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Schiano C, Benincasa G, Franzese M, Della Mura N, Pane K, Salvatore M, Napoli C. Epigenetic-sensitive pathways in personalized therapy of major cardiovascular diseases. Pharmacol Ther 2020; 210:107514. [PMID: 32105674 DOI: 10.1016/j.pharmthera.2020.107514] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The complex pathobiology underlying cardiovascular diseases (CVDs) has yet to be explained. Aberrant epigenetic changes may result from alterations in enzymatic activities, which are responsible for putting in and/or out the covalent groups, altering the epigenome and then modulating gene expression. The identification of novel individual epigenetic-sensitive trajectories at single cell level might provide additional opportunities to establish predictive, diagnostic and prognostic biomarkers as well as drug targets in CVDs. To date, most of studies investigated DNA methylation mechanism and miRNA regulation as epigenetics marks. During atherogenesis, big epigenetic changes in DNA methylation and different ncRNAs, such as miR-93, miR-340, miR-433, miR-765, CHROME, were identified into endothelial cells, smooth muscle cells, and macrophages. During man development, lipid metabolism, inflammation and homocysteine homeostasis, alter vascular transcriptional mechanism of fundamental genes such as ABCA1, SREBP2, NOS, HIF1. At histone level, increased HDAC9 was associated with matrix metalloproteinase 1 (MMP1) and MMP2 expression in pro-inflammatory macrophages of human carotid plaque other than to have a positive effect on toll like receptor signaling and innate immunity. HDAC9 deficiency promoted inflammation resolution and reverse cholesterol transport, which might block atherosclerosis progression and promote lesion regression. Here, we describe main human epigenetic mechanisms involved in atherosclerosis, coronary heart disease, ischemic stroke, peripheral artery disease; cardiomyopathy and heart failure. Different epigenetics mechanisms are activated, such as regulation by circular RNAs, as MICRA, and epitranscriptomics at RNA level. Moreover, in order to open new frontiers for precision medicine and personalized therapy, we offer a panoramic view on the most innovative bioinformatic tools designed to identify putative genes and molecular networks underlying CVDs in man.
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Affiliation(s)
- Concetta Schiano
- Clinical Department of Internal Medicine and Specialistics, Department of Advanced Clinical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Giuditta Benincasa
- Clinical Department of Internal Medicine and Specialistics, Department of Advanced Clinical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | | | | | | | - Claudio Napoli
- Clinical Department of Internal Medicine and Specialistics, Department of Advanced Clinical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy; IRCCS SDN, Naples, Italy
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Scognamiglio M, Costa D, Sorriento A, Napoli C. Current Drugs and Nutraceuticals for the Treatment of Patients with Dyslipidemias. Curr Pharm Des 2019; 25:85-95. [DOI: 10.2174/1381612825666190130101108] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/20/2019] [Indexed: 02/05/2023]
Abstract
Coronary heart disease (CHD) remains the leading cause of disability and death in industrialized Countries.
Among many conditions, which contribute to the etiology and progression of CHD, the presence of high
low density lipoprotein-cholesterol (LDL-C) levels represents the major risk factor. Therefore, the reduction of
LDL-C levels plays a key role in the management of patients with high or very high cardiovascular risk. Although
statins represent the gold standard therapy for the reduction of cholesterol levels, these drugs do not allow to
achieve target levels of LDL-C in all patients. Indeed, a significant number of patients resulted intolerants, especially
when the dosage increased. The availability of new lipid-lowering drugs, such as ezetimibe and PCSK9
inhibitors, may represent an important alternative or complement to the conventional lipid-lowering therapies.
However, long-term studies are still needed to define both efficacy and safety of use of these latter new drugs.
Some nutraceuticals may become an adequate and effective support in the management of some patients. To date,
several nutraceuticals with different mechanism of actions that provide a good tolerability are available as lipidlowering
agents. In particular, the most investigated are red yeast rice, phytosterols, berberine, beta-glucans and
soy. The aim of this review was to report recent data on the efficacy and safety of principle hypocholesterolemic
drugs available and to evaluate the possible role of some nutraceuticals as support therapy in the management of
patients with dyslipidemias.
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Affiliation(s)
- Michele Scognamiglio
- U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine and Transplant Immunology, Clinical Department of Internal Medicine and Specialistics, Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, University of Campania , Italy
| | - Dario Costa
- U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine and Transplant Immunology, Clinical Department of Internal Medicine and Specialistics, Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, University of Campania , Italy
| | - Antonio Sorriento
- U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine and Transplant Immunology, Clinical Department of Internal Medicine and Specialistics, Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, University of Campania , Italy
| | - Claudio Napoli
- U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine and Transplant Immunology, Clinical Department of Internal Medicine and Specialistics, Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, University of Campania , Italy
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Sommese L, Benincasa G, Lanza M, Sorriento A, Schiano C, Lucchese R, Alfano R, Nicoletti GF, Napoli C. Novel epigenetic-sensitive clinical challenges both in type 1 and type 2 diabetes. J Diabetes Complications 2018; 32:1076-1084. [PMID: 30190170 DOI: 10.1016/j.jdiacomp.2018.08.012] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 07/26/2018] [Accepted: 08/15/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Epigenetics modulated tissue-specific gene expression during the onset of type 1 and type 2 diabetes and their complications. METHODS We searched the PubMed recent studies about the main epigenetic tags involved in type 1 and type 2 diabetes onset and their clinical complications. PubMed studies about the epigenetic tags involved in type 1 and 2 diabetes onset was searched. RESULTS The epigenetic methylation maps of cord blood samples highlighted differences in the methylation status of CpG sites within the MHC genes between carriers of diabetes type 1 DR3-DQ2 and DR4-DQ8 risk haplotypes. β cell-derived unmethylated INS DNA showed the decline of β-cell mass preserving insulin secretion. Differentially methylated regions in pancreatic islets from type 2 diabetes covered PDX1, TCF7L2, and ADCY5 promoters during islet dysfunction. The recruitment of SET7 and SUV39H1 histone methyltransferases and LSD-1 lysine-specific demethylase-1 at NF-kβ-p65 promoter in vascular cells was involved in coronary heart disease. Neutrophil extracellular trap, activated by protein arginine deiminase-4, impaired wound healing from diabetic foot ulcers. MiR-199a-3p over-expression induced coagulative cascade, swelling and pain by a down-regulation of SERPIN-E2 in diabetic peripheral neuropathy. A DNA hypo-methylation and histone hyper-acetylation at MIOX promoter led an overexpression of ROS, fibronectin, HIF-1α, and NOX-4 associated with diabetic tubulopathy. A hypo-methylation of H3K4 at SOD2 promoter by LSD-1 increased ROS causing diabetic retinopathy. CONCLUSIONS Epigenetics played a relevant role in prevention, diagnosis, and treatment of diabetes.
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MESH Headings
- Biomarkers/analysis
- DNA Methylation/physiology
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/diagnosis
- Diabetes Mellitus, Type 1/genetics
- Diabetes Mellitus, Type 1/therapy
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/diagnosis
- Diabetes Mellitus, Type 2/genetics
- Diabetes Mellitus, Type 2/therapy
- Diabetic Foot/genetics
- Epigenesis, Genetic/physiology
- Genetic Predisposition to Disease
- Genome-Wide Association Study
- Humans
- Precision Medicine/methods
- Precision Medicine/trends
- Promoter Regions, Genetic/drug effects
- Promoter Regions, Genetic/genetics
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Affiliation(s)
- Linda Sommese
- U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine, Department of Experimental Medicine, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy.
| | - Giuditta Benincasa
- U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine, Department of Internal and Specialty Medicine, Azienda Ospedaliera Universitaria, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Michele Lanza
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Università della Campania Luigi Vanvitelli, Napoli, Italy
| | - Antonio Sorriento
- U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine, Department of Internal and Specialty Medicine, Azienda Ospedaliera Universitaria, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | | | - Roberta Lucchese
- U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine, Department of Internal and Specialty Medicine, Azienda Ospedaliera Universitaria, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Roberto Alfano
- Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Giovanni Francesco Nicoletti
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Università della Campania Luigi Vanvitelli, Napoli, Italy
| | - Claudio Napoli
- IRCCS SDN, Naples, Italy; Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy
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Kolovou V, Diakoumakou O, Papazafiropoulou AK, Katsiki N, Fragopoulou E, Vasiliadis I, Degiannis D, Duntas L, Antonopoulou S, Kolovou G. Biomarkers and Gene Polymorphisms in Members of Long- and Short-lived Families: A Longevity Study. Open Cardiovasc Med J 2018; 12:59-70. [PMID: 30159092 PMCID: PMC6080062 DOI: 10.2174/1874192401812010059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 06/15/2018] [Accepted: 06/18/2018] [Indexed: 01/11/2023] Open
Abstract
Background The influence of biomarkers in human lifespan has been investigated but with no clear results yet. Materials and methods Lipids, Uric Acid (UA), Adiponectin (ADIPOQ), Insulin-like Growth Factor (IGF-1), cholesteryl ester transfer protein (CETP) and angiotensin-converting enzyme (ACE) proteins, as well as CETP, ADIPOQ, insulin-like growth factor binding protein-3 (IGFBP3) and ACE-gene polymorphisms were evaluated in 149 Greek individuals. The Long-Lived Families (LON) (n=84) comprised of 3 generations: long-lived aged ≥90 years (P), offspring (FL1) and their grandchildren (FL2), while the Short-Lived Families (EAD) (n=65) where both parents died <75 years, comprised of 2 generations: middle-aged (FD1) and children (FD2). Results Serum CETP and IGF-1 levels were lower, whereas AdipoQ concentrations were higher in P compared with FL1 and FL2 members (CETP: p = 0.03 for both comparisons; IGF-1 p < 0.001 for both comparisons and ADIPOQ: p = 0.001 and p = 0.004, respectively). Furthermore, serum triglycerides, UA and glucose concentrations were higher in FD1 compared with FD2 subjects (p=0.001, 0.02 and ≤0.001, respectively). In FD2 and FL2, CETP levels were lower in individuals with B2B2 compared with B1B1 genotype (p=0.007). Additionally, ACE concentrations were higher in individuals with DD compared with II genotype in both Families (p=0.001). After adjustment for age and gender, CETP levels were lower in P and FL2 individuals with B2B2 compared with the B1B1 genotype (p=0.004 and 0.007, respectively). Conclusion Increase serum TGs, UA and GL concentrations were higher in the middle-aged individuals compared with their children in families independently of their lifespan. The serum adiponectin concentration was the highest in the oldest old individuals implying beneficial influence on lifespan. Independently of family's lifespan history, the youngest individuals with CETPB2B2 genotype, compared with individuals with CETPB1B1 genotypes, had lower serum CETP concentrations. The knowledge of the unfavourable gene(s)influencing human lifespan may be helpful in encouraging individuals to follow healthier lifestyle habits and better control their high-risk biomarkers.
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Affiliation(s)
- Vana Kolovou
- Molecular Immunology Laboratory, Onassis Cardiac Surgery Center, Athens, Greece.,Department of Science Nutrition-Dietetics, Harokopio University, Athens, Greece
| | - Olga Diakoumakou
- Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece
| | | | - Niki Katsiki
- 2 Propedeutic Department of Internal Medicine, Hippokration University Hospital, Thessaloniki, Greece
| | | | | | - Dimitris Degiannis
- Molecular Immunology Laboratory, Onassis Cardiac Surgery Center, Athens, Greece
| | - Leonidas Duntas
- Evgenideion Hospital, Unit of Endocrinology Diabetes and Metabolism, University of Athens, Athens, Greece
| | | | - Genovefa Kolovou
- Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece
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Picascia A, Grimaldi V, Iannone C, Soricelli A, Napoli C. Innate and adaptive immune response in stroke: Focus on epigenetic regulation. J Neuroimmunol 2015; 289:111-20. [PMID: 26616880 DOI: 10.1016/j.jneuroim.2015.10.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 10/17/2015] [Accepted: 10/20/2015] [Indexed: 12/12/2022]
Abstract
Inflammation and immune response play a pivotal role in the pathophysiology of ischemic stroke giving their contribution to tissue damage and repair. Emerging evidence supports the involvement of epigenetic mechanisms such as methylation, histone modification and miRNAs in the pathogenesis of stroke. Interestingly, epigenetics can influence the molecular events involved in ischemic injury by controlling the switch from pro- to anti-inflammatory response, however, this is still a field to be fully explored. The knowledge of epigenetic processes could to allow for the discovery of more sensitive and specific biomarkers for risk, onset, and progression of disease as well as further novel tools to be used in both primary prevention and therapy of stroke. Indeed, studies performed in vitro and in small animal models seem to suggest a neuroprotective role of HDAC inhibitors (e.g. valproic acid) and antagomir (e.g. anti-miR-181a) in ischemic condition by modulation of both immune and inflammatory pathways. Thus, the clinical implications of altered epigenetic mechanisms for the prevention of stroke are very promising but clinical prospective studies and translational approaches are still warranted.
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Affiliation(s)
- Antonietta Picascia
- U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Department of Internal Medicine and Specialistics, Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Naples, Italy
| | - Vincenzo Grimaldi
- U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Department of Internal Medicine and Specialistics, Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Naples, Italy.
| | - Carmela Iannone
- U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Department of Internal Medicine and Specialistics, Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Naples, Italy
| | - Andrea Soricelli
- IRCCS Research Institute SDN, Naples, Italy; Department of Studies of Institutions and Territorial Systems, University of Naples Parthenope, Naples, Italy
| | - Claudio Napoli
- U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Department of Internal Medicine and Specialistics, Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Naples, Italy; IRCCS Research Institute SDN, Naples, Italy
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Abstract
Cardiovascular disease continues to be the leading cause of global morbidity and mortality. Traditional risk factors account for only part of the attributable risk. The origins of atherosclerosis are in early life, a potential albeit largely unrecognized window of opportunity for early detection and treatment of subclinical cardiovascular disease. There are robust epidemiological data indicating that poor intrauterine growth and/or prematurity, and perinatal factors such as maternal hypercholesterolaemia, smoking, diabetes and obesity, are associated with adverse cardiovascular intermediate phenotypes in childhood and adulthood. Many of these early-life risk factors result in a heightened inflammatory state. Inflammation is a central mechanism in the development of atherosclerosis and cardiovascular disease, but few studies have investigated the role of overt perinatal infection and inflammation (chorioamnionitis) as a potential contributor to cardiovascular risk. Limited evidence from human and experimental models suggests an association between chorioamnionitis and cardiac and vascular dysfunction. Early life inflammatory events may be an important mechanism in the early development of cardiovascular risk and may provide insights into the associations between perinatal factors and adult cardiovascular disease. This review aims to summarise current data on the early life origins of atherosclerosis and cardiovascular disease, with particular focus on perinatal inflammation.
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Grimaldi V, Vietri MT, Schiano C, Picascia A, De Pascale MR, Fiorito C, Casamassimi A, Napoli C. Epigenetic reprogramming in atherosclerosis. Curr Atheroscler Rep 2015; 17:476. [PMID: 25433555 DOI: 10.1007/s11883-014-0476-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Recent data support the involvement of epigenetic alterations in the pathogenesis of atherosclerosis. The most widely investigated epigenetic mechanism is DNA methylation although also histone code changes occur during the diverse steps of atherosclerosis, such as endothelial cell proliferation, vascular smooth muscle cell (SMC) differentiation, and inflammatory pathway activation. In this review, we focus on the main genes that are epigenetically modified during the atherogenic process, particularly nitric oxide synthase (NOS), estrogen receptors (ERs), collagen type XV alpha 1 (COL15A1), vascular endothelial growth factor receptor (VEGFR), and ten-eleven translocation (TET), which are involved in endothelial dysfunction; gamma interferon (IFN-γ), forkhead box p3 (FOXP3), and tumor necrosis factor-α (TNF-α), associated with atherosclerotic inflammatory process; and p66shc, lectin-like oxLDL receptor (LOX1), and apolipoprotein E (APOE) genes, which are regulated by high cholesterol and homocysteine (Hcy) levels. Furthermore, we also discuss the role of non-coding RNAs (ncRNA) in atherosclerosis. NcRNAs are involved in epigenetic regulation of endothelial function, SMC proliferation, cholesterol synthesis, lipid metabolism, and inflammatory response.
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Affiliation(s)
- Vincenzo Grimaldi
- U.O.C. Immunohematology, Transfusion Medicine and Transplant Immunology [SIMT], Regional Reference Laboratory of Transplant Immunology [LIT], Azienda Universitaria Policlinico (AOU), Second University of Naples (SUN), Piazza L. Miraglia 2, 80138, Naples, Italy,
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Guo CF, Li JY. A combination of Tween 80 with CaCl2 enhances the hypocholesterolemic activity of bile salt hydrolase-active Lactobacillus casei F0422 in rats fed a cholesterol-rich diet. J Funct Foods 2014. [DOI: 10.1016/j.jff.2014.04.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Zabuga OG, Akhaladze NG, Vaiserman AM. Nutritional programming: Theoretical concepts and experimental evidence. ADVANCES IN GERONTOLOGY 2014. [DOI: 10.1134/s2079057014010159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kelishadi R, Poursafa P. A review on the genetic, environmental, and lifestyle aspects of the early-life origins of cardiovascular disease. Curr Probl Pediatr Adolesc Health Care 2014; 44:54-72. [PMID: 24607261 DOI: 10.1016/j.cppeds.2013.12.005] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 12/04/2013] [Indexed: 12/29/2022]
Abstract
This article is a comprehensive review on developmental origins of health and disease regarding various factors related to the origins of cardiovascular diseases from early life. It presents a summary of the impacts of various factors such as epigenetics; gene-environment interaction; ethnic predisposition to cardiovascular diseases and their underlying risk factors; prenatal factors; fetal programming; maternal weight status and weight gain during pregnancy; type of feeding during infancy; growth pattern during childhood; obesity; stunting; socioeconomic status; dietary and physical activity habits; active, secondhand, and thirdhand smoking, as well as environmental factors including air pollution and global climate change on the development and progress of cardiovascular diseases and their risk factors. The importance of early identification of predisposing factors for cardiovascular diseases for primordial and primary prevention of cardiovascular diseases from early life is highlighted.
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Affiliation(s)
- Roya Kelishadi
- Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parinaz Poursafa
- Environment Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Isordia-Salas I, Galván-Plata ME, Leaños-Miranda A, Aguilar-Sosa E, Anaya-Gómez F, Majluf-Cruz A, Santiago-Germán D. Proinflammatory and prothrombotic state in subjects with different glucose tolerance status before cardiovascular disease. J Diabetes Res 2014; 2014:631902. [PMID: 24772446 PMCID: PMC3977085 DOI: 10.1155/2014/631902] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 01/22/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Inflammation has been associated with insulin resistance, type 2 diabetes mellitus (T2DM), and atherothrombosis. AIM To determine differences in levels of proinflammatory and prothrombotic markers such as high sensitivity C-reactive protein (hs-CRP) and fibrinogen in subjects with normal glucose tolerance (NGT), prediabetes, and T2DM and to establish their relationship with other cardiovascular risk factors before clinical manifestations of cardiovascular disease. METHODS We conducted a nonrandomized, cross-sectional assay in a hospital at México City. The levels of hs-CRP and fibrinogen were measured and compared according to glucose tolerance status. RESULTS We enrolled 1047 individuals and they were distributed into NGT n = 473, pre-DM n = 250, and T2DM n = 216. There was a statistical difference between NGT and T2DM groups for fibrinogen (P = 0.01) and hs-CRP (P = 0.05). Fibrinogen and hs-CRP showed a significant positive correlation coefficient (r = 0.53, P<0.0001). In a multiple stepwise regression analysis, the variability in fibrinogen levels was explained by age, HbA1c, and hs-CRP (adjusted R² = 0.31, P<0.0001), and for hs-CRP it was explained by BMI and fibrinogen (adjusted R² = 0.33, P<0.0001). CONCLUSION Inflammation and prothrombotic state are present in people with T2DM lacking cardiovascular disease. Fibrinogen and Hs-CRP are positively correlated. Fibrinogen and hs-CRP concentrations are predominantly determined by BMI rather than glucose levels.
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Affiliation(s)
- Irma Isordia-Salas
- Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, H.G.R. No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro” Instituto Mexicano del Seguro Social, Apartado Postal B 32, Coahuila No. 5, 06703 México, DF, Mexico
- *Irma Isordia-Salas:
| | - María Eugenia Galván-Plata
- Servicio de Medicina Interna, UMAE, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, 06720 México, DF, Mexico
| | - Alfredo Leaños-Miranda
- Unidad de Investigación Médica en Medicina Reproductiva, UMAE H.G.O. No. 4, Instituto Mexicano del Seguro Social, 01070 México, DF, Mexico
| | - Eberth Aguilar-Sosa
- Servicio de Medicina Interna, H.G.Z. A 2 “Francisco del Paso y Troncoso”, del Instituto Mexicano del Seguro Social, 08400 México, DF, Mexico
| | - Francisco Anaya-Gómez
- Servicio de Medicina Interna, H.G.R. No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro” Instituto Mexicano del Seguro Social, 03100 México, DF, Mexico
| | - Abraham Majluf-Cruz
- Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, H.G.R. No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro” Instituto Mexicano del Seguro Social, Apartado Postal B 32, Coahuila No. 5, 06703 México, DF, Mexico
| | - David Santiago-Germán
- Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, H.G.R. No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro” Instituto Mexicano del Seguro Social, Apartado Postal B 32, Coahuila No. 5, 06703 México, DF, Mexico
- Servicio de Urgencias, H.G.R. No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro” Instituto Mexicano del Seguro Social, 03100 México, DF, Mexico
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Bibliography. Hyperlipidaemia and cardiovascular disease. Current world literature. Curr Opin Lipidol 2012; 23:386-91. [PMID: 22801387 DOI: 10.1097/mol.0b013e32835670af] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Napoli C, Crudele V, Soricelli A, Al-Omran M, Vitale N, Infante T, Mancini FP. Primary prevention of atherosclerosis: a clinical challenge for the reversal of epigenetic mechanisms? Circulation 2012; 125:2363-73. [PMID: 22586291 DOI: 10.1161/circulationaha.111.085787] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Claudio Napoli
- Department of General Pathology, Excellence Research Centre on Cardiovascular Diseases, 1st School of Medicine, Second University of Naples, Naples, Italy.
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Napoli C, Casamassimi A, Crudele V, Infante T, Abbondanza C. Kidney and heart interactions during cardiorenal syndrome: a molecular and clinical pathogenic framework. Future Cardiol 2012; 7:485-97. [PMID: 21797745 DOI: 10.2217/fca.11.24] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The heart and kidney are physiologically interconnected. Cardiorenal syndrome (CRS) is a pathological disorder where acute or chronic dysfunction in one organ may induce dysfunction in the other one. Although classical studies have proposed a role for hypertension, dyslipidemia and endothelial dysfunction, CRS should be considered as a complex molecular interplay of neurohumoral pathway activation including the sympathetic nervous system, the renin angiotensin aldosterone axis, the endothelin system and the arginine vasopressin system. This activation may induce vascular inflammation, oxidative stress, accelerated atherosclerosis, cardiac hypertrophy and both myocardial and intrarenal fibrosis with progression of CRS treatment. More recently, epigenetics has opened new pathogenic molecular routes for CRS. This will lead to a more rapid development of novel, safe and effective clinical therapies.
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Affiliation(s)
- Claudio Napoli
- Dipartimento di Patologia Generale, Centro di Eccellenza sulle Malattie Cardiovascolari, Facoltà di Medicina e Chirurgia, Seconda Università di Napoli, Via Costantinopoli 16, 80138 Napoli, Italy.
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Napoli C, Infante T, Casamassimi A. Maternal-foetal epigenetic interactions in the beginning of cardiovascular damage. Cardiovasc Res 2011; 92:367-74. [PMID: 21764886 DOI: 10.1093/cvr/cvr201] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Several studies indicate that impaired foetal growth, and in utero exposure to risk factors, especially maternal hypercholesterolaemia, may be relevant for the early onset of cardiovascular damage. The exact molecular mechanisms of such foetal programming are still unclear. Epigenetics may represent one of the possible scientific explanations of the impact of such intrauterine risk factors for the subsequent development of cardiovascular disease (CVD) during adulthood. Translational studies support this hypothesis; however, a direct causality in humans has not been ascertained. This hypothesis could be investigated in primates and in human post-mortem foetal arteries. Importantly, some studies also suggest the transgenerational transmission of epigenetic risk. The recently launched International Human Epigenome Consortium and the NIH Roadmap Epigenomics Mapping Consortium will provide the rationale for a useful clinical scenario for primary prevention and therapy of CVD. Despite the heritable nature of epigenetic modification, the clinically relevant information shows that it could be reversible through therapeutic approaches, including histone deacetylase inhibitors, histone acetyltransferase inhibitors, and commonly used drugs such as statins.
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Affiliation(s)
- Claudio Napoli
- Department of General Pathology, Division of Clinical Pathology and Excellence Research Centre on Cardiovascular Disease, U.O.C. Division of Immunohematology and Transplantation-CRT, 1st School of Medicine, Complesso S. Andrea delle Dame, Second University of Naples, 80138 Naples, Italy.
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