate School of Medicine, Niigata, Japan
| | - Emi Sakurai
- Department of Pharmacology, Osaka City University Medical School, Osaka, Japan.,Applied Pharmacology and Therapeutics, Osaka City University Medical School, Osaka, Japan
| | - Katsuyuki Miura
- Department of Pharmacology, Osaka City University Medical School, Osaka, Japan.,Applied Pharmacology and Therapeutics, Osaka City University Medical School, Osaka, Japan
| | - Hiroshi Iwao
- Department of Pharmacology, Osaka City University Medical School, Osaka, Japan.,Department of Education, Shitennoji University, Habikino, Japan
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170
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5-methoxytryptophan is a potential marker for post-myocardial infarction heart failure - a preliminary approach to clinical utility. Int J Cardiol 2016; 222:895-900. [DOI: 10.1016/j.ijcard.2016.07.293] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 07/26/2016] [Accepted: 07/30/2016] [Indexed: 02/06/2023]
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171
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Bennardo M, Alibhai F, Tsimakouridze E, Chinnappareddy N, Podobed P, Reitz C, Pyle WG, Simpson J, Martino TA. Day-night dependence of gene expression and inflammatory responses in the remodeling murine heart post-myocardial infarction. Am J Physiol Regul Integr Comp Physiol 2016; 311:R1243-R1254. [PMID: 27733386 DOI: 10.1152/ajpregu.00200.2016] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 10/05/2016] [Accepted: 10/05/2016] [Indexed: 01/10/2023]
Abstract
Diurnal or circadian rhythms are fundamentally important for healthy cardiovascular physiology and play a role in timing of onset and tolerance to myocardial infarction (MI) in patients. Whether time of day of MI triggers different molecular and cellular responses that can influence myocardial remodeling is not known. This study was designed to test whether time of day of MI triggers different gene expression, humoral, and innate inflammatory responses that contribute to cardiac repair after MI. Mice were infarcted by left anterior descending coronary artery ligation (MI model) within a 2-h time window either shortly after lights on or lights off, and the early remodeling responses at 8 h postinfarction were examined. We found that sleep-MI preferentially triggers early expression of genes associated with inflammatory responses, whereas wake-MI triggers more genes associated with metabolic pathways and transcription/translation, by microarray analyses. Homozygous clock mutant mice exhibit altered diurnal gene expression profiles, consistent with their cycling before onset of MI. In the first 8 h, crucial for innate immune responses to MI, there are also significant differences in sleep-MI and wake-MI serum cytokine responses and in neutrophil infiltration to infarcted myocardium. By 1-wk post-MI, there are differences in survivorship between the sleep and wake MI mice that could be explained by the different molecular and cellular responses. Our whole body physiology, tissues, and cells exhibit endogenous daily rhythms, and understanding their role in triggering effective responses after MI could lead to new strategies to benefit patients with cardiovascular disease.
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Affiliation(s)
- Michael Bennardo
- Centre for Cardiovascular Investigations, Department of Biomedical Sciences, University of Guelph, Guelph, Ontario, Canada; and
| | - Faisal Alibhai
- Centre for Cardiovascular Investigations, Department of Biomedical Sciences, University of Guelph, Guelph, Ontario, Canada; and
| | - Elena Tsimakouridze
- Centre for Cardiovascular Investigations, Department of Biomedical Sciences, University of Guelph, Guelph, Ontario, Canada; and
| | - Nirmala Chinnappareddy
- Centre for Cardiovascular Investigations, Department of Biomedical Sciences, University of Guelph, Guelph, Ontario, Canada; and
| | - Peter Podobed
- Centre for Cardiovascular Investigations, Department of Biomedical Sciences, University of Guelph, Guelph, Ontario, Canada; and
| | - Cristine Reitz
- Centre for Cardiovascular Investigations, Department of Biomedical Sciences, University of Guelph, Guelph, Ontario, Canada; and
| | - W Glen Pyle
- Centre for Cardiovascular Investigations, Department of Biomedical Sciences, University of Guelph, Guelph, Ontario, Canada; and
| | - Jeremy Simpson
- Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Tami A Martino
- Centre for Cardiovascular Investigations, Department of Biomedical Sciences, University of Guelph, Guelph, Ontario, Canada; and
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172
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Rischpler C, Dirschinger RJ, Nekolla SG, Kossmann H, Nicolosi S, Hanus F, van Marwick S, Kunze KP, Meinicke A, Götze K, Kastrati A, Langwieser N, Ibrahim T, Nahrendorf M, Schwaiger M, Laugwitz KL. Prospective Evaluation of 18F-Fluorodeoxyglucose Uptake in Postischemic Myocardium by Simultaneous Positron Emission Tomography/Magnetic Resonance Imaging as a Prognostic Marker of Functional Outcome. Circ Cardiovasc Imaging 2016; 9:e004316. [PMID: 27056601 DOI: 10.1161/circimaging.115.004316] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 02/12/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND The immune system orchestrates the repair of infarcted myocardium. Imaging of the cellular inflammatory response by (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography/magnetic resonance imaging in the heart has been demonstrated in preclinical and clinical studies. However, the clinical relevance of post-MI (18)F-FDG uptake in the heart has not been elucidated. The objective of this study was to explore the value of (18)F-FDG positron emission tomography/magnetic resonance imaging in patients after acute myocardial infarction as a biosignal for left ventricular functional outcome. METHODS AND RESULTS We prospectively enrolled 49 patients with ST-segment-elevation myocardial infarction and performed (18)F-FDG positron emission tomography/magnetic resonance imaging 5 days after percutaneous coronary intervention and follow-up cardiac magnetic resonance imaging after 6 to 9 months. In a subset of patients, (99m)Tc-sestamibi single-photon emission computed tomography was performed with tracer injection before revascularization. Cellular innate immune response was analyzed at multiple time points. Segmental comparison of (18)F-FDG-uptake and late gadolinium enhancement showed substantial overlap (κ=0.66), whereas quantitative analysis demonstrated that (18)F-FDG extent exceeded late gadolinium enhancement extent (33.2±16.2% left ventricular myocardium versus 20.4±10.6% left ventricular myocardium, P<0.0001) and corresponded to the area at risk (r=0.87, P<0.0001). The peripheral blood count of CD14(high)/CD16(+) monocytes correlated with the infarction size and (18)F-FDG signal extent (r=0.53, P<0.002 and r=0.42, P<0.02, respectively). (18)F-FDG uptake in the infarcted myocardium was highest in areas with transmural scar, and the standardized uptake valuemean was associated with left ventricular functional outcome independent of infarct size (Δ ejection fraction: P<0.04, Δ end-diastolic volume: P<0.02, Δ end-systolic volume: P<0.005). CONCLUSIONS In this study, the intensity of (18)F-FDG uptake in the myocardium after acute myocardial infarction correlated inversely with functional outcome at 6 months. Thus, (18)F-FDG uptake in infarcted myocardium may represent a novel biosignal of myocardial injury.
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Affiliation(s)
- Christoph Rischpler
- From the Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar (C.R., S.G.N., S.N., S.v.M., K.P.K., A.M., M.S.), Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar (R.J.D., H.K., F.H., N.L., T.I., K.-L.L.), Medizinische Klinik und Poliklinik III, Klinikum rechts der Isar (K.G.), and Deutsches Herzzentrum (A.K.), Technische Universität München, Munich, Germany; DZKH (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (C.R., S.G.N., A.K., M.S., K.-L.L.); and Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston (M.N.)
| | - Ralf J Dirschinger
- From the Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar (C.R., S.G.N., S.N., S.v.M., K.P.K., A.M., M.S.), Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar (R.J.D., H.K., F.H., N.L., T.I., K.-L.L.), Medizinische Klinik und Poliklinik III, Klinikum rechts der Isar (K.G.), and Deutsches Herzzentrum (A.K.), Technische Universität München, Munich, Germany; DZKH (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (C.R., S.G.N., A.K., M.S., K.-L.L.); and Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston (M.N.)
| | - Stephan G Nekolla
- From the Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar (C.R., S.G.N., S.N., S.v.M., K.P.K., A.M., M.S.), Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar (R.J.D., H.K., F.H., N.L., T.I., K.-L.L.), Medizinische Klinik und Poliklinik III, Klinikum rechts der Isar (K.G.), and Deutsches Herzzentrum (A.K.), Technische Universität München, Munich, Germany; DZKH (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (C.R., S.G.N., A.K., M.S., K.-L.L.); and Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston (M.N.)
| | - Hans Kossmann
- From the Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar (C.R., S.G.N., S.N., S.v.M., K.P.K., A.M., M.S.), Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar (R.J.D., H.K., F.H., N.L., T.I., K.-L.L.), Medizinische Klinik und Poliklinik III, Klinikum rechts der Isar (K.G.), and Deutsches Herzzentrum (A.K.), Technische Universität München, Munich, Germany; DZKH (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (C.R., S.G.N., A.K., M.S., K.-L.L.); and Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston (M.N.)
| | - Stefania Nicolosi
- From the Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar (C.R., S.G.N., S.N., S.v.M., K.P.K., A.M., M.S.), Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar (R.J.D., H.K., F.H., N.L., T.I., K.-L.L.), Medizinische Klinik und Poliklinik III, Klinikum rechts der Isar (K.G.), and Deutsches Herzzentrum (A.K.), Technische Universität München, Munich, Germany; DZKH (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (C.R., S.G.N., A.K., M.S., K.-L.L.); and Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston (M.N.)
| | - Franziska Hanus
- From the Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar (C.R., S.G.N., S.N., S.v.M., K.P.K., A.M., M.S.), Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar (R.J.D., H.K., F.H., N.L., T.I., K.-L.L.), Medizinische Klinik und Poliklinik III, Klinikum rechts der Isar (K.G.), and Deutsches Herzzentrum (A.K.), Technische Universität München, Munich, Germany; DZKH (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (C.R., S.G.N., A.K., M.S., K.-L.L.); and Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston (M.N.)
| | - Sandra van Marwick
- From the Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar (C.R., S.G.N., S.N., S.v.M., K.P.K., A.M., M.S.), Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar (R.J.D., H.K., F.H., N.L., T.I., K.-L.L.), Medizinische Klinik und Poliklinik III, Klinikum rechts der Isar (K.G.), and Deutsches Herzzentrum (A.K.), Technische Universität München, Munich, Germany; DZKH (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (C.R., S.G.N., A.K., M.S., K.-L.L.); and Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston (M.N.)
| | - Karl P Kunze
- From the Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar (C.R., S.G.N., S.N., S.v.M., K.P.K., A.M., M.S.), Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar (R.J.D., H.K., F.H., N.L., T.I., K.-L.L.), Medizinische Klinik und Poliklinik III, Klinikum rechts der Isar (K.G.), and Deutsches Herzzentrum (A.K.), Technische Universität München, Munich, Germany; DZKH (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (C.R., S.G.N., A.K., M.S., K.-L.L.); and Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston (M.N.)
| | - Alexander Meinicke
- From the Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar (C.R., S.G.N., S.N., S.v.M., K.P.K., A.M., M.S.), Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar (R.J.D., H.K., F.H., N.L., T.I., K.-L.L.), Medizinische Klinik und Poliklinik III, Klinikum rechts der Isar (K.G.), and Deutsches Herzzentrum (A.K.), Technische Universität München, Munich, Germany; DZKH (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (C.R., S.G.N., A.K., M.S., K.-L.L.); and Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston (M.N.)
| | - Katharina Götze
- From the Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar (C.R., S.G.N., S.N., S.v.M., K.P.K., A.M., M.S.), Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar (R.J.D., H.K., F.H., N.L., T.I., K.-L.L.), Medizinische Klinik und Poliklinik III, Klinikum rechts der Isar (K.G.), and Deutsches Herzzentrum (A.K.), Technische Universität München, Munich, Germany; DZKH (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (C.R., S.G.N., A.K., M.S., K.-L.L.); and Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston (M.N.)
| | - Adnan Kastrati
- From the Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar (C.R., S.G.N., S.N., S.v.M., K.P.K., A.M., M.S.), Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar (R.J.D., H.K., F.H., N.L., T.I., K.-L.L.), Medizinische Klinik und Poliklinik III, Klinikum rechts der Isar (K.G.), and Deutsches Herzzentrum (A.K.), Technische Universität München, Munich, Germany; DZKH (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (C.R., S.G.N., A.K., M.S., K.-L.L.); and Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston (M.N.)
| | - Nicolas Langwieser
- From the Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar (C.R., S.G.N., S.N., S.v.M., K.P.K., A.M., M.S.), Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar (R.J.D., H.K., F.H., N.L., T.I., K.-L.L.), Medizinische Klinik und Poliklinik III, Klinikum rechts der Isar (K.G.), and Deutsches Herzzentrum (A.K.), Technische Universität München, Munich, Germany; DZKH (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (C.R., S.G.N., A.K., M.S., K.-L.L.); and Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston (M.N.)
| | - Tareq Ibrahim
- From the Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar (C.R., S.G.N., S.N., S.v.M., K.P.K., A.M., M.S.), Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar (R.J.D., H.K., F.H., N.L., T.I., K.-L.L.), Medizinische Klinik und Poliklinik III, Klinikum rechts der Isar (K.G.), and Deutsches Herzzentrum (A.K.), Technische Universität München, Munich, Germany; DZKH (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (C.R., S.G.N., A.K., M.S., K.-L.L.); and Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston (M.N.)
| | - Matthias Nahrendorf
- From the Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar (C.R., S.G.N., S.N., S.v.M., K.P.K., A.M., M.S.), Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar (R.J.D., H.K., F.H., N.L., T.I., K.-L.L.), Medizinische Klinik und Poliklinik III, Klinikum rechts der Isar (K.G.), and Deutsches Herzzentrum (A.K.), Technische Universität München, Munich, Germany; DZKH (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (C.R., S.G.N., A.K., M.S., K.-L.L.); and Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston (M.N.)
| | - Markus Schwaiger
- From the Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar (C.R., S.G.N., S.N., S.v.M., K.P.K., A.M., M.S.), Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar (R.J.D., H.K., F.H., N.L., T.I., K.-L.L.), Medizinische Klinik und Poliklinik III, Klinikum rechts der Isar (K.G.), and Deutsches Herzzentrum (A.K.), Technische Universität München, Munich, Germany; DZKH (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (C.R., S.G.N., A.K., M.S., K.-L.L.); and Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston (M.N.)
| | - Karl-Ludwig Laugwitz
- From the Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar (C.R., S.G.N., S.N., S.v.M., K.P.K., A.M., M.S.), Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar (R.J.D., H.K., F.H., N.L., T.I., K.-L.L.), Medizinische Klinik und Poliklinik III, Klinikum rechts der Isar (K.G.), and Deutsches Herzzentrum (A.K.), Technische Universität München, Munich, Germany; DZKH (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (C.R., S.G.N., A.K., M.S., K.-L.L.); and Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston (M.N.).
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173
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Grisanti LA, Gumpert AM, Traynham CJ, Gorsky JE, Repas AA, Gao E, Carter RL, Yu D, Calvert JW, García AP, Ibáñez B, Rabinowitz JE, Koch WJ, Tilley DG. Leukocyte-Expressed β2-Adrenergic Receptors Are Essential for Survival After Acute Myocardial Injury. Circulation 2016; 134:153-67. [PMID: 27364164 DOI: 10.1161/circulationaha.116.022304] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 05/17/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Immune cell-mediated inflammation is an essential process for mounting a repair response after myocardial infarction (MI). The sympathetic nervous system is known to regulate immune system function through β-adrenergic receptors (βARs); however, their role in regulating immune cell responses to acute cardiac injury is unknown. METHODS Wild-type (WT) mice were irradiated followed by isoform-specific βAR knockout (βARKO) or WT bone-marrow transplantation (BMT) and after full reconstitution underwent MI surgery. Survival was monitored over time, and alterations in immune cell infiltration after MI were examined through immunohistochemistry. Alterations in splenic function were identified through the investigation of altered adhesion receptor expression. RESULTS β2ARKO BMT mice displayed 100% mortality resulting from cardiac rupture within 12 days after MI compared with ≈20% mortality in WT BMT mice. β2ARKO BMT mice displayed severely reduced post-MI cardiac infiltration of leukocytes with reciprocally enhanced splenic retention of the same immune cell populations. Splenic retention of the leukocytes was associated with an increase in vascular cell adhesion molecule-1 expression, which itself was regulated via β-arrestin-dependent β2AR signaling. Furthermore, vascular cell adhesion molecule-1 expression in both mouse and human macrophages was sensitive to β2AR activity, and spleens from human tissue donors treated with β-blocker showed enhanced vascular cell adhesion molecule-1 expression. The impairments in splenic retention and cardiac infiltration of leukocytes after MI were restored to WT levels via lentiviral-mediated re-expression of β2AR in β2ARKO bone marrow before transplantation, which also resulted in post-MI survival rates comparable to those in WT BMT mice. CONCLUSIONS Immune cell-expressed β2AR plays an essential role in regulating the early inflammatory repair response to acute myocardial injury by facilitating cardiac leukocyte infiltration.
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Affiliation(s)
- Laurel A Grisanti
- From Center for Translational Medicine (L.A.G., A.M.G., C.J.T., J.E.G., A.A.R., E.G., R.L.C., J.E.R., W.J.K., D.G.T.), Department of Pharmacology (E.G., J.E.R., W.J.K., D.G.T.), and Department of Clinical Sciences (D.Y.), Temple University School of Medicine, Philadelphia, PA; Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine and Carlyle Fraser Heart Center, Atlanta, GA (J.W.C.); and Spanish National Center for Cardiovascular Research, Madrid, Spain (A.P.G., B.I.)
| | - Anna M Gumpert
- From Center for Translational Medicine (L.A.G., A.M.G., C.J.T., J.E.G., A.A.R., E.G., R.L.C., J.E.R., W.J.K., D.G.T.), Department of Pharmacology (E.G., J.E.R., W.J.K., D.G.T.), and Department of Clinical Sciences (D.Y.), Temple University School of Medicine, Philadelphia, PA; Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine and Carlyle Fraser Heart Center, Atlanta, GA (J.W.C.); and Spanish National Center for Cardiovascular Research, Madrid, Spain (A.P.G., B.I.)
| | - Christopher J Traynham
- From Center for Translational Medicine (L.A.G., A.M.G., C.J.T., J.E.G., A.A.R., E.G., R.L.C., J.E.R., W.J.K., D.G.T.), Department of Pharmacology (E.G., J.E.R., W.J.K., D.G.T.), and Department of Clinical Sciences (D.Y.), Temple University School of Medicine, Philadelphia, PA; Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine and Carlyle Fraser Heart Center, Atlanta, GA (J.W.C.); and Spanish National Center for Cardiovascular Research, Madrid, Spain (A.P.G., B.I.)
| | - Joshua E Gorsky
- From Center for Translational Medicine (L.A.G., A.M.G., C.J.T., J.E.G., A.A.R., E.G., R.L.C., J.E.R., W.J.K., D.G.T.), Department of Pharmacology (E.G., J.E.R., W.J.K., D.G.T.), and Department of Clinical Sciences (D.Y.), Temple University School of Medicine, Philadelphia, PA; Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine and Carlyle Fraser Heart Center, Atlanta, GA (J.W.C.); and Spanish National Center for Cardiovascular Research, Madrid, Spain (A.P.G., B.I.)
| | - Ashley A Repas
- From Center for Translational Medicine (L.A.G., A.M.G., C.J.T., J.E.G., A.A.R., E.G., R.L.C., J.E.R., W.J.K., D.G.T.), Department of Pharmacology (E.G., J.E.R., W.J.K., D.G.T.), and Department of Clinical Sciences (D.Y.), Temple University School of Medicine, Philadelphia, PA; Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine and Carlyle Fraser Heart Center, Atlanta, GA (J.W.C.); and Spanish National Center for Cardiovascular Research, Madrid, Spain (A.P.G., B.I.)
| | - Erhe Gao
- From Center for Translational Medicine (L.A.G., A.M.G., C.J.T., J.E.G., A.A.R., E.G., R.L.C., J.E.R., W.J.K., D.G.T.), Department of Pharmacology (E.G., J.E.R., W.J.K., D.G.T.), and Department of Clinical Sciences (D.Y.), Temple University School of Medicine, Philadelphia, PA; Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine and Carlyle Fraser Heart Center, Atlanta, GA (J.W.C.); and Spanish National Center for Cardiovascular Research, Madrid, Spain (A.P.G., B.I.)
| | - Rhonda L Carter
- From Center for Translational Medicine (L.A.G., A.M.G., C.J.T., J.E.G., A.A.R., E.G., R.L.C., J.E.R., W.J.K., D.G.T.), Department of Pharmacology (E.G., J.E.R., W.J.K., D.G.T.), and Department of Clinical Sciences (D.Y.), Temple University School of Medicine, Philadelphia, PA; Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine and Carlyle Fraser Heart Center, Atlanta, GA (J.W.C.); and Spanish National Center for Cardiovascular Research, Madrid, Spain (A.P.G., B.I.)
| | - Daohai Yu
- From Center for Translational Medicine (L.A.G., A.M.G., C.J.T., J.E.G., A.A.R., E.G., R.L.C., J.E.R., W.J.K., D.G.T.), Department of Pharmacology (E.G., J.E.R., W.J.K., D.G.T.), and Department of Clinical Sciences (D.Y.), Temple University School of Medicine, Philadelphia, PA; Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine and Carlyle Fraser Heart Center, Atlanta, GA (J.W.C.); and Spanish National Center for Cardiovascular Research, Madrid, Spain (A.P.G., B.I.)
| | - John W Calvert
- From Center for Translational Medicine (L.A.G., A.M.G., C.J.T., J.E.G., A.A.R., E.G., R.L.C., J.E.R., W.J.K., D.G.T.), Department of Pharmacology (E.G., J.E.R., W.J.K., D.G.T.), and Department of Clinical Sciences (D.Y.), Temple University School of Medicine, Philadelphia, PA; Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine and Carlyle Fraser Heart Center, Atlanta, GA (J.W.C.); and Spanish National Center for Cardiovascular Research, Madrid, Spain (A.P.G., B.I.)
| | - Andrés Pun García
- From Center for Translational Medicine (L.A.G., A.M.G., C.J.T., J.E.G., A.A.R., E.G., R.L.C., J.E.R., W.J.K., D.G.T.), Department of Pharmacology (E.G., J.E.R., W.J.K., D.G.T.), and Department of Clinical Sciences (D.Y.), Temple University School of Medicine, Philadelphia, PA; Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine and Carlyle Fraser Heart Center, Atlanta, GA (J.W.C.); and Spanish National Center for Cardiovascular Research, Madrid, Spain (A.P.G., B.I.)
| | - Borja Ibáñez
- From Center for Translational Medicine (L.A.G., A.M.G., C.J.T., J.E.G., A.A.R., E.G., R.L.C., J.E.R., W.J.K., D.G.T.), Department of Pharmacology (E.G., J.E.R., W.J.K., D.G.T.), and Department of Clinical Sciences (D.Y.), Temple University School of Medicine, Philadelphia, PA; Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine and Carlyle Fraser Heart Center, Atlanta, GA (J.W.C.); and Spanish National Center for Cardiovascular Research, Madrid, Spain (A.P.G., B.I.)
| | - Joseph E Rabinowitz
- From Center for Translational Medicine (L.A.G., A.M.G., C.J.T., J.E.G., A.A.R., E.G., R.L.C., J.E.R., W.J.K., D.G.T.), Department of Pharmacology (E.G., J.E.R., W.J.K., D.G.T.), and Department of Clinical Sciences (D.Y.), Temple University School of Medicine, Philadelphia, PA; Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine and Carlyle Fraser Heart Center, Atlanta, GA (J.W.C.); and Spanish National Center for Cardiovascular Research, Madrid, Spain (A.P.G., B.I.)
| | - Walter J Koch
- From Center for Translational Medicine (L.A.G., A.M.G., C.J.T., J.E.G., A.A.R., E.G., R.L.C., J.E.R., W.J.K., D.G.T.), Department of Pharmacology (E.G., J.E.R., W.J.K., D.G.T.), and Department of Clinical Sciences (D.Y.), Temple University School of Medicine, Philadelphia, PA; Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine and Carlyle Fraser Heart Center, Atlanta, GA (J.W.C.); and Spanish National Center for Cardiovascular Research, Madrid, Spain (A.P.G., B.I.)
| | - Douglas G Tilley
- From Center for Translational Medicine (L.A.G., A.M.G., C.J.T., J.E.G., A.A.R., E.G., R.L.C., J.E.R., W.J.K., D.G.T.), Department of Pharmacology (E.G., J.E.R., W.J.K., D.G.T.), and Department of Clinical Sciences (D.Y.), Temple University School of Medicine, Philadelphia, PA; Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine and Carlyle Fraser Heart Center, Atlanta, GA (J.W.C.); and Spanish National Center for Cardiovascular Research, Madrid, Spain (A.P.G., B.I.).
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Tao L, Bei Y, Zhang H, Xiao J, Li X. Exercise for the heart: signaling pathways. Oncotarget 2016; 6:20773-84. [PMID: 26318584 PMCID: PMC4673228 DOI: 10.18632/oncotarget.4770] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Accepted: 07/10/2015] [Indexed: 12/30/2022] Open
Abstract
Physical exercise, a potent functional intervention in protecting against cardiovascular diseases, is a hot topic in recent years. Exercise has been shown to reduce cardiac risk factors, protect against myocardial damage, and increase cardiac function. This improves quality of life and decreases mortality and morbidity in a variety of cardiovascular diseases, including myocardial infarction, cardiac ischemia/reperfusion injury, diabetic cardiomyopathy, cardiac aging, and pulmonary hypertension. The cellular adaptation to exercise can be associated with both endogenous and exogenous factors: (1) exercise induces cardiac growth via hypertrophy and renewal of cardiomyocytes, and (2) exercise induces endothelial progenitor cells to proliferate, migrate and differentiate into mature endothelial cells, giving rise to endothelial regeneration and angiogenesis. The cellular adaptations associated with exercise are due to the activation of several signaling pathways, in particular, the growth factor neuregulin1 (NRG1)-ErbB4-C/EBPβ and insulin-like growth factor (IGF)-1-PI3k-Akt signaling pathways. Of interest, microRNAs (miRNAs, miRs) such as miR-222 also play a major role in the beneficial effects of exercise. Thus, exploring the mechanisms mediating exercise-induced benefits will be instrumental for devising new effective therapies against cardiovascular diseases.
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Affiliation(s)
- Lichan Tao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yihua Bei
- Regeneration and Ageing Lab and Experimental Center of Life Sciences, School of Life Science, Shanghai University, Shanghai 200444, China.,Shanghai Key Laboratory of Bio-Energy Crops, School of Life Science, Shanghai University, Shanghai 200444, China
| | - Haifeng Zhang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Junjie Xiao
- Regeneration and Ageing Lab and Experimental Center of Life Sciences, School of Life Science, Shanghai University, Shanghai 200444, China.,Shanghai Key Laboratory of Bio-Energy Crops, School of Life Science, Shanghai University, Shanghai 200444, China
| | - Xinli Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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175
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Westman PC, Lipinski MJ, Luger D, Waksman R, Bonow RO, Wu E, Epstein SE. Inflammation as a Driver of Adverse Left Ventricular Remodeling After Acute Myocardial Infarction. J Am Coll Cardiol 2016; 67:2050-60. [DOI: 10.1016/j.jacc.2016.01.073] [Citation(s) in RCA: 218] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 01/20/2016] [Accepted: 01/26/2016] [Indexed: 12/18/2022]
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176
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Zhou X, Liu XL, Ji WJ, Liu JX, Guo ZZ, Ren D, Ma YQ, Zeng S, Xu ZW, Li HX, Wang PP, Zhang Z, Li YM, Benefield BC, Zawada AM, Thorp EB, Lee DC, Heine GH. The Kinetics of Circulating Monocyte Subsets and Monocyte-Platelet Aggregates in the Acute Phase of ST-Elevation Myocardial Infarction: Associations with 2-Year Cardiovascular Events. Medicine (Baltimore) 2016; 95:e3466. [PMID: 27149446 PMCID: PMC4863763 DOI: 10.1097/md.0000000000003466] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
In experimental myocardial infarction (MI), a rise in cell counts of circulating monocyte subsets contributes to impaired myocardial healing and to atherosclerotic plaque destabilization. In humans, the prognostic role of monocyte subsets in patients suffering ST-elevation MI (STEMI) is still unclear. In the present study, we aimed to determine the kinetics of the 3 monocyte subsets (classical CD14++CD16-, intermediate CD14++CD16+, and nonclassical CD14+CD16++ monocytes), as well as the subset-specific monocyte-platelet aggregates (MPA), in acute STEMI followed by primary percutaneous coronary intervention (PCI), and their relationships with cardiovascular outcomes during a 2-year follow-up.Monocyte subsets and MPA were measured in 100 STEMI patients receiving primary PCI on days 1, 2, 3, 5, and 7 of symptom onset, which were compared with 60 stable coronary heart disease patients and 35 healthy volunteers. From day 1 to day 7, significant increases in the counts of CD14++CD16+ monocytes and CD14++CD16+ MPA were observed, with peak levels on day 2. During a median follow-up of 2.0 years, 28 first cardiovascular events (defined as cardiovascular death, nonfatal ischemic stroke, recurrent MI, need for emergency or repeat revascularization, and rehospitalization for heart failure) were recorded. After adjustment for confounders, CD14++CD16+ monocytosis (day 1 [HR: 3.428; 95% CI: 1.597-7.358; P = 0.002], day 2 [HR: 4.835; 95% CI: 1.106-21.13; P = 0.04], day 3 [HR: 2.734; 95% CI: 1.138-6.564; P = 0.02], and day 7 [HR: 2.647; 95% CI: 1.196-5.861; P = 0.02]), as well as increased levels of CD14++CD16+ MPA measured on all time points (days 1, 2, 3, 5, and 7), had predictive values for adverse cardiovascular events.In conclusion, our data show the expansion of the CD14++CD16+ monocyte subset during acute phase of STEMI has predictive values for 2-year adverse cardiovascular outcomes in patients treated with primary PCI. Future studies will be warranted to elucidate whether CD14++CD16+ monocytes may become a target cell population for new therapeutic strategies after STEMI.
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Affiliation(s)
- Xin Zhou
- From the Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury (XZ, X-LL, W-JJ, J-XL, Z-ZG, DR, Y-QM, SZ, Z-WX, H-XL, Y-ML), Pingjin Hospital Heart Center, Logistics University of Chinese People's Armed Police Forces, Tianjin, China; Division of Community Health and Humanities (PPW), Faculty of Medicine, Memorial University of Newfoundland, Newfoundland and Labrador, Canada; Department of Radiology (ZZ); Feinberg Cardiovascular Research Institute (BCB, DCL); Department of Pathology (EBT), Northwestern University Feinberg School of Medicine, Chicago, IL, USA; and Department of Internal Medicine IV (AMZ and GHH), Nephrology and Hypertension, Saarland University Medical Center, Homburg, Germany
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177
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Marchetti C, Toldo S, Chojnacki J, Mezzaroma E, Liu K, Salloum FN, Nordio A, Carbone S, Mauro AG, Das A, Zalavadia AA, Halquist MS, Federici M, Van Tassell BW, Zhang S, Abbate A. Pharmacologic Inhibition of the NLRP3 Inflammasome Preserves Cardiac Function After Ischemic and Nonischemic Injury in the Mouse. J Cardiovasc Pharmacol 2016; 66:1-8. [PMID: 25915511 DOI: 10.1097/fjc.0000000000000247] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Sterile inflammation resulting from myocardial injury activates the NLRP3 inflammasome and amplifies the inflammatory response mediating further damage. METHODS We used 2 experimental models of ischemic injury (acute myocardial infarction [AMI] with and without reperfusion) and a model of nonischemic injury due to doxorubicin 10 mg/kg to determine whether the NLRP3 inflammasome preserved cardiac function after injury. RESULTS Treatment with the NLRP3 inflammasome inhibitor in the reperfused AMI model caused a significant reduction in infarct size measured at pathology or as serum cardiac troponin I level (-56% and -82%, respectively, both P < 0.001) and preserved left ventricular fractional shortening (LVFS, 31 ± 2 vs. vehicle 26% ± 1%, P = 0.003). In the non-reperfused AMI model, treatment with the NLRP3 inhibitor significantly limited LV systolic dysfunction at 7 days (LVFS of 20 ± 2 vs. 14% ± 1%, P = 0.002), without a significant effect on infarct size. In the doxorubicin model, a significant increase in myocardial interstitial fibrosis and a decline in systolic function were seen in vehicle-treated mice, whereas treatment with the NLRP3 inhibitor significantly reduced fibrosis (-80%, P = 0.001) and preserved systolic function (LVFS 35 ± 2 vs. vehicle 27% ± 2%, P = 0.017). CONCLUSIONS Pharmacological inhibition of the NLRP3 inflammasome limits cell death and LV systolic dysfunction after ischemic and nonischemic injury in the mouse.
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Affiliation(s)
- Carlo Marchetti
- *VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA; †Victoria Johnson Research Laboratories, Richmond, VA; ‡Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Departments of §Medicinal Chemistry; ‖Pharmacotherapy and Outcome Studies, and ¶Pharmaceutics Virginia Commonwealth University, Richmond, VA
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178
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Deletion of interleukin-6 prevents cardiac inflammation, fibrosis and dysfunction without affecting blood pressure in angiotensin II-high salt-induced hypertension. J Hypertens 2016; 33:144-52. [PMID: 25304471 DOI: 10.1097/hjh.0000000000000358] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Inflammation has been proposed as a key component in the development of hypertension and cardiac remodeling associated with different cardiovascular diseases. However, the role of the proinflammatory cytokine interleukin-6 in the chronic stage of hypertension is not well defined. Here, we tested the hypothesis that deletion of interleukin-6 protects against the development of hypertension, cardiac inflammation, fibrosis, remodeling and dysfunction induced by high salt diet and angiotensin II (Ang II). METHODS Male C57BL/6J and interleukin-6-knock out (KO) mice were implanted with telemetry devices for blood pressure (BP) measurements, fed a 4% NaCl diet, and infused with either vehicle or Ang II (90 ng/min per mouse subcutaneously) for 8 weeks. We studied BP and cardiac function by echocardiography at baseline, 4 and 8 weeks. RESULTS Myocyte cross-sectional area (MCSA), macrophage infiltration, and myocardial fibrosis were also assessed. BP increased similarly in both strains when treated with Ang II and high salt (Ang II-high salt); however, C57BL/6J mice developed a more severe decrease in left ventricle ejection fraction, fibrosis, and macrophage infiltration compared with interleukin-6-KO mice. No differences between strains were observed in MCSA, capillary density and MCSA to capillary density ratio. CONCLUSION In conclusion, absence of interleukin -6 did not alter the development of Ang II-high salt-induced hypertension and cardiac hypertrophy, but it prevented the development of cardiac dysfunction, myocardial inflammation, and fibrosis. This indicates that interleukin-6 plays an important role in hypertensive heart damage but not in the development of hypertension.
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179
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Kelkar AA, Butler J, Schelbert EB, Greene SJ, Quyyumi AA, Bonow RO, Cohen I, Gheorghiade M, Lipinski MJ, Sun W, Luger D, Epstein SE. Mechanisms Contributing to the Progression of Ischemic and Nonischemic Dilated Cardiomyopathy: Possible Modulating Effects of Paracrine Activities of Stem Cells. J Am Coll Cardiol 2016; 66:2038-2047. [PMID: 26516007 DOI: 10.1016/j.jacc.2015.09.010] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 08/24/2015] [Accepted: 09/02/2015] [Indexed: 02/08/2023]
Abstract
Over the past 1.5 decades, numerous stem cell trials have been performed in patients with cardiovascular disease. Although encouraging outcome signals have been reported, these have been small, leading to uncertainty as to whether they will translate into significantly improved outcomes. A reassessment of the rationale for the use of stem cells in cardiovascular disease is therefore timely. Such a rationale should include analyses of why previous trials have not produced significant benefit and address whether mechanisms contributing to disease progression might benefit from known activities of stem cells. The present paper provides such a reassessment, focusing on patients with left ventricular systolic dysfunction, either nonischemic or ischemic. We conclude that many mechanisms contributing to progressive left ventricular dysfunction are matched by stem cell activities that could attenuate the myocardial effect of such mechanisms. This suggests that stem cell strategies may improve patient outcomes and justifies further testing.
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Affiliation(s)
| | | | - Erik B Schelbert
- Cardiology Division, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Stephen J Greene
- Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Robert O Bonow
- Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ira Cohen
- Stony Brook University, Stony Brook, New York
| | - Mihai Gheorghiade
- Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Michael J Lipinski
- MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, DC
| | - Wei Sun
- MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, DC
| | - Dror Luger
- MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, DC
| | - Stephen E Epstein
- MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, DC
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180
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Kan X, Wu Y, Ma Y, Zhang C, Li P, Wu L, Zhang S, Li Y, Du J. Deficiency of IL-12p35 improves cardiac repair after myocardial infarction by promoting angiogenesis. Cardiovasc Res 2016; 109:249-259. [DOI: 10.1093/cvr/cvv255] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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181
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Börekçi A, Gür M, Türkoğlu C, Baykan AO, Şeker T, Şahin DY, Harbalıoğlu H, Elbasan Z, Topuz M, Çaylı M. Neutrophil to Lymphocyte Ratio Predicts Left Ventricular Remodeling in Patients with ST Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention. Korean Circ J 2016; 46:15-22. [PMID: 26798381 PMCID: PMC4720845 DOI: 10.4070/kcj.2016.46.1.15] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/24/2015] [Accepted: 07/27/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES It has been demonstrated that the neutrophil/lymphocyte ratio (NLR) might be a useful marker to predict cardiovascular risk and events. We aimed to investigate the role of the NLR to predict ventricular remodeling (VR) in patients with anterior ST-elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention. SUBJECTS AND METHODS We prospectively included 274 consecutive anterior STEMI patients. Echocardiography was performed during admission and at six months after myocardial infarction. VR was defined as at least 20% increase from baseline in left ventricular end-diastolic volume. Patients were divided into two groups according to their VR status: VR (n=67) and non-VR (n=207). Total and differential leukocyte count, N-terminal pro-brain natriuretic peptide (NT-proBNP) and other biochemical markers were measured at admission and 24 hours later. RESULTS Compared with the non-VR group, peak creatine kinase MB (CK-MB), NT-proBNP (24 h), neutrophil/lymphocyte ratio, presence of diabetes, no-reflow frequency and wall motion score index were significantly higher in patients with VR (p<0.05 for all). On multivariate logistic regression analysis, NLR (β=2.000, 95% confidence interval=1.577-2.537, p<0.001) as well as peak CK-MB, NT-proBNP (24 h), WMSI and diabetes incidence were associated with VR. The cutoff value of the neutrophil/lymphocyte ratio obtained by receiver operator characteristic curve analysis was 4.25 for the prediction of VR (sensitivity: 79 %, specificity: 74%). CONCLUSION In patients with anterior STEMI, initial NLR and NT-proBNP measured 24 hours after admission may be useful for predicting adverse cardiovascular events including left VR.
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Affiliation(s)
- Abdurrezzak Börekçi
- Department of Cardiology, School of Medicine, Kafkas University, Kars, Turkey
| | - Mustafa Gür
- Department of Cardiology, School of Medicine, Kafkas University, Kars, Turkey
| | - Caner Türkoğlu
- Department of Cardiology, Yenimahalle State Hospital, Ankara, Turkey
| | - Ahmet Oytun Baykan
- Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Taner Şeker
- Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Durmuş Yıldıray Şahin
- Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Hazar Harbalıoğlu
- Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Zafer Elbasan
- Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Mustafa Topuz
- Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Murat Çaylı
- Department of Cardiology, School of Medicine, Dicle University, Diyarbakır, Turkey
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Saxena A, Russo I, Frangogiannis NG. Inflammation as a therapeutic target in myocardial infarction: learning from past failures to meet future challenges. Transl Res 2016; 167:152-66. [PMID: 26241027 PMCID: PMC4684426 DOI: 10.1016/j.trsl.2015.07.002] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 07/08/2015] [Accepted: 07/09/2015] [Indexed: 12/14/2022]
Abstract
In the infarcted myocardium, necrotic cardiomyocytes release danger signals, activating an intense inflammatory response. Inflammatory pathways play a crucial role in regulation of a wide range of cellular processes involved in injury, repair, and remodeling of the infarcted heart. Proinflammatory cytokines, such as tumor necrosis factor α and interleukin 1, are markedly upregulated in the infarcted myocardium and promote adhesive interactions between endothelial cells and leukocytes by stimulating chemokine and adhesion molecule expression. Distinct pairs of chemokines and chemokine receptors are implicated in recruitment of various leukocyte subpopulations in the infarcted myocardium. For more than the past 30 years, extensive experimental work has explored the role of inflammatory signals and the contributions of leukocyte subpopulations in myocardial infarction. Robust evidence derived from experimental models of myocardial infarction has identified inflammatory targets that may attenuate cardiomyocyte injury or protect from adverse remodeling. Unfortunately, attempts to translate the promising experimental findings to clinical therapy have failed. This review article discusses the biology of the inflammatory response after myocardial infarction, attempts to identify the causes for the translational failures of the past, and proposes promising new therapeutic directions. Because of their potential involvement in injurious, reparative, and regenerative responses, inflammatory cells may hold the key for design of new therapies in myocardial infarction.
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Affiliation(s)
- Amit Saxena
- Department of Medicine (Cardiology), The Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, Bronx, NY
| | - Ilaria Russo
- Department of Medicine (Cardiology), The Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, Bronx, NY
| | - Nikolaos G Frangogiannis
- Department of Medicine (Cardiology), The Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, Bronx, NY.
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183
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Alestalo K, Miettinen JA, Vuolteenaho O, Huikuri H, Lehenkari P. Bone Marrow Mononuclear Cell Transplantation Restores Inflammatory Balance of Cytokines after ST Segment Elevation Myocardial Infarction. PLoS One 2015; 10:e0145094. [PMID: 26690350 PMCID: PMC4687062 DOI: 10.1371/journal.pone.0145094] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 11/29/2015] [Indexed: 01/10/2023] Open
Abstract
Background Acute myocardial infarction (AMI) launches an inflammatory response and a repair process to compensate cardiac function. During this process, the balance between proinflammatory and anti-inflammatory cytokines is important for optimal cardiac repair. Stem cell transplantation after AMI improves tissue repair and increases the ventricular ejection fraction. Here, we studied in detail the acute effect of bone marrow mononuclear cell (BMMNC) transplantation on proinflammatory and anti-inflammatory cytokines in patients with ST segment elevation myocardial infarction (STEMI). Methods Patients with STEMI treated with thrombolysis followed by percutaneous coronary intervention (PCI) were randomly assigned to receive either BMMNC or saline as an intracoronary injection. Cardiac function was evaluated by left ventricle angiogram during the PCI and again after 6 months. The concentrations of 27 cytokines were measured from plasma samples up to 4 days after the PCI and the intracoronary injection. Results Twenty-six patients (control group, n = 12; BMMNC group, n = 14) from the previously reported FINCELL study (n = 80) were included to this study. At day 2, the change in the proinflammatory cytokines correlated with the change in the anti-inflammatory cytokines in both groups (Kendall’s tau, control 0.6; BMMNC 0.7). At day 4, the correlation had completely disappeared in the control group but was preserved in the BMMNC group (Kendall’s tau, control 0.3; BMMNC 0.7). Conclusions BMMNC transplantation is associated with preserved balance between pro- and anti-inflammatory cytokines after STEMI in PCI-treated patients. This may partly explain the favorable effect of stem cell transplantation after AMI.
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Affiliation(s)
- Kirsi Alestalo
- Surgery Clinic, Medical Research Center, Oulu University Hospital, Oulu, Finland
- Department of Anatomy and Cell Biology, Medical Research Center, University of Oulu, Oulu, Finland
- * E-mail:
| | - Johanna A. Miettinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Olli Vuolteenaho
- Department of Physiology, Institute of Biomedicine, University of Oulu, Oulu, Finland
| | - Heikki Huikuri
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Petri Lehenkari
- Surgery Clinic, Medical Research Center, Oulu University Hospital, Oulu, Finland
- Department of Anatomy and Cell Biology, Medical Research Center, University of Oulu, Oulu, Finland
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184
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van Hout GPJ, Jansen of Lorkeers SJ, Wever KE, Sena ES, Kouwenberg LHJA, van Solinge WW, Macleod MR, Doevendans PA, Pasterkamp G, Chamuleau SAJ, Hoefer IE. Translational failure of anti-inflammatory compounds for myocardial infarction: a meta-analysis of large animal models. Cardiovasc Res 2015; 109:240-8. [PMID: 26487693 DOI: 10.1093/cvr/cvv239] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 10/11/2015] [Indexed: 02/01/2023] Open
Abstract
AIMS Numerous anti-inflammatory drugs have been tested in large animal studies of myocardial infarction (MI). Despite positive results, translation of anti-inflammatory strategies into clinical practice has proved to be difficult. Critical disparities between preclinical and clinical study design that influence efficacy may partly be responsible for this translational failure. The aim of the present systematic review was to better understand which factors underlie the failure of transition towards the clinic. METHODS AND RESULTS Meta-analysis and regression of large animal studies were performed to identify sources that influenced effect size of anti-inflammatory compounds in large animal models of MI. We included 183 studies, containing 3331 large animals. Infarct size (IS) as a ratio of the area at risk (12.7%; 95% confidence interval, CI 11.1-14.4%, P < 0.001) and IS as a ratio of the left ventricle (3.9%; 95% CI 3.1-4.7%, P < 0.001) were reduced in treatment compared with control groups. Effect size was higher when outcome was assessed early after MI (P = 0.013) and where studies included only male animals (P < 0.001). Mortality in treated animals was higher in studies that blinded the investigator during the experiment (P = 0.041) and depended on the type of drug used (P < 0.001). CONCLUSIONS As expected, treatment with anti-inflammatory drugs leads to smaller infarct size in large animal MI models. Timing of outcome assessment, sex, and study quality are significantly associated with outcome and may explain part of the translational failure in clinical settings. Effect size depends on the type of drug used, enabling identification of compounds for future clinical testing.
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Affiliation(s)
- Gerardus P J van Hout
- Experimental Cardiology Laboratory, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584CX, The Netherlands
| | | | - Kimberly E Wever
- Systematic Review Centre for Laboratory Animal Experimentation, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Emily S Sena
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Lisanne H J A Kouwenberg
- Experimental Cardiology Laboratory, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584CX, The Netherlands
| | - Wouter W van Solinge
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Malcolm R Macleod
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Pieter A Doevendans
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gerard Pasterkamp
- Experimental Cardiology Laboratory, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584CX, The Netherlands Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Steven A J Chamuleau
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Imo E Hoefer
- Experimental Cardiology Laboratory, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584CX, The Netherlands Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
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185
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Elevated mean neutrophil volume represents altered neutrophil composition and reflects damage after myocardial infarction. Basic Res Cardiol 2015; 110:58. [PMID: 26467178 PMCID: PMC4605987 DOI: 10.1007/s00395-015-0513-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 09/22/2015] [Accepted: 09/24/2015] [Indexed: 11/27/2022]
Abstract
Myocardial infarction (MI) induces an inflammatory response in which neutrophils fulfill a prominent role. Mean neutrophil volume (MNV) represents the average size of the circulating neutrophil population. Our goal was to determine the effect of MI on MNV and investigate the mechanisms behind MNV elevation. MNV of 84 MI patients was compared with the MNV of 209 stable angina patients and correlated to simultaneously measured CK levels. Fourteen pigs were subjected to temporary coronary balloon occlusion and blood was sampled at multiple time points to measure MNV. Echocardiography was performed followed by ex vivo infarct size assessment after 72 h. MNV was higher in MI patients compared to stable angina patients (602 SD26 AU vs. 580 SD20 AU, p < 0.0001) and correlated with simultaneously measured CK levels (R = 0.357, p < 0.0001). In pigs, MNV was elevated post-MI (451 SD11 AU vs. 469 SD12 AU), p < 0.0001). MNV correlated with infarct size (R = 0.705, p = 0.007) and inversely correlated with left ventricular ejection fraction (R = −0.718, p = 0.009). Cell sorting revealed an increased presence of banded neutrophils after MI, which have a higher MNV compared to mature neutrophils post-MI (495 SD14 AU vs. 478 SD11 AU, p = 0.012). MNV from coronary sinus blood was higher than MNV of neutrophils from simultaneously sampled arterial blood (463 SD7.6 AU vs. 461 SD8.6 AU, p = 0.013) post-MI. The current study shows MNV is elevated and reflects cardiac damage post-MI. MNV increases due to altered neutrophil composition and systemic neutrophil activation. MNV may be an interesting parameter for prognostic assessment in MI and provide new insights into pathological innate immune responses evoked by ischemia–reperfusion.
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186
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Seropian IM, Abbate A. Letter by Seropian and Abbate regarding article, "effect of tumor necrosis factor inhibitor treatment on proximal right coronary chronic total occlusion in a patient with rheumatoid arthritis". Circulation 2015; 132:e162. [PMID: 26416635 DOI: 10.1161/circulationaha.115.015865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ignacio M Seropian
- Interventional Cardiology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Antonio Abbate
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA
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187
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Hinkel R, Lange P, Petersen B, Gottlieb E, Ng JKM, Finger S, Horstkotte J, Lee S, Thormann M, Knorr M, El-Aouni C, Boekstegers P, Reichart B, Wenzel P, Niemann H, Kupatt C. Heme Oxygenase-1 Gene Therapy Provides Cardioprotection Via Control of Post-Ischemic Inflammation: An Experimental Study in a Pre-Clinical Pig Model. J Am Coll Cardiol 2015; 66:154-65. [PMID: 26160631 DOI: 10.1016/j.jacc.2015.04.064] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 04/01/2015] [Accepted: 04/13/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND Heme oxygenase-1 (HO-1) is an inducible stress-responsive enzyme converting heme to bilirubin, carbon monoxide, and free iron, which exerts anti-inflammatory and antiapoptotic effects. Although efficient cardioprotection after HO-1 overexpression has been reported in rodents, its role in attenuating post-ischemic inflammation is unclear. OBJECTIVES This study assessed the efficacy of recombinant adenoassociated virus (rAAV)-encoding human heme oxygenase-1 (hHO-1) in attenuating post-ischemic inflammation in a murine and a porcine ischemia/reperfusion model. METHODS Murine ischemia was induced by 45 min of left anterior descending occlusion, followed by 24 h of reperfusion and functional as well as fluorescent-activated cell sorting analysis. Porcine hearts were subjected to 60 min of ischemia and 24h of reperfusion before hemodynamic and histologic analyses were performed. RESULTS Human microvascular endothelial cells transfected with hHO-1 displayed an attenuated interleukin-6 and intercellular adhesion molecule 1 expression, resulting in reduced monocytic THP-1 cell recruitment in vitro. In murine left anterior descending occlusion and reperfusion, the post-ischemic influx of CD45(+) leukocytes, Ly-6G(+) neutrophils, and Ly-6C(high) monocytes was further exacerbated in HO-1-deficient hearts and reversed by rAAV.hHO-1 treatment. Conversely, in our porcine model of ischemia, the post-ischemic influx of myeloperoxidase-positive neutrophils and CD14(+) monocytes was reduced by 49% and 87% after rAAV.hHO-1 transduction, similar to hHO-1 transgenic pigs. Functionally, rAAV.hHO-1 and hHO-1 transgenic left ventricles displayed a smaller loss of ejection fraction than control animals. CONCLUSIONS Whereas HO-1 deficiency exacerbates post-ischemic cardiac inflammation in mice, hHO-1 gene therapy attenuates inflammation after ischemia and reperfusion in murine and porcine hearts. Regional hHO-1 gene therapy provides cardioprotection in a pre-clinical porcine ischemia/reperfusion model.
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Affiliation(s)
- Rabea Hinkel
- Medizinische Klinik I, Klinikum Grosshadern, Ludwig Maximilian University, Munich, Germany; Institute for Cardiovascular Prevention, Ludwig Maximillian University, Munich, Germany; Medizinische Klinik I, Klinikum Rechts der Isar, Technical University of Munich, and German Center for Cardiovascular Research, partner site Munich Heart Alliance, Munich, Germany
| | - Philipp Lange
- Medizinische Klinik I, Klinikum Grosshadern, Ludwig Maximilian University, Munich, Germany
| | - Björn Petersen
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Mariensee, Germany
| | - Elena Gottlieb
- Medizinische Klinik I, Klinikum Grosshadern, Ludwig Maximilian University, Munich, Germany
| | - Judy King Man Ng
- Medizinische Klinik I, Klinikum Grosshadern, Ludwig Maximilian University, Munich, Germany; Medizinische Klinik I, Klinikum Rechts der Isar, Technical University of Munich, and German Center for Cardiovascular Research, partner site Munich Heart Alliance, Munich, Germany
| | - Stefanie Finger
- Department of Medicine 2, Center for Thrombosis and Hemostasis Mainz and German Center for Cardiovascular Research, partner site Rhine Main, Mainz, Germany
| | - Jan Horstkotte
- Medizinische Klinik I, Klinikum Grosshadern, Ludwig Maximilian University, Munich, Germany
| | - Seungmin Lee
- Medizinische Klinik I, Klinikum Grosshadern, Ludwig Maximilian University, Munich, Germany
| | - Michael Thormann
- Medizinische Klinik I, Klinikum Grosshadern, Ludwig Maximilian University, Munich, Germany
| | - Maike Knorr
- Department of Medicine 2, Center for Thrombosis and Hemostasis Mainz and German Center for Cardiovascular Research, partner site Rhine Main, Mainz, Germany
| | - Chiraz El-Aouni
- Medizinische Klinik I, Klinikum Grosshadern, Ludwig Maximilian University, Munich, Germany
| | - Peter Boekstegers
- Medizinische Klinik I, Klinikum Grosshadern, Ludwig Maximilian University, Munich, Germany
| | - Bruno Reichart
- Walter-Brendel-Centre for Experimental Medicine, Munich, Germany
| | - Philip Wenzel
- Department of Medicine 2, Center for Thrombosis and Hemostasis Mainz and German Center for Cardiovascular Research, partner site Rhine Main, Mainz, Germany
| | - Heiner Niemann
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut, Mariensee, Germany
| | - Christian Kupatt
- Medizinische Klinik I, Klinikum Grosshadern, Ludwig Maximilian University, Munich, Germany; Medizinische Klinik I, Klinikum Rechts der Isar, Technical University of Munich, and German Center for Cardiovascular Research, partner site Munich Heart Alliance, Munich, Germany; Walter-Brendel-Centre for Experimental Medicine, Munich, Germany.
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188
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Abstract
Myocardial infarction is defined as sudden ischemic death of myocardial tissue. In the clinical context, myocardial infarction is usually due to thrombotic occlusion of a coronary vessel caused by rupture of a vulnerable plaque. Ischemia induces profound metabolic and ionic perturbations in the affected myocardium and causes rapid depression of systolic function. Prolonged myocardial ischemia activates a "wavefront" of cardiomyocyte death that extends from the subendocardium to the subepicardium. Mitochondrial alterations are prominently involved in apoptosis and necrosis of cardiomyocytes in the infarcted heart. The adult mammalian heart has negligible regenerative capacity, thus the infarcted myocardium heals through formation of a scar. Infarct healing is dependent on an inflammatory cascade, triggered by alarmins released by dying cells. Clearance of dead cells and matrix debris by infiltrating phagocytes activates anti-inflammatory pathways leading to suppression of cytokine and chemokine signaling. Activation of the renin-angiotensin-aldosterone system and release of transforming growth factor-β induce conversion of fibroblasts into myofibroblasts, promoting deposition of extracellular matrix proteins. Infarct healing is intertwined with geometric remodeling of the chamber, characterized by dilation, hypertrophy of viable segments, and progressive dysfunction. This review manuscript describes the molecular signals and cellular effectors implicated in injury, repair, and remodeling of the infarcted heart, the mechanistic basis of the most common complications associated with myocardial infarction, and the pathophysiologic effects of established treatment strategies. Moreover, we discuss the implications of pathophysiological insights in design and implementation of new promising therapeutic approaches for patients with myocardial infarction.
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Affiliation(s)
- Nikolaos G Frangogiannis
- The Wilf Family Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
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189
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Alfaidi M, Wilson H, Daigneault M, Burnett A, Ridger V, Chamberlain J, Francis S. Neutrophil elastase promotes interleukin-1β secretion from human coronary endothelium. J Biol Chem 2015; 290:24067-78. [PMID: 26269588 DOI: 10.1074/jbc.m115.659029] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Indexed: 11/06/2022] Open
Abstract
The endothelium is critically involved in the pathogenesis of atherosclerosis by producing pro-inflammatory mediators, including IL-1β. Coronary arteries from patients with ischemic heart disease express large amounts of IL-1β in the endothelium. However, the mechanism by which endothelial cells (ECs) release IL-1β remains to be elucidated. We investigated neutrophil elastase (NE), a potent serine protease detected in vulnerable areas of human carotid plaques, as a potential "trigger" for IL-1β processing and release. This study tested the hypothesis that NE potentiates the processing and release of IL-1β from human coronary endothelium. We found that NE cleaves the pro-isoform of IL-1β in ECs and causes significant secretion of bioactive IL-1β via extracellular vesicles. This release was attenuated significantly by inhibition of neutrophil elastase but not caspase-1. Transient increases in intracellular Ca(2+) levels were observed prior to secretion. Inside ECs, and after NE treatment only, IL-1β was detected within LAMP-1-positive multivesicular bodies. The released vesicles contained bioactive IL-1β. In vivo, in experimental atherosclerosis, NE was detected in mature atherosclerotic plaques, predominantly in the endothelium, alongside IL-1β. This study reveals a novel mechanistic link between NE expression in atherosclerotic plaques and concomitant pro-inflammatory bioactive IL-1β secretion from ECs. This could reveal additional potential anti-IL-1β therapeutic targets and provide further insights into the inflammatory process by which vascular disease develops.
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Affiliation(s)
- Mabruka Alfaidi
- From the Department of Cardiovascular Science, Medical School, University of Sheffield, Sheffield S10 2RX, United Kingdom
| | - Heather Wilson
- From the Department of Cardiovascular Science, Medical School, University of Sheffield, Sheffield S10 2RX, United Kingdom
| | - Marc Daigneault
- From the Department of Cardiovascular Science, Medical School, University of Sheffield, Sheffield S10 2RX, United Kingdom
| | - Amanda Burnett
- From the Department of Cardiovascular Science, Medical School, University of Sheffield, Sheffield S10 2RX, United Kingdom
| | - Victoria Ridger
- From the Department of Cardiovascular Science, Medical School, University of Sheffield, Sheffield S10 2RX, United Kingdom
| | - Janet Chamberlain
- From the Department of Cardiovascular Science, Medical School, University of Sheffield, Sheffield S10 2RX, United Kingdom
| | - Sheila Francis
- From the Department of Cardiovascular Science, Medical School, University of Sheffield, Sheffield S10 2RX, United Kingdom
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190
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Yu X, Liao Y. New insights into autocrine cytokines produced by ischemic cardiomyocytes and ventricular remodeling. SCIENCE CHINA-LIFE SCIENCES 2015. [PMID: 26208823 DOI: 10.1007/s11427-015-4883-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Xian Yu
- Laboratory of Cardiovascular Immunology, Institute of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.,Laboratory of Biological Targeted Therapy of the Ministry of Education, Wuhan, 430022, China
| | - YuHua Liao
- Laboratory of Cardiovascular Immunology, Institute of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. .,Laboratory of Biological Targeted Therapy of the Ministry of Education, Wuhan, 430022, China.
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191
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State of the Art on the Evidence Base in Cardiac Regenerative Therapy: Overview of 41 Systematic Reviews. BIOMED RESEARCH INTERNATIONAL 2015; 2015:613782. [PMID: 26176013 PMCID: PMC4484838 DOI: 10.1155/2015/613782] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 03/16/2015] [Indexed: 02/05/2023]
Abstract
Objectives. To provide a comprehensive appraisal of the evidence from secondary research on cardiac regenerative therapy. Study Design and Setting. Overview of systematic reviews of controlled clinical trials concerning stem cell administration or mobilization in patients with cardiovascular disease. Results. After a systematic database search, we short-listed 41 reviews (660 patients). Twenty-two (54%) reviews focused on acute myocardial infarction (AMI), 19 (46%) on chronic ischemic heart disease (IHD) or heart failure (HF), 29 (71%) on bone marrow-derived stem-cells (BMSC), and 36 (88%) to randomized trials only. Substantial variability among reviews was found for validity (AMSTAR score: median 9 [minimum 3]; 1st quartile 9; 3rd quartile 10; maximum 11), effect estimates (change in ejection fraction from baseline to follow-up: 3.47% [0.02%; 2.90%; 4.22%; 6.11%]), and citations (Web of Science yearly citations: 4.1 [0; 2.2; 6.5; 68.9]). No significant association was found between these three features. However, reviews focusing on BMSC therapy had higher validity scores (P = 0.008) and showed more pronounced effect estimates (P = 0.002). Higher citations were associated with journal impact factor (P = 0.007), corresponding author from North America/Europe (P = 0.022), and inclusion of nonrandomized trials (P = 0.046). Conclusions. Substantial heterogeneity is apparent among these reviews in terms of quality and effect estimates.
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192
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Thymoquinone Protects against Myocardial Ischemic Injury by Mitigating Oxidative Stress and Inflammation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:143629. [PMID: 26101531 PMCID: PMC4458551 DOI: 10.1155/2015/143629] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 02/21/2015] [Indexed: 02/01/2023]
Abstract
The present study was aimed at investigating the cardioprotective activity of thymoquinone (TMQ), an active principle of the herb, Nigella sativa, which is used for the management of various diseases. The present study examined the cardioprotective effect of TMQ in isoproterenol- (ISP-) induced myocardial infarction in rats. Myocardial infarction was induced by two subcutaneous injections of ISP (85 mg/kg) at an interval of 24 hr. TMQ (20 mg/kg) was administered orally for 21 days. ISP-treated rats showed depletion of antioxidants and marker enzymes from myocardium along with lipid peroxidation and enhanced levels of proinflammatory cytokines. ISP also induced histopathological alterations in myocardium. Treatment with TMQ prevented the depletion of endogenous antioxidants and myocyte injury marker enzymes and inhibited lipid peroxidation as well as reducing the levels of proinflammatory cytokines. TMQ pretreatment also reduced myonecrosis, edema, and infiltration of inflammatory cells and showed preservation of cardiomyocytes histoarchitecture. The present study results demonstrate that TMQ exerts cardioprotective effect by mitigating oxidative stress, augmenting endogenous antioxidants, and maintaining structural integrity. The results of the present study indicate that TMQ may serve as an excellent agent alone or as adjuvant to prevent the onset and progression of myocardial injury.
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193
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Jeong MH. Searching for the key to improve infarcted cardiac wall motion and prevent ventricular remodeling after ST-segment elevation myocardial infarction: Beyond symptom-onset-to-balloon time. Anatol J Cardiol 2015; 15:371-2. [PMID: 25993712 PMCID: PMC5779172 DOI: 10.5152/akd.2015.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Myung Ho Jeong
- Professor, Principal Investigator of Korea Acute Myocardial Infarction Registry, Director of The Heart Research Center Nominated by Korea Ministry of Health and Welfare, Chonnam National University Hospital; Dongku, Gwangju-Republic of Korea.
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194
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Toldo S, Mezzaroma E, Mauro AG, Salloum F, Van Tassell BW, Abbate A. The inflammasome in myocardial injury and cardiac remodeling. Antioxid Redox Signal 2015; 22:1146-61. [PMID: 25330141 DOI: 10.1089/ars.2014.5989] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
SIGNIFICANCE An inflammatory response follows an injury of any nature, and while such a response is an attempt to promote healing, it may, itself, result in further injury. RECENT ADVANCES The inflammasome is a macromolecular structure recently recognized as a central mediator in the acute inflammatory response. The inflammasome senses the injury and it amplifies the response by leading to the release of powerful pro-inflammatory cytokines, interleukin-1β (IL-1β) and IL-18. CRITICAL ISSUES The activation of the inflammasome in the heart during ischemic and nonischemic injury represents an exaggerated response to sterile injury and promotes adverse cardiac remodeling and failure. FUTURE DIRECTIONS Pilot clinical trials have explored blockade of the inflammasome-derived IL-1β and have shown beneficial effects on cardiac function. Additional clinical studies testing this approach are warranted. Moreover, specific inflammasome inhibitors that are ready for clinical use are currently lacking.
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Affiliation(s)
- Stefano Toldo
- 1 VCU Pauley Heart Center, Virginia Commonwealth University , Richmond, Virginia
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195
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Yu J, Lu Y, Li Y, Xiao L, Xing Y, Li Y, Wu L. Role of S100A1 in hypoxia-induced inflammatory response in cardiomyocytes via TLR4/ROS/NF-κB pathway. J Pharm Pharmacol 2015; 67:1240-50. [PMID: 25880347 DOI: 10.1111/jphp.12415] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 02/27/2015] [Indexed: 01/28/2023]
Abstract
Abstract
Objectives
S100A1 plays a crucial role in hypoxia-induced inflammatory response in cardiomyocytes. However, the role of S100A1 in hypoxia-induced inflammatory response in cardiomyocytes is still unknown.
Methods
enzyme-linked immunosorbent assay (ELISA) was performed for the determination of inflammatory cytokines. Immunocytochemistry and immunofluorescence, Western blot analysis and Real-time polymerase chain reaction (RT-PCR) were conducted to assess protein or mRNA expressions. Fluorogenic probe dihydroethidium (DHE) was used to evaluate the generation of reactive oxygen species (ROS) while Hoechst 33342 staining for apoptosis. Small interfering RNA (siRNA) for S100A1 was used to evaluate the role of S100A1.
Key findings
The levels of ROS and inflammatory cytokine including tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6 and IL-8 in H9c2 cells were increased remarkably by hypoxia. However, IL-37 protein or mRNA levels were decreased significantly. Both Toll-like receptor 4 (TLR4) inhibitor Ethyl (6R)-6-[N-(2-Chloro-4fluorophenyl)sulfamoyl]cyclohex-1-ene-1-carboxylate (TAK-242) treatment or siRNA S100A1 downregulated TLR4 expression and inflammatory cytokine level and mRNA in H9c2 cells, as well as weakening ROS and phospho-p65 Nuclear factor (NF)-κB levels. Further, S100A1 treatment significantly reduced TNF-α protein or mRNA level whereas enhanced IL-37 protein or mRNA level, and could attenuate ROS and phospho-p65 NF-κB levels.
Conclusions
Our results demonstrate that S100A1 can regulate the inflammatory response and oxidative stress in H9C2 cells via TLR4/ROS/NF-κB pathway. These findings provide an interesting strategy for protecting cardiomyocytes from hypoxia-induced inflammatory response.
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Affiliation(s)
- Jiangkun Yu
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yanyu Lu
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yapeng Li
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lili Xiao
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yu Xing
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yanshen Li
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Leiming Wu
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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196
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Peruzzi M, Biondi-Zoccai G, Abbate A, Giordano A, Frati G. Commentary: which comes first, the phoenix or the flame? Reflections on the role of inflammation in patients undergoing lower limb revascularization for peripheral artery disease. J Endovasc Ther 2015; 22:240-2. [PMID: 25809369 DOI: 10.1177/1526602815573217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
| | - Giuseppe Biondi-Zoccai
- Sapienza University of Rome, Latina, Italy Eleonora Lorillard Spencer Cenci Foundation, Rome, Italy
| | | | - Arturo Giordano
- Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy Casa di Salute Santa Lucia, San Giuseppe Vesuviano, Italy
| | - Giacomo Frati
- Sapienza University of Rome, Latina, Italy IRCCS Neuromed, Pozzilli, Italy
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197
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Seropian IM, Sonnino C, Van Tassell BW, Biasucci LM, Abbate A. Inflammatory markers in ST-elevation acute myocardial infarction. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2015; 5:382-95. [PMID: 25681486 DOI: 10.1177/2048872615568965] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 01/02/2015] [Indexed: 01/05/2023]
Abstract
After acute myocardial infarction, ventricular remodeling is characterized by changes at the molecular, structural, geometrical and functional level that determine progression to heart failure. Inflammation plays a key role in wound healing and scar formation, affecting ventricular remodeling. Several, rather different, components of the inflammatory response were studied as biomarkers in ST-elevation acute myocardial infarction. Widely available and inexpensive tests, such as leukocyte count at admission, as well as more sophisticated immunoassays provide powerful predictors of adverse outcome in patients with ST-elevation acute myocardial infarction. We review the value of inflammatory markers in ST-elevation acute myocardial infarction and their association with ventricular remodeling, heart failure and sudden death. In conclusion, the use of these biomarkers may identify subjects at greater risk of adverse events and perhaps provide an insight into the mechanisms of disease progression.
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Affiliation(s)
- Ignacio M Seropian
- Interventional Cardiology Department, Hospital Italiano de Buenos Aires, Argentina
| | - Chiara Sonnino
- VCU Pauley Heart Center, Virginia Commonwealth University, USA Victoria Johnson Research Laboratory, Virginia Commonwealth University, USA Department of Cardiovascular Medicine, Catholic University, Italy
| | - Benjamin W Van Tassell
- VCU Pauley Heart Center, Virginia Commonwealth University, USA Victoria Johnson Research Laboratory, Virginia Commonwealth University, USA School of Pharmacy, Virginia Commonwealth University, USA
| | - Luigi M Biasucci
- Department of Cardiovascular Medicine, Catholic University, Italy
| | - Antonio Abbate
- VCU Pauley Heart Center, Virginia Commonwealth University, USA Victoria Johnson Research Laboratory, Virginia Commonwealth University, USA
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198
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Traditional Chinese Medication Qiliqiangxin attenuates cardiac remodeling after acute myocardial infarction in mice. Sci Rep 2015; 5:8374. [PMID: 25669146 PMCID: PMC4648480 DOI: 10.1038/srep08374] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 01/12/2015] [Indexed: 12/15/2022] Open
Abstract
In a multicenter randomized double-blind study we demonstrated that Qiliqiangxin (QLQX), a traditional Chinese medicine, had a protective effect in heart failure patients. However, whether and via which mechanism QLQX attenuates cardiac remodeling after acute myocardial infarction (AMI) is still unclear. AMI was created by ligating the left anterior descending coronary artery in mice. Treating the mice in the initial 3 days after AMI with QLQX did not change infarct size. However, QLQX treatment ameliorated adverse cardiac remodeling 3 weeks after AMI including better preservation of cardiac function, decreased apoptosis and reduced fibrosis. Peroxisome proliferator-activated receptor-γ (PPARγ) was down-regulated in control animals after AMI and up-regulated by QLQX administration. Interestingly, expression of AKT, SAPK/JNK, and ERK was not altered by QLQX treatment. Inhibition of PPARγ reduced the beneficial effects of QLQX in AMI remodeling, whereas activation of PPARγ failed to provide additional improvement in the presence of QLQX, suggesting a key role for PPARγ in the effects of QLQX during cardiac remodeling after AMI. This study indicates that QLQX attenuates cardiac remodeling after AMI by increasing PPARγ levels. Taken together, QLQX warrants further investigation as as a therapeutic intervention to mitigate remodeling and heart failure after AMI.
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199
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Comparative safety of interleukin-1 blockade with anakinra in patients with ST-segment elevation acute myocardial infarction (from the VCU-ART and VCU-ART2 pilot studies). Am J Cardiol 2015; 115:288-92. [PMID: 25482680 DOI: 10.1016/j.amjcard.2014.11.003] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Revised: 11/03/2014] [Accepted: 11/03/2014] [Indexed: 02/08/2023]
Abstract
Two pilot studies of interleukin-1 (IL-1) blockade in ST-segment elevation myocardial infarction (STEMI) showed blunted acute inflammatory response and overall favorable outcomes at 3 months follow-up. We hereby present a patient-level pooled analysis with extended follow-up of 40 patients with clinically stable STEMI randomized to anakinra, a recombinant IL-1 receptor antagonist, 100 mg/day for 14 days or placebo in a double-blinded fashion. End points included death, cardiac death, recurrent acute myocardial infarction (AMI), stroke, unstable angina, and symptomatic heart failure. Median follow-up was 28 (interquartile range 3 to 38) months. Sixteen patients (40%) had a total of 22 adverse cardiovascular events: 1 cardiac death, 4 recurrent AMI, 5 episodes of unstable angina pectoris requiring hospitalization and/or urgent revascularization, and 11 new diagnoses of heart failure. Treatment with anakinra was associated with a hazard ratio of 1.08 (95% confidence interval 0.31 to 3.74, p = 0.90) for the combined end point of death, recurrent AMI, unstable angina pectoris, or stroke and a hazard ratio of 0.16 (95% confidence interval 0.03 to 0.76, p = 0.008) for death or heart failure. In conclusion, IL-1 blockade with anakinra for 2 weeks appears, therefore, to have a neutral effect on recurrent ischemic events, whereas it may prevent new-onset heart failure long term after STEMI.
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200
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van Hout G, Jansen of Lorkeers S, Wever K, Sena E, van Solinge W, Doevendans P, Pasterkamp G, Chamuleau S, Hoefer I. Anti-inflammatory compounds to reduce infarct size in large-animal models of myocardial infarction: A meta-analysis. ACTA ACUST UNITED AC 2015. [DOI: 10.1002/ebm2.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- G.P.J. van Hout
- Experimental Cardiology Laboratory; University Medical Center Utrecht; Utrecht the Netherlands
| | | | - K.E. Wever
- Systematic Review Centre for Laboratory animal Experimentation; Radboud University Nijmegen Medical Center; Nijmegen the Netherlands
| | - E.S. Sena
- Centre for Clinical Brain Sciences; University of Edinburgh; Edinburgh UK
| | - W.W. van Solinge
- Department of Clinical Chemistry and Haematology; University Medical Center Utrecht; Utrecht the Netherlands
| | - P.A. Doevendans
- Experimental Cardiology Laboratory; University Medical Center Utrecht; Utrecht the Netherlands
- Department of Cardiology; University Medical Center Utrecht; Utrecht the Netherlands
| | - G. Pasterkamp
- Experimental Cardiology Laboratory; University Medical Center Utrecht; Utrecht the Netherlands
| | - S.A.J. Chamuleau
- Department of Cardiology; University Medical Center Utrecht; Utrecht the Netherlands
| | - I.E. Hoefer
- Experimental Cardiology Laboratory; University Medical Center Utrecht; Utrecht the Netherlands
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