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Fiordelisi A, Iaccarino G, Morisco C, Coscioni E, Sorriento D. NFkappaB is a Key Player in the Crosstalk between Inflammation and Cardiovascular Diseases. Int J Mol Sci 2019; 20:ijms20071599. [PMID: 30935055 PMCID: PMC6480579 DOI: 10.3390/ijms20071599] [Citation(s) in RCA: 124] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 03/21/2019] [Accepted: 03/26/2019] [Indexed: 02/08/2023] Open
Abstract
Inflammation is a key mechanism of cardiovascular diseases. It is an essential component of atherosclerosis and a significant risk factor for the development of cardiovascular events. In the crosstalk between inflammation and cardiovascular diseases, the transcription factor NFκB seems to be a key player since it is involved in the development and progression of both inflammation and cardiac and vascular damage. In this review, we deal with the recent findings of the role of inflammation in cardiac diseases, focusing, in particular, on NFκB as a functional link. We describe strategies for the therapeutic targeting of NFκB as a potential strategy for the failing heart.
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Affiliation(s)
- Antonella Fiordelisi
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Napoli, Italy.
| | - Guido Iaccarino
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Napoli, Italy.
| | - Carmine Morisco
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Napoli, Italy.
| | - Enrico Coscioni
- Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi d'Aragona, 84131 Salerno, Italy.
| | - Daniela Sorriento
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Napoli, Italy.
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152
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Antoniades C, Kotanidis CP, Berman DS. State-of-the-art review article. Atherosclerosis affecting fat: What can we learn by imaging perivascular adipose tissue? J Cardiovasc Comput Tomogr 2019; 13:288-296. [PMID: 30952610 PMCID: PMC6928589 DOI: 10.1016/j.jcct.2019.03.006] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/04/2019] [Accepted: 03/25/2019] [Indexed: 01/05/2023]
Abstract
Perivascular adipose tissue (PVAT) surrounding the human coronary arteries, secretes a wide range of adipocytokines affecting the biology of the adjacent vascular wall in a paracrine way. However, we have recently found that PVAT also behaves as a sensor of signals coming from the vascular wall, to which it reacts by changing its morphology and secretory profile. Indeed, vascular inflammation, a key feature of vascular disease pathogenesis, leads to the release of inflammatory signals that disseminate into local fat, inducing local lipolysis and inhibiting adipogenesis. This ability of PVAT to sense inflammatory signals from the vascular wall, can be used as a "thermometer" of the vascular wall, allowing for non-invasive detection of coronary inflammation. Vascular inflammation induces a shift of PVAT's composition from lipid to aqueous phase, resulting into increased computed tomography (CT) attenuation around the inflamed artery, forming a gradient with increasing attenuation closer to the inflamed coronary artery wall. These spatial changes in PVAT's attenuation are easily detected around culprit lesions during acute coronary syndromes. A new biomarker designed to captured these spatial changes in PVAT's attenuation around the human coronary arteries, the Fat Attenuation Index (FAI), has additional predictive value in stable patients for cardiac mortality and non-fatal heart attacks, above the prediction provided by the current state of the art that includes risk factors, calcium score and presence of high risk plaque features. The use of perivascular FAI in clinical practice may change the way we interpret cardiovascular CT angiography, as it is applicable to any coronary CT angiogram, and it offers dynamic information about the inflammatory burden of the coronary arteries, providing potential guidance for preventive measures and invasive treatments.
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Affiliation(s)
- Charalambos Antoniades
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
| | - Christos P Kotanidis
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Daniel S Berman
- Department of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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153
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Tabrizi R, Tamtaji OR, Mirhosseini N, Lankarani KB, Akbari M, Dadgostar E, Borhani-Haghighi A, Peymani P, Ahmadizar F, Asemi Z. The effects of statin use on inflammatory markers among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res 2019; 141:85-103. [PMID: 30576798 DOI: 10.1016/j.phrs.2018.12.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/24/2018] [Accepted: 12/12/2018] [Indexed: 02/08/2023]
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154
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Effects of Atorvastatin Alongside Conventional Medical Treatment on Liver Fibrosis and Dysfunction in Patients with Chronic Hepatitis B: A Double-Blinded Clinical Trial. HEPATITIS MONTHLY 2019. [DOI: 10.5812/hepatmon.84656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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155
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Oh TK, Chang CB, Shin HJ, Han S, Do SH, Lee HJ, Hwang JW. Association between perioperative statin use and postoperative pain after total knee arthroplasty. Reg Anesth Pain Med 2019; 44:221-226. [PMID: 30700616 DOI: 10.1136/rapm-2018-000018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 06/09/2018] [Accepted: 06/12/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND OBJECTIVES Data is insufficient to determine whether perioperative statin use increases or decreases postoperative pain. This study aimed to investigate the association between perioperative statin use and pain outcomes after total knee arthroplasty performed under spinal anesthesia. METHODS This is a retrospective, observational study based on medical records from a tertiary hospital between January 2005 and October 2017. Medical records of patients who underwent elective total knee arthroplasty under spinal anesthesia as inpatients were analyzed. Pain outcomes were compared through postoperative day (POD) 3 in patients who were taking statins perioperatively versus patients who were not taking statins. RESULTS A total of 1088 propensity-matched participants were included in the final analysis (544 patients in the statin group and 544 patients in the non-statin group). The total morphine equivalent consumption through POD 3 was higher in the statin group than in the non-statin group (mean (SD), statin group: 525.4 (119.7) vs non-statin group: 495.3 (115.3), 95% CI of the difference: 15.9 to 44.4, p<0.001). In the linear regression analysis, the total morphine equivalent consumption through POD 3 was 30.14 mg higher in the statin group compared with the non-statin group (95% CI 15.93 to 44.35; p<0.001). CONCLUSIONS Perioperative statin use is associated with a significant increase in postoperative opioid consumption after total knee arthroplasty performed under spinal anesthesia; however, this increase was so marginal that its clinical importance remains controversial.
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Affiliation(s)
- Tak Kyu Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Chong Bum Chang
- Department of Orthopedic Surgery, College of Medicine, Seoul National University, Seoul, Korea
| | - Hyun-Jung Shin
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sunghee Han
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Korea
| | - Sang-Hwan Do
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Korea
| | - Hei-Jin Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung-Won Hwang
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea .,Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Korea
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156
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Chaudhary R, Kinderytė M, Chaudhary R, Sukhi A, Bliden K, Tantry U, Gurbel P. HDL 3-C is a Marker of Coronary Artery Disease Severity and Inflammation in Patients on Statin Therapy. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2018; 20:1001-1006. [PMID: 30626544 DOI: 10.1016/j.carrev.2018.12.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 12/20/2018] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Low high-density lipoprotein (HDL-C) and inflammation are risk factors for coronary artery disease (CAD). However, limited data are available determining the role of HDL-C sub-particles HDL2-C and HDL3-C for assessing CAD severity in patients on statin therapy. METHODS Blood samples were obtained prior to cardiac catheterization in 304 consecutive patients with suspected CAD on statin therapy in this sub-analysis of Multi-Analyte, thrombogenic, and Genetic Markers of Atherosclerosis (MAGMA, NCT01276678) study. Detailed lipid profiling and oxidized LDL (ox-LDL) were analyzed. CAD severity was angiographically defined as severe CAD (>75% luminal diameter stenosis [LDS]) and non-severe CAD (≤75% LDS). Multi-regression analysis was performed to test for statistical significance. Receiver operator curve (ROC) analysis was performed to determine cut-point for predicting severe CAD. RESULTS Patients with severe CAD had a significantly lower total-HDL-C, lower HDL3-C and higher lipoprotein(a) levels. HDL3-C and lipoprotein(a) cholesterol [Lp(a)-C] retained statistical significance on multiple regression analysis. ROC analysis showed HDL3-C to have a C-statistic of 0.60 (p = 0.003) and Lp(a)-C to have a C-statistic of 0.61 (p = 0.0007). Patients with HDL3-C ≤ 33 mg/dL and Lp(a)-C > 7 mg/dL were found to have significantly elevated ox-LDL levels. CONCLUSION In patients on statin therapy, HDL3-C and Lp(a)-C improve prediction of severe CAD compared to a traditional lipid panel. In addition, patients with HDL3-C ≤ 33 mg/dL and Lp(a)-C > 7 mg/dL have greater inflammation marked by ox-LDL. Further studies are needed to evaluate the utility of these novel biomarkers in predicting CAD severity.
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Affiliation(s)
| | - Marija Kinderytė
- Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Falls Church FVA, USA
| | | | | | - Kevin Bliden
- Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Falls Church FVA, USA
| | - Udaya Tantry
- Platelet and Thrombosis Research, Baltimore, MD, USA
| | - Paul Gurbel
- Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Falls Church FVA, USA.
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157
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Antonopoulos AS, Tousoulis D. Statins in atrial fibrillation prevention: A closed chapter? Hellenic J Cardiol 2018; 60:48-50. [PMID: 30414456 DOI: 10.1016/j.hjc.2018.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 10/20/2018] [Accepted: 10/26/2018] [Indexed: 11/26/2022] Open
Affiliation(s)
| | - Dimitris Tousoulis
- 1(st) Cardiology Department, Hippokration Hospital, Athens Medical School, Greece
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158
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The Antineuroinflammatory Effect of Simvastatin on Lipopolysaccharide Activated Microglial Cells. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:9691085. [PMID: 30524484 PMCID: PMC6247388 DOI: 10.1155/2018/9691085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/04/2018] [Accepted: 09/06/2018] [Indexed: 01/24/2023]
Abstract
Microglial cells, upon hyperactivation, produce proinflammatory cytokines and other oxidative stress mediators causing neuroinflammation, which is associated with the progress of many neurodegenerative diseases. Suppressing the microglial activation has hence been used as an approach for treating such diseases. In this study, the antineuroinflammatory effect of simvastatin was examined in lipopolysaccharide (LPS)-activated rat C6 glioma cells. The cell proliferation and cytotoxic effect of LPS and simvastatin on C6 glioma cells was evaluated by (MTT) assay. Neuroinflammation was induced in differentiated cell lines by treatment with 3.125 μg/mL of LPS for 12 h. Upon induction, the cell lines were treated with different concentrations (3.125, 6.25, 12.5, 25, 50, 100 μM) of simvastatin and incubated in a humidified CO2 incubator for 24 to 48 h. The optimum concentrations of LPS and simvastatin were found to be 3.125 μg/mL and 25 μM, respectively, with a cell viability of more than 90% at 24 h postincubation. Furthermore, proinflammatory marker expression was analyzed by flow cytometry and showed a decrease in interferon-γ, interleukin 6, nuclear factor-κB p65, and tumor necrosis factor-α in simvastatin-treated and LPS-induced neuroinflammatory cells, and the mean fluorescent values were found to be 21.75 ± 0.76, 20.9 ± 1.90, 19.72 ± 1.29, and 16.82 ± 0.97, respectively, as compared to the untreated cells. Thus, we show that simvastatin has the potential to regulate the anti-inflammatory response in microglial cells upon LPS challenge. Hence, simvastatin can be employed as a potent anti-inflammatory drug against neuroinflammatory diseases and neurodegenerative disorders.
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159
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Roopmani P, Krishnan UM. Harnessing the pleiotropic effects of atorvastatin-fenofibrate combination for cardiovascular stents. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 92:875-891. [DOI: 10.1016/j.msec.2018.07.048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 06/23/2018] [Accepted: 07/18/2018] [Indexed: 12/20/2022]
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160
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Escate R, Mata P, Cepeda JM, Padró T, Badimon L. miR-505-3p controls chemokine receptor up-regulation in macrophages: role in familial hypercholesterolemia. FASEB J 2018; 32:601-612. [PMID: 29457550 DOI: 10.1096/fj.201700476rr] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Familial hypercholesterolemia (FH) conveys a high risk of premature atherosclerosis as a result of lifelong exposure to high LDL cholesterol levels that are not fully reduced by standard-of-care lipid-lowering treatment. Inflammatory mediators have played a role in the progression of atherosclerotic lesions. Here, we investigated whether innate immunity cells in patients with FH have a specific proinflammatory phenotype that is distinct from that of cells in normal participants. To this end, miR-505-3p-a microRNA related to chronic inflammation-and its target genes were investigated in monocyte-derived macrophages (MACs) of patients with FH (FH-MACs) and non-FH controls (co-MACs). On the basis of the profiler PCR array analysis of agomiR-505-3p-transfected MACs, we identified the chemokine receptors, CCR3, CCR4, and CXCR1, as genes that are regulated by miR-505-3p via the transcription factor, RUNX1. miR-505-3p was significantly down-regulated, whereas CCR3, CCR4, CXCR, and RUNX1 were increased in FH-MAC compared with co-MAC, with the increase being more evident in the proinflammatory M1-like FH-MAC. Chemokine receptor levels were unrelated to LDL plasma levels at entry, but correlated with age in patients with FH, not in controls. In summary, we demonstrate for first time to our knowledge that MACs from FH-MACs have an inflammatory phenotype that is characterized by the up-regulation of CCR3, CCR4, and CXCR1 under the control of miR-505-3p. These results suggest a chronic inflammatory condition in FH innate immunity cells that is not reverted by standard lipid-lowering treatment.-Escate, R., Mata, P., Cepeda, J. M., Padró, T., Badimon, L. miR-505-3p controls chemokine receptor up-regulation in macrophages: role in familial hypercholesterolemia.
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Affiliation(s)
- Rafael Escate
- Catalan Institute of Cardiovascular Sciences (ICCC), Sant Pau Biomedical Research Institute (IIB-Sant Pau) Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Hospital de Sant Pau, Barcelona, Spain
| | - Pedro Mata
- Fundación Hipercolesterolemia Familiar, Madrid, Spain
| | - Jose Maria Cepeda
- Department of Internal Medicine, Hospital Vega Baja, Orihuela, Spain
| | - Teresa Padró
- Catalan Institute of Cardiovascular Sciences (ICCC), Sant Pau Biomedical Research Institute (IIB-Sant Pau) Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Hospital de Sant Pau, Barcelona, Spain
| | - Lina Badimon
- Catalan Institute of Cardiovascular Sciences (ICCC), Sant Pau Biomedical Research Institute (IIB-Sant Pau) Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Hospital de Sant Pau, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
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161
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Guedeney P, Sorrentino S, Vogel B, Baber U, Claessen BE, Mehran R. Assessing and minimizing the risk of percutaneous coronary intervention in patients with chronic kidney disease. Expert Rev Cardiovasc Ther 2018; 16:825-835. [DOI: 10.1080/14779072.2018.1526082] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Paul Guedeney
- The Icahn School of Medicine at Mount Sinai, The Zena and Michael A. Wiener Cardiovascular Institute, New York, New York, USA
- Department of Cardiology, ACTION Study Group, Sorbonne Université - Univ Paris 06 (UPMC), INSERM UMRS 1166, Institut de Cardiologie, Paris, France
| | - Sabato Sorrentino
- The Icahn School of Medicine at Mount Sinai, The Zena and Michael A. Wiener Cardiovascular Institute, New York, New York, USA
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Birgit Vogel
- The Icahn School of Medicine at Mount Sinai, The Zena and Michael A. Wiener Cardiovascular Institute, New York, New York, USA
| | - Usman Baber
- The Icahn School of Medicine at Mount Sinai, The Zena and Michael A. Wiener Cardiovascular Institute, New York, New York, USA
| | - Bimmer E. Claessen
- The Icahn School of Medicine at Mount Sinai, The Zena and Michael A. Wiener Cardiovascular Institute, New York, New York, USA
| | - Roxana Mehran
- The Icahn School of Medicine at Mount Sinai, The Zena and Michael A. Wiener Cardiovascular Institute, New York, New York, USA
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162
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Simvastatin Effects on Inflammation and Platelet Activation Markers in Hypercholesterolemia. BIOMED RESEARCH INTERNATIONAL 2018; 2018:6508709. [PMID: 30402489 PMCID: PMC6191949 DOI: 10.1155/2018/6508709] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 09/16/2018] [Indexed: 12/19/2022]
Abstract
Background Beside the lipid-lowering effect, statins slow the progression of atherosclerosis by exerting anti-inflammatory and platelet inhibiting effects. We investigated whether platelet inhibition by simvastatin correlates with the statin effects on lipid lowering, inflammation, oxidative stress, and endothelial and platelet activation. Methods In hypercholesterolemic patients allocated to diet (n=20) or a 2-month treatment with diet plus 40 mg simvastatin (n=25), we evaluated platelet aggregating responses to ADP, collagen, and arachidonic acid (AA), the effect of aspirin on AA-induced aggregation, pro- and anti-inflammatory and atherogenic mediators (IL-1β, -5, -6, -7, -8, -9, -10, -12, and -13, IFN-γ, IP-10, Eotaxin, and sRAGE), markers of endothelium (sE-selectin, VEGF, and MCP-1) and platelet activation (sP-selectin, sCD-40L, RANTES, and PDGF-bb), and oxidative stress (8-OH-2'-deoxyguanosine). Results After treatment, beside the improvement of lipid profile, we observed the following: a reduction of platelet aggregation to ADP (p=0.0001), collagen (p=0.0001), AA (p=0.003); an increased antiaggregating effect of aspirin in the presence of AA (p=0.0001); a reduction of circulating levels of IL-6 (p=0.0034), IL-13 (p<0.0001), IFN-γ (p<0.0001), VEGF (p<0.0001), sE-selectin (p<0.0001), sCD-40L (p<0.0001), sP-selectin (p=0.003), and 8-OH-2'-deoxyguanosine (p<0.0001); an increase of IL-10 and sRAGEs (p=0.0001 for both). LDL-cholesterol levels (i) positively correlated with IL-6, IFN-γ, E-selectin, sCD-40L, 8-OH-2'-deoxyguanosine, platelet aggregation to ADP, collagen, AA, and aspirin IC-50 and (ii) negatively correlated with IL-10 and sRAGE. In multiple regression analyses, LDL-cholesterol was the strongest predictor for most parameters of platelet reactivity. Conclusion In primary hypercholesterolemia, simvastatin treatment reduced platelet activation and subclinical inflammation and improved endothelial dysfunction. LDL-cholesterol levels were the major correlate of platelet reactivity; however, other effects of statins may contribute to reducing the progression of atherosclerosis.
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163
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Wu CL, Kor CT, Chang CC, Chiu PF, Tarng DC, Hsu CC. Association of Statin Use With Mortality After Dialysis-Requiring Acute Kidney Injury: A Population-Based Cohort Study. Mayo Clin Proc 2018; 93:1474-1483. [PMID: 30286832 DOI: 10.1016/j.mayocp.2018.05.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 04/30/2018] [Accepted: 05/14/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To investigate the association between statin use and mortality in patients with dialysis-requiring acute kidney injury (AKI-D). PATIENTS AND METHODS This nationwide, population-based, retrospective cohort study included 6091 hospitalized patients with AKI-D (1271 statin users and 4820 statin nonusers) retrieved from the National Health Insurance Research Database of Taiwan between January 1, 2000, and December 31, 2012. All the patients were followed up until December 31, 2013. Primary and secondary outcomes were 1-year and in-hospital mortality, respectively. All the primary analyses were performed using the intention-to-treat approach. RESULTS During 1-year follow-up, 492 of 1271 statin users (38.7%) and 2365 of 4820 statin nonusers (49.1%) died. After propensity score matching, statin use was independently associated with lower risks of 1-year all-cause mortality (hazard ratio [HR], 0.79; 95% CI, 0.69-0.9; P<.001) and in-hospital all-cause mortality (HR, 0.84; 95% CI, 0.71-0.99; P=.04). The survival benefit of statin treatment was dose-dependent and consistent across subgroups based on sensitivity analyses. CONCLUSION Statin use was independently associated with reduced risks of 1-year and in-hospital mortality in patients with AKI-D. Statin therapy may be beneficial in this patient group. However, further clinical trials should be performed to confirm the findings.
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Affiliation(s)
- Chia-Lin Wu
- Division of Nephrology, Changhua Christian Hospital, Changhua, Taiwan; Environmental and Precision Medicine Laboratory, Changhua Christian Hospital, Changhua, Taiwan; School of Medicine, Chung-Shan Medical University, Taichung, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chew-Teng Kor
- Environmental and Precision Medicine Laboratory, Changhua Christian Hospital, Changhua, Taiwan; Graduate Institute of Statistics and Information Science, National Changhua University of Education, Changhua, Taiwan
| | - Chia-Chu Chang
- Division of Nephrology, Changhua Christian Hospital, Changhua, Taiwan; Environmental and Precision Medicine Laboratory, Changhua Christian Hospital, Changhua, Taiwan; School of Medicine, Chung-Shan Medical University, Taichung, Taiwan
| | - Ping-Fang Chiu
- Division of Nephrology, Changhua Christian Hospital, Changhua, Taiwan; School of Medicine, Chung-Shan Medical University, Taichung, Taiwan
| | - Der-Cherng Tarng
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Department and Institute of Physiology, National Yang-Ming University, Taipei, Taiwan; Division of Nephrology, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Chih-Cheng Hsu
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan; Department of Health Services Administration, China Medical University, Taichung, Taiwan; Department of Family Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan.
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164
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Bekić S, Šabanović Š, Šarlija N, Bosnić Z, Volarić N, Majnarić Trtica L. Lack of Relationships Between Serum Prolactin Concentrations and Classical Cardiovascular Risk Factors in Eastern Croatian Older Adults. Med Sci Monit 2018; 24:6900-6909. [PMID: 30267533 PMCID: PMC6441310 DOI: 10.12659/msm.909970] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background Relationships between serum prolactin concentrations and various CV risk factors in older adults have rarely been assessed. The aim of this study was to examine the relationships between serum prolactin concentrations and CV risk factors in older patients with multiple CV risk factors. Material/Methods This case-control study included 92 patients, 50–89 years old (median, 69 years), with multiple CV risk factors. We used data from general practice electronic health records and biochemical laboratory tests. Patients were divided according to categories of CV risk factors. Results Serum prolactin concentrations were significantly higher in elderly people (≤65 vs. >65) and in men (70.65±58.02 vs. 150.82±114.05 mIU/L), as well as in patients with lower renal function (156.70±127.23 vs. 72.53±37.25 mIU/L, the bottom vs. top quartile of creatinine clearance), higher serum homocysteine and TSH concentrations, and in those who used NSAID and statins. Parameters indicating chronic inflammation (CRP) and renal function decline (creatinine clearance) were significantly and independently correlated with increased serum prolactin concentrations in multiple regression analysis. Conclusions When assessing the relationships between prolactin and CV risk factors in older people with multiple CV risk factors, the effect of renal function decline and chronic inflammation should receive attention.
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Affiliation(s)
- Sanja Bekić
- Department of Internal Medicine, Family Medicine and the History of Medicine, Faculty of Medicine, University Josip Juraj Strossmayer, Osijek, Croatia
| | - Šefket Šabanović
- Department of Internal Medicine, Family Medicine and the History of Medicine, Faculty of Medicine, University Josip Juraj Strossmayer, Osijek, Croatia
| | - Nataša Šarlija
- Department of Economics, University Josip Juraj Strossmayer, Osijek, Croatia
| | - Zvonimir Bosnić
- Department of Internal Medicine, Family Medicine and the History of Medicine, Faculty of Medicine, University Josip Juraj Strossmayer, Osijek, Croatia
| | - Nikola Volarić
- Department of Physiology and Immunology, Faculty of Dental Medicine and Health, University Josip Juraj Strossmayer, Osijek, Croatia
| | - Ljiljana Majnarić Trtica
- Department of Internal Medicine, Family Medicine and the History of Medicine, Faculty of Medicine, University Josip Juraj Strossmayer, Osijek, Croatia.,Department of Physiology and Immunology, Faculty of Dental Medicine and Health, University Josip Juraj Strossmayer, Osijek, Croatia
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Chekalina N, Burmak Y, Petrov Y, Borisova Z, Manusha Y, Kazakov Y, Kaidashev I. Quercetin reduces the transcriptional activity of NF-kB in stable coronary artery disease. Indian Heart J 2018; 70:593-597. [PMID: 30392493 PMCID: PMC6204471 DOI: 10.1016/j.ihj.2018.04.006] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 03/08/2018] [Accepted: 04/10/2018] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE The aim of this study was to determine the effect of quercetin on the indicators of chronic systemic inflammation (CSI) in stable coronary artery disease (CAD). METHODS This study included 85 patients with CAD, stable angina pectoris, functional class (FC) II, and heart failure (НF) 0-І. Each patient was prescribed beta-blockers, statins, and aspirin. In addition, a total of 30 patients, forming the study group received quercetin at a daily dose of 120mg for two months, while the remaining 55 patients made up the control group. The levels of cytokines, such as tumor necrosis factor (TNF-α), interleukin-1β (IL-1β), and interleukin-10 (IL-10) in serum and the expression of the inhibitor of kappa B α (IkBα) gene in blood mononuclear cells, were determined. RESULTS The increased levels of IL-1β and TNF-α, as well as a moderate increase in IL-10 levels, were detected in the serum of patients with CAD. The expression of the IkBα gene (2-δСt) did not differ significantly between the groups. Under the influence of quercetin, levels of IL-1β and TNF-α were reduced and IL-10 levels tended to decrease. In contrast, the serum levels of these cytokines did not change significantly in the control group. The administration of quercetin decreased the expression of the IkBα gene (0.0092±0.0033 against 0.0261±0.0166, р=0.003; 2-δδСt, 2.82±1.39 times) in contrast to the control group. CONCLUSION Quercetin showed anti-inflammatory properties in patients with CAD, indicating a decrease in transcriptional activity of the nuclear factor of transcription kappa B (NF-kB).
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Affiliation(s)
- Nataliya Chekalina
- Higher State Educational Establishment of Ukraine "Ukrainian Medical Stomatological Academy", Str. Shevchenka, 23, 36000, Poltava, Ukraine.
| | - Yurii Burmak
- Higher State Educational Establishment of Ukraine "Ukrainian Medical Stomatological Academy", Str. Shevchenka, 23, 36000, Poltava, Ukraine
| | - Yeugen Petrov
- Higher State Educational Establishment of Ukraine "Ukrainian Medical Stomatological Academy", Str. Shevchenka, 23, 36000, Poltava, Ukraine
| | - Zinaida Borisova
- Higher State Educational Establishment of Ukraine "Ukrainian Medical Stomatological Academy", Str. Shevchenka, 23, 36000, Poltava, Ukraine
| | - Yulija Manusha
- Higher State Educational Establishment of Ukraine "Ukrainian Medical Stomatological Academy", Str. Shevchenka, 23, 36000, Poltava, Ukraine
| | - Yurii Kazakov
- Higher State Educational Establishment of Ukraine "Ukrainian Medical Stomatological Academy", Str. Shevchenka, 23, 36000, Poltava, Ukraine
| | - Igor Kaidashev
- Higher State Educational Establishment of Ukraine "Ukrainian Medical Stomatological Academy", Str. Shevchenka, 23, 36000, Poltava, Ukraine
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Abstract
Importance We have performed a systematic search to summarize the role of statins for preventing and treating severe preeclampsia. Objective The aim of this study was to examine whether pravastatin is a useful and safe alternative for treating preeclampsia during pregnancy. Evidence Acquisition A systematic MEDLINE (PubMed) search was performed (1979 to June 2017), which was restricted to articles published in English, using the relevant key words of "statins," "pregnancy," "preeclampsia," "obstetrical antiphospholipid syndrome," and "teratogenicity." Results The initial search provided 296 articles. Finally, 146 articles were related to the use of statins during pregnancy, regarding their effect on the fetus and the treatment of preeclampsia. Ten studies were related to in vitro studies, 25 in animals, and 24 in humans (13 case report series and 11 cohort studies). We found 84 studies on reviews of such guidelines on cardiovascular disease (35 studies), use of statins in the antiphospholipid syndrome (25 studies), statin's specific use during pregnancy (13 studies), or preeclampsia treatment (11 studies). Conclusions Although the studies are of poor quality, the rate of major congenital abnormalities in the newborn exposed to statins during pregnancy is no higher than the expected when compared with overall risk population. The review shows a potential beneficial role of statins in preventing and treating severe preeclampsia that needs to be evaluated through well-designed clinical trials. Relevance This update could influence positively the clinical practice, giving an alternative therapy for clinicians who treat preeclampsia, particularly in severe cases.
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167
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Zhang X, Xiao S, Li Q. Pravastatin polarizes the phenotype of macrophages toward M2 and elevates serum cholesterol levels in apolipoprotein E knockout mice. J Int Med Res 2018; 46:3365-3373. [PMID: 30058421 PMCID: PMC6134684 DOI: 10.1177/0300060518787671] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objective Statins are clinically used for protection against cardiovascular disease with lipid-lowering and anti-inflammatory properties. These properties tip the balance of macrophage polarization, which is an essential process in the development and progression of atherosclerosis. This study aimed to investigate the effect of pravastatin on atherosclerosis of the aorta in apolipoprotein E knockout (apoE-KO) mice without high lipid feeding. Methods Six 8-week-old apoE-KO male mice were randomly divided into two groups: a control group and a pravastatin (40 mg·kg−1·day−1)-treated group. At 35 weeks, the mice were sacrificed and the size of plaques on the aorta was assessed by Oil Red O staining. M1 and M2 macrophages were identified by inducible nitric oxide synthase and arginase-I, respectively, using immunohistochemistry. Results Pravastatin increased the size of atherosclerotic plaques in apoE-KO mice without high lipid feeding. The ratio of M1/M2 macrophages increased in atherosclerotic plaques, which might slow the process of atherosclerosis, while blood cholesterol levels were elevated. Conclusion Our study suggests that pravastatin polarizes the phenotype of macrophages toward M2 in atherosclerotic lesions, despite an increase in serum cholesterol levels in ApoE-KO mice.
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Affiliation(s)
- Xiaoling Zhang
- 1 Department of Cardiology, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People's Republic of China.,2 Department of Physiology, Faculty of Basic Medical Science, Guilin Medical University, Guilin, Guangxi, People's Republic of China
| | - Shengjun Xiao
- 3 Department of Pathology, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People's Republic of China
| | - Quanzhong Li
- 1 Department of Cardiology, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People's Republic of China
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Khambhati J, Engels M, Allard-Ratick M, Sandesara PB, Quyyumi AA, Sperling L. Immunotherapy for the prevention of atherosclerotic cardiovascular disease: Promise and possibilities. Atherosclerosis 2018; 276:1-9. [PMID: 30006321 DOI: 10.1016/j.atherosclerosis.2018.07.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/27/2018] [Accepted: 07/05/2018] [Indexed: 12/23/2022]
Abstract
Cardiovascular disease remains the leading cause of death worldwide with coronary atherosclerotic heart disease being the largest contributor. The mechanisms behind the presence and progression of atherosclerosis remain an area of intense scientific focus. Immune dysregulation and inflammation are key contributors to the development of an atherosclerotic plaque and its progression to acute coronary syndromes. Increased circulating levels of biomarkers of systemic inflammation including hsCRP are correlated with a higher cardiovascular risk. Targeting specific inflammatory pathways implicated in atherosclerotic plaque formation is an exciting area of ongoing research. Target specific therapies directed at pro-inflammatory cytokines such as IL-1β, IL-6, TNFα, and CCL2 have demonstrated slowing in the progression of atherosclerosis in animal models and improved cardiovascular outcomes in human subjects. Most notably, treatment with the monoclonal antibody canakinumab, which directly targets and neutralizes IL-1β, was recently shown to be associated with reduced risk of adverse cardiovascular events compared to placebo in a randomized, placebo-controlled trial. Several other therapies including colchicine, methotrexate and leukotriene inhibitors demonstrate the potential for lowering cardiovascular risk through immunomodulation, though further studies are needed. Understanding the role of inflammation in atherosclerosis and the development of targeted immunotherapies continues to be an evolving area of research that is rapidly becoming clinically relevant for the 21st century cardiac patient.
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Affiliation(s)
- Jay Khambhati
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
| | - Marc Engels
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Marc Allard-Ratick
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Pratik B Sandesara
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Arshed A Quyyumi
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Laurence Sperling
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
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Scoring system to predict early carotid restenosis after eversion endarterectomy by analysis of inflammatory markers. J Vasc Surg 2018; 68:118-127. [DOI: 10.1016/j.jvs.2017.09.054] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 09/25/2017] [Indexed: 12/12/2022]
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170
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Reeves KW, Pennell M, Foraker RE, Crandall CJ, Stefanick M, Paskett ED. Predictors of vasomotor symptoms among breast cancer survivors. J Cancer Surviv 2018; 12:379-387. [PMID: 29427202 PMCID: PMC5955842 DOI: 10.1007/s11764-018-0677-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 01/26/2018] [Indexed: 01/20/2023]
Abstract
PURPOSE Vasomotor symptoms (VMS) are a common side effect of breast cancer treatment, yet modifiable factors that may predict VMS among breast cancer survivors are unknown. METHODS We estimated multivariable-adjusted odds ratios and 95% confidence intervals (aOR, 95% CI) for predictors of VMS among 3595 breast cancer survivors enrolled in the Life and Longevity after Cancer (LILAC) study, an ancillary study of the Women's Health Initiative (WHI). RESULTS VMS post-diagnosis were reported by 790 (22.0%) participants. Risk of VMS after diagnosis was positively associated with prior chemotherapy (aOR 1.80, 95% CI 1.21-2.68) and adjuvant hormone therapy (aOR 2.73, 95% CI 2.08-3.58), postmenopausal hormone therapy use (aOR 1.67, 95% CI 1.30-2.13), prior VMS (aOR 2.20, 95% CI 1.73-2.80), bilateral oophorectomy (aOR 1.77, 95% CI 1.37-2.27), and baseline antidepressant use (aOR 1.49, 1.06-2.09). VMS post-diagnosis were less likely among younger women (aOR 0.94, 95% CI 0.93-0.96), women younger at menopause (aOR 0.98, 95% CI 0.97-1.00), women with more time since diagnosis (aOR 0.92, 95% CI 0.90-0.94), and diabetics (aOR 0.45, 95% CI 0.21-0.95). Metabolic syndrome was not associated with post-diagnosis VMS (aOR 0.76, 95% CI 0.45-1.28). CONCLUSIONS VMS following breast cancer diagnosis was related to a number of modifiable factors, but was unrelated to metabolic syndrome. IMPLICATIONS FOR CANCER SURVIVORS Identification of factors that predispose women to VMS following a breast cancer diagnosis may allow clinicians to recognize and address VMS in the subset of women who are most likely to experience such symptoms.
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Affiliation(s)
- Katherine W Reeves
- Department of Biostatistics and Epidemiology, University of Massachusetts, 411 Arnold House, 715 North Pleasant Street, Amherst, MA, 01003, USA.
| | - Michael Pennell
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Randi E Foraker
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Carolyn J Crandall
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Marcia Stefanick
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Electra D Paskett
- The Division of Cancer Prevention and Control, Ohio State University, Columbus, OH, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
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171
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Bala C, Rusu A, Ciobanu DM, Craciun AE, Roman G. The association study of high-sensitivity C-reactive protein, pentraxin 3, nitrotyrosine, and insulin dose in patients with insulin-treated type 2 diabetes mellitus. Ther Clin Risk Manag 2018; 14:955-963. [PMID: 29881277 PMCID: PMC5978465 DOI: 10.2147/tcrm.s162086] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
PURPOSE The objective of this study was to examine the association between insulin dose and high-sensitivity C-reactive protein (hsCRP), nitrotyrosine, and pentraxin 3 in patients with insulin-treated type 2 diabetes. PATIENTS AND METHODS Eighty patients with type 2 diabetes treated with insulin for >6 months and with stable insulin doses (±10%) within 3 months before inclusion were enrolled in this study. Medical history, including use of insulin and insulin doses, concomitant diseases and medication, and anthropometric and routine biochemical parameters were collected for each patient. hsCRP, nitrotyrosine, and pentraxin 3 were measured in fasting conditions. Comparison analysis was performed according to the distribution in tertiles of insulin dose/kg of body weight, and linear regression adjusted for confounding factors was used to examine the associations between markers of inflammation, oxidative stress, and insulin dose. RESULTS In the comparison analysis, no statistically significant difference was found between hsCRP, nitrotyrosine, and pentraxin 3 levels across tertiles of insulin dose expressed as IU/kg of body weight (p for trend >0.05 for all comparisons) except a significantly higher hsCRP level in tertile 3 compared to tertile 1 (3.9±3.6 vs 6.1±3.8 mg/dL, p=0.035). In regression analysis, after adjustment for age, gender, smoking, body mass index, glycated hemoglobin, C-peptide, metformin, antiplatelet, and statin use, only hsCRP levels were statistically significant associated with insulin dose/kg of body weight (β=0.237, p=0.043). CONCLUSION In this sample of patients with type 2 diabetes treated with insulin for >6 months, hsCRP was positively associated with insulin doses. No such association was found for pentraxin 3, a more specific marker of vascular inflammation, and for nitrotyrosine as a marker of oxidative stress.
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Affiliation(s)
- Cornelia Bala
- Department of Diabetes and Nutrition, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Adriana Rusu
- Department of Diabetes and Nutrition, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dana Mihaela Ciobanu
- Department of Diabetes and Nutrition, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Anca Elena Craciun
- Department of Diabetes and Nutrition, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gabriela Roman
- Department of Diabetes and Nutrition, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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172
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Peng S, Xu LW, Che XY, Xiao QQ, Pu J, Shao Q, He B. Atorvastatin Inhibits Inflammatory Response, Attenuates Lipid Deposition, and Improves the Stability of Vulnerable Atherosclerotic Plaques by Modulating Autophagy. Front Pharmacol 2018; 9:438. [PMID: 29773990 PMCID: PMC5943597 DOI: 10.3389/fphar.2018.00438] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 04/13/2018] [Indexed: 02/04/2023] Open
Abstract
Atherosclerosis is a chronic disease comprising intima malfunction and arterial inflammation. Recent studies have demonstrated that autophagy could inhibit inflammatory response in atherosclerosis and exert subsequent atheroprotective effects. Our previous study also demonstrated the role of autophagy in the inhibition of inflammation by atorvastatin in vitro. Therefore, in the present study, we aimed to determine whether atorvastatin could upregulate autophagy to inhibit inflammatory cytokines secretion, lipid accumulation, and improve vulnerable plaque stability, both in vitro and in vivo. First, we established a vulnerable atherosclerotic plaque mouse model through partial ligation of left common carotid artery and left renal artery to explore the effect of atorvastatin on vulnerable plaques. The results showed that atorvastatin could enhance the stability of vulnerable atherosclerotic plaques and reduce the lesion area in the aorta. Atorvastatin could also inhibit NLRP3 inflammasome activation and inflammatory cytokines, such as IL-1β, TNF-α, and IL-18 secretion in vivo. Atorvastatin treatment upregulated the expression of autophagy-related protein microtubule-associated protein light chain (LC3B) and downregulated the expression of SQSTM1/p62, which suggested that autophagy was activated in vulnerable plaques. Transmission electron microscopy further demonstrated the atorvastatin-induced increase in autophagy activity in vulnerable atherosclerotic plaques. We employed oxidized low-density lipoprotein (ox-LDL) to stimulate RAW264.7 cells with atorvastatin, which showed that atorvastatin could attenuate lipid deposition, ameliorate inflammation, inhibit NLRP3 inflammasome activation, and enhance autophagy in vitro. All these beneficial effects were abolished by 3-methyladenine treatment, an autophagy inhibitor. Atorvastatin also significantly inhibited the phosphorylation of mTOR, which strongly suggested the involvement of the mTOR pathway. Our study proposed a new role for atorvastatin as an autophagy inducer to exert anti-inflammatory and atheroprotective effects, to stabilize vulnerable atherosclerotic plaques.
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Affiliation(s)
- Shi Peng
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Long-Wei Xu
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xin-Yu Che
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qing-Qing Xiao
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Pu
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qin Shao
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ben He
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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173
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Li B, Li W, Li X, Zhou H. Inflammation: A Novel Therapeutic Target/Direction in Atherosclerosis. Curr Pharm Des 2018; 23:1216-1227. [PMID: 28034355 PMCID: PMC6302344 DOI: 10.2174/1381612822666161230142931] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 12/27/2016] [Indexed: 12/27/2022]
Abstract
Over the past two decades, the viewpoint of atherosclerosis has been replaced gradually by a lipid-driven, chronic, low-grade inflammatory disease of the arterial wall. Current treatment of atherosclerosis is focused on limiting its risk factors, such as hyperlipidemia or hypertension. However, treatment targeting the inflammatory nature of atherosclerosis is still very limited and deserves further attention to fight atherosclerosis successfully. Here, we review the current development of inflammation and atherosclerosis to discuss novel insights and potential targets in atherosclerosis, and to address drug discovery based on anti-inflammatory strategy in atherosclerotic disease.
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Affiliation(s)
- Bin Li
- Department of Pharmacology, College of Pharmacy, Third Military Medical University, Chongqing 400038. China
| | - Weihong Li
- Assisted Reproductive Center, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016. China
| | - Xiaoli Li
- Department of Pharmacology, College of Pharmacy, Third Military Medical University, Chongqing 400038. China
| | - Hong Zhou
- Department of Pharmacology, College of Pharamacy, The Third Military Medical University, P.O. Box: 400038, Chongqing. China
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174
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Antonopoulos AS, Papanikolaou E, Vogiatzi G, Oikonomou E, Tousoulis D. Anti-inflammatory agents in peripheral arterial disease. Curr Opin Pharmacol 2018; 39:1-8. [DOI: 10.1016/j.coph.2017.11.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 11/04/2017] [Accepted: 11/07/2017] [Indexed: 11/28/2022]
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175
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Antonopoulos AS, Sanna F, Sabharwal N, Thomas S, Oikonomou EK, Herdman L, Margaritis M, Shirodaria C, Kampoli AM, Akoumianakis I, Petrou M, Sayeed R, Krasopoulos G, Psarros C, Ciccone P, Brophy CM, Digby J, Kelion A, Uberoi R, Anthony S, Alexopoulos N, Tousoulis D, Achenbach S, Neubauer S, Channon KM, Antoniades C. Detecting human coronary inflammation by imaging perivascular fat. Sci Transl Med 2018; 9:9/398/eaal2658. [PMID: 28701474 DOI: 10.1126/scitranslmed.aal2658] [Citation(s) in RCA: 535] [Impact Index Per Article: 89.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/30/2017] [Accepted: 05/30/2017] [Indexed: 12/11/2022]
Abstract
Early detection of vascular inflammation would allow deployment of targeted strategies for the prevention or treatment of multiple disease states. Because vascular inflammation is not detectable with commonly used imaging modalities, we hypothesized that phenotypic changes in perivascular adipose tissue (PVAT) induced by vascular inflammation could be quantified using a new computerized tomography (CT) angiography methodology. We show that inflamed human vessels release cytokines that prevent lipid accumulation in PVAT-derived preadipocytes in vitro, ex vivo, and in vivo. We developed a three-dimensional PVAT analysis method and studied CT images of human adipose tissue explants from 453 patients undergoing cardiac surgery, relating the ex vivo images with in vivo CT scan information on the biology of the explants. We developed an imaging metric, the CT fat attenuation index (FAI), that describes adipocyte lipid content and size. The FAI has excellent sensitivity and specificity for detecting tissue inflammation as assessed by tissue uptake of 18F-fluorodeoxyglucose in positron emission tomography. In a validation cohort of 273 subjects, the FAI gradient around human coronary arteries identified early subclinical coronary artery disease in vivo, as well as detected dynamic changes of PVAT in response to variations of vascular inflammation, and inflamed, vulnerable atherosclerotic plaques during acute coronary syndromes. Our study revealed that human vessels exert paracrine effects on the surrounding PVAT, affecting local intracellular lipid accumulation in preadipocytes, which can be monitored using a CT imaging approach. This methodology can be implemented in clinical practice to noninvasively detect plaque instability in the human coronary vasculature.
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Affiliation(s)
- Alexios S Antonopoulos
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Fabio Sanna
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Nikant Sabharwal
- Cardiothoracic Directorate, Oxford University Hospitals National Health System (NHS) Foundation Trust, Oxford, UK
| | - Sheena Thomas
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Evangelos K Oikonomou
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Laura Herdman
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Marios Margaritis
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.,Oxford Centre of Research Excellence, British Heart Foundation, Oxford, UK
| | - Cheerag Shirodaria
- Cardiothoracic Directorate, Oxford University Hospitals National Health System (NHS) Foundation Trust, Oxford, UK
| | - Anna-Maria Kampoli
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Ioannis Akoumianakis
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Mario Petrou
- Department of Cardiothoracic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Rana Sayeed
- Department of Cardiothoracic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - George Krasopoulos
- Department of Cardiothoracic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Constantinos Psarros
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Patricia Ciccone
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Carl M Brophy
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Janet Digby
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Andrew Kelion
- Cardiothoracic Directorate, Oxford University Hospitals National Health System (NHS) Foundation Trust, Oxford, UK
| | - Raman Uberoi
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Suzan Anthony
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - Dimitris Tousoulis
- 1st Department of Cardiology, Athens University Medical School, Athens, Greece
| | - Stephan Achenbach
- Medizinische Klinik 2, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.,Oxford Centre of Research Excellence, British Heart Foundation, Oxford, UK.,Oxford Biomedical Research Centre, National Institute of Health Research, Oxford, UK
| | - Keith M Channon
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.,Oxford Centre of Research Excellence, British Heart Foundation, Oxford, UK.,Oxford Biomedical Research Centre, National Institute of Health Research, Oxford, UK
| | - Charalambos Antoniades
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK. .,Oxford Centre of Research Excellence, British Heart Foundation, Oxford, UK.,Oxford Biomedical Research Centre, National Institute of Health Research, Oxford, UK
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176
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Pregnancy Outcome in Women with Obstetric and Thrombotic Antiphospholipid Syndrome-A Retrospective Analysis and a Review of Additional Treatment in Pregnancy. Clin Rev Allergy Immunol 2018; 53:54-67. [PMID: 27395067 DOI: 10.1007/s12016-016-8569-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Antiphospholipid syndrome (APS) is associated with pregnancy complications such as recurrent early fetal loss (RFL), fetal death, preeclampsia (PE), and intrauterine growth restriction (obstetric APS/OAPS). Other clinical manifestations are venous and/or arterial thromboses (thrombotic APS/TAPS). The data of 37 pregnancies with OAPS and 37 pregnancies with TAPS were analyzed and compared. Overall, the most frequent APS antibodies (aPl) were LA as well as "triple-positivity"; LA antibodies were significantly more frequent in women with TAPS (67.6 % TAPS vs. 29.7 % OAPS, p < 0.010), whereas "triple-positivity" was significantly more seen in women with OAPS (40.5 % OAPS vs. 13.5 % TAPS, p < 0.010). Adequate therapy has been administered in nearly all pregnancies with TAPS, whereas in 18.9 % of pregnancies with OPS, no therapy has been given at all. One woman in OAPS and four women in TAPS were treated with plasmapheresis and immunoadsorption. There was no significant association between adverse obstetric outcome and therapy. The most frequent pregnancy complications were RFL in the OAPS group (32.4 vs. 13.5 % in TAPS) and PE in the TAPS group (18.9 % in OAPS and TAPS, respectively). The data of our study showed that pregnancies with OAPS and TAPS have a similar rate of pregnancy complications. However, pregnancies with OAPS tend to have rather RFL. Although we were not able to reveal a significant association with adverse obstetric outcome, it seems that the current adequate therapy for APS in pregnancy, consisting of LDA and LMWH, might rather prevent the development of RFL. Additionally, it might be considered to divide the obstetric APS into obstetric APS with early pregnancy complications and obstetric APS with late pregnancy complications. The division into two groups of obstetric APS might facilitate the choice of additional therapy in these women.
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177
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The current and potential health benefits of the National Health Service Health Check cardiovascular disease prevention programme in England: A microsimulation study. PLoS Med 2018; 15:e1002517. [PMID: 29509767 PMCID: PMC5839536 DOI: 10.1371/journal.pmed.1002517] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 01/25/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The National Health Service (NHS) Health Check programme was introduced in 2009 in England to systematically assess all adults in midlife for cardiovascular disease risk factors. However, its current benefit and impact on health inequalities are unknown. It is also unclear whether feasible changes in how it is delivered could result in increased benefits. It is one of the first such programmes in the world. We sought to estimate the health benefits and effect on inequalities of the current NHS Health Check programme and the impact of making feasible changes to its implementation. METHODS AND FINDINGS We developed a microsimulation model to estimate the health benefits (incident ischaemic heart disease, stroke, dementia, and lung cancer) of the NHS Health Check programme in England. We simulated a population of adults in England aged 40-45 years and followed until age 100 years, using data from the Health Survey of England (2009-2012) and the English Longitudinal Study of Aging (1998-2012), to simulate changes in risk factors for simulated individuals over time. We used recent programme data to describe uptake of NHS Health Checks and of 4 associated interventions (statin medication, antihypertensive medication, smoking cessation, and weight management). Estimates of treatment efficacy and adherence were based on trial data. We estimated the benefits of the current NHS Health Check programme compared to a healthcare system without systematic health checks. This counterfactual scenario models the detection and treatment of risk factors that occur within 'routine' primary care. We also explored the impact of making feasible changes to implementation of the programme concerning eligibility, uptake of NHS Health Checks, and uptake of treatments offered through the programme. We estimate that the NHS Health Check programme prevents 390 (95% credible interval 290 to 500) premature deaths before 80 years of age and results in an additional 1,370 (95% credible interval 1,100 to 1,690) people being free of disease (ischaemic heart disease, stroke, dementia, and lung cancer) at age 80 years per million people aged 40-45 years at baseline. Over the life of the cohort (i.e., followed from 40-45 years to 100 years), the changes result in an additional 10,000 (95% credible interval 8,200 to 13,000) quality-adjusted life years (QALYs) and an additional 9,000 (6,900 to 11,300) years of life. This equates to approximately 300 fewer premature deaths and 1,000 more people living free of these diseases each year in England. We estimate that the current programme is increasing QALYs by 3.8 days (95% credible interval 3.0-4.7) per head of population and increasing survival by 3.3 days (2.5-4.1) per head of population over the 60 years of follow-up. The current programme has a greater absolute impact on health for those living in the most deprived areas compared to those living in the least deprived areas (4.4 [2.7-6.5] days of additional quality-adjusted life per head of population versus 2.8 [1.7-4.0] days; 5.1 [3.4-7.1] additional days lived per head of population versus 3.3 [2.1-4.5] days). Making feasible changes to the delivery of the existing programme could result in a sizable increase in the benefit. For example, a strategy that combines extending eligibility to those with preexisting hypertension, extending the upper age of eligibility to 79 years, increasing uptake of health checks by 30%, and increasing treatment rates 2.5-fold amongst eligible patients (i.e., 'maximum potential' scenario) results in at least a 3-fold increase in benefits compared to the current programme (1,360 premature deaths versus 390; 5,100 people free of 1 of the 4 diseases versus 1,370; 37,000 additional QALYs versus 10,000; 33,000 additional years of life versus 9,000). Ensuring those who are assessed and eligible for statins receive statins is a particularly important strategy to increase benefits. Estimates of overall benefit are based on current incidence and management, and future declines in disease incidence or improvements in treatment could alter the actual benefits observed in the long run. We have focused on the cardiovascular element of the NHS Health Check programme. Some important noncardiovascular health outcomes (e.g., chronic obstructive pulmonary disease [COPD] prevention from smoking cessation and cancer prevention from weight loss) and other parts of the programme (e.g., brief interventions to reduce harmful alcohol consumption) have not been modelled. CONCLUSIONS Our model indicates that the current NHS Health Check programme is contributing to improvements in health and reducing health inequalities. Feasible changes in the organisation of the programme could result in more than a 3-fold increase in health benefits.
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Najjari M, Vaezi G, Hojati V, Mousavi Z, Bakhtiarian A, Nikoui V. Involvement of IL-1β and IL-6 in antiarrhythmic properties of atorvastatin in ouabain-induced arrhythmia in rats. Immunopharmacol Immunotoxicol 2018; 40:256-261. [PMID: 29486618 DOI: 10.1080/08923973.2018.1440592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE Evidence show that statins possess wide beneficial cardioprotective and anti-inflammatory effects; therefore, in the present experiment, we investigated the antiarrhythmic properties of atorvastatin in ouabain-induced arrhythmia in isolated rat atria and the role of several inflammatory cytokines in this effect. MATERIALS AND METHODS Male rats were pretreated with either of atorvastatin (10 mg/kg) or vehicle, orally once daily for 6 weeks. After induction of anesthesia, we isolated the atria and after incubation with ouabain, time of onset of arrhythmia and asystole as well as atrial beating rate and contractile force were recorded. We also measured the atrial levels of IL-1β, IL-6, and TNF-α after the injection of ouabain to animals. RESULTS Pretreatment with atorvastatin significantly delayed the onset of arrhythmia and asystole compared with vehicle-treated group (p < .01, p < .001, respectively). Incubation of ouabain boosted both atrial beating rate and contractile force in vehicle-treated group (p < .05), while these responses in atorvastatin-treated group were not significant (p > .05). Injection of ouabain elevated the atrial levels of IL-1β, IL-6, and TNF-α, while pretreatment of animals with atorvastatin could reverse the ouabain-induced increase in atrial IL-1β and IL-6 (p < .01 and p < .05, respectively). CONCLUSIONS It is concluded that observed antiarrhythmic effects of atorvastatin might be attributed to modulation of some inflammatory cytokines, at least IL-1β and IL-6.
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Affiliation(s)
- Mahya Najjari
- a Department of Biology, Damghan Branch , Islamic Azad University , Damghan , Iran
| | - Gholamhassan Vaezi
- a Department of Biology, Damghan Branch , Islamic Azad University , Damghan , Iran
| | - Vida Hojati
- a Department of Biology, Damghan Branch , Islamic Azad University , Damghan , Iran
| | - Zahra Mousavi
- b Department of Pharmacology-Toxicology, Faculty of Pharmacy , Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS) , Tehran , Iran
| | - Azam Bakhtiarian
- c Department of Pharmacology, School of Medicine , Tehran University of Medical Sciences , Tehran , Iran.,d Experimental Medicine Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - Vahid Nikoui
- e Razi Drug Research Center , Iran University of Medical Sciences , Tehran , Iran
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Kanshana JS, Rebello SC, Pathak P, Kanuri BN, Aggarwal H, Srivastava V, Khanna V, Singh V, Jagavelu K, Barthwal MK, Dikshit M. Standardized fraction of Xylocarpus moluccensis fruits improve vascular relaxation and plaque stability in dyslipidemic models of atherosclerosis. JOURNAL OF ETHNOPHARMACOLOGY 2018; 213:81-91. [PMID: 29129602 DOI: 10.1016/j.jep.2017.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/05/2017] [Accepted: 11/04/2017] [Indexed: 06/07/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Xylocarpus moluccensis (Lamk.) M. Roem of family Meliaceae has triterpenoids rich fruits. Triterpenoids have been known to possess cardioprotection and anti-atherosclerotic activities (Han and Bakovic, 2015; Wu et al., 2009). Standardized fraction of these fruits exhibited anti-dyslipidemic (Srivastava et al., 2015), anti-inflammatory (Ravangpai et al., 2011) and CNS depressant activity (Sarker et al., 2007). However, there is no report in the literature on its cardiovascular effects. AIM OF THE STUDY The present study was undertaken to assess vasoprotective, anti-atherosclerotic and further examine the anti-dyslipidemic effect of the standardized fraction of Xylocarpus moluccensis (F018) fruits in the mechanical injury and high fat diet (HFD) induced dyslipidemic/ atherosclerosis models. MATERIALS AND METHODS Guinea pigs were fed 0.08% cholesterol + 15% fat diet for 3 weeks, while ApoE KO mice were fed high fat diet for 18 weeks to induce dyslipidemia and atherosclerosis. A combination of balloon injury and high fat diet (1% cholesterol, 6% peanut oil) for 5 weeks was used to accelerate atherosclerosis in NZW rabbits. F018 was administered once daily by oral route in guinea pigs (10, 25 or 50mg/kg/day for 3 weeks), ApoE KO mice (50mg/kg/day for 6 weeks) and in NZW rabbit (25mg/kg/day for 5 weeks) to monitor its effect on dyslipidemia, vasoreactivity and plaque composition by using standard methodologies. RESULTS F018 treatment in guinea pigs (25 and 50mg/kg/day), ApoE mice (50mg/kg/day) and rabbits (25mg/kg/day) significantly reduced plasma lipids and improved ACh induced vasorelaxation. Anti-dyslipidemic effect of F018 seems to be due to the modulation of enterohepatic genes involved in the cholesterol absorption and excretion. Moreover, significant improvement in the acetylcholine (ACh) induced vasorelaxation was accompanied with reduced inflammatory burden and enhanced activation of eNOS in ApoE mice aortic tissue. Similarly inflammatory cytokines, immunolabeling of macrophage marker (CD68) and MMP-9 were reduced along with augmentation in vascular smooth muscle cells and collagen type I and III in the mechanically injured iliac artery segment in the rabbits. CONCLUSIONS Altogether, F018 preserved vasoreactivity, reduced atherosclerotic plaque progression and enhanced plaque stability by reducing lipids, inflammatory cytokines, improving endothelial function and collagen content.
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Affiliation(s)
- Jitendra S Kanshana
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Sanjay C Rebello
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Priya Pathak
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | | | - Hobby Aggarwal
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | | | - Vivek Khanna
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Vishal Singh
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Kumaravelu Jagavelu
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Manoj K Barthwal
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India
| | - Madhu Dikshit
- Pharmacology Division, CSIR-Central Drug Research Institute, Lucknow 226031, India.
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180
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Zhang J, Wang H, Yang S, Wang X. Comparison of lipid profiles and inflammation in pre- and post-menopausal women with cerebral infarction and the role of atorvastatin in such populations. Lipids Health Dis 2018; 17:20. [PMID: 29391065 PMCID: PMC5796554 DOI: 10.1186/s12944-018-0669-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 01/24/2018] [Indexed: 12/30/2022] Open
Abstract
Background The risks of atherosclerotic cardiovascular and cerebrovascular diseases in women rapidly increase with age in post-menopausal women. We aimed to investigate the lipid profiles in peri-menopausal women with cerebral infarction and to explore the effects of atorvastatin intervention. Methods We collected women aged 40-60 with cerebral infarction between January 2013 and December 2016. Atorvastatin was applied for 6 months in all included patients. Blood lipid profiles, serum pro-inflammation cytokines, intracranial plaque and NIH stroke scale (NIHSS) scores were evaluated before and after atorvastatin treatment. Results Totally 210 patients were included. Before atorvastatin treatment, post-menopausal patients had significantly higher levels of triglyceride, cholesterol, low-density lipoprotein and a reduced level of high-density lipoprotein than those in pre-menopausal patients. Blood levels of pro-inflammatory cytokines including interleukin (IL)-1, IL-6 and tumor necrosis factor-α were higher in post-menopausal patients, who had larger intracranial plaques than pre-menopausal patients. Consistently, post-menopausal patients had higher NIHSS scores than pre-menopausal ones. Atorvastatin reduced NIHSS scores and improved dyslipidemia in patients and eliminated the differences of these parameters between pre- and post-menopausal patients. Conclusions Post-menopausal patients were severer than pre-menopausal patients in terms of dyslipidemia, systemic inflammation and NIHSS scores. Atorvastatin may be beneficial for women with cerebral infarction.
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Affiliation(s)
- Jinhong Zhang
- Department of Neurology, Cangzhou People's Hospital, No.7 North Qingchi Road, Cangzhou, Hebei Province, 061000, China
| | - Hong Wang
- Department of Neurology, Cangzhou People's Hospital, No.7 North Qingchi Road, Cangzhou, Hebei Province, 061000, China.
| | - Shuying Yang
- Department of Neurology, Cangzhou People's Hospital, No.7 North Qingchi Road, Cangzhou, Hebei Province, 061000, China
| | - Xiufen Wang
- Department of Neurology, Cangzhou People's Hospital, No.7 North Qingchi Road, Cangzhou, Hebei Province, 061000, China
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Addison D, Lawler PR, Emami H, Janjua SA, Staziaki PV, Hallett TR, Hennessy O, Lee H, Szilveszter B, Lu M, Mousavi N, Nayor MG, Delling FN, Romero JM, Wirth LJ, Chan AW, Hoffmann U, Neilan TG. Incidental Statin Use and the Risk of Stroke or Transient Ischemic Attack after Radiotherapy for Head and Neck Cancer. J Stroke 2018; 20:71-79. [PMID: 29402065 PMCID: PMC5836583 DOI: 10.5853/jos.2017.01802] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 12/01/2017] [Accepted: 12/05/2017] [Indexed: 12/29/2022] Open
Abstract
Background and Purpose Interventions to reduce the risk for cerebrovascular events (CVE; stroke and transient ischemic attack [TIA]) after radiotherapy (RT) for head and neck cancer (HNCA) are needed. Among broad populations, statins reduce CVEs; however, whether statins reduce CVEs after RT for HNCA is unclear. Therefore, we aimed to test whether incidental statin use at the time of RT is associated with a lower rate of CVEs after RT for HNCA. Methods From an institutional database we identified all consecutive subjects treated with neck RT from 2002 to 2012 for HNCA. Data collection and event adjudication was performed by blinded teams. The primary outcome was a composite of ischemic stroke and TIA. The secondary outcome was ischemic stroke. The association between statin use and events was determined using Cox proportional hazard models after adjustment for traditional and RT-specific risk factors. Results The final cohort consisted of 1,011 patients (59±13 years, 30% female, 44% hypertension) with 288 (28%) on statins. Over a median follow-up of 3.4 years (interquartile range, 0.1 to 14) there were 102 CVEs (89 ischemic strokes and 13 TIAs) with 17 in statin users versus 85 in nonstatins users. In a multivariable model containing known predictors of CVE, statins were associated with a reduction in the combination of stroke and TIA (hazard ratio [HR], 0.4; 95% confidence interval [CI], 0.2 to 0.8; P=0.01) and ischemic stroke alone (HR, 0.4; 95% CI, 0.2 to 0.8; P=0.01). Conclusions Incidental statin use at the time of RT for HNCA is associated with a lower risk of stroke or TIA.
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Affiliation(s)
- Daniel Addison
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Cardio-Oncology Program, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Division of Cardiology, Department of Medicine, The Ohio State University, Columbus, OH, USA
| | - Patrick R Lawler
- Peter Munk Cardiac Centre, Toronto General Hospital, and the Heart and Stroke Richard Lewar Centre of Excellence, University of Toronto, Toronto, ON, Canada.,Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Hamed Emami
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sumbal A Janjua
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Pedro V Staziaki
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Travis R Hallett
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Orla Hennessy
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hang Lee
- Biostatistics Center, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Bálint Szilveszter
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael Lu
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Negar Mousavi
- Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Matthew G Nayor
- Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Francesca N Delling
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Javier M Romero
- Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Lori J Wirth
- Division of Oncology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Annie W Chan
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Udo Hoffmann
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Tomas G Neilan
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Cardio-Oncology Program, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Asymmetric Dimethyl Arginine as a Biomarker of Atherosclerosis in Rheumatoid Arthritis. Mediators Inflamm 2018; 2018:3897295. [PMID: 29576746 PMCID: PMC5822828 DOI: 10.1155/2018/3897295] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 11/27/2017] [Indexed: 12/17/2022] Open
Abstract
Cardiovascular disease is the main cause of morbidity and mortality in rheumatoid arthritis (RA). Despite the advent on new drugs targeting the articular manifestations, the burden of cardiovascular disease is still an unmet need in the management of RA. The pathophysiology of accelerated atherosclerosis associated to RA is not yet fully understood, and reliable and specific markers of early cardiovascular involvement are still lacking. Asymmetric dimethylarginine is gaining attention for its implication in the pathogenesis of endothelial dysfunction and as biomarkers of subclinical atherosclerosis. Moreover, the metabolic pathway of methylarginines offers possible targets for therapeutic interventions to decrease the cardiovascular risk. The purpose of this review is to describe the main causes of increased methylarginine levels in RA, their implication in accelerated atherosclerosis, the possible role as biomarkers of cardiovascular risk, and finally the available data on current pharmacological treatment.
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183
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Tong DC, Whitbourn R, MacIsaac A, Wilson A, Burns A, Palmer S, Layland J. High-Sensitivity C-Reactive Protein Is a Predictor of Coronary Microvascular Dysfunction in Patients with Ischemic Heart Disease. Front Cardiovasc Med 2018; 4:81. [PMID: 29376057 PMCID: PMC5770395 DOI: 10.3389/fcvm.2017.00081] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 12/04/2017] [Indexed: 11/18/2022] Open
Abstract
Background Inflammation and microvascular dysfunction (MVD) are independently associated with adverse cardiovascular outcomes in patients with ischemic heart disease. This study aimed to assess the relationship between inflammation, MVD, and myocardial injury. Methods Coronary microvascular function was assessed in 74 patients undergoing percutaneous coronary intervention (PCI) using the index of microvascular resistance (IMR) by a pressure–temperature sensor-tipped wire. Serum high-sensitivity C-reactive protein (hsCRP) level was quantified by rate turbidimetry. Severe MVD was defined as IMR ≥ 30. Pearson correlation was computed to assess the relationships between hsCRP, troponin, and IMR of culprit vessel. Predictors of severe MVD were assessed by regression analysis. Results Acute coronary syndromes (ACSs) represented 49% of the total cohort. Study cohort was divided into low C-reactive protein (CRP) (hsCRP < 3 mg/L) and high CRP (hsCRP ≥ 3 mg/L) groups. There was higher representation of smokers (78 vs. 52%), diabetics (39 vs. 18%), and ACS (61 vs. 33%), as well as higher body mass index (29.4 ± 4.6 vs. 27.2 ± 4.1) in the high CRP group. Pre-PCI and post-PCI IMR were significantly elevated in the high CRP group compared to the low CRP group (pre-PCI IMR: 29.0 ± 13.9 vs. 17.4 ± 11.1, p < 0.0001; post-PCI IMR: 23.0 ± 16.8 vs. 15.5 ± 8.4, p = 0.02). Peak troponin levels were significantly raised in the high CRP group (9.96 ± 17.19 vs. 1.17 ± 3.00 μg/L, p = 0.002). There was a strong positive correlation between hsCRP and pre-PCI IMR (r = 0.85, p < 0.0001). Pre- and post-PCI IMR levels were correlated with peak troponin level (r = 0.45, p < 0.0001; r = 0.33, p = 0.005, respectively). Predictors of severe MVD include male gender (OR 3.0), diabetes (OR 3.7), smoking history (OR 4.0), ACS presentation (OR 8.5), and hsCRP ≥ 3 mg/L (OR 5.6). Conclusion hsCRP is a significant predictor of MVD while MVD is associated with myocardial injury, supporting the central role of inflammation and MVD in the pathophysiology and complications of coronary artery disease. Clinical Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN): 12617000648325. Universal Trial Number (UTN): U1111-1196-2246.
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Affiliation(s)
- David C Tong
- Department of Cardiology, St. Vincent's Hospital, Melbourne, VIC, Australia.,Department of Cardiology, Peninsula Health, Melbourne, VIC, Australia
| | - Robert Whitbourn
- Department of Cardiology, St. Vincent's Hospital, Melbourne, VIC, Australia
| | - Andrew MacIsaac
- Department of Cardiology, St. Vincent's Hospital, Melbourne, VIC, Australia
| | - Andrew Wilson
- Department of Cardiology, St. Vincent's Hospital, Melbourne, VIC, Australia
| | - Andrew Burns
- Department of Cardiology, St. Vincent's Hospital, Melbourne, VIC, Australia
| | - Sonny Palmer
- Department of Cardiology, St. Vincent's Hospital, Melbourne, VIC, Australia
| | - Jamie Layland
- Department of Cardiology, St. Vincent's Hospital, Melbourne, VIC, Australia.,Department of Cardiology, Peninsula Health, Melbourne, VIC, Australia.,Department of Medicine, Monash University, Melbourne, VIC, Australia
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Al-Huseini I, Ashida N, Kimura T. Deletion of IκB-Kinase β in Smooth Muscle Cells Induces Vascular Calcification Through β-Catenin-Runt-Related Transcription Factor 2 Signaling. J Am Heart Assoc 2018; 7:JAHA.117.007405. [PMID: 29301759 PMCID: PMC5778968 DOI: 10.1161/jaha.117.007405] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Vascular calcification was previously considered as an advanced phase of atherosclerosis; however, recent studies have indicated that such calcification can appear in different situations. Nevertheless, there has been a lack of mechanistic insight to explain the difference. For example, the roles of nuclear factor-κB, a major regulator of inflammation, in vascular calcification are poorly explored, although its roles in atherosclerosis were well documented. Herein, we investigated the roles of nuclear factor-κB signaling in vascular calcification. METHODS AND RESULTS We produced mice with deletion of IKKβ, an essential kinase for nuclear factor-κB activation, in vascular smooth muscle cells (VSMCs; KO mice) and subjected them to the CaCl2-induced aorta injury model. Unexpectedly, KO mice showed more calcification of the aorta than their wild-type littermates, despite the former's suppressed nuclear factor-κB activity. Cultured VSMCs from the aorta of KO mice also showed significant calcification in vitro. In the molecular analysis, we found that Runt-related transcription factor 2, a transcriptional factor accelerating bone formation, was upregulated in cultured VSMCs from KO mice, and its regulator β-catenin was more activated with suppressed ubiquitination in KO VSMCs. Furthermore, we examined VSMCs from mice in which kinase-active or kinase-dead IKKβ was overexpressed in VSMCs. We found that kinase-independent function of IKKβ is involved in suppression of calcification via inactivation of β-catenin, which leads to suppression of Runt-related transcription factor 2 and osteoblast marker genes. CONCLUSIONS IKKβ negatively regulates VSMC calcification through β-catenin-Runt-related transcription factor 2 signaling, which revealed a novel function of IKKβ on vascular calcification.
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Affiliation(s)
- Isehaq Al-Huseini
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noboru Ashida
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Misiak B, Beszłej JA, Kotowicz K, Szewczuk-Bogusławska M, Samochowiec J, Kucharska-Mazur J, Frydecka D. Cytokine alterations and cognitive impairment in major depressive disorder: From putative mechanisms to novel treatment targets. Prog Neuropsychopharmacol Biol Psychiatry 2018; 80:177-188. [PMID: 28433456 DOI: 10.1016/j.pnpbp.2017.04.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 04/01/2017] [Indexed: 12/15/2022]
Abstract
Overwhelming evidence indicates the involvement of immune-inflammatory processes in the pathophysiology of major depressive disorder (MDD). Peripheral cytokine alterations serve as one of most consistently reported indices of subthreshold inflammatory state observed in MDD. Although cytokines cannot pass directly through the blood-brain barrier, a number of transport mechanisms have been reported. In addition, peripheral cytokines may impact central nervous system via downstream effectors of their biological activity. Animal model studies have provided evidence that cytokines might impact cognitive performance through direct and indirect effects on long-term potentiation, neurogenesis and synaptic plasticity. Therefore, it has been hypothesized that cytokine alterations might contribute to cognitive impairment that is widely observed in MDD and persists beyond episodes of acute relapse in the majority of patients. Although several studies have provided that peripheral cytokine alterations might be related to cognitive deficits in patients with MDD, the quality of evidence still leaves much to be desired due to methodological heterogeneity and limitations. In this article, we provide an overview of studies investigating the association between peripheral cytokine alterations and cognitive performance in MDD, discuss underlying mechanisms and neural substrates. Finally, we propose possible treatment targets related to cytokine alterations taking into account existing evidence for antidepressant efficacy of anti-inflammatory pharmacological treatment modalities.
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Affiliation(s)
- Błażej Misiak
- Department of Genetics, Wroclaw Medical University, 1 Marcinkowski Street, 50-368 Wroclaw, Poland.
| | - Jan Aleksander Beszłej
- Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367 Wroclaw, Poland
| | - Kamila Kotowicz
- Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367 Wroclaw, Poland
| | | | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, 26 Broniewski Street, 71-460 Szczecin, Poland
| | - Jolanta Kucharska-Mazur
- Department of Psychiatry, Pomeranian Medical University, 26 Broniewski Street, 71-460 Szczecin, Poland
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367 Wroclaw, Poland
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Lee JY, Cha BS. Effects of Combination Therapy of Statin and Thiazolidinedione on Vascular Inflammation. Korean Circ J 2018; 48:602-604. [PMID: 29968432 PMCID: PMC6031721 DOI: 10.4070/kcj.2018.0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 04/16/2018] [Indexed: 11/18/2022] Open
Affiliation(s)
- Ji-Yeon Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Bong-Soo Cha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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187
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de Grijs D, Teixeira P, Katz S. The association of statin therapy with the primary patency of femoral and popliteal artery stents. J Vasc Surg 2017; 67:1472-1479. [PMID: 29224939 DOI: 10.1016/j.jvs.2017.09.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 09/09/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE It has long been known that hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) broadly reduce cardiovascular events in patients with peripheral vascular disease. It was the goal of this study to determine whether there is an association between statin therapy and primary patency after stenting of superficial femoral and popliteal arteries. METHODS The records of all patients undergoing primary nitinol stenting of the femoral and popliteal arteries at a single institution and by a single surgeon during a 10-year period were reviewed. Demographic characteristics of the patients and risk factors were identified. TransAtlantic Inter-Society Consensus (TASC II) classifications were determined for all stented lesions. Analysis was performed to determine whether the use of statins at the time of stent placement was associated with a change in rates of primary patency. Loss of primary patency was said to have occurred when an intrastent occlusion or a ≥70% stenosis was identified by arterial duplex ultrasound or angiography. Kaplan-Meier survival curves were plotted, and differences between groups were tested by log-rank method. RESULTS Between 2004 and 2014, primary femoral or popliteal stenting was performed on 308 limbs in 250 patients. At the time of intervention, 52.4% of these patients were being treated with statin therapy; 137 interventions were done for claudication and 113 for critical limb ischemia. Of the lesions treated, 165 were TASC A or B and 85 were TASC C or D. Primary patency rates for all stented lesions were 75%, 54%, and 35% at 12, 24, and 36 months. The patency rates at 12, 24, and 36 months, respectively, were 80%, 55%, and 40% for those taking statins and 68%, 49%, and 28% for those not taking statins (P = .178). Statin therapy demonstrated a trend toward an association with improved primary patency rates in TASC A/B lesions but had no association in TASC C/D lesions (TASC A/B, P = .056; TASC C/D, P = .537). Statin compliance was found to be 87% at a mean follow-up of 24.1 months. CONCLUSIONS Although the use of statins has been shown to reduce cardiovascular morbidity and mortality in patients with peripheral vascular disease, overall there is not an association of these drugs with improved primary patency after primary stenting of femoral and popliteal artery lesions. However, when limbs are stratified for severity, less severe (TASC A/B) lesions demonstrated a trend toward a significant association between statin use and improved primary patency. This finding was not seen in more severe (TASC C/D) disease.
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Affiliation(s)
- Derek de Grijs
- Department of Surgery, Huntington Memorial Hospital, Pasadena, Calif.
| | - Pedro Teixeira
- Department of Surgery and Perioperative Care, University of Texas at Austin Dell Medical School, Austin, Tex
| | - Steven Katz
- Division of Vascular and Endovascular Surgery, Keck School of Medicine, University of Southern California, Los Angeles, Calif
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Vozenilek AE, Navratil AR, Green JM, Coleman DT, Blackburn CMR, Finney AC, Pearson BH, Chrast R, Finck BN, Klein RL, Orr AW, Woolard MD. Macrophage-Associated Lipin-1 Enzymatic Activity Contributes to Modified Low-Density Lipoprotein-Induced Proinflammatory Signaling and Atherosclerosis. Arterioscler Thromb Vasc Biol 2017; 38:324-334. [PMID: 29217509 DOI: 10.1161/atvbaha.117.310455] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 11/20/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Macrophage proinflammatory responses induced by modified low-density lipoproteins (modLDL) contribute to atherosclerotic progression. How modLDL causes macrophages to become proinflammatory is still enigmatic. Macrophage foam cell formation induced by modLDL requires glycerolipid synthesis. Lipin-1, a key enzyme in the glycerolipid synthesis pathway, contributes to modLDL-elicited macrophage proinflammatory responses in vitro. The objective of this study was to determine whether macrophage-associated lipin-1 contributes to atherogenesis and to assess its role in modLDL-mediated signaling in macrophages. APPROACH AND RESULTS We developed mice lacking lipin-1 in myeloid-derived cells and used adeno-associated viral vector 8 expressing the gain-of-function mutation of mouse proprotein convertase subtilisin/kexin type 9 (adeno-associated viral vector 8-proprotein convertase subtilisin/kexin type 9) to induce hypercholesterolemia and plaque formation. Mice lacking myeloid-associated lipin-1 had reduced atherosclerotic burden compared with control mice despite similar plasma lipid levels. Stimulation of bone marrow-derived macrophages with modLDL activated a persistent protein kinase Cα/βII-extracellular receptor kinase1/2-jun proto-oncogene signaling cascade that contributed to macrophage proinflammatory responses that was dependent on lipin-1 enzymatic activity. CONCLUSIONS Our data demonstrate that macrophage-associated lipin-1 is atherogenic, likely through persistent activation of a protein kinase Cα/βII-extracellular receptor kinase1/2-jun proto-oncogene signaling cascade that contributes to foam cell proinflammatory responses. Taken together, these results suggest that modLDL-induced foam cell formation and modLDL-induced macrophage proinflammatory responses are not independent consequences of modLDL stimulation but rather are both directly influenced by enhanced lipid synthesis.
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Affiliation(s)
- Aimee E Vozenilek
- From the Department of Microbiology and Immunology (A.E.V., C.M.R.B., M.D.W.), Department of Pathology and Translational Pathobiology (J.M.G., B.H.P., A.W.O.), Department of Cell Biology and Anatomy (A.C.F.), Feist-Weiller Cancer Center (D.T.C.), and Pharmacology, Toxicology, and Neuroscience (R.L.K.), Louisiana State University Health Sciences Center, Shreveport; Department of Pharmacology, University of California San Diego, La Jolla (A.R.N.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (R.C.); and Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO (B.N.F.)
| | - Aaron R Navratil
- From the Department of Microbiology and Immunology (A.E.V., C.M.R.B., M.D.W.), Department of Pathology and Translational Pathobiology (J.M.G., B.H.P., A.W.O.), Department of Cell Biology and Anatomy (A.C.F.), Feist-Weiller Cancer Center (D.T.C.), and Pharmacology, Toxicology, and Neuroscience (R.L.K.), Louisiana State University Health Sciences Center, Shreveport; Department of Pharmacology, University of California San Diego, La Jolla (A.R.N.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (R.C.); and Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO (B.N.F.)
| | - Jonette M Green
- From the Department of Microbiology and Immunology (A.E.V., C.M.R.B., M.D.W.), Department of Pathology and Translational Pathobiology (J.M.G., B.H.P., A.W.O.), Department of Cell Biology and Anatomy (A.C.F.), Feist-Weiller Cancer Center (D.T.C.), and Pharmacology, Toxicology, and Neuroscience (R.L.K.), Louisiana State University Health Sciences Center, Shreveport; Department of Pharmacology, University of California San Diego, La Jolla (A.R.N.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (R.C.); and Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO (B.N.F.)
| | - David T Coleman
- From the Department of Microbiology and Immunology (A.E.V., C.M.R.B., M.D.W.), Department of Pathology and Translational Pathobiology (J.M.G., B.H.P., A.W.O.), Department of Cell Biology and Anatomy (A.C.F.), Feist-Weiller Cancer Center (D.T.C.), and Pharmacology, Toxicology, and Neuroscience (R.L.K.), Louisiana State University Health Sciences Center, Shreveport; Department of Pharmacology, University of California San Diego, La Jolla (A.R.N.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (R.C.); and Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO (B.N.F.)
| | - Cassidy M R Blackburn
- From the Department of Microbiology and Immunology (A.E.V., C.M.R.B., M.D.W.), Department of Pathology and Translational Pathobiology (J.M.G., B.H.P., A.W.O.), Department of Cell Biology and Anatomy (A.C.F.), Feist-Weiller Cancer Center (D.T.C.), and Pharmacology, Toxicology, and Neuroscience (R.L.K.), Louisiana State University Health Sciences Center, Shreveport; Department of Pharmacology, University of California San Diego, La Jolla (A.R.N.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (R.C.); and Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO (B.N.F.)
| | - Alexandra C Finney
- From the Department of Microbiology and Immunology (A.E.V., C.M.R.B., M.D.W.), Department of Pathology and Translational Pathobiology (J.M.G., B.H.P., A.W.O.), Department of Cell Biology and Anatomy (A.C.F.), Feist-Weiller Cancer Center (D.T.C.), and Pharmacology, Toxicology, and Neuroscience (R.L.K.), Louisiana State University Health Sciences Center, Shreveport; Department of Pharmacology, University of California San Diego, La Jolla (A.R.N.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (R.C.); and Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO (B.N.F.)
| | - Brenna H Pearson
- From the Department of Microbiology and Immunology (A.E.V., C.M.R.B., M.D.W.), Department of Pathology and Translational Pathobiology (J.M.G., B.H.P., A.W.O.), Department of Cell Biology and Anatomy (A.C.F.), Feist-Weiller Cancer Center (D.T.C.), and Pharmacology, Toxicology, and Neuroscience (R.L.K.), Louisiana State University Health Sciences Center, Shreveport; Department of Pharmacology, University of California San Diego, La Jolla (A.R.N.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (R.C.); and Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO (B.N.F.)
| | - Roman Chrast
- From the Department of Microbiology and Immunology (A.E.V., C.M.R.B., M.D.W.), Department of Pathology and Translational Pathobiology (J.M.G., B.H.P., A.W.O.), Department of Cell Biology and Anatomy (A.C.F.), Feist-Weiller Cancer Center (D.T.C.), and Pharmacology, Toxicology, and Neuroscience (R.L.K.), Louisiana State University Health Sciences Center, Shreveport; Department of Pharmacology, University of California San Diego, La Jolla (A.R.N.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (R.C.); and Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO (B.N.F.)
| | - Brian N Finck
- From the Department of Microbiology and Immunology (A.E.V., C.M.R.B., M.D.W.), Department of Pathology and Translational Pathobiology (J.M.G., B.H.P., A.W.O.), Department of Cell Biology and Anatomy (A.C.F.), Feist-Weiller Cancer Center (D.T.C.), and Pharmacology, Toxicology, and Neuroscience (R.L.K.), Louisiana State University Health Sciences Center, Shreveport; Department of Pharmacology, University of California San Diego, La Jolla (A.R.N.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (R.C.); and Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO (B.N.F.)
| | - Ronald L Klein
- From the Department of Microbiology and Immunology (A.E.V., C.M.R.B., M.D.W.), Department of Pathology and Translational Pathobiology (J.M.G., B.H.P., A.W.O.), Department of Cell Biology and Anatomy (A.C.F.), Feist-Weiller Cancer Center (D.T.C.), and Pharmacology, Toxicology, and Neuroscience (R.L.K.), Louisiana State University Health Sciences Center, Shreveport; Department of Pharmacology, University of California San Diego, La Jolla (A.R.N.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (R.C.); and Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO (B.N.F.)
| | - A Wayne Orr
- From the Department of Microbiology and Immunology (A.E.V., C.M.R.B., M.D.W.), Department of Pathology and Translational Pathobiology (J.M.G., B.H.P., A.W.O.), Department of Cell Biology and Anatomy (A.C.F.), Feist-Weiller Cancer Center (D.T.C.), and Pharmacology, Toxicology, and Neuroscience (R.L.K.), Louisiana State University Health Sciences Center, Shreveport; Department of Pharmacology, University of California San Diego, La Jolla (A.R.N.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (R.C.); and Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO (B.N.F.)
| | - Matthew D Woolard
- From the Department of Microbiology and Immunology (A.E.V., C.M.R.B., M.D.W.), Department of Pathology and Translational Pathobiology (J.M.G., B.H.P., A.W.O.), Department of Cell Biology and Anatomy (A.C.F.), Feist-Weiller Cancer Center (D.T.C.), and Pharmacology, Toxicology, and Neuroscience (R.L.K.), Louisiana State University Health Sciences Center, Shreveport; Department of Pharmacology, University of California San Diego, La Jolla (A.R.N.); Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (R.C.); and Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO (B.N.F.).
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Mikhailidis D, Undas A, Lip G, Muntner P, Bittner V, Ray K, Watts G, Hovingh GK, Rysz J, Kastelein J, Sahebkar A, Serban C, Banach M. Association between statin use and plasma D-dimer levels. Thromb Haemost 2017; 114:546-57. [DOI: 10.1160/th14-11-0937] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 03/29/2015] [Indexed: 12/17/2022]
Abstract
SummaryD-dimers, specific breakdown fragments of cross-linked fibrin, are generally used as circulating markers of activated coagulation. Statins influence haemostatic factors, but their effect on plasma D-dimer levels is controversial. Therefore, the aim of this meta-analysis was to evaluate the association between statin therapy and plasma D-dimer levels. We searched PubMed, Web of Science, Cochrane Library, Scopus and EMBASE (up to September 25, 2014) to identify randomised controlled trials (RCTs) investigating the impact of statin therapy on plasma D-dimer levels. Two independent reviewers extracted data on study characteristics, methods and outcomes. Meta-analysis of data from nine RCTs with 1,165 participants showed a significant effect of statin therapy in reducing plasma D-dimer levels (standardised mean difference [SMD]: –0.988 µg/ml, 95 % confidence interval [CI]: –1.590 – –0.385, p=0.001). The effect size was robust in sensitivity analysis and omission of no single study significantly changed the overall estimated effect size. In the subgroup analysis, the effect of statins on plasma D-dimer levels was significant only in the subsets of studies with treatment duration ≥ 12 weeks (SMD: –0.761 µg/ml, 95 %CI: –1.163– –0.360; p< 0.001), and for lipophilic statins (atorvastatin and simvastatin) (SMD: –1.364 µg/ml, 95 % CI: –2.202– –0.526; p=0.001). Hydrophilic statins (pravastatin and rosuvastatin) did not significantly reduce plasma D-dimer levels (SMD: –0.237 µg/ml, 95 %CI: –1.140–0.665, p=0.606). This meta-analysis of RCTs suggests a decrease of plasma D-dimer levels after three months of statin therapy, and especially after treatment with lipophilic statins. Well-designed trials are required to validate these results.Note: The review process for this paper was fully handled by Christian Weber, Editor in Chief.
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190
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Antonopoulos AS, Margaritis M, Shirodaria C, Antoniades C. Translating the effects of statins: from redox regulation to suppression of vascular wall inflammation. Thromb Haemost 2017; 108:840-8. [PMID: 22872079 DOI: 10.1160/th12-05-0337] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 07/24/2012] [Indexed: 12/21/2022]
Abstract
Vascular oxidative stress is a key feature of atherogenesis, and targeting vascular redox signalling is a rational therapeutic goal in vascular disease pathogenesis. 3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitors or statins are potent lipid-lowering drugs that improve cardiovascular outcomes. It is now widely accepted that cardiovascular disease prevention by statins is dependent not only on their lipid lowering effects, but also on their beneficial effects on vascular redox signalling. Cell culture and animal models have provided important findings on the effects of statins on vascular redox and nitric oxide bioavailability. Recent evidence from studies on human vessels has further enhanced our understanding of the "pleiotropic" effects of statins on vascular wall. Reversal of endothelial dysfunction in human vessels by statins is dependent on the mevalonate pathway and Rac1 inhibition. These critical steps are responsible for reducing NADPH-oxidase activity and improving tetrahydrobiopterin bioavailability and nitric oxide synthase (NOS) coupling in human vessels. However, mevalonate pathway inhibition has been also held responsible for some of the side effects observed after statin treatment. In this review we summarise the existing knowledge on the effects of statins on vascular biology by discussing key findings from basic science as well as recent evidence from translational studies in humans. Finally, we discuss emerging aspects of statin pleiotropy, such as their effects on adipose tissue biology and adipokine synthesis that may light additional mechanistic links between statin treatment and improvement of clinical outcome in primary and secondary prevention.
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191
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Soran H, Liu Y, Adam S, Siahmansur T, Ho JH, Schofield JD, Kwok S, Gittins M, France M, Younis N, Gibson JM, Durrington PN, Rutter MK. A comparison of the effects of low- and high-dose atorvastatin on lipoprotein metabolism and inflammatory cytokines in type 2 diabetes: Results from the Protection Against Nephropathy in Diabetes with Atorvastatin (PANDA) randomized trial. J Clin Lipidol 2017; 12:44-55. [PMID: 29246729 DOI: 10.1016/j.jacl.2017.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/24/2017] [Accepted: 10/17/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Statin therapy is recommended in type 2 diabetes (T2DM) although views on treatment intensity and therapeutic targets remain divided. OBJECTIVES Our objectives were to compare the effects of high-intensity and moderate-intensity atorvastatin treatment on lipoprotein metabolism and inflammatory markers and how frequently treatment goals are met in high-risk T2DM patients. METHODS Patients with T2DM and albuminuria (urinary albumin:creatinine ratio >5 mg/mmol, total cholesterol <7 mmol/L, proteinuria <2 g/d, creatinine <200 μmol/L) were randomized to receive atorvastatin 10 mg (n = 59) or 80 mg (n = 60) daily. Baseline and 1-year follow-up data are reported. RESULTS Patients were at high cardiovascular disease risk (observed combined mortality and nonfatal cardiovascular disease annual event rate 4.8%). The non-high-density lipoprotein cholesterol (HDL-C) goal of <2.6 mmol/L was achieved in 72% of participants receiving high-dose atorvastatin, but only in 40% on low-dose atorvastatin (P < .005). The proportion achieving apolipoprotein B (apoB) <0.8 g/L on high-dose and low-dose atorvastatin was 82% and 70%, respectively (NS). Total cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol, non-HDL-C, oxidized LDL, apoB, glyc-apoB, apolipoprotein E, and lipoprotein-associated phospholipase A2 decreased significantly, more so in participants on high-dose atorvastatin. Adiponectin increased and serum amyloid A decreased without dose dependency. Neither dose produced significant changes in HDL-C, cholesterol efflux, high-sensitivity C-reactive protein, glycated hemoglobin, serum paraoxonase-1, lecithin:cholesterol acyltransferase, or cholesteryl ester transfer protein. CONCLUSIONS High-dose atorvastatin is more effective in achieving non-HDL-C therapeutic goals and in modifying LDL-related parameters. Recommended apoB treatment targets may require revision. Despite the increase in adiponectin and the decrease in serum amyloid A, HDL showed no change in functionality.
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Affiliation(s)
- Handrean Soran
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom; Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom.
| | - Yifen Liu
- Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Safwaan Adam
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom; Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Tarza Siahmansur
- Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Jan H Ho
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom; Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Jonathan D Schofield
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom; Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - See Kwok
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom; Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Matthew Gittins
- Department of Diabetes, Manchester Diabetes Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Michael France
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom; Department of Clinical Biochemistry, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Naveed Younis
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom; Department of Diabetes and Endocrinology, University Hospital South Manchester NHS Foundation Trust, Wythenshawe Hospital, Manchester, United Kingdom
| | - J Martin Gibson
- Department of Diabetes and Endocrinology, Salford Royal NHS Foundation Trust, University of Manchester, Manchester, United Kingdom
| | - Paul N Durrington
- Cardiovascular Trials Unit, The Old St Mary's Hospital, Central Manchester University Hospitals, Manchester, United Kingdom; Division of Cardiovascular Sciences, Cardiovascular Research Group, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Martin K Rutter
- Department of Diabetes, Manchester Diabetes Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
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Escate R, Mata P, Cepeda JM, Padreó T, Badimon L. miR-505-3p controls chemokine receptor up-regulation in macrophages: role in familial hypercholesterolemia. FASEB J 2017; 32:601-612. [PMID: 32172543 DOI: 10.1096/fj.201700476r] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 09/11/2017] [Indexed: 12/16/2022]
Abstract
Familial hypercholesterolemia (FH) conveys a high risk of premature atherosclerosis as a result of lifelong exposure to high LDL cholesterol levels that are not fully reduced by standard-of-care lipid-lowering treatment. Inflammatory mediators have played a role in the progression of atherosclerotic lesions. Here, we investigated whether innate immunity cells in patients with FH have a specific proinflammatory phenotype that is distinct from that of cells in normal participants. To this end, miR-505-3p-a microRNA related to chronic inflammation-and its target genes were investigated in monocyte-derived macrophages (MACs) of patients with FH (FH-MACs) and non-FH controls (co-MACs). On the basis of the profiler PCR array analysis of agomiR-505-3p-transfected MACs, we identified the chemokine receptors, CCR3, CCR4, and CXCR1, as genes that are regulated by miR-505-3p via the transcription factor, RUNX1. miR-505-3p was significantly down-regulated, whereas CCR3, CCR4, CXCR, and RUNX1 were increased in FH-MAC compared with co-MAC, with the increase being more evident in the proinflammatory M1-like FH-MAC. Chemokine receptor levels were unrelated to LDL plasma levels at entry, but correlated with age in patients with FH, not in controls. In summary, we demonstrate for first time to our knowledge that MACs from FH-MACs have an inflammatory phenotype that is characterized by the up-regulation of CCR3, CCR4, and CXCR1 under the control of miR-505-3p. These results suggest a chronic inflammatory condition in FH innate immunity cells that is not reverted by standard lipid-lowering treatment.-Escate, R., Mata, P., Cepeda, J.M., Padró, T., Badimon, L. miR-505-3p controls chemokine receptor up-regulation in macrophages: role in familial hypercholesterolemia. FASEB J. 32, 601-612 (2018). www.fasebj.org.
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Affiliation(s)
- Rafael Escate
- Catalan Institute of Cardiovascular Sciences (ICCC), Sant Pau Biomedical Research Institute (IIB-Sant Pau) Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Hospital de Sant Pau, Barcelona, Spain
| | - Pedro Mata
- Fundacion Hipercolesterolemia Familiar, Madrid, Spain
| | - Jose Maria Cepeda
- Department of Internal Medicine, Hospital Vega Baja, Orihuela, Spain
| | - Teresa Padreó
- Catalan Institute of Cardiovascular Sciences (ICCC), Sant Pau Biomedical Research Institute (IIB-Sant Pau) Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Hospital de Sant Pau, Barcelona, Spain
| | - Lina Badimon
- Catalan Institute of Cardiovascular Sciences (ICCC), Sant Pau Biomedical Research Institute (IIB-Sant Pau) Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Hospital de Sant Pau, Barcelona, Spain.,Universitat Autonoma de Barcelona, Barcelona, Spain
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193
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Speirs C, Williams JJL, Riches K, Salt IP, Palmer TM. Linking energy sensing to suppression of JAK-STAT signalling: A potential route for repurposing AMPK activators? Pharmacol Res 2017; 128:88-100. [PMID: 29037480 DOI: 10.1016/j.phrs.2017.10.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/12/2017] [Accepted: 10/12/2017] [Indexed: 02/07/2023]
Abstract
Exaggerated Janus kinase-signal transducer and activator of transcription (JAK-STAT) signalling is key to the pathogenesis of pro-inflammatory disorders, such as rheumatoid arthritis and cardiovascular diseases. Mutational activation of JAKs is also responsible for several haematological malignancies, including myeloproliferative neoplasms and acute lymphoblastic leukaemia. Accumulating evidence links adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK), an energy sensor and regulator of organismal and cellular metabolism, with the suppression of immune and inflammatory processes. Recent studies have shown that activation of AMPK can limit JAK-STAT-dependent signalling pathways via several mechanisms. These novel findings support AMPK activation as a strategy for management of an array of disorders characterised by hyper-activation of the JAK-STAT pathway. This review discusses the pivotal role of JAK-STAT signalling in a range of disorders and how both established clinically used and novel AMPK activators might be used to treat these conditions.
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Affiliation(s)
- Claire Speirs
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Jamie J L Williams
- School of Pharmacy and Medical Sciences, University of Bradford, Bradford BD7 1DP, UK
| | - Kirsten Riches
- School of Chemistry and Biosciences, University of Bradford, Bradford BD7 1DP, UK
| | - Ian P Salt
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Timothy M Palmer
- School of Pharmacy and Medical Sciences, University of Bradford, Bradford BD7 1DP, UK.
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Nurullahoğlu-Atalık KE, Kutlu S, Solak H, Koca RÖ. Cilostazol enhances atorvastatin-induced vasodilation of female rat aorta during aging. Physiol Int 2017; 104:226-234. [DOI: 10.1556/2060.104.2017.3.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Statins have cholesterol-independent effects including an increased vascular nitric oxide activity and are commonly used by patients with cardiovascular disease. Such patients frequently have cardiovascular diseases, which may be treated with cilostazol, a platelet aggregation inhibitor. This study was designed to investigate whether combined use of cilostazol would increase the inhibitory effect of statin on vascular smooth muscle and how maturation would affect these responses. Female Wistar rats, aged 3–4 months (young) and 14–15 months (adult), were sacrificed by cervical dislocation and the thoracic aorta was dissected and cut into 3- to 4-mm-long rings. The rings were mounted under a resting tension of 1 g in a 20-ml organ bath filled with Krebs–Henseleit solution. Rings were precontracted with phenylephrine (10−6 M), and the presence of endothelium was confirmed with acetylcholine (10−6 M). Then, the concentration–response curves were obtained for atorvastatin alone (10−10 to 3 × 10−4 M; control) and in the presence of cilostazol (10−6 M) in young and adult rat aortas. This experimental protocol was also carried out in aorta rings, which had been pretreated with NG-nitro-l-arginine methyl ester (l-NAME, 10−4 M). Atorvastatin induced concentration-dependent relaxations in young and adult rat thoracic aorta rings precontracted with phenylephrine. The pIC50 value of atorvastatin was significantly decreased in adult rat aortas. In addition, pretreatment of aortas with cilostazol enhanced the potency of atorvastatin in both young and adult aortas. Incubation with l-NAME did not completely eliminate the relaxations to atorvastatin in the presence of cilostazol. These results suggest that combined application of cilostazol with atorvastatin was significantly more potent than atorvastatin alone. Combined drug therapy may be efficacious in delaying the occurrence of cardiovascular events.
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Affiliation(s)
- KE Nurullahoğlu-Atalık
- 1 Department of Pharmacology, Faculty of Meram Medicine, University of Necmettin Erbakan, Konya, Turkey
| | - S Kutlu
- 2 Department of Physiology, Faculty of Meram Medicine, University of Necmettin Erbakan, Konya, Turkey
| | - H Solak
- 2 Department of Physiology, Faculty of Meram Medicine, University of Necmettin Erbakan, Konya, Turkey
| | - R Özen Koca
- 2 Department of Physiology, Faculty of Meram Medicine, University of Necmettin Erbakan, Konya, Turkey
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195
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Abstract
PURPOSE OF REVIEW Atherosclerosis is now considered a chronic inflammatory disease. Oxidative stress induced by generation of excess reactive oxygen species has emerged as a critical, final common mechanism in atherosclerosis. Reactive oxygen species (ROS) are a group of small reactive molecules that play critical roles in the regulation of various cell functions and biological processes. Although essential for vascular homeostasis, uncontrolled production of ROS is implicated in vascular injury. Endogenous anti-oxidants function as checkpoints to avoid these untoward consequences of ROS, and an imbalance in the oxidant/anti-oxidant mechanisms leads to a state of oxidative stress. In this review, we discuss the role of ROS and anti-oxidant mechanisms in the development and progression of atherosclerosis, the role of oxidized low-density lipoprotein cholesterol, and highlight potential anti-oxidant therapeutic strategies relevant to atherosclerosis. RECENT FINDINGS There is growing evidence on how traditional risk factors translate into oxidative stress and contribute to atherosclerosis. Clinical trials evaluating anti-oxidant supplements had failed to improve atherosclerosis. Current studies focus on newer ROS scavengers that specifically target mitochondrial ROS, newer nanotechnology-based drug delivery systems, gene therapies, and anti-miRNAs. Synthetic LOX-1 modulators that inhibit the effects of Ox-LDL are currently in development. Research over the past few decades has led to identification of multiple ROS generating systems that could potentially be modulated in atherosclerosis. Therapeutic approaches currently being used for atheroslcerotic vascular disease such as aspirin, statins, and renin-angiotensin system inhibitors exert a pleiotropic antioxidative effects. There is ongoing research to identify novel therapeutic modalities to selectively target oxidative stress in atherosclerosis.
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196
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Han F, Xiao Q, Peng S, Che X, Jiang L, Shao Q, He B. Atorvastatin ameliorates LPS‐induced inflammatory response by autophagy via AKT/mTOR signaling pathway. J Cell Biochem 2017; 119:1604-1615. [DOI: 10.1002/jcb.26320] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 08/02/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Fei Han
- Department of CardiologyRen‐Ji Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Qing‐Qing Xiao
- Department of CardiologyRen‐Ji Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Shi Peng
- Department of CardiologyRen‐Ji Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Xin‐Yu Che
- Department of CardiologyRen‐Ji Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Li‐Sheng Jiang
- Department of CardiologyRen‐Ji Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Qin Shao
- Department of CardiologyRen‐Ji Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Ben He
- Department of CardiologyRen‐Ji Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
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197
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Lv ZH, Phuong TA, Jin SJ, Li XX, Xu M. Protection by simvastatin on hyperglycemia-induced endothelial dysfunction through inhibiting NLRP3 inflammasomes. Oncotarget 2017; 8:91291-91305. [PMID: 29207644 PMCID: PMC5710924 DOI: 10.18632/oncotarget.20443] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 07/25/2017] [Indexed: 12/24/2022] Open
Abstract
Recent studies have demonstrated that NLRP3 inflammasome complex acts as pivotal elements to initiate inflammatory responses and plays an important role in the dysfunction of cardiovascular complications. Meanwhile, simvastatin prevents vascular endothelial dysfunction from inflammasome invasion contributing to reduce cardiovascular risk. However, Whether or not the simvastatin improves vascular endothelial barrier function through inhibiting the activation of NLRP3 inflammasome pathway remains unknown. Here, we explored the role and mechanisms of simvastatin in the activation of NLRP3 inflammasome which are involved in vascular endothelial hyperpermeability causing by the disruption of tight junction protein ZO-1 and adherens junction protein VE-Cadherin, an early initiation of cardiovascular complication. Our results found that high glucose significantly induced the formation and activation of NLRP3 inflammasome through NADPH oxidase-dependent reactive oxygen species (ROS) formation, associated with vascular endothelial hyperpermeability causing by ZO-1 and VE-Cadherin disruption in the rat aortic endothelial cells (RAECs). Simvastatin treatment remarkably abolished vascular endothelial hyperpermeability and enhanced the protein expression of ZO-1 and VE-Cadherin through NLRP3 inflammasome. Mechanistically, the inhibitory role of simvastatin endothelial hyperpermeability is attributed to the decreased release of cytoplasmic high mobility group box protein-1 (HMGB1) derived from endothelial NLRP3 inflammasome activation. We further confirm the protective role of simvastatin on vascular leakage in the heart of diabetic rats injected with Evans blue dye, which was associated with HMGB1 release in the serum. Collectively, the mechanism of simvastatin treatment alleviating vascular endothelial permeability dysfunction may be through inhibiting the NLRP3 inflammasome-dependent HMGB1 release in RAECs.
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Affiliation(s)
- Zhen-Huan Lv
- Department of Clinical Pharmacy, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009, China
| | - Trinh Anh Phuong
- Department of Clinical Pharmacy, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009, China
| | - Shi-Jie Jin
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou 311400, China
| | - Xiao-Xue Li
- Department of Pathology, Medical School of Southeast University, Nanjing 210009, China
| | - Ming Xu
- Department of Clinical Pharmacy, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009, China
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198
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Ma H, Liu Y, Xie H, Zhang G, Zhan H, Liu Z, Wang P, Geng Q, Guo L. The renoprotective effects of simvastatin and atorvastatin in patients with acute coronary syndrome undergoing percutaneous coronary intervention: An observational study. Medicine (Baltimore) 2017; 96:e7351. [PMID: 28796030 PMCID: PMC5556196 DOI: 10.1097/md.0000000000007351] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Some statins, such as atorvastatin, have proven renoprotective effects. The comparative renoprotective potential of simvastatin is less clear. This study aimed to compare the renoprotective effects of simvastatin with atorvastatin in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). This observational study examined the medical records of 271 patients who were treated at the Guangdong Cardiovascular Institute from April 2004 to February 2008. Patients had received either 40 mg simvastatin (n = 128) or 20 mg atorvastatin (n = 143), daily, for a period of at least 6 months following PCI. Declined renal function (DRF) was defined at the occurrence of chronic kidney disease (CKD) or elevated CKD stages at 6-months post-PCI. Results showed that the incidence of DRF was similar among patients taking simvastatin or atorvastatin (25.00% vs 26.57%, respectively). Kaplan-Meier survival analysis showed that patients who developed DRF had a higher incidence of mortality and major adverse cardiovascular events (MACEs) than those without DRF (17.41% vs 28.57%, P = .0308). Multivariate logistic regression analysis identified diabetes and baseline estimated glomerular filtration rate as independent risk factors for DRF. Collectively, our results indicate that simvastatin has comparable renoprotective effects to atorvastatin in ACS patients undergoing PCI. Further studies are warranted to confirm the comparative renoprotective effects of statins.
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Affiliation(s)
- Huan Ma
- Cardic Rehabilitation Department, Guangdong Cardiovascular Institute, Guangdong General Hospital
| | - Yong Liu
- Cardic Rehabilitation Department, Guangdong Cardiovascular Institute, Guangdong General Hospital
| | - Haixia Xie
- Cardic Rehabilitation Department, Guangdong Cardiovascular Institute, Guangdong General Hospital
| | - Guolin Zhang
- Cardic Rehabilitation Department, Guangdong Cardiovascular Institute, Guangdong General Hospital
| | - Huimin Zhan
- Cardic Rehabilitation Department, Guangdong Cardiovascular Institute, Guangdong General Hospital
| | - Zhi Liu
- Cardic Rehabilitation Department, Guangdong Cardiovascular Institute, Guangdong General Hospital
| | - Ping Wang
- Cardic Rehabilitation Department, Guangdong Cardiovascular Institute, Guangdong General Hospital
| | - Qingshan Geng
- Guangdong Academy of Medical Sciences, Guangdong, China
| | - Lan Guo
- Cardic Rehabilitation Department, Guangdong Cardiovascular Institute, Guangdong General Hospital
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199
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Mirroring the CANTOS revolution: is anti-inflammatory therapy for diabetes just around the corner? Cardiovasc Diabetol 2017; 16:91. [PMID: 28724428 PMCID: PMC5517949 DOI: 10.1186/s12933-017-0573-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 07/09/2017] [Indexed: 12/20/2022] Open
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200
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Abstract
Inflammasomes are protein complexes formed upon encounter of microbial or damage-associated stimuli. The main output of inflammasome assembly is activation of caspase-1, a protease involved in both pro-inflammatory and host-protective responses. Defined bacterial or viral ligands have been identified for the inflammasome-forming receptors AIM2, NLRP1, and NLRC4. The signals activating other inflammasomes, NLRP3, NLRP6, and pyrin, are less well understood. Recent studies implicated several low-molecular-weight compounds traditionally linked to metabolism, not immunity, in modulation of inflammasome signaling. Furthermore, genetic, pharmacological, or pathogen-mediated interference with energy metabolism also affects inflammasome activation. Here we review the findings on how microbial- and host-derived metabolites regulate activation of the NLRP3 and NLRP6 inflammasomes. We discuss the different models of how glycolysis and mitochondrial metabolism control the NLRP3 inflammasome. Finally, we summarize the findings on metabolic control of pyrin and point to open questions to be addressed to broaden our understanding of metabolism-inflammasome interactions.
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Affiliation(s)
- Tomasz Próchnicki
- Institute of Innate Immunity, University Hospitals Bonn, 53127 Bonn, Germany
| | - Eicke Latz
- Institute of Innate Immunity, University Hospitals Bonn, 53127 Bonn, Germany; Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA; German Center of Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany; Centre for Molecular Inflammation Research (CEMIR), Norwegian University of Science and Technology, 7491 Trondheim, Norway.
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