1
|
Liang L, Song J, Miao S, Xie Q, Li W, Huang H, Shen D, Zhang W. Modulation of lipid profile by secretory phospholipase A2 group IIA: Verification with a transgenic mouse model. Biochem Biophys Res Commun 2024; 712-713:149955. [PMID: 38640737 DOI: 10.1016/j.bbrc.2024.149955] [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: 04/02/2024] [Revised: 04/15/2024] [Accepted: 04/15/2024] [Indexed: 04/21/2024]
Abstract
We previously demonstrated a positive relation of secretory phospholipase A2 group IIA (sPLA2-IIA) with circulating high-density lipoprotein cholesterol (HDL-C) in patients with coronary artery disease, and sPLA2-IIA increased cholesterol efflux in THP-1 cells through peroxisome proliferator-activated receptor-γ (PPAR-γ)/liver X receptor α/ATP-binding cassette transporter A1 (ABCA1) signaling pathway. The aim of the present study was to examine the role of sPLA2-IIA over-expression on lipid profile in a transgenic mouse model. Fifteen apoE-/- and C57BL/7 female mice received bone marrow transplantation from transgenic SPLA2-IIA mice, and treated with specific PPAR-γ inhibitor GW9662. High fat diet was given after one week of bone marrow transplantation, and animals were sacrificed after twelve weeks. Immunohistochemical staining showed over-expression of sPLA2-IIA protein in the lung and spleen. The circulating level of HDL-C, but not that of low-density lipoprotein cholesterol (LDL-C), total cholesterol, or total triglyceride, was increased by sPLA2-IIA over-expression, and was subsequently reversed by GW9662 treatment. Over-expression of sPLA2-IIA resulted in augmented expression of cholesterol transporter ABCA1 at mRNA level in the aortas, and at protein level in macrophages, co-localized with macrophage specific antigen CD68. GW9662 exerted potent inhibitory effects on sPLA2-IIA-induced ABCA1 expression. Conclusively, we demonstrated the effects of sPLA2-IIA on circulating HDL-C level and the expression of ABCA1, possibly through regulation of PPAR-γ signaling in transgenic mouse model, that is in concert with the conditions in patients with coronary artery disease.
Collapse
Affiliation(s)
- Ling Liang
- Department of Cardiology, Xiamen Key Laboratory of Cardiac Electrophysiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, China.
| | - Jing Song
- Laboratory Animal Center, Xiamen University, Xiamen, 361005, China
| | - Shisheng Miao
- Department of Cardiology, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361004, China
| | - Qiang Xie
- Department of Cardiology, Xiamen Key Laboratory of Cardiac Electrophysiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, China; Xiamen Key Laboratory of Cardiac Electrophysiology, Xiamen Institute of Cardiovascular Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, China
| | - Weihua Li
- Department of Cardiology, Xiamen Key Laboratory of Cardiac Electrophysiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, China; Xiamen Key Laboratory of Cardiac Electrophysiology, Xiamen Institute of Cardiovascular Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, China
| | - Honglang Huang
- Xiamen Key Laboratory of Cardiac Electrophysiology, Xiamen Institute of Cardiovascular Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, China
| | - Dongyan Shen
- Cell Therapy Research Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, China
| | - Wei Zhang
- Xiamen Key Laboratory of Cardiac Electrophysiology, Xiamen Institute of Cardiovascular Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, China.
| |
Collapse
|
2
|
Carter RW, Gerardo CJ, Samuel SP, Kumar S, Kotehal SD, Mukherjee PP, Shirazi FM, Akpunonu PD, Bammigatti C, Bhalla A, Manikath N, Platts-Mills TF, Lewin MR. The BRAVO Clinical Study Protocol: Oral Varespladib for Inhibition of Secretory Phospholipase A2 in the Treatment of Snakebite Envenoming. Toxins (Basel) 2022; 15:22. [PMID: 36668842 PMCID: PMC9862656 DOI: 10.3390/toxins15010022] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/19/2022] [Accepted: 12/24/2022] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Snakebite is an urgent, unmet global medical need causing significant morbidity and mortality worldwide. Varespladib is a potent inhibitor of venom secretory phospholipase A2 (sPLA2) that can be administered orally via its prodrug, varespladib-methyl. Extensive preclinical data support clinical evaluation of varespladib as a treatment for snakebite envenoming (SBE). The protocol reported here was designed to evaluate varespladib-methyl for SBE from any snake species in multiple geographies. METHODS AND ANALYSIS BRAVO (Broad-spectrum Rapid Antidote: Varespladib Oral for snakebite) is a multicenter, randomized, double-blind, placebo-controlled, phase 2 study to evaluate the safety, tolerability, and efficacy of oral varespladib-methyl plus standard of care (SoC) vs. SoC plus placebo in patients presenting with acute SBE by any venomous snake species. Male and female patients 5 years of age and older who meet eligibility criteria will be randomly assigned 1:1 to varespladib-methyl or placebo. The primary outcome is the Snakebite Severity Score (SSS) that has been modified for international use. This composite outcome is based on the sum of the pulmonary, cardiovascular, nervous, hematologic, and renal systems components of the updated SSS. ETHICS AND DISSEMINATION This protocol was submitted to regulatory authorities in India and the US. A Clinical Trial No Objection Certificate from the India Central Drugs Standard Control Organisation, Drug Controller General-India, and a Notice to Proceed from the US Food and Drug Administration have been obtained. The study protocol was approved by properly constituted, valid institutional review boards or ethics committees at each study site. This study is being conducted in compliance with the April 1996 ICH Guidance for Industry GCP E6, the Integrated Addendum to ICH E6 (R2) of November 2016, and the applicable regulations of the country in which the study is conducted. The trial is registered on Clinical trials.gov, NCT#04996264 and Clinical Trials Registry-India, 2021/07/045079 000062.
Collapse
Affiliation(s)
| | - Charles J. Gerardo
- Department of Emergency Medicine, Duke University, Durham, NC 27708, USA
| | | | - Surendra Kumar
- Department of Medicine, Sardar Patel Medical College, PBM Hospital, Bikaner 334001, India
| | - Suneetha D. Kotehal
- Department of Medicine, Mysore Medical College and Research Institute, Mysore 570001, India
| | - Partha P. Mukherjee
- Department of General Medicine, Calcutta National Medical College, Kolkata 700014, India
| | - Farshad M. Shirazi
- Arizona Poison & Drug Information Center, College of Pharmacy and University of Arizona College of Medicine, University of Arizona, Tucson, AZ 85721, USA
| | - Peter D. Akpunonu
- Department of Emergency Medicine and Medical Toxicology, University of Kentucky College of Medicine, Lexington, KY 40506, USA
| | - Chanaveerappa Bammigatti
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India
| | - Ashish Bhalla
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Neeraj Manikath
- Department of Emergency Medicine, Government Medical College, Kozhikode 673008, India
| | | | | |
Collapse
|
3
|
Shim KH, Sharma N, An SSA. Prion therapeutics: Lessons from the past. Prion 2022; 16:265-294. [PMID: 36515657 PMCID: PMC9754114 DOI: 10.1080/19336896.2022.2153551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 12/15/2022] Open
Abstract
Prion diseases are a group of incurable zoonotic neurodegenerative diseases (NDDs) in humans and other animals caused by the prion proteins. The abnormal folding and aggregation of the soluble cellular prion proteins (PrPC) into scrapie isoform (PrPSc) in the Central nervous system (CNS) resulted in brain damage and other neurological symptoms. Different therapeutic approaches, including stalling PrPC to PrPSc conversion, increasing PrPSc removal, and PrPC stabilization, for which a spectrum of compounds, ranging from organic compounds to antibodies, have been explored. Additionally, a non-PrP targeted drug strategy using serpin inhibitors has been discussed. Despite numerous scaffolds being screened for anti-prion activity in vitro, only a few were effective in vivo and unfortunately, almost none of them proved effective in the clinical studies, most likely due to toxicity and lack of permeability. Recently, encouraging results from a prion-protein monoclonal antibody, PRN100, were presented in the first human trial on CJD patients, which gives a hope for better future for the discovery of other new molecules to treat prion diseases. In this comprehensive review, we have re-visited the history and discussed various classes of anti-prion agents, their structure, mode of action, and toxicity. Understanding pathogenesis would be vital for developing future treatments for prion diseases. Based on the outcomes of existing therapies, new anti-prion agents could be identified/synthesized/designed with reduced toxicity and increased bioavailability, which could probably be effective in treating prion diseases.
Collapse
Affiliation(s)
- Kyu Hwan Shim
- Department of Bionano Technology, Gachon University, Seongnam, South Korea
| | - Niti Sharma
- Department of Bionano Technology, Gachon University, Seongnam, South Korea
| | - Seong Soo A An
- Department of Bionano Technology, Gachon University, Seongnam, South Korea
| |
Collapse
|
4
|
Varespladib in the Treatment of Snakebite Envenoming: Development History and Preclinical Evidence Supporting Advancement to Clinical Trials in Patients Bitten by Venomous Snakes. Toxins (Basel) 2022; 14:toxins14110783. [PMID: 36422958 PMCID: PMC9695340 DOI: 10.3390/toxins14110783] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/26/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022] Open
Abstract
The availability of effective, reliably accessible, and affordable treatments for snakebite envenoming is a critical and long unmet medical need. Recently, small, synthetic toxin-specific inhibitors with oral bioavailability used in conjunction with antivenom have been identified as having the potential to greatly improve outcomes after snakebite. Varespladib, a small, synthetic molecule that broadly and potently inhibits secreted phospholipase A2 (sPLA2s) venom toxins has renewed interest in this class of inhibitors due to its potential utility in the treatment of snakebite envenoming. The development of varespladib and its oral dosage form, varespladib-methyl, has been accelerated by previous clinical development campaigns to treat non-envenoming conditions related to ulcerative colitis, rheumatoid arthritis, asthma, sepsis, and acute coronary syndrome. To date, twenty-nine clinical studies evaluating the safety, pharmacokinetics (PK), and efficacy of varespladib for non-snakebite envenoming conditions have been completed in more than 4600 human subjects, and the drugs were generally well-tolerated and considered safe for use in humans. Since 2016, more than 30 publications describing the structure, function, and efficacy of varespladib have directly addressed its potential for the treatment of snakebite. This review summarizes preclinical findings and outlines the scientific support, the potential limitations, and the next steps in the development of varespladib's use as a snakebite treatment, which is now in Phase 2 human clinical trials in the United States and India.
Collapse
|
5
|
Arrahman A, Kazandjian TD, Still KBM, Slagboom J, Somsen GW, Vonk FJ, Casewell NR, Kool J. A Combined Bioassay and Nanofractionation Approach to Investigate the Anticoagulant Toxins of Mamba and Cobra Venoms and Their Inhibition by Varespladib. Toxins (Basel) 2022; 14:736. [PMID: 36355986 PMCID: PMC9695013 DOI: 10.3390/toxins14110736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 01/26/2023] Open
Abstract
Envenomation by elapid snakes primarily results in neurotoxic symptoms and, consequently, are the primary focus of therapeutic research concerning such venoms. However, mounting evidence suggests these venoms can additionally cause coagulopathic symptoms, as demonstrated by some Asian elapids and African spitting cobras. This study sought to investigate the coagulopathic potential of venoms from medically important elapids of the genera Naja (true cobras), Hemachatus (rinkhals), and Dendroaspis (mambas). Crude venoms were bioassayed for coagulant effects using a plasma coagulation assay before RPLC/MS was used to separate and identify venom toxins in parallel with a nanofractionation module. Subsequently, coagulation bioassays were performed on the nanofractionated toxins, along with in-solution tryptic digestion and proteomics analysis. These experiments were then repeated on both crude venoms and on the nanofractionated venom toxins with the addition of either the phospholipase A2 (PLA2) inhibitor varespladib or the snake venom metalloproteinase (SVMP) inhibitor marimastat. Our results demonstrate that various African elapid venoms have an anticoagulant effect, and that this activity is significantly reduced for cobra venoms by the addition of varespladib, though this inhibitor had no effect against anticoagulation caused by mamba venoms. Marimastat showed limited capacity to reduce anticoagulation in elapids, affecting only N. haje and H. haemachatus venom at higher doses. Proteomic analysis of nanofractionated toxins revealed that the anticoagulant toxins in cobra venoms were both acidic and basic PLA2s, while the causative toxins in mamba venoms remain uncertain. This implies that while PLA2 inhibitors such as varespladib and metalloproteinase inhibitors such as marimastat are viable candidates for novel snakebite treatments, they are not likely to be effective against mamba envenomings.
Collapse
Affiliation(s)
- Arif Arrahman
- Division of Bioanalytical Chemistry, Department of Chemistry and Pharmaceutical Sciences, Faculty of Sciences, Amsterdam Institute of Molecular and Life Sciences (AIMMS), Vrije Universiteit Amsterdam, De Boelelaan 1083, 1081 HV Amsterdam, The Netherlands
- Centre for Analytical Sciences Amsterdam (CASA), 1012 WX Amsterdam, The Netherlands
- Faculty of Pharmacy, Universitas Indonesia, Kampus Baru UI, Depok 16424, Indonesia
| | - Taline D. Kazandjian
- Centre for Snakebite Research and Interventions. Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| | - Kristina B. M. Still
- Division of Bioanalytical Chemistry, Department of Chemistry and Pharmaceutical Sciences, Faculty of Sciences, Amsterdam Institute of Molecular and Life Sciences (AIMMS), Vrije Universiteit Amsterdam, De Boelelaan 1083, 1081 HV Amsterdam, The Netherlands
- Centre for Analytical Sciences Amsterdam (CASA), 1012 WX Amsterdam, The Netherlands
| | - Julien Slagboom
- Division of Bioanalytical Chemistry, Department of Chemistry and Pharmaceutical Sciences, Faculty of Sciences, Amsterdam Institute of Molecular and Life Sciences (AIMMS), Vrije Universiteit Amsterdam, De Boelelaan 1083, 1081 HV Amsterdam, The Netherlands
- Centre for Analytical Sciences Amsterdam (CASA), 1012 WX Amsterdam, The Netherlands
| | - Govert W. Somsen
- Division of Bioanalytical Chemistry, Department of Chemistry and Pharmaceutical Sciences, Faculty of Sciences, Amsterdam Institute of Molecular and Life Sciences (AIMMS), Vrije Universiteit Amsterdam, De Boelelaan 1083, 1081 HV Amsterdam, The Netherlands
- Centre for Analytical Sciences Amsterdam (CASA), 1012 WX Amsterdam, The Netherlands
| | - Freek J. Vonk
- Division of Bioanalytical Chemistry, Department of Chemistry and Pharmaceutical Sciences, Faculty of Sciences, Amsterdam Institute of Molecular and Life Sciences (AIMMS), Vrije Universiteit Amsterdam, De Boelelaan 1083, 1081 HV Amsterdam, The Netherlands
- Naturalis Biodiversity Centre, Darwinweg 2, 2333 CR Leiden, The Netherlands
| | - Nicholas R. Casewell
- Centre for Snakebite Research and Interventions. Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| | - Jeroen Kool
- Division of Bioanalytical Chemistry, Department of Chemistry and Pharmaceutical Sciences, Faculty of Sciences, Amsterdam Institute of Molecular and Life Sciences (AIMMS), Vrije Universiteit Amsterdam, De Boelelaan 1083, 1081 HV Amsterdam, The Netherlands
- Centre for Analytical Sciences Amsterdam (CASA), 1012 WX Amsterdam, The Netherlands
| |
Collapse
|
6
|
Sophiya P, Urs D, K. Lone J, Giresha AS, Krishna Ram H, Manjunatha JG, El-Serehy HA, Narayanappa M, Shankar J, Bhardwaj R, Ahmad Guru S, Dharmappa KK. Quercitrin neutralizes sPLA2IIa activity, reduces the inflammatory IL-6 level in PC3 cell lines, and exhibits anti-tumor activity in the EAC-bearing mice model. Front Pharmacol 2022; 13:996285. [PMID: 36324674 PMCID: PMC9620381 DOI: 10.3389/fphar.2022.996285] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/15/2022] [Indexed: 04/12/2024] Open
Abstract
Human phospholipase A2 group IIa (sPLA2IIa) is an inflammatory enzyme that plays a significant role in tumorigenesis. Inhibiting the sPLA2IIa enzyme with an effective molecule can reduce the inflammatory response and halt cancer progression. The present study evaluates quercitrin, a biflavonoid, for sPLA2IIa inhibition and anticancer activity. Quercitrin inhibited sPLA2IIa activity to a greater extent-at 86.24% ± 1.41 with an IC50 value of 8.77 μM ± 0.9. The nature of sPLA2IIa inhibition was evaluated by increasing calcium concentration from 2.5 to 15 µM and substrate from 20 to 120 nM, which did not alter the level of inhibition. Intrinsic fluorescence and far UV-CD studies confirmed the direct interaction of quercitrin with the sPLA2IIa enzyme. This significantly reduced the sPLA2IIa-induced hemolytic activity and mouse paw edema from 97.32% ± 1.23-16.91% ± 2.03 and 172.87% ± 1.9-118.41% ± 2.53, respectively. As an anticancer activity, quercitrin reduced PC-3 cell viability from 98.66% ± 2.51-18.3% ± 1.52 and significantly decreased the IL-6 level in a dose-dependent manner from 98.35% ± 2.2-37.12% ± 2.4. It increased the mean survival time (MST) of EAC-bearing Swiss albino mice from 30 to 35 days. It obeyed Lipinski's rule of five, suggesting a druggable property. Thus, all the above experimental results were promising and encouraged further investigation into developing quercitrin as a therapeutic drug for both inflammatory diseases and cancers.
Collapse
Affiliation(s)
- P. Sophiya
- Inflammation Research Laboratory, Department of Studies and Research in Biochemistry, Jnana Kaveri Post Graduate campus, Mangalore University, Kushalanagar, India
| | - Deepadarshan Urs
- Inflammation Research Laboratory, Department of Studies and Research in Biochemistry, Jnana Kaveri Post Graduate campus, Mangalore University, Kushalanagar, India
| | - Jafar K. Lone
- ICAR-National Bureau of Plant Genetic Resources, New Delhi, India
| | - A. S. Giresha
- Department of Biochemistry, School of Science, Jain (Deemed-to-be University), Bangalore, India
| | - H. Krishna Ram
- Nisarga Research and Development Trust (T), Bengaluru, India
| | - J. G. Manjunatha
- Department of Chemistry, FMKMC College, Mangalore University Constituent College, Madikeri, India
| | - Hamed A. El-Serehy
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - M. Narayanappa
- Inflammation Research Laboratory, Department of Studies and Research in Biochemistry, Jnana Kaveri Post Graduate campus, Mangalore University, Kushalanagar, India
| | - J. Shankar
- Department of Studies in Food Technology, Davanagere University, Davanagere, India
| | - Ragini Bhardwaj
- Department of Microbiology and Biotechnology, Banasthali Vidyapith, Jaipur, India
| | - Sameer Ahmad Guru
- Department of Development of Biology and Regenerative Medicine, Lurie Children Hospital, Northwestern University, Chicago, IL, United States
| | - K. K. Dharmappa
- Inflammation Research Laboratory, Department of Studies and Research in Biochemistry, Jnana Kaveri Post Graduate campus, Mangalore University, Kushalanagar, India
| |
Collapse
|
7
|
Sinapicacid Inhibits Group IIA Secretory Phospholipase A2 and Its Inflammatory Response in Mice. Antioxidants (Basel) 2022; 11:antiox11071251. [PMID: 35883742 PMCID: PMC9312209 DOI: 10.3390/antiox11071251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/13/2022] [Accepted: 06/22/2022] [Indexed: 02/04/2023] Open
Abstract
Human Group IIA secreted phospholipase A2 (sPLA2-IIA) enzyme plays a crucial role in several chronic inflammatory diseases such asasthma, atherosclerosis, gout, bronchitis, etc. Several studies showed that the antioxidants exert an anti-inflammatory function by inhibiting the sPLA2-IIA enzyme. Hence, the present study evaluated an antioxidant molecule, sinapic acid, for sPLA2-IIA inhibition as an anti-inflammatory function. Initially, the antioxidant efficacy of sinapic acid was evaluated, and it showed greater antioxidant potency. Further, sinapic acid inhibited 94.4 ± 4.83% of sPLA2-IIA activity with an IC50 value of 4.16 ± 0.13 µM. The mode of sPLA2-IIA inhibition was examined by increasing the substrate concentration from 30 to 120nM and the calcium concentration from 2.5 to 15 mM, which did not change the level of inhibition. Further, sinapic acid altered the intrinsic fluorescence and distorted the far UltraViolet Circular Dichroism (UV-CD) spectra of the sPLA2-IIA, indicating the direct enzyme-inhibitor interaction. Sinapic acid reduced the sPLA2-IIA mediated hemolytic activity from 94 ± 2.19% to 12.35 ± 2.57% and mouse paw edema from 171.75 ± 2.2% to 114.8 ± 1.98%, demonstrating the anti-inflammatory efficiency of sinapic acid by in situ and in vivo methods, respectively. Finally, sinapic acid reduced the hemorrhagic effect of Vipera russelli venom hemorrhagic complex-I (VR-HC-I) as an anti-hemorrhagic function. Thus, the above experimental results revealed the sinapic acid potency to be an antioxidant, anti-inflammatory and anti-hemorrhagic molecule, and therefore, it appears to be a promising therapeutic agent.
Collapse
|
8
|
Xie C, Albulescu LO, Still KBM, Slagboom J, Zhao Y, Jiang Z, Somsen GW, Vonk FJ, Casewell NR, Kool J. Varespladib Inhibits the Phospholipase A 2 and Coagulopathic Activities of Venom Components from Hemotoxic Snakes. Biomedicines 2020; 8:E165. [PMID: 32560391 PMCID: PMC7345350 DOI: 10.3390/biomedicines8060165] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/04/2020] [Accepted: 06/11/2020] [Indexed: 11/17/2022] Open
Abstract
Phospholipase A2 (PLA2) enzymes are important toxins found in many snake venoms, and they can exhibit a variety of toxic activities including causing hemolysis and/or anticoagulation. In this study, the inhibiting effects of the small molecule PLA2 inhibitor varespladib on snake venom PLA2s was investigated by nanofractionation analytics, which combined chromatography, mass spectrometry (MS), and bioassays. The venoms of the medically important snake species Bothrops asper, Calloselasma rhodostoma, Deinagkistrodon acutus, Daboia russelii, Echis carinatus, Echis ocellatus, and Oxyuranus scutellatus were separated by liquid chromatography (LC) followed by nanofractionation and interrogation of the fractions by a coagulation assay and a PLA2 assay. Next, we assessed the ability of varespladib to inhibit the activity of enzymatic PLA2s and the coagulopathic toxicities induced by fractionated snake venom toxins, and identified these bioactive venom toxins and those inhibited by varespladib by using parallel recorded LC-MS data and proteomics analysis. We demonstrated here that varespladib was not only capable of inhibiting the PLA2 activities of hemotoxic snake venoms, but can also effectively neutralize the coagulopathic toxicities (most profoundly anticoagulation) induced by venom toxins. While varespladib effectively inhibited PLA2 toxins responsible for anticoagulant effects, we also found some evidence that this inhibitory molecule can partially abrogate procoagulant venom effects caused by different toxin families. These findings further emphasize the potential clinical utility of varespladib in mitigating the toxic effects of certain snakebites.
Collapse
Affiliation(s)
- Chunfang Xie
- Amsterdam Institute of Molecular and Life Sciences, Division of BioAnalytical Chemistry, Department of Chemistry and Pharmaceutical Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (C.X.); (K.B.M.S.); (J.S.); (G.W.S.); (F.J.V.)
- Centre for Analytical Sciences Amsterdam (CASA), 1098 XH Amsterdam, The Netherlands
| | - Laura-Oana Albulescu
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK; (L.-O.A.); (N.R.C.)
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| | - Kristina B. M. Still
- Amsterdam Institute of Molecular and Life Sciences, Division of BioAnalytical Chemistry, Department of Chemistry and Pharmaceutical Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (C.X.); (K.B.M.S.); (J.S.); (G.W.S.); (F.J.V.)
- Centre for Analytical Sciences Amsterdam (CASA), 1098 XH Amsterdam, The Netherlands
| | - Julien Slagboom
- Amsterdam Institute of Molecular and Life Sciences, Division of BioAnalytical Chemistry, Department of Chemistry and Pharmaceutical Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (C.X.); (K.B.M.S.); (J.S.); (G.W.S.); (F.J.V.)
- Centre for Analytical Sciences Amsterdam (CASA), 1098 XH Amsterdam, The Netherlands
| | - Yumei Zhao
- Institute of Pharmaceutical Analysis, College of Pharmacy, Jinan University, Huangpu Avenue West 601, Guangzhou 510632, China; (Y.Z.); (Z.J.)
| | - Zhengjin Jiang
- Institute of Pharmaceutical Analysis, College of Pharmacy, Jinan University, Huangpu Avenue West 601, Guangzhou 510632, China; (Y.Z.); (Z.J.)
| | - Govert W. Somsen
- Amsterdam Institute of Molecular and Life Sciences, Division of BioAnalytical Chemistry, Department of Chemistry and Pharmaceutical Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (C.X.); (K.B.M.S.); (J.S.); (G.W.S.); (F.J.V.)
- Centre for Analytical Sciences Amsterdam (CASA), 1098 XH Amsterdam, The Netherlands
| | - Freek J. Vonk
- Amsterdam Institute of Molecular and Life Sciences, Division of BioAnalytical Chemistry, Department of Chemistry and Pharmaceutical Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (C.X.); (K.B.M.S.); (J.S.); (G.W.S.); (F.J.V.)
- Centre for Analytical Sciences Amsterdam (CASA), 1098 XH Amsterdam, The Netherlands
- Naturalis Biodiversity Center, Darwinweg 2, 2333 CR Leiden, The Netherlands
| | - Nicholas R. Casewell
- Centre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK; (L.-O.A.); (N.R.C.)
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| | - Jeroen Kool
- Amsterdam Institute of Molecular and Life Sciences, Division of BioAnalytical Chemistry, Department of Chemistry and Pharmaceutical Sciences, Faculty of Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands; (C.X.); (K.B.M.S.); (J.S.); (G.W.S.); (F.J.V.)
- Centre for Analytical Sciences Amsterdam (CASA), 1098 XH Amsterdam, The Netherlands
| |
Collapse
|
9
|
Hu Q, Hao P, Liu Q, Dong M, Gong Y, Zhang C, Zhang Y. Mendelian randomization studies on atherosclerotic cardiovascular disease: evidence and limitations. SCIENCE CHINA-LIFE SCIENCES 2019; 62:758-770. [DOI: 10.1007/s11427-019-9537-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 03/26/2019] [Indexed: 12/26/2022]
|
10
|
Neutralizing properties of LY315920 toward snake venom group I and II myotoxic phospholipases A2. Toxicon 2019; 157:1-7. [DOI: 10.1016/j.toxicon.2018.11.292] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/25/2018] [Accepted: 11/09/2018] [Indexed: 12/22/2022]
|
11
|
Jin HX, Zhang YH, Guo RN, Zhao SN. Inhibition of MEK/ERK/STAT3 signaling in oleuropein treatment inhibits myocardial ischemia/reperfusion. Int J Mol Med 2018; 42:1034-1043. [PMID: 29767261 DOI: 10.3892/ijmm.2018.3673] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 03/22/2018] [Indexed: 11/06/2022] Open
Abstract
Studies have shown that oleuropein has antifungal, anti‑inflammatory, antiviral, antioxidant, anticancer and hypoglycemic functions. TTC solution staining was used to measure myocardial infarction size. A commercial kit was used to measure lactate dehydrogenase (LDH), creatinine kinase‑MB (CK‑MB), tumor necrosis factor‑α (TNF‑α), interleukin‑1β (IL‑1β), IL 6, superoxide dismutase (SOD), glutathione (GSH), malondialdehyde (MDA) and catalase levels. Western blot analysis was used to measure p53, p-MEK p-ERK and p‑IκBα protein expression. The present study reports that the protective effect of oleuropein also prevents against myocardial ischemia/reperfusion (myocardial I/R). The aim of this retrospective study was to evaluate this protective effect of oleuropein and the mechanisms by which myocardial I/R is prevented. Oleuropein inhibited myocardial infarction size, CK‑MB and LDH serum levels in a myocardial I/R rat model. Moreover, oleuropein also attenuated caspase‑3 activity, and p53, phosphorylated (p)‑mitogen‑activated protein kinase kinase (MEK), p‑extracellular signal‑regulated protein kinase (ERK) and p‑IκBα protein expression. TNF‑α, IL‑1β, IL‑6 and MDA were decreased; SOD, GSH and catalase levels inhibited TNF‑α, IL‑1β, IL-6 and MDA levels, and increased SOD, GSH and catalase levels in myocardial I/R rats treated with oleuropein. Rats orally administered the MEK inhibitor PD0325901, in addition to oleuropein, exhibited inhibited myocardial infarction size, CK‑MB and LDH serum levels compared with rats treated with oleuropein only. Rats treated with MEK inhibitor also exhibited suppressed caspase‑3 activity, p53, p‑MEK p‑ERK and p‑IκBα protein expression, TNF‑α, IL‑1β, IL‑6, SOD, GSH, MDA and catalase levels, and induced p‑signal transducer and activator of transcription 3 (STAT3) protein expression compared with rats treated with oleuropein only. Taken together, these results suggest that MEK/ERK/STAT3 signaling regulates the inhibition of myocardial I/R in rats treated with oleuropein.
Collapse
Affiliation(s)
- Hong-Xu Jin
- Department of Anesthesiology, Harrison International Peace Hospital, Hebei Medical University, Hengshui, Hebei 053000, P.R. China
| | - Yun-Hu Zhang
- Department of General Medicine, Harrison International Peace Hospital, Hebei Medical University, Hengshui, Hebei 053000, P.R. China
| | - Ruo-Nan Guo
- Department of Internal Medicine‑Pediatrics, The Fifth People's Hospital, Hengshui, Hebei 053000, P.R. China
| | - Su-Nuan Zhao
- Department of Pediatrics, Anping General Hospital, Anping, Hebei 053600, P.R. China
| |
Collapse
|
12
|
Effects of Anti-Inflammatory Medications in Patients With Coronary Artery Disease: A Focus on Losmapimod. Cardiol Rev 2018; 26:152-156. [DOI: 10.1097/crd.0000000000000176] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
13
|
Chistiakov DA, Melnichenko AA, Grechko AV, Myasoedova VA, Orekhov AN. Potential of anti-inflammatory agents for treatment of atherosclerosis. Exp Mol Pathol 2018; 104:114-124. [PMID: 29378168 DOI: 10.1016/j.yexmp.2018.01.008] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 12/30/2017] [Accepted: 01/17/2018] [Indexed: 12/23/2022]
Abstract
Chronic inflammation is a central pathogenic mechanism of atherosclerosis induction and progression. Vascular inflammation is associated with accelerated onset of late atherosclerosis complications. Atherosclerosis-related inflammation is mediated by a complex cocktail of pro-inflammatory cytokines, chemokines, bioactive lipids, and adhesion molecules, and blocking the key pro-atherogenic inflammatory mechanisms can be beneficial for treatment of atherosclerosis. Therapeutic agents that specifically target some of the atherosclerosis-related inflammatory mechanisms have been evaluated in preclinical and clinical studies. The most promising anti-inflammatory compounds for treatment of atherosclerosis include non-specific anti-inflammatory drugs, phospholipase inhibitors, blockers of major inflammatory cytokines, leukotrienes, adhesion molecules, and pro-inflammatory signaling pathways, such as CCL2-CCR2 axis or p38 MAPK pathway. Ongoing studies attempt evaluating therapeutic utility of these anti-inflammatory drugs for treatment of atherosclerosis. The obtained results are important for our understanding of atherosclerosis-related inflammatory mechanisms and for designing randomized controlled studies assessing the effect of specific anti-inflammatory strategies on cardiovascular outcomes.
Collapse
Affiliation(s)
- Dimitry A Chistiakov
- Department of Neurochemistry, Division of Basic and Applied Neurobiology, Serbsky Federal Medical Research Center of Psychiatry and Narcology, Moscow 119991, Russia
| | - Alexandra A Melnichenko
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Sciences, Moscow 125315, Russia
| | - Andrey V Grechko
- Federal Scientific Clinical Center for Resuscitation and Rehabilitation, Moscow 109240, Russia
| | - Veronika A Myasoedova
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Sciences, Moscow 125315, Russia
| | - Alexander N Orekhov
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Sciences, Moscow 125315, Russia; Institute for Atherosclerosis Research, Skolkovo Innovative Center, Moscow 121609, Russia.
| |
Collapse
|
14
|
Abstract
The importance of inflammation and inflammatory pathways in atherosclerotic disease and acute coronary syndromes (ACS) is well established. The success of statin therapy rests not only on potently reducing levels of low-density lipoprotein cholesterol, but also on the many beneficial, pleiotropic effects statin therapy has on various inflammatory mechanisms in atherosclerotic disease, from reducing endothelial dysfunction to attenuating levels of serum C-reactive protein. Due to the growing awareness of the importance of inflammation in ACS, investigators have attempted to develop novel therapies against known markers of inflammation for several decades. Targeted pathways have ranged from inhibiting C5 cleavage with a high-affinity monoclonal antibody against C5 to inhibiting the activation of the p38 mitogen-activated protein kinase signaling cascades. In each of these instances, despite promising early preclinical and mechanistic studies and phase 2 trials suggesting a potential benefit in reducing post-MI complications or restenosis, these novel therapies have failed to show benefits during large, phase 3 clinical outcomes trials. This review discusses several examples of novel anti-inflammatory therapies that failed to show significant improvement on clinical outcomes when tested in large, randomized trials and highlights potential explanations for why targeted therapies against known markers of inflammation in ACS have failed to launch.
Collapse
Key Words
- ACS, acute coronary syndromes
- CABG, coronary artery bypass graft
- CAD, coronary artery disease
- HDL-C, high-density lipoprotein cholesterol
- IL, interleukin
- LDL-C, low-density lipoprotein cholesterol
- Lp-PLA2, lipoprotein-associated phospholipase A2
- MAPK, mitogen-activated protein kinase
- MI, myocardial infarction
- NSTEMI, non–ST-segment myocardial infarction
- PCI, percutaneous coronary intervention
- PSGL, P-selectin glycoprotein ligand
- STEMI, ST-segment elevation myocardial infarction
- SVG, saphenous vein grafts
- TBR, tissue-to-background ratio
- acute coronary syndrome
- anti-inflammatory
- drug targets
- hsCRP, high-sensitivity C-reactive protein
- sPLA2, secretory phospholipase A2
Collapse
|
15
|
Rosenson RS, Koenig W. Mendelian Randomization Analyses for Selection of Therapeutic Targets for Cardiovascular Disease Prevention: a Note of Circumspection. Cardiovasc Drugs Ther 2016; 30:65-74. [PMID: 26797681 DOI: 10.1007/s10557-016-6642-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Genetic factors identified from genome-wide association studies have been used to understand causative variants for complex diseases. Studies conducted on large populations of individuals from many geographical regions have provided insights into genetic pathways involved in the causal pathway for atherosclerotic cardiovascular disease. A single genetic trait may ineffectively evaluate the pathway of interest, and it may not account for other complementary genetic pathways that may be activated at various stages of the disease process or evidence-based therapies that alter the molecular and cellular milieu.
Collapse
Affiliation(s)
- Robert S Rosenson
- Cardiometabolics Unit, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY, 10029, USA.
| | - Wolfgang Koenig
- Klinik für Herz-& Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Lazarettstr. 36, 80636, Munich, Germany
| |
Collapse
|
16
|
Qu Q, Liu Y, Yan X, Fan X, Liu N, Wu G. A Novel Pentapeptide Targeting Integrin β3-Subunit Inhibits Platelet Aggregation and Its Application in Rat for Thrombosis Prevention. Front Pharmacol 2016; 7:49. [PMID: 27014063 PMCID: PMC4782163 DOI: 10.3389/fphar.2016.00049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 02/22/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Qingrong Qu
- Department and Institute of Cardiology, Zhongda Hospital, Medical School of Southeast UniversityNanjing, China
| | - Yamin Liu
- Center of Clinical Laboratory Medicine of Zhongda Hospital, Institute of Biotechnology and Clinical Pharmacy, Southeast UniversityNanjing, China
- Pharmacy Department of Zhongda Hospital, Southeast UniversityNanjing, China
| | - Xuejiao Yan
- Department and Institute of Cardiology, Zhongda Hospital, Medical School of Southeast UniversityNanjing, China
| | - Xiaobo Fan
- Center of Clinical Laboratory Medicine of Zhongda Hospital, Institute of Biotechnology and Clinical Pharmacy, Southeast UniversityNanjing, China
| | - Naifeng Liu
- Department and Institute of Cardiology, Zhongda Hospital, Medical School of Southeast UniversityNanjing, China
- Naifeng Liu
| | - Guoqiu Wu
- Center of Clinical Laboratory Medicine of Zhongda Hospital, Institute of Biotechnology and Clinical Pharmacy, Southeast UniversityNanjing, China
- *Correspondence: Guoqiu Wu
| |
Collapse
|
17
|
Therapeutic Role of Innovative Anti-Inflammatory Medications in the Prevention of Acute Coronary Syndrome. Cardiol Rev 2015; 23:252-60. [DOI: 10.1097/crd.0000000000000062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
18
|
Swerdlow DI, Hingorani AD, Humphries SE. Genetic Risk Factors and Mendelian Randomization in Cardiovascular Disease. Curr Cardiol Rep 2015; 17:33. [DOI: 10.1007/s11886-015-0584-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
19
|
Guardiola M, Exeter HJ, Perret C, Folkersen L, van’t Hooft F, Eriksson P, Franco-Cereceda A, Paulsson-Berne G, Palmen J, Li K, Cooper JA, Khaw KT, Mallat Z, Ninio E, Karabina SA, Humphries SE, Boekholdt SM, Holmes MV, Talmud PJ. PLA2G10
Gene Variants, sPLA2 Activity, and Coronary Heart Disease Risk. ACTA ACUST UNITED AC 2015; 8:356-62. [DOI: 10.1161/circgenetics.114.000633] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 12/17/2014] [Indexed: 11/16/2022]
Abstract
Background—
Observational studies report that secretory phospholipase A2 (sPLA2) activity is a marker for coronary heart disease (CHD) risk, and activity measures are thought to represent the composite activity of sPLA2-IIA, -V, and -X. The aim of this study was to use genetic variants of
PLA2G10
, encoding sPLA2-X, to investigate the contribution of sPLA2-X to the measure of sPLA2 activity and coronary heart disease (CHD) risk traits and outcome.
Methods and Results—
Three
PLA2G10
tagging single-nucleotide polymorphisms (rs72546339, rs72546340, and rs4003232) and a previously studied
PLA2G10
coding single-nucleotide polymorphism rs4003228, R38C, were genotyped in a nested case: control cohort drawn from the prospective EPIC-Norfolk Study (2175 cases and 2175 controls). Meta-analysis of rs4003228 (R38C) and CHD was performed using data from the Northwick Park Heart Study II and 2 published cohorts AtheroGene and SIPLAC, providing in total an additional 1884 cases and 3119 controls. EPIC-Norfolk subjects in the highest tertile of sPLA2 activity were older and had higher inflammatory markers compared with those in the lowest tertile for sPLA2 activity. None of the
PLA2G10
tagging single-nucleotide polymorphism nor R38C, a functional variant, were significantly associated with sPLA2 activity, intermediate CHD risk traits, or CHD risk. In meta-analysis, the summary odds ratio for R38C was odds ratio=0.97 (95% confidence interval, 0.77–1.22).
Conclusions—
PLA2G10
variants are not significantly associated with plasma sPLA2 activity or with CHD risk.
Collapse
Affiliation(s)
- Montse Guardiola
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - Holly J. Exeter
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - Claire Perret
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - Lasse Folkersen
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - Ferdinand van’t Hooft
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - Per Eriksson
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - Anders Franco-Cereceda
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - Gabrielle Paulsson-Berne
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - Jutta Palmen
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - KaWah Li
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - Jackie A. Cooper
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - Kay-Tee Khaw
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - Ziad Mallat
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - Ewa Ninio
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - Sonia-Athina Karabina
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - Steve E. Humphries
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - S. Matthijs Boekholdt
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - Michael V. Holmes
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| | - Philippa J. Talmud
- From the Center for Cardiovascular Genetics, Institute of Cardiovascular Science (M.G., H.J.E., J.P., K.W.L., J.A.C., S.E.H., P.J.T.), and Genetic Epidemiology Group, Department of Epidemiology and Public Health (M.V.H.), University College London, London, UK; Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, CIBERDEM, IISPV, Reus, Spain (M.G.); Genomics and Pathophysiology of Cardiovascular Diseases Team, ICAN, Sorbonne Universités, UPMC University Paris 06, INSERM UMR_S
| |
Collapse
|
20
|
Woudstra P, Damman P, Kuijt WJ, Kikkert WJ, Grundeken MJ, van Brussel PM, Stroobants AK, van Straalen JP, Fischer JC, Koch KT, Henriques JPS, Piek JJ, Tijssen JGP, de Winter RJ. Admission lipoprotein-associated phospholipase A2 activity is not associated with long-term clinical outcomes after ST-segment elevation myocardial infarction. PLoS One 2014; 9:e96251. [PMID: 24788873 PMCID: PMC4006846 DOI: 10.1371/journal.pone.0096251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 04/07/2014] [Indexed: 12/31/2022] Open
Abstract
Background Lipoprotein-associated phospholipase A2 (Lp-PLA2) activity is a biomarker predicting cardiovascular diseases in a real-world. However, the prognostic value in patients undergoing primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI) on long-term clinical outcomes is unknown. Methods Lp-PLA2 activity was measured in samples obtained prior to pPCI from consecutive STEMI patients in a high-volume intervention center from 2005 until 2007. Five years all-cause mortality was estimated with the Kaplan-Meier method and compared among tertiles of Lp-PLA2 activity during complete follow-up and with a landmark at 30 days. In a subpopulation clinical endpoints were assessed at three years. The prognostic value of Lp-PLA2, in addition to the Thrombolysis In Myocardial Infarction or multimarker risk score, was assessed in multivariable Cox regression. Results The cohort (n = 987) was divided into tertiles (low <144, intermediate 144–179, and high >179 nmol/min/mL). Among the tertiles differences in baseline characteristics associated with long-term mortality were observed. However, no significant differences in five years mortality in association with Lp-PLA2 activity levels were found; intermediate versus low Lp-PLA2 (HR 0.97; CI 95% 0.68–1.40; p = 0.88) or high versus low Lp-PLA2 (HR 0.75; CI 95% 0.51–1.11; p = 0.15). Both in a landmark analysis and after adjustments for the established risk scores and selection of cases with biomarkers obtained, non-significant differences among the tertiles were observed. In the subpopulation no significant differences in clinical endpoints were observed among the tertiles. Conclusion Lp-PLA2 activity levels at admission prior to pPCI in STEMI patients are not associated with the incidence of short and/or long-term clinical endpoints. Lp-PLA2 as an independent and clinically useful biomarker in the risk stratification of STEMI patients still remains to be proven.
Collapse
Affiliation(s)
- Pier Woudstra
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Peter Damman
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Wichert J. Kuijt
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Wouter J. Kikkert
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Maik J. Grundeken
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Peter M. van Brussel
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - An K. Stroobants
- Department of Clinical Chemistry, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Jan P. van Straalen
- Department of Clinical Chemistry, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Johan C. Fischer
- Department of Clinical Chemistry, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Karel T. Koch
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - José P. S. Henriques
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Jan J. Piek
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Jan G. P. Tijssen
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Robbert J. de Winter
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
- * E-mail:
| |
Collapse
|
21
|
Advances in mechanisms, imaging and management of the unstable plaque. Atherosclerosis 2014; 233:467-477. [PMID: 24530781 DOI: 10.1016/j.atherosclerosis.2014.01.036] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 01/14/2014] [Accepted: 01/15/2014] [Indexed: 01/09/2023]
Abstract
Post-mortem observations demonstrated that plaque fissure was the final event leading to coronary thrombosis and occlusion in about two-thirds of cases of sudden coronary death. Plaques prone to fissure have, therefore, been defined "vulnerable plaques" and are identified by specific anatomic features including thin inflamed fibrous cap, large lipidic core and positive remodeling. Accordingly, elegant imaging modalities have been developed in order to identify this "holy grail". However, the results of prognostic studies based on the identification of vulnerable plaques have not been encouraging because of the low positive predictive value for major cardiovascular events. This observation is not surprising as the pathogenesis of acute coronary syndromes is complex and multifactorial. In this review we propose a pathogenetic classification of acute coronary syndromes in the attempt to identify homogeneous groups of patients with a common mechanism of coronary instability which can be identified by using specific biomarkers and imaging techniques, and become a specific therapeutic target.
Collapse
|
22
|
Marini MG, Sonnino C, Previtero M, Biasucci LM. Targeting inflammation: impact on atherothrombosis. J Cardiovasc Transl Res 2013; 7:9-18. [PMID: 24327329 DOI: 10.1007/s12265-013-9523-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 11/19/2013] [Indexed: 12/17/2022]
Abstract
Atherothrombosis is a worldwide epidemic accounting for an unacceptable toll of deaths and disabilities. Its pathophysiology is complex and hardly referable to a specific mechanism; however, in the last 20 years, a growing amount of evidence has demonstrated that inflammatory processes play a major role from the very beginning to the ultimate complication of atherothrombosis. These evidences are addressing a growing interest toward anti-inflammatory agents as preventive or curative treatments of atherothrombosis. At present, accumulated data are not conclusive, but strong evidence exists in favor of an anti-inflammatory positive effect for several drugs as statins or renin-angiotensin inhibitors. More conclusive data are expected from ongoing trials directly exploring the role of specific cytokines antagonists.
Collapse
Affiliation(s)
- Maria Giulia Marini
- Institute of Cardiology, Catholic University, Largo Vito, Rome, 00168, Italy
| | | | | | | |
Collapse
|
23
|
Jabor B, Choi H, Ruel I, Hafiane A, Mourad W, Genest J. Lipoprotein-Associated Phospholipase A2 (Lp-PLA2) in Acute Coronary Syndrome: Relationship With Low-Density Lipoprotein Cholesterol. Can J Cardiol 2013; 29:1679-86. [DOI: 10.1016/j.cjca.2013.09.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 09/25/2013] [Accepted: 09/25/2013] [Indexed: 11/29/2022] Open
|
24
|
Inflammation and atherosclerosis: disease modulating therapies. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2013; 15:681-95. [PMID: 23979859 DOI: 10.1007/s11936-013-0268-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OPINION STATEMENT Advances in the mechanistic understanding of atheroma initiation, repair, progression, and rupture have solidified the pivotal role played by the immune system in the pathophysiology of atherosclerotic vascular disease. These mechanistic findings have been extended into humans, with a strong evidence basis for the independent association between elevated blood markers of inflammation and future cardiovascular (CV) events. Investigations with statins as well as more conventional anti-inflammatory medications provide indirect evidence to support the concept that modifying immune responses can improve CV outcomes; however, robust evidence to support the use of anti-inflammatory treatment strategies to manage atherosclerotic vascular disease is still lacking. Such evidence may emerge from a new wave of clinical trials directly exploring the effects of targeted immune modulation on CV risk. These trials will provide key additional insights into atherosclerosis and will help determine the fate of immune modulation as a new treatment strategy in atherosclerotic vascular disease.
Collapse
|
25
|
Holmes MV, Simon T, Exeter HJ, Folkersen L, Asselbergs FW, Guardiola M, Cooper JA, Palmen J, Hubacek JA, Carruthers KF, Horne BD, Brunisholz KD, Mega JL, van Iperen EPA, Li M, Leusink M, Trompet S, Verschuren JJW, Hovingh GK, Dehghan A, Nelson CP, Kotti S, Danchin N, Scholz M, Haase CL, Rothenbacher D, Swerdlow DI, Kuchenbaecker KB, Staines-Urias E, Goel A, van 't Hooft F, Gertow K, de Faire U, Panayiotou AG, Tremoli E, Baldassarre D, Veglia F, Holdt LM, Beutner F, Gansevoort RT, Navis GJ, Mateo Leach I, Breitling LP, Brenner H, Thiery J, Dallmeier D, Franco-Cereceda A, Boer JMA, Stephens JW, Hofker MH, Tedgui A, Hofman A, Uitterlinden AG, Adamkova V, Pitha J, Onland-Moret NC, Cramer MJ, Nathoe HM, Spiering W, Klungel OH, Kumari M, Whincup PH, Morrow DA, Braund PS, Hall AS, Olsson AG, Doevendans PA, Trip MD, Tobin MD, Hamsten A, Watkins H, Koenig W, Nicolaides AN, Teupser D, Day INM, Carlquist JF, Gaunt TR, Ford I, Sattar N, Tsimikas S, Schwartz GG, Lawlor DA, Morris RW, Sandhu MS, Poledne R, Maitland-van der Zee AH, Khaw KT, Keating BJ, van der Harst P, Price JF, Mehta SR, Yusuf S, Witteman JCM, Franco OH, Jukema JW, de Knijff P, Tybjaerg-Hansen A, Rader DJ, Farrall M, Samani NJ, Kivimaki M, Fox KAA, Humphries SE, Anderson JL, Boekholdt SM, Palmer TM, Eriksson P, Paré G, Hingorani AD, Sabatine MS, Mallat Z, Casas JP, Talmud PJ. Secretory phospholipase A(2)-IIA and cardiovascular disease: a mendelian randomization study. J Am Coll Cardiol 2013; 62:1966-1976. [PMID: 23916927 PMCID: PMC3826105 DOI: 10.1016/j.jacc.2013.06.044] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 05/22/2013] [Accepted: 06/27/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVES This study sought to investigate the role of secretory phospholipase A2 (sPLA2)-IIA in cardiovascular disease. BACKGROUND Higher circulating levels of sPLA2-IIA mass or sPLA2 enzyme activity have been associated with increased risk of cardiovascular events. However, it is not clear if this association is causal. A recent phase III clinical trial of an sPLA2 inhibitor (varespladib) was stopped prematurely for lack of efficacy. METHODS We conducted a Mendelian randomization meta-analysis of 19 general population studies (8,021 incident, 7,513 prevalent major vascular events [MVE] in 74,683 individuals) and 10 acute coronary syndrome (ACS) cohorts (2,520 recurrent MVE in 18,355 individuals) using rs11573156, a variant in PLA2G2A encoding the sPLA2-IIA isoenzyme, as an instrumental variable. RESULTS PLA2G2A rs11573156 C allele associated with lower circulating sPLA2-IIA mass (38% to 44%) and sPLA2 enzyme activity (3% to 23%) per C allele. The odds ratio (OR) for MVE per rs11573156 C allele was 1.02 (95% confidence interval [CI]: 0.98 to 1.06) in general populations and 0.96 (95% CI: 0.90 to 1.03) in ACS cohorts. In the general population studies, the OR derived from the genetic instrumental variable analysis for MVE for a 1-log unit lower sPLA2-IIA mass was 1.04 (95% CI: 0.96 to 1.13), and differed from the non-genetic observational estimate (OR: 0.69; 95% CI: 0.61 to 0.79). In the ACS cohorts, both the genetic instrumental variable and observational ORs showed a null association with MVE. Instrumental variable analysis failed to show associations between sPLA2 enzyme activity and MVE. CONCLUSIONS Reducing sPLA2-IIA mass is unlikely to be a useful therapeutic goal for preventing cardiovascular events.
Collapse
Affiliation(s)
- Michael V Holmes
- Faculty of Population Health Sciences, University College London, London, United Kingdom.
| | - Tabassome Simon
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Department of Clinical Pharmacology, URC-EST, Paris, France; Université Pierre et Marie Curie, Paris, France; INSERM, U 698, Paris, France
| | - Holly J Exeter
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Lasse Folkersen
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Durrer Center for Cardiogenetic Research, Amsterdam, the Netherlands
| | - Montse Guardiola
- Unitat de Recerca en Lípids i Arteriosclerosi, IISPV, Universitat Rovira i Virgili, CIBERDEM, Reus, Spain
| | - Jackie A Cooper
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Jutta Palmen
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Jaroslav A Hubacek
- Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Kathryn F Carruthers
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Benjamin D Horne
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, Utah; Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | | | - Jessica L Mega
- TIMI Study Group, Divison of Cardiovascular Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, Massachusetts
| | - Erik P A van Iperen
- Durrer Center for Cardiogenetic Research, Amsterdam, the Netherlands; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Mingyao Li
- Department of Biostatistics & Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Maarten Leusink
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Stella Trompet
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | | | - G Kees Hovingh
- Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Abbas Dehghan
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands; Member of the Netherlands Consortium on Healthy Aging (NCHA), Leiden, the Netherlands
| | - Christopher P Nelson
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom; Leicester NIHR Biomedical Research Unit in Cardiovascular Disease, Glenfield Hospital, Leicester, United Kingdom
| | - Salma Kotti
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Department of Clinical Pharmacology, URC-EST, Paris, France
| | - Nicolas Danchin
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Cardiology, Paris, France; Université Paris Descartes, Paris V, Paris, France
| | - Markus Scholz
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany; LIFE: Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Christiane L Haase
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Dietrich Rothenbacher
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Division of Clinical Epidemiology & Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Daniel I Swerdlow
- Faculty of Population Health Sciences, University College London, London, United Kingdom
| | - Karoline B Kuchenbaecker
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Eleonora Staines-Urias
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Anuj Goel
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom; Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom
| | - Ferdinand van 't Hooft
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Karl Gertow
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Ulf de Faire
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Andrie G Panayiotou
- Cyprus Cardiovascular Educational and Research Trust, Nicosia, Cyprus and Cyprus International Institute for Environmental and Public Health in association with the Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Elena Tremoli
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Universitá di Milano, Milan, Italy; Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Damiano Baldassarre
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Universitá di Milano, Milan, Italy; Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | | | - Lesca M Holdt
- LIFE: Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; Institute of Laboratory Medicine, University Hospital Munich (LMU), Ludwig-Maximilians-University Munich, Munich, Germany
| | - Frank Beutner
- LIFE: Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Department of Internal Medicine/Cardiology, Heart Center, University of Leipzig, Leipzig, Germany
| | - Ron T Gansevoort
- University Medical Center Groningen, University of Groningen, Department of Internal Medicine, Groningen, the Netherlands
| | - Gerjan J Navis
- University Medical Center Groningen, University of Groningen, Department of Internal Medicine, Groningen, the Netherlands
| | - Irene Mateo Leach
- University Medical Center Groningen, University of Groningen, Department of Cardiology, Groningen, the Netherlands
| | - Lutz P Breitling
- Division of Clinical Epidemiology & Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology & Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Joachim Thiery
- LIFE: Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Dhayana Dallmeier
- Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, Ulm, Germany
| | - Anders Franco-Cereceda
- Cardiothoracic Surgery Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Jolanda M A Boer
- Department for Nutrition and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Jeffrey W Stephens
- Diabetes Research Group, Institute of Life Sciences, College of Medicine, Swansea University, Swansea, Wales, United Kingdom
| | - Marten H Hofker
- Department of Pathology and Medical Biology, Medical Biology Section, Molecular Genetics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Alain Tedgui
- Inserm U970, Paris-Cardiovascular Research Center, Paris, France
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands; Member of the Netherlands Consortium on Healthy Aging (NCHA), Leiden, the Netherlands
| | - André G Uitterlinden
- Member of the Netherlands Consortium on Healthy Aging (NCHA), Leiden, the Netherlands; Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Vera Adamkova
- Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Jan Pitha
- Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - N Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Maarten J Cramer
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hendrik M Nathoe
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Wilko Spiering
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Olaf H Klungel
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Meena Kumari
- Faculty of Population Health Sciences, University College London, London, United Kingdom
| | - Peter H Whincup
- Division of Population Health Sciences and Education, St George's, University of London, London, United Kingdom
| | - David A Morrow
- TIMI Study Group, Divison of Cardiovascular Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, Massachusetts
| | - Peter S Braund
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Alistair S Hall
- Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, United Kingdom
| | - Anders G Olsson
- Stockholm Heart Center, Stockholm, and Linköping University, Linkőping, Sweden
| | - Pieter A Doevendans
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Mieke D Trip
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Martin D Tobin
- Departments of Health Sciences & Genetics, University of Leicester, Leicester, United Kingdom
| | - Anders Hamsten
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Hugh Watkins
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom; Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom
| | - Wolfgang Koenig
- Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, Ulm, Germany
| | - Andrew N Nicolaides
- Department of Vascular Surgery, Imperial College, London, United Kingdom; Cyprus Cardiovascular Educational and Research Trust, Nicosia, Cyprus
| | - Daniel Teupser
- LIFE: Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany; Institute of Laboratory Medicine, University Hospital Munich (LMU), Ludwig-Maximilians-University Munich, Munich, Germany
| | - Ian N M Day
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Department of Clinical Pharmacology, URC-EST, Paris, France
| | - John F Carlquist
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, Utah; Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Tom R Gaunt
- MRC Centre for Causal Analyses in Translational Epidemiology (CAiTE), and Bristol Genetic Epidemiology Laboratories (BGEL), School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Ian Ford
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Naveed Sattar
- British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Sotirios Tsimikas
- Division of Cardiovascular Diseases, Department of Medicine, University of California San Diego, La Jolla, California
| | - Gregory G Schwartz
- VA Medical Center and University of Colorado School of Medicine, Denver, Colorado
| | - Debbie A Lawlor
- MRC Centre for Causal Analyses in Translational Epidemiology (CAiTE), and Bristol Genetic Epidemiology Laboratories (BGEL), School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Richard W Morris
- Department of Primary Care & Population Health, University College London, Royal Free Campus, London, United Kingdom
| | - Manjinder S Sandhu
- VA Medical Center and University of Colorado School of Medicine, Denver, Colorado
| | - Rudolf Poledne
- Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Anke H Maitland-van der Zee
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Brendan J Keating
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Pim van der Harst
- University Medical Center Groningen, University of Groningen, Department of Cardiology, Groningen, the Netherlands
| | - Jackie F Price
- Centre for Population Health Sciences, University of Edinburgh, United Kingdom
| | - Shamir R Mehta
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Interventional Cardiology, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Salim Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Jaqueline C M Witteman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands; Member of the Netherlands Consortium on Healthy Aging (NCHA), Leiden, the Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands; Member of the Netherlands Consortium on Healthy Aging (NCHA), Leiden, the Netherlands
| | - J Wouter Jukema
- Durrer Center for Cardiogenetic Research, Amsterdam, the Netherlands; Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, the Netherlands
| | - Peter de Knijff
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Anne Tybjaerg-Hansen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Daniel J Rader
- Preventive Cardiovascular Medicine, Penn Heart and Vascular Center, Philadelphia, Pennsylvania
| | - Martin Farrall
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom; Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom
| | - Nilesh J Samani
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom; Leicester NIHR Biomedical Research Unit in Cardiovascular Disease, Glenfield Hospital, Leicester, United Kingdom
| | - Mika Kivimaki
- Faculty of Population Health Sciences, University College London, London, United Kingdom
| | - Keith A A Fox
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Steve E Humphries
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Jeffrey L Anderson
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, Utah; Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - S Matthijs Boekholdt
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Tom M Palmer
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Per Eriksson
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Guillaume Paré
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada; Genetic and Molecular Epidemiology Laboratory, McMaster University, Hamilton, Ontario, Canada
| | - Aroon D Hingorani
- Faculty of Population Health Sciences, University College London, London, United Kingdom; Centre for Clinical Pharmacology, Division of Medicine, University College London, London, United Kingdom
| | - Marc S Sabatine
- TIMI Study Group, Divison of Cardiovascular Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, Massachusetts
| | - Ziad Mallat
- Inserm U970, Paris-Cardiovascular Research Center, Paris, France; Division of Cardiovascular Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Juan P Casas
- Faculty of Population Health Sciences, University College London, London, United Kingdom; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
| | - Philippa J Talmud
- Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, United Kingdom
| |
Collapse
|
26
|
Antoniu SA. Discontinued drugs for pulmonary, allergy, gastrointestinal, arthritis (2012). Expert Opin Investig Drugs 2013; 22:1453-64. [PMID: 24024675 DOI: 10.1517/13543784.2013.836489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Various compounds are developed to interfere with pathogenic pathways involved in inflammation processes. Some of them are able to enter the clinical development for different diseases with a common pathogenic denominator such as, for example, rheumatoid arthritis and chronic obstructive pulmonary disease (COPD), based on the preclinical evidence, but not all these molecules prove to be efficacious while tested in different phases of clinical development. AREAS COVERED This review discusses about the drugs that were discontinued from further development for pulmonary, allergy, gastrointestinal and arthritis diseases EXPERT OPINION Most of the drugs discontinued during 2012 were compounds with anti-inflammatory activity which were mostly designed to treat arthritis/rheumatoid arthritis. Some of these molecules were also intended for COPD. Many of them failed the late phases of the clinical development.
Collapse
Affiliation(s)
- Sabina Antonela Antoniu
- University of Medicine and Pharmacy, Department of Interdisciplinarity-Palliative Care Nursing , Grigore T Popa Iasi, 16 Universitatii Str, Iasi 700115 , Romania
| |
Collapse
|
27
|
Libby P, Lichtman AH, Hansson GK. Immune effector mechanisms implicated in atherosclerosis: from mice to humans. Immunity 2013; 38:1092-104. [PMID: 23809160 DOI: 10.1016/j.immuni.2013.06.009] [Citation(s) in RCA: 481] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 06/12/2013] [Indexed: 02/06/2023]
Abstract
According to the traditional view, atherosclerosis results from a passive buildup of cholesterol in the artery wall. Yet, burgeoning evidence implicates inflammation and immune effector mechanisms in the pathogenesis of this disease. Both innate and adaptive immunity operate during atherogenesis and link many traditional risk factors to altered arterial functions. Inflammatory pathways have become targets in the quest for novel preventive and therapeutic strategies against cardiovascular disease, a growing contributor to morbidity and mortality worldwide. Here we review current experimental and clinical knowledge of the pathogenesis of atherosclerosis through an immunological lens and how host defense mechanisms essential for survival of the species actually contribute to this chronic disease but also present new opportunities for its mitigation.
Collapse
Affiliation(s)
- Peter Libby
- Brigham and Women's Hospital, Harvard Medical School, 77 Avenue Louis Pasteur, NRB7, Boston, MA 02115, USA.
| | | | | |
Collapse
|
28
|
Takahashi S, Suzuki K, Watanabe Y, Watanabe K, Fujioka D, Nakamura T, Obata JE, Kawabata K, Mishina H, Kugiyama K. Phospholipase A2 expression in coronary thrombus is increased in patients with recurrent cardiac events after acute myocardial infarction. Int J Cardiol 2013; 168:4214-21. [PMID: 23948114 DOI: 10.1016/j.ijcard.2013.07.154] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 07/10/2013] [Accepted: 07/15/2013] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Intracoronary thrombus is a source of active lipid mediators including eicosanoids that play a critical role in the pathogenesis of acute myocardial infarction (AMI). Eicosanoids are derived from arachidonic acid generated by phospholipase A(2) (PLA(2)). This study examined whether PLA(2) is expressed in the aspirated coronary thrombus and whether PLA(2) expression in the thrombus may be related to recurrence of cardiac events and development of atherosclerosis in the culprit coronary artery after AMI. METHODS Intracoronary thrombus was obtained using an aspiration catheter from 48 patients with AMI, who had successful emergent treatment with percutaneous coronary intervention (PCI). Repeated intravascular ultrasound in the culprit coronary artery was performed at emergent PCI and 6 months later in a subgroup of 20 patients. RESULTS There was a higher prevalence of cells in the thrombus that were immunopositive to group IIA, IVA, V and X PLA2s in patients with (n = 11) than without (n = 37) cardiac events during 6 months of follow-up (P < 0.05 for all). The prevalence of the cells that were immunopositive to group IIA, IVA and V PLA2s in the thrombus was significantly associated with the percent increase in atheroma volume (r = 0.60, 0.55 and 0.45, respectively, P < 0.05 for all) after 6 months in the native coronary segment distal to the culprit coronary lesion. CONCLUSION PLA(2) expression in coronary thrombus is associated with recurrence of cardiac events and development of atherosclerosis in the culprit coronary artery in AMI survivors.
Collapse
Affiliation(s)
- Soichiro Takahashi
- Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Yamanashi, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Ferreira RC, Freitag DF, Cutler AJ, Howson JMM, Rainbow DB, Smyth DJ, Kaptoge S, Clarke P, Boreham C, Coulson RM, Pekalski ML, Chen WM, Onengut-Gumuscu S, Rich SS, Butterworth AS, Malarstig A, Danesh J, Todd JA. Functional IL6R 358Ala allele impairs classical IL-6 receptor signaling and influences risk of diverse inflammatory diseases. PLoS Genet 2013; 9:e1003444. [PMID: 23593036 PMCID: PMC3617094 DOI: 10.1371/journal.pgen.1003444] [Citation(s) in RCA: 200] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 02/26/2013] [Indexed: 12/21/2022] Open
Abstract
Inflammation, which is directly regulated by interleukin-6 (IL-6) signaling, is implicated in the etiology of several chronic diseases. Although a common, non-synonymous variant in the IL-6 receptor gene (IL6R Asp358Ala; rs2228145 A>C) is associated with the risk of several common diseases, with the 358Ala allele conferring protection from coronary heart disease (CHD), rheumatoid arthritis (RA), atrial fibrillation (AF), abdominal aortic aneurysm (AAA), and increased susceptibility to asthma, the variant's effect on IL-6 signaling is not known. Here we provide evidence for the association of this non-synonymous variant with the risk of type 1 diabetes (T1D) in two independent populations and confirm that rs2228145 is the major determinant of the concentration of circulating soluble IL-6R (sIL-6R) levels (34.6% increase in sIL-6R per copy of the minor allele 358Ala; rs2228145 [C]). To further investigate the molecular mechanism of this variant, we analyzed expression of IL-6R in peripheral blood mononuclear cells (PBMCs) in 128 volunteers from the Cambridge BioResource. We demonstrate that, although 358Ala increases transcription of the soluble IL6R isoform (P = 8.3×10−22) and not the membrane-bound isoform, 358Ala reduces surface expression of IL-6R on CD4+ T cells and monocytes (up to 28% reduction per allele; P≤5.6×10−22). Importantly, reduced expression of membrane-bound IL-6R resulted in impaired IL-6 responsiveness, as measured by decreased phosphorylation of the transcription factors STAT3 and STAT1 following stimulation with IL-6 (P≤5.2×10−7). Our findings elucidate the regulation of IL-6 signaling by IL-6R, which is causally relevant to several complex diseases, identify mechanisms for new approaches to target the IL-6/IL-6R axis, and anticipate differences in treatment response to IL-6 therapies based on this common IL6R variant. Interleukin-6 (IL-6) is a complex cytokine, which plays a critical role in the regulation of inflammatory responses. Genetic variation in the IL-6 receptor gene is associated with the risk of several human diseases with an inflammatory component, including coronary heart disease, rheumatoid arthritis, and asthma. A common non-synonymous single nucleotide polymorphism in this gene (Asp358Ala) has been suggested to be the causal variant in this region by affecting the circulatory concentrations of soluble IL-6R (sIL-6R). In this study we extend the genetic association of this variant to type 1 diabetes and provide evidence that this variant exerts its functional mechanism by regulating the balance between sIL-6R (generated through cleavage of the surface receptor and by alternative splicing of a soluble IL6R isoform) and membrane-bound IL-6R. These data show for the first time that the minor allele of this non-synonymous variant (Ala358) directly controls the surface levels of IL-6R on individual immune cells and that these differences in protein levels translate into a functional impairment in IL-6R signaling. These findings may have implications for clinical trials targeting inflammatory mechanisms involving IL-6R signaling and may provide tools for identifying patients with specific benefit from therapeutic intervention in the IL-6R signaling pathway.
Collapse
Affiliation(s)
- Ricardo C. Ferreira
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
| | - Daniel F. Freitag
- Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Cambridge, United Kingdom
| | - Antony J. Cutler
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
| | - Joanna M. M. Howson
- Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Cambridge, United Kingdom
| | - Daniel B. Rainbow
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
| | - Deborah J. Smyth
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
| | - Stephen Kaptoge
- Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Cambridge, United Kingdom
| | - Pamela Clarke
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
| | - Charlotte Boreham
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
| | - Richard M. Coulson
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
| | - Marcin L. Pekalski
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
| | - Wei-Min Chen
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, United States of America
| | - Suna Onengut-Gumuscu
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, United States of America
| | - Stephen S. Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, United States of America
| | - Adam S. Butterworth
- Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Cambridge, United Kingdom
| | - Anders Malarstig
- Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Cambridge, United Kingdom
- Precision Medicine, Pfizer Global Research and Development, Cambridge, United Kingdom
| | - John Danesh
- Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Cambridge, United Kingdom
| | - John A. Todd
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
- * E-mail:
| |
Collapse
|
30
|
Ait-Oufella H, Herbin O, Lahoute C, Coatrieux C, Loyer X, Joffre J, Laurans L, Ramkhelawon B, Blanc-Brude O, Karabina S, Girard CA, Payré C, Yamamoto K, Binder CJ, Murakami M, Tedgui A, Lambeau G, Mallat Z. Group X Secreted Phospholipase A2 Limits the Development of Atherosclerosis in LDL Receptor–Null Mice. Arterioscler Thromb Vasc Biol 2013; 33:466-73. [DOI: 10.1161/atvbaha.112.300309] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
Several secreted phospholipases A2 (sPLA2s), including group IIA, III, V, and X, have been linked to the development of atherosclerosis, which led to the clinical testing of A-002 (varespladib), a broad sPLA2 inhibitor for the treatment of coronary artery disease. Group X sPLA2 (PLA2G10) has the most potent hydrolyzing activity toward phosphatidylcholine and is believed to play a proatherogenic role.
Methods and Results—
Here, we show that
Ldlr
–/–
mice reconstituted with bone marrow from mouse group X–deficient mice (
Pla2g10
–/–
) unexpectedly display a doubling of plaque size compared with
Pla2g10
+/+
chimeric mice. Macrophages of
Pla2g10
–/–
mice are more susceptible to apoptosis in vitro, which is associated with a 4-fold increase of plaque necrotic core in vivo. In addition, chimeric
Pla2g10
–/–
mice show exaggerated T lymphocyte (Th)1 immune response, associated with enhanced T-cell infiltration in atherosclerotic plaques. Interestingly, overexpression of human PLA2G10 in murine bone marrow cells leads to significant reduction of Th1 response and to 50% reduction of lesion size.
Conclusion—
PLA2G10 expression in bone marrow cells controls a proatherogenic Th1 response and limits the development of atherosclerosis. The results may provide an explanation for the recently reported inefficacy of A-002 (varespladib) to treat patients with coronary artery disease. Indeed, A-002 is a nonselective sPLA2 inhibitor that inhibits both proatherogenic (groups IIA and V) and antiatherogenic (group X) sPLA2s. Our results suggest that selective targeting of individual sPLA2 enzymes may be a better strategy to treat cardiovascular diseases.
Collapse
Affiliation(s)
- Hafid Ait-Oufella
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Olivier Herbin
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Charlotte Lahoute
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Christelle Coatrieux
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Xavier Loyer
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Jeremie Joffre
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Ludivine Laurans
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Bhama Ramkhelawon
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Olivier Blanc-Brude
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Sonia Karabina
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Christophe A. Girard
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Christine Payré
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Kei Yamamoto
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Christoph J. Binder
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Makoto Murakami
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Alain Tedgui
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Gérard Lambeau
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| | - Ziad Mallat
- From the Inserm U970, Paris Cardiovascular Research Center, Université René Descartes, Paris, France (H.A.-O., O.H., C.L., X.L., J.J., L.L., B.R., O.B.-B., A.T., Z.M.); Service de Réanimation Médicale, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, Paris, France (H.A.-O.); Institute of Molecular and Cellular Pharmacology (IPMC), UMR 7275 CNRS- and Université de Nice-Sophia Antipolis, Valbonne, France (C.C., C.A.G., C.P., G.L.); Inserm UMRS 937, Paris, France (S.K.); Lipid Metabolism
| |
Collapse
|
31
|
Korotaeva A, Samoilova E, Pavlunina T, Panasenko OM. Halogenated phospholipids regulate secretory phospholipase A2 group IIA activity. Chem Phys Lipids 2013; 167-168:51-6. [PMID: 23438648 DOI: 10.1016/j.chemphyslip.2013.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 01/14/2013] [Accepted: 02/12/2013] [Indexed: 11/28/2022]
Abstract
Secretory phospholipase A2 group IIA (sPLA2-IIA) is an active participant of inflammation. The enzyme destroys bacterial cell wall and induces production of biologically active lipid mediators. It is involved in various pathological processes and high serum content and activity of sPLA2-IIA are associated with adverse cardiovascular events. Study of sPLA2-IIA regulation is of great physiological and clinical importance and is necessary for better understanding of mechanisms underlying inflammation. Another major participant of inflammatory response is the enzyme myeloperoxidase (MPO) which is secreted by neutrophils in the focus of inflammation and catalyzes formation of HOCl and HOBr. Both halogenated (chloro- and bromohydrins) and oxidized lipids are formed due to interaction between HOCl and HOBr with unsaturated bonds of phospholipid acyl chains. Previously we showed that oxidized phospholipids stimulate sPLA2-IIA activity. In this study we examined the effects of chloro- and bromohydrins of 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) on sPLA2-IIA activity. In contrast to POPC, chloro- and bromohydrins of POPC (POPC-Cl and POPC-Br, respectively) were not hydrolyzed by sPLA2-IIA. In addition, phospholipids which are sPLA2-IIA substrates, were not cleaved by the enzyme in the presence of POPC-Cl and POPC-Br. Halogenohydrins of POPC prevented the activity of both purified and serum sPLA2-IIA. Blocking effects of POPC-Cl and POPC-Br were abolished by increased concentrations of phospholipid-substrate. These results suggest that halogenated phospholipids formed in MPO-dependent reactions can be considered as a new class of biologically active compounds potentially capable of regulating sPLA2-IIA activity in the areas of inflammation and producing the effects opposite to those of oxidized phospholipids. Control over sPLA2-IIA can be useful in the therapy of diseases involving systemic inflammation.
Collapse
|
32
|
Pathogenesis of Acute Coronary Syndromes. J Am Coll Cardiol 2013; 61:1-11. [DOI: 10.1016/j.jacc.2012.07.064] [Citation(s) in RCA: 169] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 07/05/2012] [Accepted: 07/10/2012] [Indexed: 02/02/2023]
|
33
|
Abstract
PURPOSE OF REVIEW Inflammation has been widely acknowledged to contribute throughout all stages of atherogenesis. However, these recent advances in our understanding have not been translated into clinical practice in which the mainstay of treatment is still lipid-targeted therapy. This review provides an overview of promising anti-inflammatory therapies in atherosclerosis, and discusses potential drawbacks and clinical benefits. RECENT FINDINGS Immunosuppressive drugs are likely to beneficially affect atherogenesis. Several novel anti-inflammatory targets have been scrutinized, of which some have reached clinical development stage, such as cytokine targets interleukin-1 and interleukin-6, CCR2 antagonist, selective phospholipase, and leukotriene inhibitors. Novel imaging modalities such as MRI and PET-computed tomography provide valuable surrogate inflammatory endpoints for risk stratification and testing anti-inflammatory agents in cardiovascular randomized trials. SUMMARY Anti-inflammatory therapies hold great promise in cardiovascular prevention regimens; however, atherosclerosis is a chronic disease, and systemic long-term use of anti-inflammatory agents carries the risk of complications arising from immunosuppression. In order to successfully add immunosuppressive drugs to our routine armament, we need to identify high-risk patients who benefit from anti-inflammatory treatment, increase our insight into the inflammatory pathogenesis of atherogenesis, and find safe and effective compounds capable of directly suppressing plaque inflammation.
Collapse
|
34
|
|
35
|
Affiliation(s)
- S Matthijs Boekholdt
- Department of Cardiology, Academic Medical Center, 1105AZ Amsterdam, Netherlands.
| | | |
Collapse
|