1
|
Silva-Velasco DL, Cervantes-Pérez LG, Sánchez-Mendoza A. ACE inhibitors and their interaction with systems and molecules involved in metabolism. Heliyon 2024; 10:e24655. [PMID: 38298628 PMCID: PMC10828069 DOI: 10.1016/j.heliyon.2024.e24655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
The main function of the renin-angiotensin-aldosterone system (RAAS) is the regulation of blood pressure; therefore, researchers have focused on its study to treat cardiovascular and renal diseases. One of the most widely used treatments derived from the study of RAAS, is the use of angiotensin-converting enzyme inhibitors (ACEi). Since it was discovered, the main target of ACEi has been the cardiovascular and renal systems. However, being the RAAS expressed locally in several specialized tissues and cells such as pneumocytes, hepatocytes, spleenocytes, enterocytes, adipocytes, and neurons the effect of inhibitors has expanded, because it is expected that RAAS has a role in the specific function of those cells. Many chronic degenerative diseases compromise the correct function of those organs, and in most of them, the RAAS is overactivated. Therefore, the use of ACEi must exert a benefit on an impaired system. Accordingly, the objective of this review is to present a brief overview of the cardiovascular and renal actions of ACEi and its effects in organs that are not the classic targets of ACEi that carry on glucose and lipid metabolism.
Collapse
Affiliation(s)
| | - Luz G. Cervantes-Pérez
- Departamento de Farmacología, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Alicia Sánchez-Mendoza
- Departamento de Farmacología, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| |
Collapse
|
2
|
Krysiak R, Kowalcze K, Okopień B. Impact of Lisinopril on Cardiometabolic Risk Factors in Sisters of Women With Polycystic Ovary Syndrome. J Clin Pharmacol 2023; 63:1045-1052. [PMID: 37173821 DOI: 10.1002/jcph.2268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
Women with polycystic ovary syndrome (PCOS), the most common endocrinopathy in reproductive age, are characterized by increased cardiometabolic risk. Similar hormonal and metabolic changes were found in their siblings. The purpose of our study was to compare blood pressure-lowering and pleiotropic effects of lisinopril between sisters of women with PCOS and their unrelated peers. The study included two age-, body mass index-, and blood pressure-matched groups of women with grade 1 hypertension: 26 sisters of PCOS probands (Group 1) and 26 individuals without a family history of PCOS (Group 2), receiving 10-40 mg of lisinopril daily. Blood pressure, glucose homeostasis markers, plasma levels of lipids (androgens, estradiol, high-sensitivity C-reactive protein (hsCRP), homocysteine, fibrinogen, and uric acid), and urinary albumin-to-creatinine ratio (UACR) were measured before lisinopril treatment and 6 months later. At baseline, the study groups differed in insulin sensitivity, testosterone, free androgen index (FAI), hsCRP, homocysteine, and UACR. Blood pressure-lowering properties of lisinopril did not differ between the groups. The decrease in homocysteine and UACR, although observed in both groups, was stronger in Group 2 than in Group 1. Only in women without a family history of PCOS lisinopril improved insulin sensitivity and reduce hsCRP, fibrinogen, and uric acid. The remaining markers did not change throughout the study. Cardiometabolic effects of lisinopril correlated with testosterone, free androgen index, and changes in insulin sensitivity. The obtained results suggest that cardiometabolic effects of lisinopril may be slightly less pronounced in sisters of women with PCOS than in women without a family history of this disorder.
Collapse
Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
| | - Karolina Kowalcze
- Department of Pediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
| |
Collapse
|
3
|
Kanugula AK, Kaur J, Batra J, Ankireddypalli AR, Velagapudi R. Renin-Angiotensin System: Updated Understanding and Role in Physiological and Pathophysiological States. Cureus 2023; 15:e40725. [PMID: 37350982 PMCID: PMC10283427 DOI: 10.7759/cureus.40725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2023] [Indexed: 06/24/2023] Open
Abstract
The classical view of the renin-angiotensin system (RAS) is that of the circulating hormone pathway involved in salt and water homeostasis and blood pressure regulation. It is also involved in the pathogenesis of cardiac and renal disorders. This led to the creation of drugs blocking the actions of this classical pathway, which improved cardiac and renal outcomes. Our understanding of the RAS has significantly expanded with the discovery of new peptides involved in this complex pathway. Over the last two decades, a counter-regulatory or protective pathway has been discovered that opposes the effects of the classical pathway. Components of RAS are also implicated in the pathogenesis of obesity and its metabolic diseases. The continued discovery of newer molecules also provides novel therapeutic targets to improve disease outcomes. This article aims to provide an overview of an updated understanding of the RAS, its role in physiological and pathological processes, and potential novel therapeutic options from RAS for managing cardiorenal disorders, obesity, and related metabolic disorders.
Collapse
Affiliation(s)
- Ashok Kumar Kanugula
- Department of Internal Medicine, Wellstar Health System - Spalding Regional Hospital, Griffin, USA
| | - Jasleen Kaur
- Department of Endocrinology, Diabetes, and Metabolism, HealthPartners, Minneapolis, USA
| | - Jaskaran Batra
- Department of Internal Medicine, Univerity of Pittsburg Medical Center (UPMC) McKeesport, McKeesport, USA
| | | | - Ravikanth Velagapudi
- Department of Pulmonary and Critical Care Medicine, Spectrum Health/Michigan State University, Grand Rapids, USA
| |
Collapse
|
4
|
Fajloun Z, Abi Khattar Z, Kovacic H, Legros C, Sabatier JM. Understanding and Relieving of Neuropathic Disorders in the Long COVID. Infect Disord Drug Targets 2023; 23:e270223214061. [PMID: 36843369 DOI: 10.2174/1871526523666230227113205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/28/2023]
Affiliation(s)
- Ziad Fajloun
- Department of Biology, Faculty of Sciences 3, Lebanese University, Campus Michel Slayman Ras Maska, Tripoli 1352, Lebanon
- Laboratory of Applied Biotechnology (LBA3B), Azm Center for Research in Biotechnology and its Applications, EDST, Lebanese University, Tripoli 1300, Lebanon
| | - Ziad Abi Khattar
- Laboratory of Georesources, Geosciences and Environment (L2GE), Microbiology/Tox-Ecotoxicology Team, Faculty of Sciences 2, Lebanese University, Campus Fanar, Jdeidet El-Matn, Beirut, P.O. Box 90656, Lebanon
| | - Hervé Kovacic
- CNRS, INP, Inst Neurophysiopathol, Aix- Marseille Univ, Marseille 13385, France
| | - Christian Legros
- Univ Angers, INSERM, CNRS, MITOVASC, Team 2 CarMe, SFR ICAT, Angers 49000, France
| | - Jean-Marc Sabatier
- CNRS, INP, Inst Neurophysiopathol, Aix- Marseille Univ, Marseille 13385, France
| |
Collapse
|
5
|
Yao J, Wang Y, Yang L, Ren M, Li L, Wang H. Prevalence of possible sarcopenia in community-dwelling older Chinese adults: a cross-sectional study. BMJ Open 2022; 12:e067425. [PMID: 36517096 PMCID: PMC9756196 DOI: 10.1136/bmjopen-2022-067425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To determine the prevalence of possible sarcopenia and its association with other conditions in older adults in Bengbu, China. DESIGN, SETTING AND PARTICIPANTS A cross-sectional study of 1082 community-dwelling Chinese people aged at least 60 years from March to June 2022. METHODS Handgrip strength and information regarding associated conditions were collected. Possible sarcopenia was estimated based on handgrip strength with cut-off values (<28 kg in men; <18 kg in women) recommended by the Asia Working Group for Sarcopenia in 2019. Mann-Whitney U tests, χ2 tests and binary logistic regression analyses were used to explore relationships between possible sarcopenia and associated conditions. RESULTS Possible sarcopenia was more prevalent in men (52.79%, n=246, age 79.43±7.33 years among men with possible sarcopenia) than in women (44.48%, n=274, age 78.90±7.71 years among women with possible sarcopenia). In men, possible sarcopenia positively correlated with high age (OR 2.658, 95% CI 1.758 to 4.019), physical inactivity (OR 2.779, 95% CI 1.646 to 4.691) and diabetes (OR 4.269, 95% CI 2.397 to 7.602), and negatively with hypertension (OR 0.586, 95% CI 0.384 to 0.893). The risk of possible sarcopenia in men decreased by 12.6% for every 1 kg/m2 increase of body mass index (OR 0.874, 95% CI 0.817 to 0.935). In women, possible sarcopenia positively correlated with high age (OR 3.821, 95% CI 2.677 to 5.455), physical inactivity (OR 2.185, 95% CI 1.488 to 3.210) and arthritis (OR 2.076, 95% CI 1.411 to 3.056). CONCLUSION Possible sarcopenia is prevalent in older adults and the factors affecting possible sarcopenia are different in men and women. Health education about these target factors can be considered as a potential measure to prevent possible sarcopenia.
Collapse
Affiliation(s)
- Jiaqin Yao
- School of Nursing, Bengbu Medical College, Bengbu, Anhui, China
| | - Yaoting Wang
- Graduate School, Bengbu Medical College, Bengbu, Anhui, China
| | - Lin Yang
- School of Nursing, Bengbu Medical College, Bengbu, Anhui, China
| | - Mengting Ren
- School of Nursing, Bengbu Medical College, Bengbu, Anhui, China
| | - Lingyan Li
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Hongyu Wang
- Physical Fitness Center, Bengbu Medical College, Bengbu, Anhui, China
| |
Collapse
|
6
|
Shi M, Mathai ML, Xu G, Su XQ, McAinch AJ. The effect of dietary supplementation with blueberry, cyanidin-3-O-β-glucoside, yoghurt and its peptides on gene expression associated with glucose metabolism in skeletal muscle obtained from a high-fat-high-carbohydrate diet induced obesity model. PLoS One 2022; 17:e0270306. [PMID: 36112580 PMCID: PMC9481010 DOI: 10.1371/journal.pone.0270306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/07/2022] [Indexed: 11/18/2022] Open
Abstract
Obesity is a leading global health problem contributing to various chronic diseases, including type II diabetes mellitus (T2DM). The aim of this study was to investigate whether blueberries, yoghurt, and their respective bioactive components, Cyanidin-3-O-β-glucoside (C3G) and peptides alone or in combinations, alter the expression of genes related to glucose metabolism in skeletal muscles from diet-induced obese mice. In extensor digitorum longus (EDL), yoghurt up-regulated the expression of activation of 5’adenosine monophosphate-activated protein kinase (AMPK), insulin receptor substrate-1 (IRS-1), phosphatidylinositol-3 kinase (PI3K) and glucose transporter 4 (GLUT4), and down-regulated the expression of angiotensin II receptor type 1 (AGTR-1). The combination of blueberries and yoghurt down-regulated the mRNA expression of AGTR-1 and Forkhead box protein O1 (FoxO1) in the EDL. Whereas the combination of C3G and peptides down-regulated AGTR-1 and up-regulated GLUT4 mRNA expression in the EDL. In the soleus, blueberries and yoghurt alone, and their combination down-regulated AGTR-1 and up-regulated GLUT4 mRNA expression. In summary blueberries and yoghurt, regulated multiple genes associated with glucose metabolism in skeletal muscles, and therefore may play a role in the management and prevention of T2DM.
Collapse
Affiliation(s)
- Min Shi
- Institute for Health and Sport, Victoria University, Melbourne, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, Melbourne, Australia
| | - Michael L. Mathai
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Guoqin Xu
- Institute for Health and Sport, Victoria University, Melbourne, Australia
- Department of Sports and Health, Guangzhou Sport University, Guangzhou, China
| | - Xiao Q. Su
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Andrew J. McAinch
- Institute for Health and Sport, Victoria University, Melbourne, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, Melbourne, Australia
- * E-mail:
| |
Collapse
|
7
|
Flück M, Vaughan D, Rittweger J, Giraud MN. Post-translational dysregulation of glucose uptake during exhaustive cycling exercise in vastus lateralis muscle of healthy homozygous carriers of the ACE deletion allele. Front Physiol 2022; 13:933792. [PMID: 36148310 PMCID: PMC9488703 DOI: 10.3389/fphys.2022.933792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/26/2022] [Indexed: 12/04/2022] Open
Abstract
Homozygous carriers of the deletion allele in the gene for angiotensin-converting enzyme (ACE-DD) demonstrate an elevated risk to develop inactivity-related type II diabetes and show an overshoot of blood glucose concentration with enduring exercise compared to insertion allele carriers. We hypothesized that ACE-DD genotypes exhibit a perturbed activity of signaling processes governing capillary-dependent glucose uptake in vastus lateralis muscle during exhaustive cycling exercise, which is associated with the aerobic fitness state. 27 healthy, male white Caucasian subjects (26.8 ± 1.1 years; BMI 23.6 +/− 0.6 kg m−2) were characterized for their aerobic fitness based on a threshold of 50 ml O2 min−1 kg−1 and the ACE-I/D genotype. Subjects completed a session of exhaustive one-legged exercise in the fasted state under concomitant measurement of cardiorespiratory function. Capillary blood and biopsies were collected before, and ½ and 8 h after exercise to quantify glucose and lipid metabolism-related compounds (lipoproteins, total cholesterol, ketones) in blood, the phosphorylation of 45 signaling proteins, muscle glycogen and capillaries. Effects of aerobic fitness, ACE-I/D genotype, and exercise were assessed with analysis of variance (ANOVA) under the hypothesis of a dominant effect of the insertion allele. Exertion with one-legged exercise manifested in a reduction of glycogen concentration ½ h after exercise (−0.046 mg glycogen mg−1 protein). Blood glucose concentration rose immediately after exercise in association with the ACE-I/D genotype (ACE-DD: +26%, ACE-ID/II: +6%) and independent of the fitness state (p = 0.452). Variability in total cholesterol was associated with exercise and fitness. In fit subjects, the phosphorylation levels of glucose uptake-regulating kinases [AKT-pT308 (+156%), SRC-pY419, p38α-pT180/T182, HCK-pY411], as well as cytokine/angiotensin 1-7 signaling factors [(STAT5A-pY694, STAT5B-pY699, FYN-pY420, EGFR-pY1086] were higher in angiotensin converting enzyme I-allele carriers than ACE-DD genotypes after exercise. Conversely, the AKT-S473 phosphorylation level (+117%) and angiotensin 2’s blood concentration (+191%) were higher in ACE-DD genotypes. AKT-S473 phosphorylation levels post-exercise correlated to anatomical parameters of muscle performance and metabolic parameters (p < 0.05 and │r│>0.70). The observations identify reciprocal alterations of S473 and T308 phosphorylation of AKT as gatekeeper of a post-translational dysregulation of transcapillary glucose uptake in ACE-DD genotypes which may be targeted in personalized approaches to mitigate type II diabetes.
Collapse
Affiliation(s)
- Martin Flück
- Institute for Biomedical Research Into Human Movement and Health, Manchester Metropolitan University, Manchester, United Kingdom
- Heart Repair and Regeneration Laboratory, Department EMC, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - David Vaughan
- Institute for Biomedical Research Into Human Movement and Health, Manchester Metropolitan University, Manchester, United Kingdom
| | - Jörn Rittweger
- Institute for Biomedical Research Into Human Movement and Health, Manchester Metropolitan University, Manchester, United Kingdom
- Department of Muscle and Bone Metabolism, Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Marie-Noëlle Giraud
- Heart Repair and Regeneration Laboratory, Department EMC, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| |
Collapse
|
8
|
Park J, Barahona‐Torres N, Jang S, Mok KY, Kim HJ, Han S, Cho K, Zhou X, Fu AKY, Ip NY, Seo J, Choi M, Jeong H, Hwang D, Lee DY, Byun MS, Yi D, Han JW, Mook‐Jung I, Hardy J. Multi-Omics-Based Autophagy-Related Untypical Subtypes in Patients with Cerebral Amyloid Pathology. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2201212. [PMID: 35694866 PMCID: PMC9376815 DOI: 10.1002/advs.202201212] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/26/2022] [Indexed: 05/05/2023]
Abstract
Recent multi-omics analyses paved the way for a comprehensive understanding of pathological processes. However, only few studies have explored Alzheimer's disease (AD) despite the possibility of biological subtypes within these patients. For this study, unsupervised classification of four datasets (genetics, miRNA transcriptomics, proteomics, and blood-based biomarkers) using Multi-Omics Factor Analysis+ (MOFA+), along with systems-biological approaches following various downstream analyses are performed. New subgroups within 170 patients with cerebral amyloid pathology (Aβ+) are revealed and the features of them are identified based on the top-rated targets constructing multi-omics factors of both whole (M-TPAD) and immune-focused models (M-IPAD). The authors explored the characteristics of subtypes and possible key-drivers for AD pathogenesis. Further in-depth studies showed that these subtypes are associated with longitudinal brain changes and autophagy pathways are main contributors. The significance of autophagy or clustering tendency is validated in peripheral blood mononuclear cells (PBMCs; n = 120 including 30 Aβ- and 90 Aβ+), induced pluripotent stem cell-derived human brain organoids/microglia (n = 12 including 5 Aβ-, 5 Aβ+, and CRISPR-Cas9 apolipoprotein isogenic lines), and human brain transcriptome (n = 78). Collectively, this study provides a strategy for precision medicine therapy and drug development for AD using integrative multi-omics analysis and network modelling.
Collapse
Affiliation(s)
- Jong‐Chan Park
- Department of Neurodegenerative DiseaseUCL Queen Square Institute of NeurologyUniversity College LondonLondonWC1N 3BGUK
- Department of Biochemistry and Biomedical SciencesCollege of MedicineSeoul National UniversitySeoul03080Republic of Korea
- Neuroscience Research InstituteMedical Research CenterCollege of MedicineSeoul National UniversitySeoul03080Republic of Korea
- SNU Korea Dementia Research CenterCollege of MedicineSeoul National UniversitySeoul03080Republic of Korea
| | - Natalia Barahona‐Torres
- Department of Neurodegenerative DiseaseUCL Queen Square Institute of NeurologyUniversity College LondonLondonWC1N 3BGUK
| | - So‐Yeong Jang
- Department of Bio and Brain EngineeringKorea Advanced Institute of Science and TechnologyDaejeon34141Republic of Korea
| | - Kin Y. Mok
- Department of Neurodegenerative DiseaseUCL Queen Square Institute of NeurologyUniversity College LondonLondonWC1N 3BGUK
| | - Haeng Jun Kim
- Department of Biochemistry and Biomedical SciencesCollege of MedicineSeoul National UniversitySeoul03080Republic of Korea
- SNU Korea Dementia Research CenterCollege of MedicineSeoul National UniversitySeoul03080Republic of Korea
| | - Sun‐Ho Han
- Department of Biochemistry and Biomedical SciencesCollege of MedicineSeoul National UniversitySeoul03080Republic of Korea
- Neuroscience Research InstituteMedical Research CenterCollege of MedicineSeoul National UniversitySeoul03080Republic of Korea
- SNU Korea Dementia Research CenterCollege of MedicineSeoul National UniversitySeoul03080Republic of Korea
| | - Kwang‐Hyun Cho
- Department of Bio and Brain EngineeringKorea Advanced Institute of Science and TechnologyDaejeon34141Republic of Korea
| | - Xiaopu Zhou
- Division of Life ScienceState Key Laboratory of Molecular NeuroscienceMolecular Neuroscience CenterThe Hong Kong University of Science and TechnologyClear Water Bay, KowloonHong Kong999077China
- Hong Kong Center for Neurodegenerative DiseasesHong Kong Science ParkHong Kong999077China
- Guangdong Provincial Key Laboratory of Brain ScienceDisease and Drug DevelopmentHKUST Shenzhen Research InstituteShenzhen‐Hong Kong Institute of Brain ScienceShenzhenGuangdong518057China
| | - Amy K. Y. Fu
- Division of Life ScienceState Key Laboratory of Molecular NeuroscienceMolecular Neuroscience CenterThe Hong Kong University of Science and TechnologyClear Water Bay, KowloonHong Kong999077China
- Hong Kong Center for Neurodegenerative DiseasesHong Kong Science ParkHong Kong999077China
- Guangdong Provincial Key Laboratory of Brain ScienceDisease and Drug DevelopmentHKUST Shenzhen Research InstituteShenzhen‐Hong Kong Institute of Brain ScienceShenzhenGuangdong518057China
| | - Nancy Y. Ip
- Division of Life ScienceState Key Laboratory of Molecular NeuroscienceMolecular Neuroscience CenterThe Hong Kong University of Science and TechnologyClear Water Bay, KowloonHong Kong999077China
- Hong Kong Center for Neurodegenerative DiseasesHong Kong Science ParkHong Kong999077China
- Guangdong Provincial Key Laboratory of Brain ScienceDisease and Drug DevelopmentHKUST Shenzhen Research InstituteShenzhen‐Hong Kong Institute of Brain ScienceShenzhenGuangdong518057China
| | - Jieun Seo
- Department of Laboratory MedicineSeverance HospitalYonsei University College of MedicineSeoul03722Republic of Korea
| | - Murim Choi
- Department of Biochemistry and Biomedical SciencesCollege of MedicineSeoul National UniversitySeoul03080Republic of Korea
| | - Hyobin Jeong
- European Molecular Biology LaboratoryGenome Biology UnitHeidelberg69117Germany
| | - Daehee Hwang
- Department of Biological SciencesSeoul National UniversitySeoul08826Republic of Korea
| | - Dong Young Lee
- Institute of Human Behavioral MedicineMedical Research CenterSeoul National UniversitySeoul03080Republic of Korea
- Department of PsychiatryCollege of medicineSeoul National UniversitySeoul03080Republic of Korea
- Department of NeuropsychiatrySeoul National University HospitalSeoul03080Republic of Korea
| | - Min Soo Byun
- Department of PsychiatryPusan National University Yangsan HospitalYangsan50612Republic of Korea
| | - Dahyun Yi
- Biomedical Research InstituteSeoul National University HospitalSeoul03082Republic of Korea
| | - Jong Won Han
- Department of Biochemistry and Biomedical SciencesCollege of MedicineSeoul National UniversitySeoul03080Republic of Korea
| | - Inhee Mook‐Jung
- Department of Biochemistry and Biomedical SciencesCollege of MedicineSeoul National UniversitySeoul03080Republic of Korea
- Neuroscience Research InstituteMedical Research CenterCollege of MedicineSeoul National UniversitySeoul03080Republic of Korea
- SNU Korea Dementia Research CenterCollege of MedicineSeoul National UniversitySeoul03080Republic of Korea
| | - John Hardy
- Department of Neurodegenerative DiseaseUCL Queen Square Institute of NeurologyUniversity College LondonLondonWC1N 3BGUK
| |
Collapse
|
9
|
Nephroprotective Effects of Semaglutide as Mono- and Combination Treatment with Lisinopril in a Mouse Model of Hypertension-Accelerated Diabetic Kidney Disease. Biomedicines 2022; 10:biomedicines10071661. [PMID: 35884965 PMCID: PMC9313388 DOI: 10.3390/biomedicines10071661] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/02/2022] [Accepted: 07/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Obesity, hyperglycemia and hypertension are critical risk factors for development of diabetic kidney disease (DKD). Emerging evidence suggests that glucagon-like peptide-1 receptor (GLP-1R) agonists improve cardiovascular and renal outcomes in type 2 diabetes patients. Here, we characterized the effect of the long-acting GLP-1R agonist semaglutide alone and in combination with an ACE inhibitor (lisinopril) in a model of hypertension-accelerated, advanced DKD facilitated by adeno-associated virus-mediated renin overexpression (ReninAAV) in uninephrectomized (UNx) female diabetic db/db mice. Methods: Female db/db mice received a single intravenous injection of ReninAAV 1 week prior to UNx. Six weeks post-nephrectomy, db/db UNx-ReninAAV mice were administered (q.d.) vehicle, semaglutide (30 nmol/kg, s.c.) or semaglutide (30 nmol/kg, s.c.) + lisinopril (30 mg/kg, p.o.) for 11 weeks. Endpoints included blood pressure, plasma/urine biochemistry, kidney histopathology and RNA sequencing. Results: Vehicle-dosed db/db UNx-ReninAAV mice developed hallmarks of DKD characterized by severe albuminuria and advanced glomerulosclerosis. Semaglutide robustly reduced hyperglycemia, hypertension and albuminuria concurrent with notable improvements in glomerulosclerosis severity, podocyte filtration slit density, urine/renal kidney injury molecule-1 (KIM-1) levels and gene expression markers of inflammation and fibrogenesis in db/db UNx-ReninAAV mice. Co-administration of lisinopril further ameliorated hypertension and glomerulosclerosis. Conclusions: Semaglutide improves disease hallmarks in the db/db UNx-ReninAAV mouse model of advanced DKD. Further benefits on renal outcomes were obtained by adjunctive antihypertensive standard of care. Collectively, our study supports the development of semaglutide for management of DKD.
Collapse
|
10
|
Kommentar zu Diabetesprävention: Reduzieren Antihypertensiva das Erkrankungsrisiko? DIABETOL STOFFWECHS 2022. [DOI: 10.1055/a-1732-8870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
11
|
Crilly S, Parry-Jones A, Wang X, Selley JN, Cook J, Tapia VS, Anderson CS, Allan SM, Kasher PR. Zebrafish drug screening identifies candidate therapies for neuroprotection after spontaneous intracerebral haemorrhage. Dis Model Mech 2022; 15:274873. [PMID: 35098999 PMCID: PMC8990924 DOI: 10.1242/dmm.049227] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 01/19/2022] [Indexed: 11/20/2022] Open
Abstract
Despite the global health burden, treatment of spontaneous intracerebral haemorrhage (ICH) is largely supportive and translation of specific medical therapies has not been successful. Zebrafish larvae offer a unique platform for drug screening to rapidly identify neuroprotective compounds following ICH. We applied the Spectrum Library compounds to zebrafish larvae acutely after ICH to screen for decreased brain cell death and identified 150 successful drugs. Candidates were then evaluated for possible indications with other cardiovascular diseases. Six compounds were identified including two angiotensin converting enzyme inhibitors (ACE-I). Ramipril and quinapril were further assessed to confirm a significant 55% reduction in brain cell death. Proteomic analysis revealed potential mechanisms of neuroprotection. Using the INTERACT2 clinical trial dataset, we demonstrate a significant reduction in the adjusted odds of an unfavourable shift in the modified Rankin Scale at 90 days for patients receiving an ACE-I after ICH (vs. no ACE-I; odds ratio 0.80; 95% confidence interval 0.68-0.95; P=0.009). The zebrafish larval model of spontaneous ICH can be used as a reliable drug screening platform, and has identified therapeutics which may offer neuroprotection.
Collapse
Affiliation(s)
- Siobhan Crilly
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester; Oxford Road, Manchester, M13 9PT, UK.,Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, UK
| | - Adrian Parry-Jones
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, UK.,Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester; Oxford Road, Manchester, M13 9PT, UK.,Manchester Centre for Clinical Neurosciences, Salford Royal, NHS Foundation Trust, Manchester Academic Health Science Centre; Stott Lane, Salford, M6 8HD, UK
| | - Xia Wang
- The George Institute for Global Health; Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Julian N Selley
- The Biological Mass Spectrometry Core Research Facility, Faculty of Biology, Medicine and Health, The University of Manchester, M13 9PL, UK
| | - James Cook
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester; Oxford Road, Manchester, M13 9PT, UK.,Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, UK
| | - Victor S Tapia
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester; Oxford Road, Manchester, M13 9PT, UK.,Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, UK
| | - Craig S Anderson
- The George Institute for Global Health; Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Stuart M Allan
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester; Oxford Road, Manchester, M13 9PT, UK.,Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, UK
| | - Paul R Kasher
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester; Oxford Road, Manchester, M13 9PT, UK.,Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, UK
| |
Collapse
|
12
|
Sasaki KI, Fukumoto Y. Sarcopenia as a comorbidity of cardiovascular disease. J Cardiol 2021; 79:596-604. [PMID: 34906433 DOI: 10.1016/j.jjcc.2021.10.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/27/2022]
Abstract
Sarcopenia, the lowered skeletal muscle mass, weakened skeletal muscle strength, and reduced physical performance with aging, is a component of frailty and high-risk factor for falls, resulting in an increase in mortality. In cardiovascular disease (CVD) patients, systemic inflammation, oxidative stress, overactivation of ubiquitin-proteasome system, endothelial dysfunction, lowering muscle blood flow, impaired glucose tolerance, hormonal changes, and physical inactivity possibly contribute to CVD-related sarcopenia. Prevalence of sarcopenia and osteosarcopenia, which is osteopenia and sarcopenia coexisting together, seems to be higher in CVD patients than in community-dwelling adults, suggesting the necessity of early diagnosis and prevention of CVD-related sarcopenia. Atrial stiffness, coronary artery calcification score, and serum vitamin D levels may be of help as the biomarkers to suspect sarcopenia, and renin-angiotensin-aldosterone system inhibitors may play a role in the medical prevention and treatment of CVD-related sarcopenia. There are few reports to convince the efficacies of dietary and antioxidant supplementation on sarcopenia at present, whereas aerobic and resistance training exercises have been recognized as an effective strategy to prevent and treat sarcopenia.
Collapse
Affiliation(s)
- Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan.
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan
| |
Collapse
|
13
|
Angiotensin II inhibition: a potential treatment to slow the progression of sarcopenia. Clin Sci (Lond) 2021; 135:2503-2520. [PMID: 34751393 DOI: 10.1042/cs20210719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/21/2021] [Accepted: 10/29/2021] [Indexed: 02/07/2023]
Abstract
Sarcopenia is defined as the progressive and generalized loss of skeletal muscle mass and strength, which is associated with increased likelihood of adverse outcomes including falls, fractures, physical disability, and mortality. The etiology of sarcopenia has been postulated to be multifactorial with genetics, aging, immobility, nutritional deficiencies, inflammation, stress, and endocrine factors all contributing to the imbalance of muscle anabolism and catabolism. The prevalence of sarcopenia is estimated to range from 13 to 24% in adults over 60 years of age and up to 50% in persons aged 80 and older. As the population continues to age, the prevalence of sarcopenia continues to increase and is expected to affect 500 million people by the year 2050. Sarcopenia impacts the overall health of patients through limitations in functional status, increase in hospital readmissions, poorer hospital outcomes, and increase in overall mortality. Thus, there exists a need to prevent or reduce the occurrence of sarcopenia. Here, we explore the potential mechanisms and current studies regarding angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme (ACE) inhibitors on reducing the development of sarcopenia through the associated changes in cardiovascular function, renal function, muscle fiber composition, inflammation, endothelial dysfunction, metabolic efficiency, and mitochondrial function.
Collapse
|
14
|
Jeong JH, Sprick JD, DaCosta D, Quyyumi AA, Park J. Renin-Angiotensin System Blockade Is Associated with Exercise Capacity, Sympathetic Activity, and Endothelial Function in Patients with Chronic Kidney Disease. Kidney Blood Press Res 2021; 47:103-112. [PMID: 34758473 PMCID: PMC8844058 DOI: 10.1159/000520760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/01/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) patients have exercise intolerance and exaggerated blood pressure reactivity during exercise that are mediated by sympathetic nervous system (SNS) overactivation and decreased nitric oxide (NO) bioavailability. The activation of the renin-angiotensin system (RAS) increases SNS activation and reduces NO synthesis, and prior studies suggest that RAS blockade attenuates declines in physical function. We hypothesized that RAS inhibitor (RASi) use is associated with higher exercise capacity mediated by decreased SNS activity and increased NO-dependent endothelial function in CKD. METHOD In 35 CKD patients (57 ± 7 years) and 20 controls (CONs) (53 ± 8 years), we measured exercise capacity (peak oxygen consumption [VO2peak]), muscle sympathetic nervous activity (MSNA), and flow-mediated dilation (FMD) for NO-dependent endothelial function. RESULTS CKD patients treated with RASi (CKD + RASi, n = 25) had greater VO2peak than CKD patients not treated with RASi (CKD no RASi, n = 10), but lower VO2peak than CONs (23.3 ± 5.8 vs. 16.4 ± 2.9, p = 0.007; vs. 30.0 ± 7.7, p = 0.016 mL/min/kg, respectively). CKD + RASi had lower resting MSNA and greater FMD than CKD no RASi. Compared to CONs, CKD + RASi had similar MSNA but lower FMD. VO2peak was positively associated with FMD (r = 0.417, p = 0.038) and was predicted by the combination of FMD and RASi status (r2 = 0.344, p = 0.01) and MSNA and RASi status (r2 = 0.575, p = 0.040) in CKD patients. CONCLUSION In summary, CKD patients with RASi have higher exercise capacity than those not on RASi. Higher exercise capacity in the RASi-treated group was associated with lower resting SNS activity and higher NO-dependent vascular endothelial function.
Collapse
Affiliation(s)
- Jin Hee Jeong
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA,
- Research Service Line, Department of Veterans Affairs Health Care System, Decatur, Georgia, USA,
| | - Justin D Sprick
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
- Research Service Line, Department of Veterans Affairs Health Care System, Decatur, Georgia, USA
| | - Dana DaCosta
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
- Research Service Line, Department of Veterans Affairs Health Care System, Decatur, Georgia, USA
| | - Arshed A Quyyumi
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jeanie Park
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
- Research Service Line, Department of Veterans Affairs Health Care System, Decatur, Georgia, USA
| |
Collapse
|
15
|
Martignoni M, Benedetti M, Davey GP, Tipton KF, McDonald AG. Degradation of thymic humoral factor γ2 in human, rat and mouse blood: An experimental and theoretical study. BIOCHIMICA ET BIOPHYSICA ACTA-PROTEINS AND PROTEOMICS 2020; 1868:140467. [PMID: 32512181 PMCID: PMC7274130 DOI: 10.1016/j.bbapap.2020.140467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/12/2020] [Accepted: 06/03/2020] [Indexed: 11/28/2022]
Abstract
The degradation of the immunomodulatory octapeptide, thymic humoral factor γ2 (THF-γ2, thymoctonan) has been studied in whole blood samples from human, rat and mouse. The peptide, Leu-Glu-Asp-Gly-Pro-Lys-Phe-Leu, was shown to be rapidly degraded by peptidases. The half-life of the intact peptide was less than 6 min at 37 °C in blood from the three species tested. The main fragments formed from THF-γ2 were found to be Glu-Asp-Gly-Pro-Lys-Phe-Leu (2–8), Asp-Gly-Pro-Lys-Phe-Leu (3–8) and Glu-Asp-Gly-Pro-Lys (2–6) in human and in rat blood and 2–8 and 2–6 in mouse blood. Analysis of the time course of degradation revealed a sequential removal of single amino acids from the N-terminus (aminopeptidase activities) in a process that was apparently unable to cleave the Gly-Pro bond (positions 4–5 in the peptide) together with an independent cleavage of the Lys-Phe bond (positions 6–7 in the peptide) to release the dipeptide Phe-Leu. This behaviour and the effects of inhibitors showed the involvement of metallo-exopeptidases in the N-terminal digestion and a phosphoramidon-sensitive metallo-endopeptidase in the cleavage of the Lys-Phe bond. The degradation patterns in human blood were modelled in terms of the competing pathways involved approximating to first-order kinetics, and an analytical solution obtained via the method of Laplace Transforms. The half-life of THF degradation in whole rat blood sample was found to be significantly lower than in human or mouse.
The immunomodulatory octapeptide THF-γ2 is rapidly degraded in human and rodent blood.
The half-life of the intact peptide was <6 min in all species.
The nature of the peptidases involved was determined by the use of specific inhibitors.
Laplace transforms were used to model the degradation patterns in human blood.
Collapse
Affiliation(s)
| | | | - Gavin P Davey
- School of Biochemistry and Immunology, Trinity College, Dublin 2, Ireland
| | - Keith F Tipton
- School of Biochemistry and Immunology, Trinity College, Dublin 2, Ireland
| | - Andrew G McDonald
- School of Biochemistry and Immunology, Trinity College, Dublin 2, Ireland.
| |
Collapse
|
16
|
Muñoz N, Pedreañez A, Mosquera J. Angiotensin II Induces Increased Myocardial Expression of Receptor for Advanced Glycation End Products, Monocyte/Macrophage Infiltration and Circulating Endothelin-1 in Rats With Experimental Diabetes. Can J Diabetes 2020; 44:651-656. [PMID: 32654973 DOI: 10.1016/j.jcjd.2020.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 03/24/2020] [Accepted: 03/24/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES It is known that the receptor for advanced glycation end products (RAGE) activation is involved in the pathogenesis of cardiovascular disease in diabetes. Previous studies have shown the presence of angiotensin II (Ang II) in diabetes, suggesting a role for this hormone during the disease. However, the association between RAGE and Ang II during pathologic cardiac remodelling after streptozotocin (STZ)-induced diabetes remains unclear. Because Ang II is capable of inducing pro-inflammatory events, blocking its production (enalapril), and its action on its receptor (losartan) could decrease inflammatory events in the myocardium in this experimental model of diabetes. Thus, the aim of this study was to assess the association between RAGE expression, inflammatory events and Ang II in the myocardium during STZ-induced diabetes. METHODS Diabetes was induced by intravenous injection of STZ in Sprague-Dawley rats. Myocardial expressions of RAGE, monocyte/macrophage (ED-1-positive cells) infiltration and the intercellular adhesion molecule-1 were determined by histochemical methods. Levels of circulating endothelin-1 (ET-1) were determined by enzyme-linked immunoassay. Effects of Ang II included blocking using losartan (15 mg/kg body weight per day by gastric gavage) or enalapril (18 mg/kg body weight per day by gastric gavage). RESULTS Increased expression of both RAGE and ED-1 was seen in the myocardium, but expression of myocardial vascular intercellular adhesion molecule-1 remained unchanged. Circulating levels of ET-1 in STZ rats were increased. Renin‒angiotensin system inhibition decreased expression of myocardial RAGE, ED-1 and ET-1. CONCLUSIONS The present findings suggest a role for Ang II in myocardial inflammation in STZ-induced diabetes mediated by RAGE and ET-1.
Collapse
Affiliation(s)
- Nelson Muñoz
- Facultad de Ciencias de la Salud, Universidad Nacional de Chimborazo, Carrera de Medicina, Riobamba, Ecuador
| | - Adriana Pedreañez
- Cátedra de Inmunología, Escuela de Bioanálisis, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela
| | - Jesús Mosquera
- Instituto de Investigaciones Clínicas "Dr. Américo Negrette," Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela.
| |
Collapse
|
17
|
Shi M, O'Keefe L, Simcocks AC, Su XQ, McAinch AJ. The effect of cyanidin-3-O-β-glucoside and peptides extracted from yoghurt on glucose uptake and gene expression in human primary skeletal muscle myotubes from obese and obese diabetic participants. J Funct Foods 2018. [DOI: 10.1016/j.jff.2018.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
18
|
Loloi J, Miller AJ, Bingaman SS, Silberman Y, Arnold AC. Angiotensin-(1-7) contributes to insulin-sensitizing effects of angiotensin-converting enzyme inhibition in obese mice. Am J Physiol Endocrinol Metab 2018; 315:E1204-E1211. [PMID: 30300010 PMCID: PMC6336955 DOI: 10.1152/ajpendo.00281.2018] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Angiotensin-converting enzyme (ACE) inhibitors reduce body weight, lower blood pressure (BP), and improve insulin sensitivity in animal models of cardiometabolic syndrome. These effects are generally attributed to reduced angiotensin (ANG) II formation; however, these therapies also increase levels of ANG-(1-7), a beneficial hormone opposing ANG II actions. We hypothesized that this ANG-(1-7) generation contributes to the insulin-sensitizing effects of ACE inhibition in obese mice. Adult male C57BL/6J mice were placed on a 60% high-fat diet for 11 wk. During the last 3 wk of diet, mice received normal water or water containing the ACE inhibitor captopril (50 mg/l) as well as the ANG-(1-7) mas receptor antagonist A779 (400 or 800 ng·kg-1·min-1) or saline vehicle via subcutaneous osmotic minipumps. At the end of treatment, arterial BP was measured, and hyperinsulinemic-euglycemic clamps were performed in conscious obese mice receiving vehicle, captopril, captopril plus A779, or A779 ( n = 6-13/group). Captopril reduced body weight (28 ± 2 vs. 41 ± 2 g saline; P = 0.001), lowered systolic BP (109 ± 6 vs. 144 ± 7 mmHg saline; P = 0.041), and improved whole-body insulin sensitivity (steady-state glucose infusion rate: 31 ± 4 vs. 16 ± 2 mg·kg-1·min-1 saline; P = 0.001) in obese mice. A779 attenuated captopril-mediated improvements in insulin sensitivity (23 ± 2 mg·kg-1·min-1; P = 0.042), with no effect on body weight (32 ± 2 g; P = 0.441) or BP (111 ± 7 mmHg; P = 0.788). There was no effect of A779 alone on cardiometabolic outcomes. These data suggest that insulin-sensitizing effects of ACE inhibition are in part due to activation of ANG-(1-7)/ mas receptor pathways and provide new insight into mechanisms underlying the positive metabolic effects of these therapies.
Collapse
Affiliation(s)
- Justin Loloi
- Department of Neural and Behavioral Sciences, Pennsylvania State University College of Medicine , Hershey, Pennsylvania
| | - Amanda J Miller
- Department of Neural and Behavioral Sciences, Pennsylvania State University College of Medicine , Hershey, Pennsylvania
| | - Sarah S Bingaman
- Department of Neural and Behavioral Sciences, Pennsylvania State University College of Medicine , Hershey, Pennsylvania
| | - Yuval Silberman
- Department of Neural and Behavioral Sciences, Pennsylvania State University College of Medicine , Hershey, Pennsylvania
| | - Amy C Arnold
- Department of Neural and Behavioral Sciences, Pennsylvania State University College of Medicine , Hershey, Pennsylvania
| |
Collapse
|
19
|
Pongpanich P, Pitakpaiboonkul P, Takkavatakarn K, Praditpornsilpa K, Eiam-Ong S, Susantitaphong P. The benefits of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers combined with calcium channel blockers on metabolic, renal, and cardiovascular outcomes in hypertensive patients: a meta-analysis. Int Urol Nephrol 2018; 50:2261-2278. [DOI: 10.1007/s11255-018-1991-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 09/19/2018] [Indexed: 11/29/2022]
|
20
|
Hye Khan MA, Kolb L, Skibba M, Hartmann M, Blöcher R, Proschak E, Imig JD. A novel dual PPAR-γ agonist/sEH inhibitor treats diabetic complications in a rat model of type 2 diabetes. Diabetologia 2018; 61:2235-2246. [PMID: 30032428 PMCID: PMC6563928 DOI: 10.1007/s00125-018-4685-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 06/13/2018] [Indexed: 12/19/2022]
Abstract
AIMS/HYPOTHESIS The metabolic syndrome is a cluster of risk correlates that can progress to type 2 diabetes. The present study aims to evaluate a novel molecule with a dual action against the metabolic syndrome and type 2 diabetes. METHODS We developed and tested a novel dual modulator, RB394, which acts as a soluble epoxide hydrolase (sEH) inhibitor and a peroxisome proliferator-activated receptor-γ (PPAR-γ) agonist in rat models of the metabolic syndrome-the obese spontaneously hypertensive (SHROB) rat and the obese diabetic Zucker fatty/spontaneously hypertensive heart failure F1 hybrid (ZSF1) rat. In SHROB rats we studied the ability of RB394 to prevent metabolic syndrome phenotypes, while in ZSF1 obese diabetic rats we compared RB394 with the ACE inhibitor enalapril in the treatment of type 2 diabetes and associated comorbid conditions. RB394 (10 mg/kg daily) and enalapril (10 mg/kg daily) were administered orally for 8 weeks. RESULTS RB394 blunted the development of hypertension, insulin resistance, hyperlipidaemia and kidney injury in SHROB rats and reduced fasting blood glucose and HbA1c, improved glucose tolerance, reduced blood pressure and improved lipid profiles in obese ZSF1 rats. A reduction in liver fibrosis and hepatosteatosis was evident in RB394-treated obese ZSF1 rats. Unlike RB394, enalapril did not demonstrate any positive effects in relation to diabetes, hyperlipidaemia or liver dysfunction in obese ZSF1 rats. RB394 ameliorated diabetic nephropathy by reducing renal interstitial fibrosis and renal tubular and glomerular injury in obese diabetic ZSF1 rats. Intriguingly, enalapril demonstrated a weaker action against diabetic nephropathy in obese ZSF1 rats. CONCLUSIONS/INTERPRETATION These findings demonstrate that a novel sHE inhibitor/PPAR-γ agonist molecule targets multiple risk factors of the metabolic syndrome and is a glucose-lowering agent with a strong ability to treat diabetic complications.
Collapse
Affiliation(s)
- Md Abdul Hye Khan
- Department of Pharmacology & Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
| | - Lauren Kolb
- Department of Pharmacology & Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
| | - Melissa Skibba
- Department of Pharmacology & Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
| | - Markus Hartmann
- Institute of Pharmaceutical Chemistry, Goethe-University of Frankfurt, Frankfurt am Main, Germany
| | - René Blöcher
- Institute of Pharmaceutical Chemistry, Goethe-University of Frankfurt, Frankfurt am Main, Germany
| | - Ewgenij Proschak
- Institute of Pharmaceutical Chemistry, Goethe-University of Frankfurt, Frankfurt am Main, Germany
| | - John D Imig
- Department of Pharmacology & Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
| |
Collapse
|
21
|
Aprahamian I, Sassaki E, Dos Santos MF, Izbicki R, Pulgrossi RC, Biella MM, Borges ACN, Sassaki MM, Torres LM, Fernandez ÍS, Pião OA, Castro PLM, Fontenele PA, Yassuda MS. Hypertension and frailty in older adults. J Clin Hypertens (Greenwich) 2017; 20:186-192. [PMID: 29105991 DOI: 10.1111/jch.13135] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 08/15/2017] [Accepted: 08/23/2017] [Indexed: 01/16/2023]
Abstract
The association between hypertension and frailty syndrome in older adults remains unclear. There is scarce information about the prevalence of hypertension among frail elderly patients or on its relationship with frailty. Up to one quarter of frail elderly patients present without comorbidity or disability, yet frailty is a leading cause of death. The knowledge and better control of frailty risk factors could influence prognosis. The present study evaluated: (1) the prevalence of hypertension in robust, prefrail, and frail elderly; and (2) factors that might be associated with frailty including hypertension. A cross-sectional study was conducted in 619 older adults at a university-based outpatient center. Study protocol included sociodemographic data, measures of blood pressure and body mass index, frailty screening according to the internationally validated FRAIL (fatigue, resistance, ambulation, illnesses, and loss of weight) scale, number of comorbidities, drug use assessment, physical activity, cognitive status, and activities of daily living. Ordinal logistic regression was used to evaluate factors associated with frailty. Prevalence of hypertension and frailty was 67.3% and 14.8%, respectively, in the total sample. Hypertension was more prevalent in the prefrail (72.5%) and frail (83%) groups than among controls (51.7%). Hypertension, physical activity, number of prescribed drugs, and cognitive performance were significantly associated with frailty status. Hypertension presented an odds ratio of 1.77 towards frailty (95% confidence interval, 1.21-2.60; P = .002). Hypertension was more prevalent in frail elderly patients and was significantly associated with frailty. Intensive control of hypertension could influence the trajectory of frailty, and this hypothesis should be explored in future prospective clinical trials.
Collapse
Affiliation(s)
- Ivan Aprahamian
- Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, São Paulo, Brazil.,Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Eduardo Sassaki
- Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, São Paulo, Brazil
| | - Marília F Dos Santos
- Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, São Paulo, Brazil
| | - Rafael Izbicki
- Department of Statistics, Federal University of São Carlos, São Carlos, Brazil
| | - Rafael C Pulgrossi
- Department of Statistics, Federal University of São Carlos, São Carlos, Brazil
| | - Marina M Biella
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Ana Camila N Borges
- Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, São Paulo, Brazil
| | - Marcela M Sassaki
- Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, São Paulo, Brazil
| | - Leonardo M Torres
- Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, São Paulo, Brazil
| | - Ícaro S Fernandez
- Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, São Paulo, Brazil
| | - Olívia A Pião
- Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, São Paulo, Brazil
| | - Paula L M Castro
- Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, São Paulo, Brazil
| | - Pedro A Fontenele
- Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, São Paulo, Brazil
| | - Mônica S Yassuda
- Department of Neurology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.,School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
22
|
Ko SC, Jung WK, Lee SH, Lee DH, Jeon YJ. Antihypertensive effect of an enzymatic hydrolysate from Styela clava flesh tissue in type 2 diabetic patients with hypertension. Nutr Res Pract 2017; 11:396-401. [PMID: 28989576 PMCID: PMC5621362 DOI: 10.4162/nrp.2017.11.5.396] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 05/14/2017] [Accepted: 07/20/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND/OBJECTIVES In this randomized, placebo-controlled, double-blind study, we evaluated the antihypertensive effects of enzymatic hydrolysate from Styela clava flesh tissue in patients with type 2 diabetes mellitus (T2DM) and hypertension. SUBJECTS/METHODS S. clava flesh tissue hydrolysate (SFTH) (n = 34) and placebo (n = 22) were randomly allocated to the study subjects. Each subject ingested two test capsules (500 mg) containing powdered SFTH (SFTH group) or placebo capsules (placebo group) during four weeks. RESULTS In the SFTH group, systolic and diastolic blood pressure decreased significantly 4 weeks after ingestion by 9.9 mmHg (P < 0.01) and 7.8 mmHg (P < 0.01), respectively. In addition, the SFTH group exhibited a significant decrease in hemoglobin A1c with a tendency toward improvement in homeostasis model assessment of insulin resistance, triglyceride, apolipoprotein B and plasma insulin levels after 4 weeks. No adverse effects were observed in other indexes, including biochemical and hematological parameters in both groups. CONCLUSION The results of our study suggested that SFTH exerts a regulatory, antihypertensive effect in patients with T2DM and hypertension.
Collapse
Affiliation(s)
- Seok-Chun Ko
- Marine-Integrated Bionics Research Center, Pukyong National University, Busan 48513, Korea
| | - Won-Kyo Jung
- Marine-Integrated Bionics Research Center, Pukyong National University, Busan 48513, Korea.,Department of Biomedical Engineering, and Center for Marine-Integrated Biomedical Technology (BK21 Plus), Pukyong National University, Busan 48513, Korea
| | - Seung-Hong Lee
- Department of Pharmaceutical Engineering, Soonchunhyang University, 22 Soonchunhyangro, Shinchang-myeon, Asan-si, Chungnam 31538, Korea
| | - Dae Ho Lee
- Department of Internal Medicine, Gachon University Gil Medical Center, 21 Namdong-daero 774 road, Incheon 21565, Korea
| | - You-Jin Jeon
- Department of Marine Life Science, Jeju National University, 102 Jejudaehak-ro, Jeju-si, Jeju 63243, Korea
| |
Collapse
|
23
|
Curtis KJ, Meyrick VM, Mehta B, Haji GS, Li K, Montgomery H, Man WDC, Polkey MI, Hopkinson NS. Angiotensin-Converting Enzyme Inhibition as an Adjunct to Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2017; 194:1349-1357. [PMID: 27248440 DOI: 10.1164/rccm.201601-0094oc] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
RATIONALE Epidemiological studies in older individuals have found an association between the use of angiotensin-converting enzyme (ACE) inhibition (ACE-I) therapy and preserved locomotor muscle mass, strength, and walking speed. ACE-I therapy might therefore have a role in the context of pulmonary rehabilitation (PR). OBJECTIVES To investigate the hypothesis that enalapril, an ACE inhibitor, would augment the improvement in exercise capacity seen during PR. METHODS We performed a double-blind, placebo-controlled, parallel-group randomized controlled trial. Patients with chronic obstructive pulmonary disease, who had at least moderate airflow obstruction and were taking part in PR, were randomized to either 10 weeks of therapy with an ACE inhibitor (10 mg enalapril) or placebo. MEASUREMENTS AND MAIN RESULTS The primary outcome measurement was the change in peak power (assessed using cycle ergometry) from baseline. Eighty patients were enrolled, 78 were randomized (age 67 ± 8 years; FEV1 48 ± 21% predicted), and 65 completed the trial (34 on placebo, 31 on the ACE inhibitor). The ACE inhibitor-treated group demonstrated a significant reduction in systolic blood pressure (Δ, -16 mm Hg; 95% confidence interval [CI], -22 to -11) and serum ACE activity (Δ, -18 IU/L; 95% CI, -23 to -12) versus placebo (between-group differences, P < 0.0001). Peak power increased significantly more in the placebo group (placebo Δ, +9 W; 95% CI, 5 to 13 vs. ACE-I Δ, +1 W; 95% CI, -2 to 4; between-group difference, 8 W; 95% CI, 3 to 13; P = 0.001). There was no significant between-group difference in quadriceps strength or health-related quality of life. CONCLUSIONS Use of the ACE inhibitor enalapril, together with a program of PR, in patients without an established indication for ACE-I, reduced the peak work rate response to exercise training in patients with chronic obstructive pulmonary disease.
Collapse
Affiliation(s)
- Katrina J Curtis
- 1 National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College, London, United Kingdom
| | - Victoria M Meyrick
- 1 National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College, London, United Kingdom.,2 Department of Respiratory Medicine, King's College London NHS Foundation Trust, London, United Kingdom
| | - Bhavin Mehta
- 1 National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College, London, United Kingdom
| | - Gulam S Haji
- 1 National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College, London, United Kingdom
| | - Kawah Li
- 3 Institute for Sport, Exercise and Health, University College London, London, United Kingdom; and
| | - Hugh Montgomery
- 3 Institute for Sport, Exercise and Health, University College London, London, United Kingdom; and
| | - William D-C Man
- 1 National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College, London, United Kingdom.,4 Harefield Pulmonary Rehabilitation Unit, Harefield Hospital, London, United Kingdom
| | - Michael I Polkey
- 1 National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College, London, United Kingdom
| | - Nicholas S Hopkinson
- 1 National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College, London, United Kingdom
| |
Collapse
|
24
|
Kim TN, Lee EJ, Hong JW, Kim JM, Won JC, Kim MK, Noh JH, Ko KS, Rhee BD, Kim DJ. Relationship Between Sarcopenia and Albuminuria: The 2011 Korea National Health and Nutrition Examination Survey. Medicine (Baltimore) 2016; 95:e2500. [PMID: 26817888 PMCID: PMC4998262 DOI: 10.1097/md.0000000000002500] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Studies have shown that albuminuria, obesity, and sarcopenia may share pathophysiological processes related to cardiovascular disease risk. Their direct relationships, however, have not been examined. This study investigated the association between albuminuria and sarcopenia in a representative fraction of the Korean population.Of the 10,589 people who participated in the 2011 Korea National Health and Nutrition Examination Survey, 2158 participants aged over 19 years had been tested for albumin-to-creatinine ratio and for body composition data using dual-energy x-ray absorptiometry. Albuminuria was defined as an albumin-to-creatinine ratio ≥30 mg/g. Sarcopenia was defined as a skeletal muscle index (SMI) (SMI (%) = total appendicular skeletal muscle mass [kg]/weight [kg] × 100) of less than 1 standard deviation (SD) (grade 1) or 2 SD (grade 2) below the sex-specific mean for a younger reference group.The prevalence of albuminuria was higher in those with grade 2 sarcopenia than in those with a normal SMI or grade 1 sarcopenia (33.3% versus 8.4% and 8.9%; P < 0.001). Conversely, grade 2 sarcopenia was also more prevalent in participants with albuminuria than in those with the upper tertile of normoalbuminuria. In addition, multiple logistic regression analysis showed the odds ratio for albuminuria risk in the grade 2 sarcopenia group was 2.93 (95% confidence interval [CI], 1.46-5.88), compared with normal SMI after adjusting for potential confounding factors, including the presence of obesity, diabetes, and hypertension. Moreover, individuals with albuminuria had an odds ratio of 3.39 (95% [confidence interval], 1.38-8.37) for grade 2 sarcopenia compared with those in the lowest tertile of normoalbuminuria.This is the first study to demonstrate that individuals with sarcopenia exhibited increased risk of albuminuria and vice versa.
Collapse
Affiliation(s)
- Tae Nyun Kim
- From the Department of Internal Medicine, Cardiovascular and Metabolic Disease Center (TNK); Department of Internal Medicine, Haeundae Paik Hospital, Busan (EJL, MKK); Department of Internal Medicine, Ilsan-Paik Hospital, Koyang (JWH, JHN, D-JK); and Department of Internal Medicine, Cardiovascular and Metabolic Disease Center, College of Medicine, Sanggye Paik Hospital, Inje University, Seoul, South Korea (JMK, JCW, KSK, BDR)
| | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Ko SC, Kim JI, Park SJ, Jung WK, Jeon YJ. Antihypertensive peptide purified from Styela clava flesh tissue stimulates glucose uptake through AMP-activated protein kinase (AMPK) activation in skeletal muscle cells. Eur Food Res Technol 2015. [DOI: 10.1007/s00217-015-2526-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
26
|
Nicklas BJ. Heterogeneity of Physical Function Responses to Exercise in Older Adults: Possible Contribution of Variation in the Angiotensin-1 Converting Enzyme (ACE) Gene? PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2015; 5:575-84. [PMID: 26162198 DOI: 10.1177/1745691610383512] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Behavioral exercise interventions, aimed at improving either aerobic endurance or muscular strength, are currently the only therapy found, on average, to consistently retard loss of physical function in aging adults. However, not all individuals experience the same magnitude of benefit from a given exercise treatment, and certain persons may respond more favorably to a particular mode of exercise than another. Research now shows that genetic predisposition is one of the factors accounting for interindividual differences in responses to exercise as well as differences in the propensity to engage in exercise. This article discusses how a common variant in a single gene (the angiotensin-1 converting enzyme gene) could emerge as a prospective tool to identify older individuals more likely to benefit from and adhere to a specific type of exercise activity over another type.
Collapse
Affiliation(s)
- Barbara J Nicklas
- Department of Internal Medicine, Wake Forest University Health Sciences, Winston-Salem, NC
| |
Collapse
|
27
|
Yang Y, Yu B, Chen Y. Blood disorders typically associated with renal transplantation. Front Cell Dev Biol 2015; 3:18. [PMID: 25853131 PMCID: PMC4365751 DOI: 10.3389/fcell.2015.00018] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 03/03/2015] [Indexed: 12/11/2022] Open
Abstract
Renal transplantation has become one of the most common surgical procedures performed to replace a diseased kidney with a healthy kidney from a donor. It can help patients with kidney failure live decades longer. However, renal transplantation also faces a risk of developing various blood disorders. The blood disorders typically associated with renal transplantation can be divided into two main categories: (1) Common disorders including post-transplant anemia (PTA), post-transplant lymphoproliferative disorder (PTLD), post-transplant erythrocytosis (PTE), and post-transplant cytopenias (PTC, leukopenia/neutropenia, thrombocytopenia, and pancytopenia); and (2) Uncommon but serious disorders including hemophagocytic syndrome (HPS), thrombotic microangiopathy (TMA), therapy-related myelodysplasia (t-MDS), and therapy-related acute myeloid leukemia (t-AML). Although many etiological factors involve the development of post-transplant blood disorders, immunosuppressive agents, and viral infections could be the two major contributors to most blood disorders and cause hematological abnormalities and immunodeficiency by suppressing hematopoietic function of bone marrow. Hematological abnormalities and immunodeficiency will result in severe clinical outcomes in renal transplant recipients. Understanding how blood disorders develop will help cure these life-threatening complications. A potential therapeutic strategy against post-transplant blood disorders should focus on tapering immunosuppression or replacing myelotoxic immunosuppressive drugs with lower toxic alternatives, recognizing and treating promptly the etiological virus, bacteria, or protozoan, restoring both hematopoietic function of bone marrow and normal blood counts, and improving kidney graft survival.
Collapse
Affiliation(s)
- Yu Yang
- Department of Urology, First Affiliated Hospital of PLA General Hospital Beijing, China
| | - Bo Yu
- Department of Urology, First Affiliated Hospital of PLA General Hospital Beijing, China
| | - Yun Chen
- BrightstarTech, Inc. Clarksburg, MD, USA
| |
Collapse
|
28
|
Simon CB, Lee-McMullen B, Phelan D, Gilkes J, Carter CS, Buford TW. The renin-angiotensin system and prevention of age-related functional decline: where are we now? AGE (DORDRECHT, NETHERLANDS) 2015; 37:9753. [PMID: 25663422 PMCID: PMC4320995 DOI: 10.1007/s11357-015-9753-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 01/27/2015] [Indexed: 05/19/2023]
Abstract
Declining physical function is a major health problem for older adults as it is associated with multiple comorbidities and mortality. Exercise has been shown to improve physical function, though response to exercise is variable. Conversely, drugs targeting the renin-angiotensin system (RAS) pathway, including angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs), are also reported to improve physical function. In the past decade, significant strides have been made to understand the complexity and specificity of the RAS system as it pertains to physical function in older adults. Prior findings have also determined that interactions between antihypertensive medications and exercise may influence physical function above and beyond either factor alone. We review the latest research on RAS, exercise, and physical function for older adults. We also outline future research aims in this area, including genetic influences and clinical phenotyping, for the purpose of maintaining or improving physical function through tailored treatments.
Collapse
Affiliation(s)
- Corey B. Simon
- />Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL USA
| | - Brittany Lee-McMullen
- />Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, FL USA
| | - Dane Phelan
- />Department of Molecular Genetics and Microbiology, College of Medicine, University of Florida, Gainesville, FL USA
| | - Janine Gilkes
- />Department of Medicine, College of Medicine, University of Florida, Gainesville, FL USA
| | - Christy S. Carter
- />Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, FL USA
| | - Thomas W. Buford
- />Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, FL USA
- />Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL USA
| |
Collapse
|
29
|
Mesarwi OA, Sharma EV, Jun JC, Polotsky VY. Metabolic dysfunction in obstructive sleep apnea: A critical examination of underlying mechanisms. Sleep Biol Rhythms 2014; 13:2-17. [PMID: 26412981 DOI: 10.1111/sbr.12078] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
It has recently become clear that obstructive sleep apnea (OSA) is an independent risk factor for the development of metabolic syndrome, a disorder of defective energy storage and use. Several mechanisms have been proposed to explain this finding, drawing upon the characteristics that define OSA. In particular, intermittent hypoxia, sleep fragmentation, elevated sympathetic tone, and oxidative stress - all consequences of OSA - have been implicated in the progression of poor metabolic outcomes in OSA. In this review we examine the evidence to support each of these disease manifestations of OSA as a unique risk for metabolic dysfunction. Tissue hypoxia and sleep fragmentation are each directly connected to insulin resistance and hypertension, and each of these also may increase sympathetic tone, resulting in defective glucose homeostasis, excessive lipolysis, and elevated blood pressure. Oxidative stress further worsens insulin resistance and in turn, metabolic dysfunction also increases oxidative stress. However, despite many studies linking each of these individual components of OSA to the development of metabolic syndrome, there are very few reports that actually provide a coherent narrative about the mechanism underlying metabolic dysfunction in OSA.
Collapse
Affiliation(s)
- Omar A Mesarwi
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Jonathan C Jun
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | |
Collapse
|
30
|
Santos SHS, Andrade JMO. Angiotensin 1-7: a peptide for preventing and treating metabolic syndrome. Peptides 2014; 59:34-41. [PMID: 25017239 DOI: 10.1016/j.peptides.2014.07.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 07/02/2014] [Accepted: 07/02/2014] [Indexed: 12/14/2022]
Abstract
Angiotensin-(1-7) is one of the most important active peptides of the renin-angiotensin system (RAS) with recognized cardiovascular relevance; however several studies have shown the potential therapeutic role of Ang-(1-7) on treating and preventing metabolic disorders as well. This peptide achieves a special importance considering that in the last few decades obesity and metabolic syndrome (MS) have become a growing worldwide health problem. Angiotensin (Ang) II is the most studied component of RAS and is increased during obesity, diabetes and dyslipidemia (MS); some experimental evidence has shown that Ang II modulates appetite and metabolism as well as mechanisms that induce adipose tissue growth and metabolism in peripheral organs. Recent articles demonstrated that Ang-(1-7)/Mas axis modulates lipid and glucose metabolism and counterregulates the effects of Ang II. Based on these data, angiotensin-converting enzyme 2 (ACE2)/Ang-(1-7)/Mas pathway activation have been advocated as a new tool for treating metabolic diseases. This review summarizes the new evidence from animal and human experiments indicating the use of Ang-(1-7) in prevention and treatment of obesity and metabolic disorders.
Collapse
Affiliation(s)
- Sérgio Henrique Sousa Santos
- Pharmacology Department, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil; Laboratory of Health Science, Postgraduate Program in Health Sciences, Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, Minas Gerais, Brazil.
| | - João Marcus Oliveira Andrade
- Laboratory of Health Science, Postgraduate Program in Health Sciences, Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, Minas Gerais, Brazil
| |
Collapse
|
31
|
Alba AC, Delgado DH. Optimal medical treatment of cardiovascular risk factors: can we prevent the development of heart failure? Expert Rev Cardiovasc Ther 2014; 7:147-57. [DOI: 10.1586/14779072.7.2.147] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
32
|
Echeverría-Rodríguez O, Del Valle-Mondragón L, Hong E. Angiotensin 1-7 improves insulin sensitivity by increasing skeletal muscle glucose uptake in vivo. Peptides 2014; 51:26-30. [PMID: 24184594 DOI: 10.1016/j.peptides.2013.10.022] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 10/14/2013] [Accepted: 10/15/2013] [Indexed: 12/12/2022]
Abstract
The renin-angiotensin system (RAS) regulates skeletal muscle insulin sensitivity through different mechanisms. The overactivation of the ACE (angiotensin-converting enzyme)/Ang (angiotensin) II/AT1R (Ang II type 1 receptor) axis has been associated with the development of insulin resistance, whereas the stimulation of the ACE2/Ang 1-7/MasR (Mas receptor) axis improves insulin sensitivity. The in vivo mechanisms by which this axis enhances skeletal muscle insulin sensitivity are scarcely known. In this work, we investigated whether rat soleus muscle expresses the ACE2/Ang 1-7/MasR axis and determined the effect of Ang 1-7 on rat skeletal muscle glucose uptake in vivo. Western blot analysis revealed the expression of ACE2 and MasR, while Ang 1-7 levels were detected in rat soleus muscle by capillary zone electrophoresis. The euglycemic clamp exhibited that Ang 1-7 by itself did not promote glucose transport, but it increased insulin-stimulated glucose disposal in the rat. In a similar manner, captopril (an ACE inhibitor) enhanced insulin-induced glucose uptake and this effect was blocked by the MasR antagonist A-779. Our results show for the first time that rat soleus muscle expresses the ACE2/Ang 1-7/MasR axis of the RAS, and Ang 1-7 improves insulin sensitivity by enhancing insulin-stimulated glucose uptake in rat skeletal muscle in vivo. Thus, endogenous (systemic and/or local) Ang 1-7 could regulate insulin-mediated glucose transport in vivo.
Collapse
Affiliation(s)
- Omar Echeverría-Rodríguez
- Departamento de Farmacobiología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), Sede Sur, Mexico City, Mexico
| | | | - Enrique Hong
- Departamento de Farmacobiología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), Sede Sur, Mexico City, Mexico.
| |
Collapse
|
33
|
Femminella GD, de Lucia C, Iacotucci P, Formisano R, Petraglia L, Allocca E, Ratto E, D'Amico L, Rengo C, Pagano G, Bonaduce D, Rengo G, Ferrara N. Neuro-hormonal effects of physical activity in the elderly. Front Physiol 2013; 4:378. [PMID: 24391595 PMCID: PMC3868730 DOI: 10.3389/fphys.2013.00378] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 12/04/2013] [Indexed: 01/14/2023] Open
Abstract
Thanks to diagnostic and therapeutic advances, the elderly population is continuously increasing in the western countries. Accordingly, the prevalence of most chronic age-related diseases will increase considerably in the next decades, thus it will be necessary to implement effective preventive measures to face this epidemiological challenge. Among those, physical activity exerts a crucial role, since it has been proven to reduce the risk of cardiovascular diseases, diabetes, obesity, cognitive impairment and cancer. The favorable effects of exercise on cardiovascular homeostasis can be at least in part ascribed to the modulation of the neuro-hormonal systems implicated in cardiovascular pathophysiology. In the elderly, exercise has been shown to affect catecholamine secretion and biosynthesis, to positively modulate the renin-angiotensin-aldosterone system and to reduce the levels of plasma brain natriuretic peptides. Moreover, drugs modulating the neuro-hormonal systems may favorably affect physical capacity in the elderly. Thus, efforts should be made to actually make physical activity become part of the therapeutic tools in the elderly.
Collapse
Affiliation(s)
- Grazia D Femminella
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Claudio de Lucia
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Paola Iacotucci
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Roberto Formisano
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Laura Petraglia
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Elena Allocca
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Enza Ratto
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Loreta D'Amico
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Carlo Rengo
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy ; Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN) Telese Terme, Italy
| | - Gennaro Pagano
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Domenico Bonaduce
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy ; Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN) Telese Terme, Italy
| | - Nicola Ferrara
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy ; Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN) Telese Terme, Italy
| |
Collapse
|
34
|
Renin-angiotensin system blockade: a novel therapeutic approach in chronic obstructive pulmonary disease. Clin Sci (Lond) 2012; 123:487-98. [PMID: 22757959 DOI: 10.1042/cs20120081] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
ACE (angiotensin-converting enzyme) inhibitors and ARBs (angiotensin II receptor blockers) are already widely used for the treatment and prevention of cardiovascular disease and their potential role in other disease states has become increasingly recognized. COPD (chronic obstructive pulmonary disease) is characterized by pathological inflammatory processes involving the lung parenchyma, airways and vascular bed. The aim of the present review is to outline the role of the RAS (renin-angiotensin system) in the pathogenesis of COPD, including reference to results from fibrotic lung conditions and pulmonary hypertension. The review will, in particular, address the emerging evidence that ACE inhibition could have a beneficial effect on skeletal muscle function and cardiovascular co-morbidity in COPD patients. The evidence to support the effect of RAS blockade as a novel therapeutic approach in COPD will be discussed.
Collapse
|
35
|
Sauermann R, Schmidt WM, Krebs M, Brunner M, Müller M. Ramipril modulates circadian gene expression in skeletal muscle. Pharmacogenet Genomics 2012; 21:751-9. [PMID: 21881539 DOI: 10.1097/fpc.0b013e32834a8621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Treatment with angiotensin converting enzyme (ACE)-inhibitors favorably affects glucose metabolism and the development of diabetes mellitus by largely elusive mechanisms. To identify these mechanisms, we studied the effect of ACE-inhibition on gene expression in skeletal muscle, a primary target tissue for insulin in glucose homeostasis. METHODS A subject-blinded and analyst-blinded, placebo-controlled study was conducted in nine healthy men. Two consecutive muscle biopsies were conducted before and 9 h after a single dose of either 10-mg ramipril (n=6) or placebo (n=3), (randomly allocated). Muscle ribonucleic acid was subjected to transcriptome profiling. RESULTS In both ramipril-treated or placebo-treated individuals, the majority of genes with differential expression between the two time points belonged to the family of diurnally regulated genes, such as the NR1D1 and NR1D2 genes (nuclear receptor subfamily 1, group D, members 1 and 2) or members of the period homolog family (PER1-3). Ramipril significantly modulated the expression of other diurnally regulated genes, such as aryl hydrocarbon receptor nuclear translocator-like (ARNTL), encoding aryl hydrocarbon receptor nuclear translocator-like, a core component of the circadian clock (P=0.02). Concomitant attenuation of NR1D1 downregulation (-2.4-fold compared with -4.1-fold in placebo; P=0.04), a transcriptional repressor of ARNTL, supported the view that ramipril might modulate glucose homeostasis pathways involving the NR1D1 ARNTL axis. CONCLUSION As circadian rhythms are deranged in patients who are diabetic, modulated expression of circadian clock genes by ramipril could explain the favorable metabolic effects of therapeutic ACE-inhibition.
Collapse
Affiliation(s)
- Robert Sauermann
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | | | | | | | | |
Collapse
|
36
|
Carter CS, Marzetti E, Leeuwenburgh C, Manini T, Foster TC, Groban L, Scarpace PJ, Morgan D. Usefulness of preclinical models for assessing the efficacy of late-life interventions for sarcopenia. J Gerontol A Biol Sci Med Sci 2011; 67:17-27. [PMID: 21636833 DOI: 10.1093/gerona/glr042] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Caloric restriction and physical exercise have proven beneficial against age-associated changes in body composition and declining physical performance; however, little is known regarding what benefit these interventions might have when initiated late in life. The study of mimetics of diet and exercise and the combination thereof may provide additional treatments for a vulnerable elderly population; however, how and when to initiate such interventions requires consideration in developing the most safe and efficacious treatment strategies. In this review, we focus on preclinical late-life intervention studies, which assess the relationship between physical function, sarcopenia, and body composition. We provide a conceptual framework for the ever-changing definition of sarcopenia and a rationale for the use of an appropriate rodent model of this condition. We finish by providing our perspective regarding the implications of this body of work and future areas of research that may also contribute to the ultimate goal of extending healthspan.
Collapse
Affiliation(s)
- Christy S Carter
- Department of Aging and Geriatric Research, Institute on Aging, University of Florida, Gainesville, FL 32610, USA.
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Carter CS, Giovannini S, Seo DO, DuPree J, Morgan D, Chung HY, Lees H, Daniels M, Hubbard GB, Lee S, Ikeno Y, Foster TC, Buford TW, Marzetti E. Differential effects of enalapril and losartan on body composition and indices of muscle quality in aged male Fischer 344 × Brown Norway rats. AGE (DORDRECHT, NETHERLANDS) 2011; 33:167-183. [PMID: 21153712 PMCID: PMC3127467 DOI: 10.1007/s11357-010-9196-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Accepted: 11/14/2010] [Indexed: 05/29/2023]
Abstract
The primary purpose of the present set of studies was to provide a direct comparison of the effects of the angiotensin-converting enzyme inhibitor enalapril and the angiotensin receptor blocker losartan on body composition, physical performance, and muscle quality when administered late in life to aged rats. Overall, enalapril treatment consistently attenuated age-related increases in adiposity relative to both placebo and losartan. The maximal effect was achieved after 3 months of treatment (between 24 and 27 months of age), at a dose of 40 mg/kg and was observed in the absence of any changes in physical activity, body temperature, or food intake. In addition, the reduction in fat mass was not due to changes in pathology given that enalapril attenuated age-related increases in tumor development relative to placebo- and losartan-treated animals. Both enalapril and losartan attenuated age-related decreases in grip strength, suggesting that changes in body composition appear dissociated from improvements in physical function and may reflect a differential impact of enalapril and losartan on muscle quality. To link changes in adiposity to improvements in skeletal muscle quality, we performed gene array analyses to generate hypotheses regarding cell signaling pathways altered with enalapril treatment. Based on these results, our primary follow-up pathway was mitochondria-mediated apoptosis of myocytes. Relative to losartan- and placebo-treated rats, only enalapril decreased DNA fragmentation and caspase-dependent apoptotic signaling. These data suggest that attenuation of the severity of skeletal muscle apoptosis promoted by enalapril may represent a distinct mechanism through which this compound improves muscle strength/quality.
Collapse
Affiliation(s)
- Christy S Carter
- Department of Aging and Geriatric Research, Institute on Aging, University of Florida, Gainesville, FL 32610, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Zhu CF, Li GZ, Peng HB, Zhang F, Chen Y, Li Y. Treatment with marine collagen peptides modulates glucose and lipid metabolism in Chinese patients with type 2 diabetes mellitus. Appl Physiol Nutr Metab 2011; 35:797-804. [PMID: 21164551 DOI: 10.1139/h10-075] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This study was aimed at examining the therapeutic effects of marine collagen peptides (MCPs) from fish hydrolysate in Chinese patients with type 2 diabetes mellitus (T2DM). A total of 100 diabetic patients and 50 healthy controls were recruited. Diabetic patients were randomized into treatment and control groups. The patients in the treatment group received an additional 13 g of MCPs daily for 3 months. Their blood samples were collected before, and 1.5 and 3 months after, treatment to evaluate glucose and lipid metabolism. The levels of serum high-sensitivity C-reactive protein (hs-CRP), nitric oxide (NO), bradykinin, prostacyclin (PGI2), and adipokines were determined. Significantly reduced levels of fasting blood glucose, human glycated hemoglobin A1c (GHbA1c), fasting blood insulin, total triglycerides, total cholesterol, low-density lipoprotein, and free-fatty acids, but increased levels of insulin sensitivity index and HDL were observed in T2DM patients following treatment with MCPs for 1.5 and 3 months. The values of these measures were significantly lower or higher than those of patient controls (p < 0.01), respectively. Interestingly, significantly decreased levels of hs-CRP and NO, but increased levels of bradykinin, PGI2, and adiponectin were detected in MCP-treated T2DM patients (p < 0.01), as compared with their basal values or the levels in patient controls. MCP treatment improved glucose and lipid metabolism in diabetic patients.
Collapse
Affiliation(s)
- Cui-Feng Zhu
- Department of Nutrition, Shenzhen Hospital of Peking University, Shenzhen 518036, China.
| | | | | | | | | | | |
Collapse
|
39
|
Abstract
Diabetes has emerged as the modern day epidemic that is currently affecting over 220 million people worldwide and claiming at least 1.1 million lives in 2005 alone. The rise in diabetes is largely attributed to the epidemic of obesity together with sedentary lifestyle as well as unhealthy dietary habits. Despite evidence that glycemic control as well as control of other cardiovascular disease (CVD) risk factors such as hypertension and dyslipidemia decreases morbidity and mortality in the diabetic population, control of glycemia and other CVD risk factors remains largely suboptimal making the concept of prevention of diabetes very appealing to control CVD risk, especially that such a risk is already increased in people in the prediabetic stage. Several large controlled trials have been completed testing various options for diabetes prevention. In this paper we present an update on prevention of type 2 diabetes highlighting the major recent trials completed to date in this very important area of investigation.
Collapse
Affiliation(s)
- Jocelyne G Karam
- Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219, USA.
| | | |
Collapse
|
40
|
Pretty C, Chase JG, Le Compte A, Lin J, Shaw G. Impact of metoprolol on insulin sensitivity in the ICU. ACTA ACUST UNITED AC 2011. [DOI: 10.3182/20110828-6-it-1002.01729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
41
|
Abstract
Sarcopenia is the progressive generalized loss of skeletal muscle mass, strength, and function which occurs as a consequence of aging. With a growing older population, there has been great interest in developing approaches to counteract the effects of sarcopenia, and thereby reduce the age-related decline and disability. This paper reviews (1) the mechanisms of sarcopenia, (2) the diagnosis of sarcopenia, and (3) the potential interventions for sarcopenia. Multiple factors appear to be involved in the development of sarcopenia including the loss of muscle mass and muscle fibers, increased inflammation, altered hormonal levels, poor nutritional status, and altered renin-angiotensin system. The lack of diagnostic criteria to identify patients with sarcopenia hinders potential management options. To date, pharmacological interventions have shown limited efficacy in counteracting the effects of sarcopenia. Recent evidence has shown benefits with angiotensin-converting enzyme inhibitors; however, further randomized controlled trials are required. Resistance training remains the most effective intervention for sarcopenia; however, older people maybe unable or unwilling to embark on strenuous exercise training programs.
Collapse
Affiliation(s)
- Louise A Burton
- Ageing and Health, Division of Medical Sciences, University of Dundee, Dundee, Scotland, United Kingdom
| | - Deepa Sumukadas
- Ageing and Health, Division of Medical Sciences, University of Dundee, Dundee, Scotland, United Kingdom
| |
Collapse
|
42
|
Abstract
The renin-angiotensin system (RAS) plays key roles throughout the cardiovascular continuum, and blockade of this system--either through angiotensin-converting enzyme (ACE) inhibition or through angiotensin II type 1 (AT(1)) receptor antagonism--now occupies a central place in the management of cardiovascular disease (CVD). Understanding of the RAS has expanded in recent years with the identification of new pathways for formation of angiotensin II and novel effector peptides, such as angiotensin-(1-7), which may constitute new therapeutic targets. A substantial proportion of the benefits of ACE inhibitors, including vasodilation, improvements in endothelial function, and inhibition of cell proliferation, appear to be attributable to decreases in angiotensin II and increases in bradykinin. In addition, however, there is evidence that other mechanisms, such as modulation of ACE signaling, may also contribute. Angiotensin receptor blockers (ARBs) selectively block AT(1) receptors and allow unopposed stimulation of AT(2) receptors, with potentially beneficial vasodilatory, anti-inflammatory, and antiproliferative effects. As a result, these agents share many of the clinical benefits of ACE inhibitors. Both ACE inhibitors and ARBs have been shown to exert multiple antiatherogenic actions, and to reduce clinical events in high-risk participants; their use is recommended in current guidelines for the secondary prevention of CVD.
Collapse
Affiliation(s)
- Jeffrey L Probstfield
- Clinical Trials Service Unit, Division of Cardiology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
| | | |
Collapse
|
43
|
Thaveau F, Zoll J, Bouitbir J, N’Guessan B, Plobner P, Chakfe N, Kretz JG, Richard R, Piquard F, Geny B. Effect of chronic pre-treatment with angiotensin converting enzyme inhibition on skeletal muscle mitochondrial recovery after ischemia/reperfusion. Fundam Clin Pharmacol 2009; 24:333-40. [DOI: 10.1111/j.1472-8206.2009.00763.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
44
|
Gray SL, LaCroix AZ, Aragaki AK, McDermott M, Cochrane BB, Kooperberg CL, Murray AM, Rodriguez B, Black H, Woods NF. Angiotensin-converting enzyme inhibitor use and incident frailty in women aged 65 and older: prospective findings from the Women's Health Initiative Observational Study. J Am Geriatr Soc 2009; 57:297-303. [PMID: 19207145 DOI: 10.1111/j.1532-5415.2008.02121.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To examine the associations between current use, duration, and potency of angiotensin-converting enzyme (ACE) inhibitors and incident frailty in women aged 65 and older who were not frail at baseline. DESIGN Data were from the Women's Health Initiative Observational Study (WHI-OS), a prospective study conducted at 40 U.S. clinical centers. PARTICIPANTS Women aged 65 to 79 at baseline who were not frail (N=27,378). MEASUREMENTS Current ACE inhibitor use was ascertained through direct inspection of medicine containers at baseline. Components of frailty were self-reported low physical function or impaired walking, exhaustion, low physical activity, and unintended weight. Frailty was ascertained through self-reported and physical measurements data at baseline and 3-year clinic contacts. RESULTS By the 3-year follow-up, 3,950 (14.4%) women had developed frailty. Current ACE inhibitor use had no association with incident frailty (multivariate adjusted odds ratio=0.96, 95% confidence interval=0.82-1.13). Duration and potency of ACE inhibitor use were also not significantly associated with incident frailty. A similar pattern of results was observed when incident cardiovascular disease events were studied as a separate outcome or when the sample was restricted to subjects with hypertension. CONCLUSION Overall, incidence of frailty was similar in current ACE inhibitor users and nonusers.
Collapse
|
45
|
Edgerton DS, Cherrington AD, Neal DW, Scott M, Lautz M, Brown N, Petro J, Hobbs CH, Leach C, Del Parigi A, Strack TR. Inhaled insulin is associated with prolonged enhancement of glucose disposal in muscle and liver in the canine. J Pharmacol Exp Ther 2009; 328:970-5. [PMID: 19098161 PMCID: PMC3202424 DOI: 10.1124/jpet.108.146985] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2008] [Accepted: 12/16/2008] [Indexed: 11/22/2022] Open
Abstract
Diabetic patients treated with inhaled insulin exhibit reduced fasting plasma glucose levels. In dogs, insulin action in muscle is enhanced for as long as 3 h after insulin inhalation. This study was designed to determine whether this effect lasts for a prolonged duration such that it could explain the effect observed in diabetic patients. Human insulin was administered via inhalation (Exubera; n = 9) or infusion (Humulin R; n = 9) in dogs using an infusion algorithm that yielded matched plasma insulin kinetics between the two groups. Somatostatin was infused to prevent insulin secretion, and glucagon was infused to replace basal plasma levels of the hormone. Glucose was infused into the portal vein at 4 mg/kg/min and into a peripheral vein to maintain the arterial plasma glucose level at 160 mg/dl. Arterial and hepatic sinusoidal insulin and glucose levels were virtually identical in the two groups. Notwithstanding, glucose utilization was greater when insulin was administered by inhalation. At its peak, the peripheral glucose infusion rate was 4 mg/kg/min greater in the inhalation group, and a 50% difference between groups persisted over 8 h. Inhalation of insulin caused a greater increase in nonhepatic glucose uptake in the first 3 h after inhalation; thereafter, net hepatic glucose uptake was greater. Inhalation of insulin was associated with greater than expected (based on insulin levels) glucose disposal. This may explain the reduced fasting glucose concentrations observed in humans after administration of certain inhaled insulin formulations compared with subcutaneous insulin.
Collapse
Affiliation(s)
- Dale S Edgerton
- Molecular Physiology and Biophysics, Vanderbilt University Medical Center, 710 Robinson Research Building, Nashville, TN 37232-0615, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Febba A, Sesso R, Barreto GP, Liboni CS, Franco MCP, Casarini DE. Stunting growth: association of the blood pressure levels and ACE activity in early childhood. Pediatr Nephrol 2009; 24:379-86. [PMID: 18791745 DOI: 10.1007/s00467-008-0980-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Revised: 08/03/2008] [Accepted: 08/05/2008] [Indexed: 11/24/2022]
Abstract
Angiotensin converting enzyme (ACE) converts angiotensin I to angiotensin II and inactive bradykinin. Several studies carried out in our laboratory have consistently identified three isoforms of ACE, at 65, 90 and 190 kDa, with the 90-kDa isoform being a possible genetic marker of hypertension. Based on these observations and the fact that nutritional stunting can be associated with hypertension, we have investigated the expression and activity of ACE in stunted children and its association with blood pressure (BP) levels and nutritional state. Sixty children aged 2-7 years were selected for this study. A urine sample was collected from each child. Angiotensin converting enzyme activity was evaluated using two different substrates, and ACE expression was detected by Western blotting. Our results show that nutritional stunting is associated with high ACE activity in childhood and that adjustment by gender does not modify the strength of this association. A greater percentage of stunted children had increased BP levels, and this clinical parameter was inversely correlated with anthropometric indicators. A greater urinary protein expression of the three ACE isoforms was observed in the group of children with growth stunting. Our findings suggest that the reported high risk of hypertension in stunted adolescents and adults are, at least partly, associated with abnormalities in the renin-angiotensin system.
Collapse
Affiliation(s)
- Andréia Febba
- Division of Nephrology, Federal University of São Paulo, R. Botucatu, 740, São Paulo, SP, Brazil, 04023-900
| | | | | | | | | | | |
Collapse
|
47
|
Sumukadas D, Witham MD, Struthers AD, McMurdo MET. Ace inhibitors as a therapy for sarcopenia - evidence and possible mechanisms. J Nutr Health Aging 2008; 12:480-5. [PMID: 18615230 DOI: 10.1007/bf02982709] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- D Sumukadas
- Ageing and Health, Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, University of Dundee, Dundee.
| | | | | | | |
Collapse
|
48
|
Droma Y, Hanaoka M, Basnyat B, Arjyal A, Neupane P, Pandit A, Sharma D, Ito M, Miwa N, Katsuyama Y, Ota M, Kubo K. Adaptation to high altitude in Sherpas: association with the insertion/deletion polymorphism in the Angiotensin-converting enzyme gene. Wilderness Environ Med 2008; 19:22-9. [PMID: 18333655 DOI: 10.1580/06-weme-or-073.1] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Sherpas are well-known for their physical strength at high altitudes. They adapt to high altitude so well that little acute or chronic mountain sickness has been documented in them. The possible genetic basis for this adaptation is, however, unclear. The objective of this study was to elucidate the genetic background underlying this characteristic among Sherpas with respect to the angiotension-converting enzyme (ACE) gene. METHODS We enrolled 105 Sherpa volunteers in Namche Bazaar (3440 meters) and 111 non-Sherpa Nepalese volunteers in Kathmandu Valley (1330 meters) in Nepal. Information about high-altitude exposure and physiological phenotypes was obtained via fieldwork investigation. The genotype of the insertion/deletion (I/D) polymorphism in the ACE gene was identified by polymerase chain reaction. Serum ACE activity was also measured. RESULTS The distribution of the I dominant genotype (II & ID) and the I allelic frequency were significantly more prevalent in Sherpas (II & ID: 94.3%, I allele: 73.3%) than in non-Sherpas (II & ID: 85.6%, P = .035; I allele: 64.0%, P = .036). Moreover, despite residing at high altitude, the circulating ACE levels of Sherpas were statistically similar to those of non-Sherpas at low altitudes (Sherpas: 14.5 +/- 0.4 IU/L/37 degrees C; non-Sherpas: 14.7 +/- 0.4 IU/L/37 degrees C; P = .755). CONCLUSIONS These findings suggest that the overrepresented I allele of the ACE gene in Sherpas might be one of the fundamental genetic factors responsible for maintaining physiological low-altitude ACE activity at high altitude, which may have an advantageous physiological role in adapting to a high-altitude environment.
Collapse
Affiliation(s)
- Yunden Droma
- First Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Hayden MR, Sowers JR. Treating hypertension while protecting the vulnerable islet in the cardiometabolic syndrome. ACTA ACUST UNITED AC 2008; 2:239-66. [PMID: 20409906 DOI: 10.1016/j.jash.2007.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2007] [Revised: 12/06/2007] [Accepted: 12/06/2007] [Indexed: 12/19/2022]
Abstract
Hypertension, a multifactorial-polygenic disease, interacts with multiple environmental stressors and results in functional and structural changes in numerous end organs, including the cardiovascular system. This can result in coronary heart disease, stroke, peripheral vascular disease, congestive heart failure, end-stage renal disease, insulin resistance, and damage to the pancreatic islet. Hypertension is the most important modifiable risk factor for major health problems encountered in clinical practice. Whereas hypertension was once thought to be a medical condition based on discrete blood pressure readings, a new concept has emerged defining hypertension as part of a complex and progressive metabolic and cardiovascular disease, an important part of a cardiometabolic syndrome. The central role of insulin resistance, oxidative stress, endothelial dysfunction, metabolic signaling defects within tissues, and the role of enhanced tissue renin-angiotensin-aldosterone system activity as it relates to hypertension and type 2 diabetes mellitus are emphasized. Additionally, this review focuses on the effect of hypertension on functional and structural changes associated with the vulnerable pancreatic islet. Various classes of antihypertensive drugs are reviewed, especially their roles in delaying or preventing damage to the vulnerable pancreatic islet, and thus delaying the development of type 2 diabetes mellitus.
Collapse
Affiliation(s)
- Melvin R Hayden
- Departments of Internal Medicine, Endocrinology Diabetes and Metabolism, and Diabetes and Cardiovascular Disease Research Center, School of Medicine, University of Missouri-Columbia, Health Sciences Center, Columbia, Missouri, USA
| | | |
Collapse
|
50
|
Fonseca VA, Bratcher C, Thethi T. Pharmacological treatment of the insulin resistance syndrome in people without diabetes. Metab Syndr Relat Disord 2008; 3:332-8. [PMID: 18370733 DOI: 10.1089/met.2005.3.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Vivian A Fonseca
- Tulane University Health Sciences Center, and Department of Veterans Affairs Medical Center, New Orleans, Louisiana
| | | | | |
Collapse
|