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Areleogbe SE, Peter MU, Oniyide AA, Akintayo CO, Fafure AA, Oyeleke MB, Ajadi IO, Amusa OA, Ayodeji A, Olaniyi KS. Blockade of mineralocorticoid receptor by low-dose spironolactone rescues hypothalamic-ovarian dysfunction in PCOS experimental rat model. ENDOCRINE AND METABOLIC SCIENCE 2022. [DOI: 10.1016/j.endmts.2022.100123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Bioletto F, Bollati M, Lopez C, Arata S, Procopio M, Ponzetto F, Ghigo E, Maccario M, Parasiliti-Caprino M. Primary Aldosteronism and Resistant Hypertension: A Pathophysiological Insight. Int J Mol Sci 2022; 23:ijms23094803. [PMID: 35563192 PMCID: PMC9100181 DOI: 10.3390/ijms23094803] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/19/2022] [Accepted: 04/25/2022] [Indexed: 12/10/2022] Open
Abstract
Primary aldosteronism (PA) is a pathological condition characterized by an excessive aldosterone secretion; once thought to be rare, PA is now recognized as the most common cause of secondary hypertension. Its prevalence increases with the severity of hypertension, reaching up to 29.1% in patients with resistant hypertension (RH). Both PA and RH are "high-risk phenotypes", associated with increased cardiovascular morbidity and mortality compared to non-PA and non-RH patients. Aldosterone excess, as occurs in PA, can contribute to the development of a RH phenotype through several mechanisms. First, inappropriate aldosterone levels with respect to the hydro-electrolytic status of the individual can cause salt retention and volume expansion by inducing sodium and water reabsorption in the kidney. Moreover, a growing body of evidence has highlighted the detrimental consequences of "non-classical" effects of aldosterone in several target tissues. Aldosterone-induced vascular remodeling, sympathetic overactivity, insulin resistance, and adipose tissue dysfunction can further contribute to the worsening of arterial hypertension and to the development of drug-resistance. In addition, the pro-oxidative, pro-fibrotic, and pro-inflammatory effects of aldosterone may aggravate end-organ damage, thereby perpetuating a vicious cycle that eventually leads to a more severe hypertensive phenotype. Finally, neither the pathophysiological mechanisms mediating aldosterone-driven blood pressure rise, nor those mediating aldosterone-driven end-organ damage, are specifically blocked by standard first-line anti-hypertensive drugs, which might further account for the drug-resistant phenotype that frequently characterizes PA patients.
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Kidney Damage Caused by Obesity and Its Feasible Treatment Drugs. Int J Mol Sci 2022; 23:ijms23020747. [PMID: 35054932 PMCID: PMC8775419 DOI: 10.3390/ijms23020747] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/05/2022] [Accepted: 01/08/2022] [Indexed: 02/07/2023] Open
Abstract
The rapid growth of obesity worldwide has made it a major health problem, while the dramatic increase in the prevalence of obesity has had a significant impact on the magnitude of chronic kidney disease (CKD), especially in developing countries. A vast amount of researchers have reported a strong relationship between obesity and chronic kidney disease, and obesity can serve as an independent risk factor for kidney disease. The histological changes of kidneys in obesity-induced renal injury include glomerular or tubular hypertrophy, focal segmental glomerulosclerosis or bulbous sclerosis. Furthermore, inflammation, renal hemodynamic changes, insulin resistance and lipid metabolism disorders are all involved in the development and progression of obesity-induced nephropathy. However, there is no targeted treatment for obesity-related kidney disease. In this review, RAS inhibitors, SGLT2 inhibitors and melatonin would be presented to treat obesity-induced kidney injury. Furthermore, we concluded that melatonin can protect the kidney damage caused by obesity by inhibiting inflammation and oxidative stress, revealing its therapeutic potential.
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Sharma I, Liao Y, Zheng X, Kanwar YS. New Pandemic: Obesity and Associated Nephropathy. Front Med (Lausanne) 2021; 8:673556. [PMID: 34268323 PMCID: PMC8275856 DOI: 10.3389/fmed.2021.673556] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/28/2021] [Indexed: 12/12/2022] Open
Abstract
Incidence of obesity related renal disorders have increased 10-folds in recent years. One of the consequences of obesity is an increased glomerular filtration rate (GFR) that leads to the enlargement of the renal glomerulus, i.e., glomerulomegaly. This heightened hyper-filtration in the setting of type 2 diabetes irreparably damages the kidney and leads to progression of end stage renal disease (ESRD). The patients suffering from type 2 diabetes have progressive proteinuria, and eventually one third of them develop chronic kidney disease (CKD) and ESRD. For ameliorating the progression of CKD, inhibitors of renin angiotensin aldosterone system (RAAS) seemed to be effective, but on a short-term basis only. Long term and stable treatment strategies like weight loss via restricted or hypo-caloric diet or bariatric surgery have yielded better promising results in terms of amelioration of proteinuria and maintenance of normal GFR. Body mass index (BMI) is considered as a traditional marker for the onset of obesity, but apparently, it is not a reliable indicator, and thus there is a need for more precise evaluation of regional fat distribution and amount of muscle mass. With respect to the pathogenesis, recent investigations have suggested perturbation in fatty acid and cholesterol metabolism as the critical mediators in ectopic renal lipid accumulation associated with inflammation, increased generation of ROS, RAAS activation and consequential tubulo-interstitial injury. This review summarizes the renewed approaches for the obesity assessment and evaluation of the pathogenesis of CKD, altered renal hemodynamics and potential therapeutic targets.
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Affiliation(s)
- Isha Sharma
- Departments of Pathology and Medicine, Northwestern University, Chicago, IL, United States
| | - Yingjun Liao
- Departments of Pathology and Medicine, Northwestern University, Chicago, IL, United States.,Department of Nephrology, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoping Zheng
- Departments of Pathology and Medicine, Northwestern University, Chicago, IL, United States.,Department of Urology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Yashpal S Kanwar
- Departments of Pathology and Medicine, Northwestern University, Chicago, IL, United States
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Hornik ES, Altman-Merino AE, Koefoed AW, Meyer KM, Stone IB, Green JA, Williams GH, Adler GK, Williams JS. A clinical trial to evaluate the effect of statin use on lowering aldosterone levels. BMC Endocr Disord 2020; 20:105. [PMID: 32664962 PMCID: PMC7362429 DOI: 10.1186/s12902-020-00587-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/07/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Statins are the first-line pharmaceutical agent in the management of hypercholesterolemia and cardiovascular (CV) risk reduction, and the most commonly prescribed class of drugs worldwide. Studies describing CV risk reduction independent of LDL-cholesterol lowering have evoked an interest in the pleiotropic mechanisms of statins' benefits. We recently demonstrated that administration of statins in animal models lowers aldosterone levels and observed an association between statin use and reduced aldosterone levels in two human cohorts, with lipophilic statins displaying a greater effect than hydrophilic statins. Therefore, we designed a randomized, placebo-controlled, double-blinded intervention study to assess whether statin treatment lowers aldosterone in a type-dependent manner in humans, with simvastatin (lipophilic) showing a greater effect than pravastatin (hydrophilic). METHODS/DESIGN One hundred five healthy participants will be recruited from the general population to enroll in a 12-week, randomized, placebo-controlled, double-blinded, 3-arm clinical trial. Ninety participants are anticipated to complete the protocol. After baseline assessment of aldosterone levels, participants will be randomized to daily simvastatin, pravastatin, or placebo. Aldosterone levels will be assessed after 2 days on study drug and again after 6 weeks and 12 weeks on study drug. Prior to each aldosterone assessment, participants will consume an isocaloric sodium and potassium-controlled run-in diet for 5 days. Assessments will occur on an inpatient research unit to control for diurnal, fasting, and posture conditions. The primary outcome will compare 12-week angiotensin II-stimulated serum aldosterone by study drug. Secondary outcomes will compare baseline and 12-week 24-h urine aldosterone by study drug. DISCUSSION Results from this rigorous study design should provide strong support that statins lower aldosterone levels in humans. These results may explain some of the beneficial effects of statins that are not attributed to the LDL-lowering effect of this important class of medications. Results would demonstrate that statin lipophilicity is an important attribute in lowering aldosterone levels. The outcomes of this program will have implications for the design of studies involving statin medications, as well as for the differential use of classes of statins. TRIAL REGISTRATION ClinicalTrials.gov; NCT02871687 ; First Posted August 18, 2016.
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Affiliation(s)
- Ezra S Hornik
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
| | - Anne E Altman-Merino
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
| | - Andrew W Koefoed
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
| | - Kayla M Meyer
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
| | - Isabella B Stone
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
| | - Jessica A Green
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
| | - Gordon H Williams
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
| | - Gail K Adler
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
| | - Jonathan S Williams
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA.
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The cytochrome 11B2 aldosterone synthase gene rs1799998 single nucleotide polymorphism determines elevated aldosterone, higher blood pressure, and reduced glomerular filtration, especially in diabetic female patients. Endocr Regul 2020; 54:217-226. [PMID: 32857720 DOI: 10.2478/enr-2020-0024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The cytochrome 11B2 aldosterone synthase gene (CYP11B2) that links to aldosterone synthase enzyme synthesis changes and blood pressure regulation is of particular interest among the renin-angiotensin-aldosterone system encoding genes. METHODS One-hundred hypertensive patients with target-organ damaging (2nd stage), moderate, high or very high cardiovascular risk were involved in the case-control study. Mean age was 59.87±8.02 years. Diabetes Mellitus type 2 (DM2) was in 28 persons. Chronic kidney disease (CKD) was diagnosed in 29 persons according to the National Kidney Foundation recommendations (2012) after glomerular filtration rate (GFR) decline <60 ml/min/1.73m2 for ≥3 months (measured by CKD-EPI equations). Aldosterone, cystatin-C, and creatinine levels were measured in serum. Control group included 48 practically healthy persons of relevant age. Gene's nucleotide polymorphism CYP11B2 (-344C/T) was examined by polymerase chain reaction. RESULTS CKD evolution in hypertensive patients followed by higher systolic and diastolic blood pressure (SBP, DBP) values increased creatinine, cystatin-C, and aldosterone serum concentrations by 28.76%, 28.41% and 29.43% (р<0.05), respectively. Polymorphic site of CYP11B2 (rs1799998) gene is associated with SBP and DBP increase (p<0.05), reduced GFR preferably calculated by CKDEPI-cystatin C (F=10.79-14.45; p<0.001) and elevated aldosterone content (F=55.84; p<0.001), creatinine and cystatin-С as well (F=4.16-5.08; p<0.05) mainly in the ТТ-genotype female carriers (p<0.001). Hypertensive women with DM2 demonstrated stronger relations of CYP11B2 gene polymorphic site with the increased aldosterone content (F=47.52; p<0.001), than women without DM2 (p<0.001) and male patients (p=0.014). CONCLUSIONS Genetic variations involving CYP11B2 might influence the kidney function, hypertension course, and severity via aldosterone secretion upregulation.
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Wang H, Tian Q, Zhang J, Liu H, Zhang X, Cao W, Zhang J, Anto EO, Li X, Wang X, Liu D, Zheng Y, Guo Z, Wu L, Song M, Wang Y, Wang W. Population-based case-control study revealed metabolomic biomarkers of suboptimal health status in Chinese population-potential utility for innovative approach by predictive, preventive, and personalized medicine. EPMA J 2020; 11:147-160. [PMID: 32549914 DOI: 10.1007/s13167-020-00200-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/06/2020] [Indexed: 12/18/2022]
Abstract
Background Suboptimal health status (SHS) is a subclinical stage of chronic diseases, and the identification of SHS provides an opportunity for the predictive, preventive, and personalized medicine (PPPM) of chronic diseases. Previous studies have reported the associations between metabolic signatures and early signs of chronic diseases. Methods This study aimed to detect the metabolic biomarkers for the identification of SHS in a case-control study. SHS questionnaire-25 (SHSQ-25) was used in a population-based health survey to measure the SHS levels of participants. The liquid chromatography-mass spectrometry-based untargeted metabolomics analysis was conducted on plasma samples collected from 50 SHS participants and 50 age- and sex-matched healthy controls. Results After adjusting for the confounders, 24 significantly differential metabolites, such as sphingomyelin, sphingosine, sphinganine, progesterone, pregnanolone, and bilirubin, were identified as the candidate biomarkers for SHS. Pathway analysis revealed that sphingolipid metabolism, taurine metabolism, and steroid hormone biosynthesis are the disturbed metabolic pathways related to SHS. A combination of four metabolic biomarkers (sphingosine, pregnanolone, taurolithocholate sulfate, cervonyl carnitine) can distinguish SHS individuals from the controls with a sensitivity of 94.0%, a specificity of 90.0%, and an area under the receiver operating characteristic curve of 0.977. Conclusion Plasma metabolites are valuable biomarkers for SHS identification, and meanwhile, SHSQ-25 can be used as an alternative health screening tool in the population-based health survey. SHS-related metabolic disturbances could be detected at the early onset of SHS, and SHS-related metabolites could create a window opportunity for PPPM of chronic diseases.
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Affiliation(s)
- Hao Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Qiuyue Tian
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Jie Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Hongqi Liu
- Student Health Center, Weifang University, Weifang, China
| | - Xiaoyu Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Weijie Cao
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Jinxia Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Enoch Odame Anto
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Xingang Li
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Xueqing Wang
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Di Liu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Yulu Zheng
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Zheng Guo
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Lijuan Wu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Manshu Song
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Wei Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
- School of Public Health, Shandong First Medical University, Taian, China
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Jezova D, Balagova L, Chmelova M, Hlavacova N. Classical Steroids in a New Fashion: Focus on Testosterone and Aldosterone. Curr Protein Pept Sci 2020; 20:1112-1118. [PMID: 31272353 DOI: 10.2174/1389203720666190704151254] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/13/2019] [Accepted: 04/12/2019] [Indexed: 01/03/2023]
Abstract
Several endocrine glands produce steroid hormones. Thanks to the work of chemists and biochemists, the main synthetic as well as metabolic pathways of steroid hormones were included in the textbooks more than 50 years ago and the classical endocrine gland functions were identified. Later on, evidence of steroid hormone effects beyond the classical endocrine gland function has been accumulating. Testosterone was shown to participate in the stress response and may influence coping with stressors. We have shown a decrease in testosterone concentrations in saliva in children undergoing a school exam compared to values on a non-exam school day. Testosterone has been associated with different cognitive functions in both adults and children. Circulating testosterone has been linked to negative symptoms of schizophrenia. Aldosterone is acting via mineralocorticoid receptors, which are thought to be fully occupied by glucocorticoids in the brain. Until now, an action of aldosterone in the brain has not been considered at all, because the enzyme 11-beta-hydroxysteroid dehydrogenase type 2, which would enable aldosterone to bind to receptors is absent in most of the brain areas. We have brought evidence that aldosterone can act in the brain and produce anxiogenic and depressogenic effects. To facilitate the translation of animal findings into clinical research, we have developed methodology for measurement of salivary aldosterone and obtained first data on a relationship between salivary aldosterone and trait anxiety. We have shown that salivary aldosterone concentrations reflect treatment outcome in patients with major depressive disorder.
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Affiliation(s)
- Daniela Jezova
- Laboratory of Pharmacological Neuroendocrinology, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Dubravska cesta 9, 845 05, Bratislava, Slovakia
| | - Lucia Balagova
- Laboratory of Pharmacological Neuroendocrinology, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Dubravska cesta 9, 845 05, Bratislava, Slovakia
| | - Magdalena Chmelova
- Laboratory of Pharmacological Neuroendocrinology, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Dubravska cesta 9, 845 05, Bratislava, Slovakia
| | - Natasa Hlavacova
- Laboratory of Pharmacological Neuroendocrinology, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Dubravska cesta 9, 845 05, Bratislava, Slovakia
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Vecchiola A, Fuentes CA, Solar I, Lagos CF, Opazo MC, Muñoz-Durango N, Riedel CA, Owen GI, Kalergis AM, Fardella CE. Eplerenone Implantation Improved Adipose Dysfunction Averting RAAS Activation and Cell Division. Front Endocrinol (Lausanne) 2020; 11:223. [PMID: 32373073 PMCID: PMC7186315 DOI: 10.3389/fendo.2020.00223] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 03/27/2020] [Indexed: 12/25/2022] Open
Abstract
Introduction: Mineralocorticoid receptor (MR) activation within adipose tissue, triggers inflammation and metabolic syndrome development. The pharmacological blockade of MR provides beneficial effects for adipose tissue. Our study evaluates the impact of eplerenone implantation upon obesity. Experimental approach: A group of mice with implanted placebo pellets were fed using two types of diet, a normal (ND) or a high fat (HFD) diet. Additionally, a group of mice fed HFD were implanted with an eplerenone pellet. Metabolic and biochemical parameters were assessed in each animal group. Adipocyte size and lipid accumulation were investigated in the liver and adipose tissue. We evaluated the components of renin-angiotensin-aldosterone system (RAAS) locally in adipose tissue. Key results: Eplerenone reduced HFD-induced body weight gain, fasting glucose levels, fat accumulation, HFD-induced adipocyte size and liver lipid accumulation and improved glucose tolerance. In the adipose tissue, HFD significantly increased the mRNA levels of the RAAS molecules relative to the ND group. Eplerenone lowered RAAS mRNA levels, components of lipid metabolism and markers of inflammation in HFD-fed animals. Conclusion: MR antagonism with eplerenone diminishes insulin resistance that is related to obesity partly via a reduction of RAAS activation, inflammatory progression and cytokines induction. This suggests that eplerenone should be further studied as a therapeutic option for obesity and overweight.
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Affiliation(s)
- Andrea Vecchiola
- Department of Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute on Immunology and Immunotherapy IMII, Santiago, Chile
| | - Cristóbal A. Fuentes
- Department of Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Isidora Solar
- Department of Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carlos F. Lagos
- Chemical Biology and Drug Discovery Lab, Facultad de Medicina y Ciencia, Universidad San Sebastián, Santiago, Chile
| | - Maria Cecilia Opazo
- Millennium Institute on Immunology and Immunotherapy IMII, Santiago, Chile
- Laboratorio de Endocrinología-Inmunología, Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile
| | - Natalia Muñoz-Durango
- Millennium Institute on Immunology and Immunotherapy IMII, Santiago, Chile
- Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia A. Riedel
- Millennium Institute on Immunology and Immunotherapy IMII, Santiago, Chile
- Laboratorio de Endocrinología-Inmunología, Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile
| | - Gareth I. Owen
- Millennium Institute on Immunology and Immunotherapy IMII, Santiago, Chile
- Department of Physiology, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alexis M. Kalergis
- Department of Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute on Immunology and Immunotherapy IMII, Santiago, Chile
- Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carlos E. Fardella
- Department of Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute on Immunology and Immunotherapy IMII, Santiago, Chile
- Center of Translational Endocrinology (CETREN), Department of Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- *Correspondence: Carlos E. Fardella
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Abstract
Patients with diabetes mellitus have >2× the risk for developing heart failure (HF; HF with reduced ejection fraction and HF with preserved ejection fraction). Cardiovascular outcomes, hospitalization, and prognosis are worse for patients with diabetes mellitus relative to those without. Beyond the structural and functional changes that characterize diabetic cardiomyopathy, a complex underlying, and interrelated pathophysiology exists. Despite the success of many commonly used antihyperglycemic therapies to lower hyperglycemia in type 2 diabetes mellitus the high prevalence of HF persists. This, therefore, raises the possibility that additional factors beyond glycemia might contribute to the increased HF risk in diabetes mellitus. This review summarizes the state of knowledge about the impact of existing antihyperglycemic therapies on HF and discusses potential mechanisms for beneficial or deleterious effects. Second, we review currently approved pharmacological therapies for HF and review evidence that addresses their efficacy in the context of diabetes mellitus. Dysregulation of many cellular mechanisms in multiple models of diabetic cardiomyopathy and in human hearts have been described. These include oxidative stress, inflammation, endoplasmic reticulum stress, aberrant insulin signaling, accumulation of advanced glycated end-products, altered autophagy, changes in myocardial substrate metabolism and mitochondrial bioenergetics, lipotoxicity, and altered signal transduction such as GRK (g-protein receptor kinase) signaling, renin angiotensin aldosterone signaling and β-2 adrenergic receptor signaling. These pathophysiological pathways might be amenable to pharmacological therapy to reduce the risk of HF in the context of type 2 diabetes mellitus. Successful targeting of these pathways could alter the prognosis and risk of HF beyond what is currently achieved using existing antihyperglycemic and HF therapeutics.
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Affiliation(s)
- Helena C Kenny
- From the Fraternal Order of Eagles Diabetes Research Center, and Division of Endocrinology and Metabolism, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City
| | - E Dale Abel
- From the Fraternal Order of Eagles Diabetes Research Center, and Division of Endocrinology and Metabolism, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City
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Role of Mineralocorticoid Receptors in Obstructive Sleep Apnea and Metabolic Syndrome. Curr Hypertens Rep 2018; 20:23. [DOI: 10.1007/s11906-018-0819-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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12
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Abstract
The most common cause of death among adults with diabetes is cardiovascular disease (CVD). In this concise review on pathogenesis of CVD in diabetes, the 4 common conditions, atherosclerosis, microangiopathy, diabetic cardiomyopathy, and cardiac autonomic neuropathy, are explored and illustrated to be caused by interrelated pathogenetic factors. Each of these diagnoses can present alone or, commonly, along with others due to overlapping pathophysiology. Although the spectrum of physiologic abnormalities that characterize the diabetes milieu is broad and go beyond hyperglycemia, the authors highlight the most relevant evidence supporting the current knowledge of potent factors that contribute to CVD in diabetes.
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Affiliation(s)
- Andrea V Haas
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Marie E McDonnell
- Diabetes Section, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Room 381, Boston, MA 02115, USA.
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13
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Ghnenis AB, Odhiambo JF, McCormick RJ, Nathanielsz PW, Ford SP. Maternal obesity in the ewe increases cardiac ventricular expression of glucocorticoid receptors, proinflammatory cytokines and fibrosis in adult male offspring. PLoS One 2017; 12:e0189977. [PMID: 29267325 PMCID: PMC5739430 DOI: 10.1371/journal.pone.0189977] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 11/03/2017] [Indexed: 12/14/2022] Open
Abstract
Obesity during human pregnancy predisposes offspring to obesity and cardiovascular disease in postnatal life. In a sheep model of maternal overnutrition/obesity we have previously reported myocardial inflammation and fibrosis, as well as cardiac dysfunction in late term fetuses, in association with chronically elevated blood cortisol. Significant research has suggested a link between elevated glucocorticoid exposure in utero and hypertension and cardiovascular disease postnatally. Here we examined the effects of maternal obesity on myocardial inflammation and fibrosis of their adult offspring. Adult male offspring from control (CON) mothers fed 100% of National Research Council (NRC) recommendations (n = 6) and male offspring from obese mothers (MO) fed 150% NRC (n = 6), were put on a 12-week ad libitum feeding challenge then necropsied. At necropsy, plasma cortisol and left and right ventricular thickness were markedly increased (P<0.05) in adult male MO offspring. Myocardial collagen content and collagen-crosslinking were greater (P<0.05) in MO offspring compared to CON offspring in association with increased mRNA and protein expression of glucocorticoid receptors (GR). No group difference was found in myocardial mineralocorticoids receptor (MR) protein expression. Further, mRNA expression for the proinflammatory cytokines: cluster of differentiation (CD)-68, transforming growth factor (TGF)-β1, and tumor necrosis factor (TNF)-α were increased (P < 0.05), and protein expression of CD-68, TGF-β1, and TNF-α tended to increase (P<0.10) in MO vs. CON offspring. These data provide evidence for MO-induced programming of elevated plasma cortisol and myocardial inflammation and fibrosis in adult offspring potentially through increased GR.
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Affiliation(s)
- Adel B. Ghnenis
- Center for the Study of Fetal Programming, Department of Animal Science, University of Wyoming, Laramie, WY, United States of America
| | - John F. Odhiambo
- Center for the Study of Fetal Programming, Department of Animal Science, University of Wyoming, Laramie, WY, United States of America
| | - Richard J. McCormick
- Center for the Study of Fetal Programming, Department of Animal Science, University of Wyoming, Laramie, WY, United States of America
| | - Peter W. Nathanielsz
- Center for the Study of Fetal Programming, Department of Animal Science, University of Wyoming, Laramie, WY, United States of America
| | - Stephen P. Ford
- Center for the Study of Fetal Programming, Department of Animal Science, University of Wyoming, Laramie, WY, United States of America
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14
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Tamargo M, Tamargo J. Future drug discovery in renin-angiotensin-aldosterone system intervention. Expert Opin Drug Discov 2017; 12:827-848. [PMID: 28541811 DOI: 10.1080/17460441.2017.1335301] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Renin-angiotensin-aldosterone system inhibitors (RAASIs), including angiotensin-converting enzyme inhibitors, angiotensin AT1 receptor blockers and mineralocorticoid receptor antagonists (MRAs), are the cornerstone for the treatment of cardiovascular and renal diseases. Areas covered: The authors searched MEDLINE, PubMed and ClinicalTrials.gov to identify eligible full-text English language papers. Herein, the authors discuss AT2-receptor agonists and ACE2/angiotensin-(1-7)/Mas-receptor axis modulators, direct renin inhibitors, brain aminopeptidase A inhibitors, biased AT1R blockers, chymase inhibitors, multitargeted drugs, vaccines and aldosterone receptor antagonists as well as aldosterone synthase inhibitors. Expert opinion: Preclinical studies have demonstrated that activation of the protective axis of the RAAS represents a novel therapeutic strategy for treating cardiovascular and renal diseases, but there are no clinical trials supporting our expectations. Non-steroidal MRAs might become the third-generation of MRAs for the treatment of heart failure, diabetes mellitus and chronic kidney disease. The main challenge for these new drugs is that conventional RAASIs are safe, effective and cheap generics. Thus, the future of new RAASIs will be directed by economical/strategic reasons.
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Affiliation(s)
- Maria Tamargo
- a Department of Cardiology , Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV , Madrid , Spain
| | - Juan Tamargo
- b Department of Pharmacology , School of Medicine, University Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV , Madrid , Spain
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15
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Hofmann A, Brunssen C, Peitzsch M, Martin M, Mittag J, Jannasch A, Engelmann F, Brown NF, Weldon SM, Huber J, Streicher R, Deussen A, Eisenhofer G, Bornstein SR, Morawietz H. Aldosterone Synthase Inhibition Improves Glucose Tolerance in Zucker Diabetic Fatty (ZDF) Rats. Endocrinology 2016; 157:3844-3855. [PMID: 27526033 DOI: 10.1210/en.2016-1358] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Plasma aldosterone is elevated in type 2 diabetes and obesity in experimental and clinical studies and can act to inhibit both glucose-stimulated insulin secretion by the β-cell and insulin signaling. Currently mineralocorticoid receptor antagonism is the best characterized treatment to ameliorate aldosterone-mediated effects. A second alternative is inhibition of aldosterone synthase, an approach with protective effects on end-organ damage in heart or kidney in animal models. The effect of aldosterone synthase inhibition on metabolic parameters in type 2 diabetes is not known. Therefore, male Zucker diabetic fatty (ZDF) rats were treated for 11 weeks with the aldosterone synthase inhibitor FAD286, beginning at 7 weeks of age. Results were compared with the mineralocorticoid receptor antagonist eplerenone. Plasma aldosterone was abolished by FAD286 and elevated more than 9-fold by eplerenone. The area under the curve calculated from an oral glucose tolerance test (OGTT) was lower and overall insulin response during OGTT was increased by FAD286. In contrast, eplerenone elevated blood glucose levels and blunted insulin secretion during the OGTT. Fasting glucose was lowered and fasting insulin was increased by FAD286 in the prediabetic state. Glycated hemoglobin was lowered by FAD286, whereas eplerenone showed no effect. We conclude that aldosterone synthase inhibition, in contrast to mineralocorticoid receptor antagonism, has the potential for beneficial effects on metabolic parameters in type 2 diabetes.
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Affiliation(s)
- Anja Hofmann
- Division of Vascular Endothelium and Microcirculation (A.H., C.B., J.M., F.E., H.M.) and Division of Clinical Neurochemistry (M.P., G.E.), Institute of Clinical Chemistry and Laboratory Medicine, Department of Medicine III (G.E., S.R.B.), University Hospital Carl Gustav Carus Dresden, and Institute of Physiology (M.M., A.D.) and Department of Cardiac Surgery (A.J.), Herzzentrum Dresden, Medical Faculty, Technische Universität Dresden, 01307 Dresden, Germany; Department of Cardio Metabolic Diseases (N.F.B., S.M.W.), Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut 06877; Department of Cardio Metabolic Diseases (J.H., R.S.), Boehringer Ingelheim Pharma GmbH and Co KG, 88400 Biberach, Germany; and Department of Endocrinology and Diabetes (S.R.B.), Division of Diabetes and Nutritional Sciences, Rayne Institute, Faculty of Life Sciences and Medicine, Kings College London, London, SE5 9PJ, United Kingdom
| | - Coy Brunssen
- Division of Vascular Endothelium and Microcirculation (A.H., C.B., J.M., F.E., H.M.) and Division of Clinical Neurochemistry (M.P., G.E.), Institute of Clinical Chemistry and Laboratory Medicine, Department of Medicine III (G.E., S.R.B.), University Hospital Carl Gustav Carus Dresden, and Institute of Physiology (M.M., A.D.) and Department of Cardiac Surgery (A.J.), Herzzentrum Dresden, Medical Faculty, Technische Universität Dresden, 01307 Dresden, Germany; Department of Cardio Metabolic Diseases (N.F.B., S.M.W.), Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut 06877; Department of Cardio Metabolic Diseases (J.H., R.S.), Boehringer Ingelheim Pharma GmbH and Co KG, 88400 Biberach, Germany; and Department of Endocrinology and Diabetes (S.R.B.), Division of Diabetes and Nutritional Sciences, Rayne Institute, Faculty of Life Sciences and Medicine, Kings College London, London, SE5 9PJ, United Kingdom
| | - Mirko Peitzsch
- Division of Vascular Endothelium and Microcirculation (A.H., C.B., J.M., F.E., H.M.) and Division of Clinical Neurochemistry (M.P., G.E.), Institute of Clinical Chemistry and Laboratory Medicine, Department of Medicine III (G.E., S.R.B.), University Hospital Carl Gustav Carus Dresden, and Institute of Physiology (M.M., A.D.) and Department of Cardiac Surgery (A.J.), Herzzentrum Dresden, Medical Faculty, Technische Universität Dresden, 01307 Dresden, Germany; Department of Cardio Metabolic Diseases (N.F.B., S.M.W.), Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut 06877; Department of Cardio Metabolic Diseases (J.H., R.S.), Boehringer Ingelheim Pharma GmbH and Co KG, 88400 Biberach, Germany; and Department of Endocrinology and Diabetes (S.R.B.), Division of Diabetes and Nutritional Sciences, Rayne Institute, Faculty of Life Sciences and Medicine, Kings College London, London, SE5 9PJ, United Kingdom
| | - Melanie Martin
- Division of Vascular Endothelium and Microcirculation (A.H., C.B., J.M., F.E., H.M.) and Division of Clinical Neurochemistry (M.P., G.E.), Institute of Clinical Chemistry and Laboratory Medicine, Department of Medicine III (G.E., S.R.B.), University Hospital Carl Gustav Carus Dresden, and Institute of Physiology (M.M., A.D.) and Department of Cardiac Surgery (A.J.), Herzzentrum Dresden, Medical Faculty, Technische Universität Dresden, 01307 Dresden, Germany; Department of Cardio Metabolic Diseases (N.F.B., S.M.W.), Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut 06877; Department of Cardio Metabolic Diseases (J.H., R.S.), Boehringer Ingelheim Pharma GmbH and Co KG, 88400 Biberach, Germany; and Department of Endocrinology and Diabetes (S.R.B.), Division of Diabetes and Nutritional Sciences, Rayne Institute, Faculty of Life Sciences and Medicine, Kings College London, London, SE5 9PJ, United Kingdom
| | - Jennifer Mittag
- Division of Vascular Endothelium and Microcirculation (A.H., C.B., J.M., F.E., H.M.) and Division of Clinical Neurochemistry (M.P., G.E.), Institute of Clinical Chemistry and Laboratory Medicine, Department of Medicine III (G.E., S.R.B.), University Hospital Carl Gustav Carus Dresden, and Institute of Physiology (M.M., A.D.) and Department of Cardiac Surgery (A.J.), Herzzentrum Dresden, Medical Faculty, Technische Universität Dresden, 01307 Dresden, Germany; Department of Cardio Metabolic Diseases (N.F.B., S.M.W.), Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut 06877; Department of Cardio Metabolic Diseases (J.H., R.S.), Boehringer Ingelheim Pharma GmbH and Co KG, 88400 Biberach, Germany; and Department of Endocrinology and Diabetes (S.R.B.), Division of Diabetes and Nutritional Sciences, Rayne Institute, Faculty of Life Sciences and Medicine, Kings College London, London, SE5 9PJ, United Kingdom
| | - Anett Jannasch
- Division of Vascular Endothelium and Microcirculation (A.H., C.B., J.M., F.E., H.M.) and Division of Clinical Neurochemistry (M.P., G.E.), Institute of Clinical Chemistry and Laboratory Medicine, Department of Medicine III (G.E., S.R.B.), University Hospital Carl Gustav Carus Dresden, and Institute of Physiology (M.M., A.D.) and Department of Cardiac Surgery (A.J.), Herzzentrum Dresden, Medical Faculty, Technische Universität Dresden, 01307 Dresden, Germany; Department of Cardio Metabolic Diseases (N.F.B., S.M.W.), Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut 06877; Department of Cardio Metabolic Diseases (J.H., R.S.), Boehringer Ingelheim Pharma GmbH and Co KG, 88400 Biberach, Germany; and Department of Endocrinology and Diabetes (S.R.B.), Division of Diabetes and Nutritional Sciences, Rayne Institute, Faculty of Life Sciences and Medicine, Kings College London, London, SE5 9PJ, United Kingdom
| | - Felix Engelmann
- Division of Vascular Endothelium and Microcirculation (A.H., C.B., J.M., F.E., H.M.) and Division of Clinical Neurochemistry (M.P., G.E.), Institute of Clinical Chemistry and Laboratory Medicine, Department of Medicine III (G.E., S.R.B.), University Hospital Carl Gustav Carus Dresden, and Institute of Physiology (M.M., A.D.) and Department of Cardiac Surgery (A.J.), Herzzentrum Dresden, Medical Faculty, Technische Universität Dresden, 01307 Dresden, Germany; Department of Cardio Metabolic Diseases (N.F.B., S.M.W.), Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut 06877; Department of Cardio Metabolic Diseases (J.H., R.S.), Boehringer Ingelheim Pharma GmbH and Co KG, 88400 Biberach, Germany; and Department of Endocrinology and Diabetes (S.R.B.), Division of Diabetes and Nutritional Sciences, Rayne Institute, Faculty of Life Sciences and Medicine, Kings College London, London, SE5 9PJ, United Kingdom
| | - Nicholas F Brown
- Division of Vascular Endothelium and Microcirculation (A.H., C.B., J.M., F.E., H.M.) and Division of Clinical Neurochemistry (M.P., G.E.), Institute of Clinical Chemistry and Laboratory Medicine, Department of Medicine III (G.E., S.R.B.), University Hospital Carl Gustav Carus Dresden, and Institute of Physiology (M.M., A.D.) and Department of Cardiac Surgery (A.J.), Herzzentrum Dresden, Medical Faculty, Technische Universität Dresden, 01307 Dresden, Germany; Department of Cardio Metabolic Diseases (N.F.B., S.M.W.), Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut 06877; Department of Cardio Metabolic Diseases (J.H., R.S.), Boehringer Ingelheim Pharma GmbH and Co KG, 88400 Biberach, Germany; and Department of Endocrinology and Diabetes (S.R.B.), Division of Diabetes and Nutritional Sciences, Rayne Institute, Faculty of Life Sciences and Medicine, Kings College London, London, SE5 9PJ, United Kingdom
| | - Steven M Weldon
- Division of Vascular Endothelium and Microcirculation (A.H., C.B., J.M., F.E., H.M.) and Division of Clinical Neurochemistry (M.P., G.E.), Institute of Clinical Chemistry and Laboratory Medicine, Department of Medicine III (G.E., S.R.B.), University Hospital Carl Gustav Carus Dresden, and Institute of Physiology (M.M., A.D.) and Department of Cardiac Surgery (A.J.), Herzzentrum Dresden, Medical Faculty, Technische Universität Dresden, 01307 Dresden, Germany; Department of Cardio Metabolic Diseases (N.F.B., S.M.W.), Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut 06877; Department of Cardio Metabolic Diseases (J.H., R.S.), Boehringer Ingelheim Pharma GmbH and Co KG, 88400 Biberach, Germany; and Department of Endocrinology and Diabetes (S.R.B.), Division of Diabetes and Nutritional Sciences, Rayne Institute, Faculty of Life Sciences and Medicine, Kings College London, London, SE5 9PJ, United Kingdom
| | - Jochen Huber
- Division of Vascular Endothelium and Microcirculation (A.H., C.B., J.M., F.E., H.M.) and Division of Clinical Neurochemistry (M.P., G.E.), Institute of Clinical Chemistry and Laboratory Medicine, Department of Medicine III (G.E., S.R.B.), University Hospital Carl Gustav Carus Dresden, and Institute of Physiology (M.M., A.D.) and Department of Cardiac Surgery (A.J.), Herzzentrum Dresden, Medical Faculty, Technische Universität Dresden, 01307 Dresden, Germany; Department of Cardio Metabolic Diseases (N.F.B., S.M.W.), Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut 06877; Department of Cardio Metabolic Diseases (J.H., R.S.), Boehringer Ingelheim Pharma GmbH and Co KG, 88400 Biberach, Germany; and Department of Endocrinology and Diabetes (S.R.B.), Division of Diabetes and Nutritional Sciences, Rayne Institute, Faculty of Life Sciences and Medicine, Kings College London, London, SE5 9PJ, United Kingdom
| | - Rüdiger Streicher
- Division of Vascular Endothelium and Microcirculation (A.H., C.B., J.M., F.E., H.M.) and Division of Clinical Neurochemistry (M.P., G.E.), Institute of Clinical Chemistry and Laboratory Medicine, Department of Medicine III (G.E., S.R.B.), University Hospital Carl Gustav Carus Dresden, and Institute of Physiology (M.M., A.D.) and Department of Cardiac Surgery (A.J.), Herzzentrum Dresden, Medical Faculty, Technische Universität Dresden, 01307 Dresden, Germany; Department of Cardio Metabolic Diseases (N.F.B., S.M.W.), Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut 06877; Department of Cardio Metabolic Diseases (J.H., R.S.), Boehringer Ingelheim Pharma GmbH and Co KG, 88400 Biberach, Germany; and Department of Endocrinology and Diabetes (S.R.B.), Division of Diabetes and Nutritional Sciences, Rayne Institute, Faculty of Life Sciences and Medicine, Kings College London, London, SE5 9PJ, United Kingdom
| | - Andreas Deussen
- Division of Vascular Endothelium and Microcirculation (A.H., C.B., J.M., F.E., H.M.) and Division of Clinical Neurochemistry (M.P., G.E.), Institute of Clinical Chemistry and Laboratory Medicine, Department of Medicine III (G.E., S.R.B.), University Hospital Carl Gustav Carus Dresden, and Institute of Physiology (M.M., A.D.) and Department of Cardiac Surgery (A.J.), Herzzentrum Dresden, Medical Faculty, Technische Universität Dresden, 01307 Dresden, Germany; Department of Cardio Metabolic Diseases (N.F.B., S.M.W.), Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut 06877; Department of Cardio Metabolic Diseases (J.H., R.S.), Boehringer Ingelheim Pharma GmbH and Co KG, 88400 Biberach, Germany; and Department of Endocrinology and Diabetes (S.R.B.), Division of Diabetes and Nutritional Sciences, Rayne Institute, Faculty of Life Sciences and Medicine, Kings College London, London, SE5 9PJ, United Kingdom
| | - Graeme Eisenhofer
- Division of Vascular Endothelium and Microcirculation (A.H., C.B., J.M., F.E., H.M.) and Division of Clinical Neurochemistry (M.P., G.E.), Institute of Clinical Chemistry and Laboratory Medicine, Department of Medicine III (G.E., S.R.B.), University Hospital Carl Gustav Carus Dresden, and Institute of Physiology (M.M., A.D.) and Department of Cardiac Surgery (A.J.), Herzzentrum Dresden, Medical Faculty, Technische Universität Dresden, 01307 Dresden, Germany; Department of Cardio Metabolic Diseases (N.F.B., S.M.W.), Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut 06877; Department of Cardio Metabolic Diseases (J.H., R.S.), Boehringer Ingelheim Pharma GmbH and Co KG, 88400 Biberach, Germany; and Department of Endocrinology and Diabetes (S.R.B.), Division of Diabetes and Nutritional Sciences, Rayne Institute, Faculty of Life Sciences and Medicine, Kings College London, London, SE5 9PJ, United Kingdom
| | - Stefan R Bornstein
- Division of Vascular Endothelium and Microcirculation (A.H., C.B., J.M., F.E., H.M.) and Division of Clinical Neurochemistry (M.P., G.E.), Institute of Clinical Chemistry and Laboratory Medicine, Department of Medicine III (G.E., S.R.B.), University Hospital Carl Gustav Carus Dresden, and Institute of Physiology (M.M., A.D.) and Department of Cardiac Surgery (A.J.), Herzzentrum Dresden, Medical Faculty, Technische Universität Dresden, 01307 Dresden, Germany; Department of Cardio Metabolic Diseases (N.F.B., S.M.W.), Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut 06877; Department of Cardio Metabolic Diseases (J.H., R.S.), Boehringer Ingelheim Pharma GmbH and Co KG, 88400 Biberach, Germany; and Department of Endocrinology and Diabetes (S.R.B.), Division of Diabetes and Nutritional Sciences, Rayne Institute, Faculty of Life Sciences and Medicine, Kings College London, London, SE5 9PJ, United Kingdom
| | - Henning Morawietz
- Division of Vascular Endothelium and Microcirculation (A.H., C.B., J.M., F.E., H.M.) and Division of Clinical Neurochemistry (M.P., G.E.), Institute of Clinical Chemistry and Laboratory Medicine, Department of Medicine III (G.E., S.R.B.), University Hospital Carl Gustav Carus Dresden, and Institute of Physiology (M.M., A.D.) and Department of Cardiac Surgery (A.J.), Herzzentrum Dresden, Medical Faculty, Technische Universität Dresden, 01307 Dresden, Germany; Department of Cardio Metabolic Diseases (N.F.B., S.M.W.), Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut 06877; Department of Cardio Metabolic Diseases (J.H., R.S.), Boehringer Ingelheim Pharma GmbH and Co KG, 88400 Biberach, Germany; and Department of Endocrinology and Diabetes (S.R.B.), Division of Diabetes and Nutritional Sciences, Rayne Institute, Faculty of Life Sciences and Medicine, Kings College London, London, SE5 9PJ, United Kingdom
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16
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Obesity-related glomerulopathy: clinical and pathologic characteristics and pathogenesis. Nat Rev Nephrol 2016; 12:453-71. [PMID: 27263398 DOI: 10.1038/nrneph.2016.75] [Citation(s) in RCA: 423] [Impact Index Per Article: 52.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The prevalence of obesity-related glomerulopathy is increasing in parallel with the worldwide obesity epidemic. Glomerular hypertrophy and adaptive focal segmental glomerulosclerosis define the condition pathologically. The glomerulus enlarges in response to obesity-induced increases in glomerular filtration rate, renal plasma flow, filtration fraction and tubular sodium reabsorption. Normal insulin/phosphatidylinositol 3-kinase/Akt and mTOR signalling are critical for podocyte hypertrophy and adaptation. Adipokines and ectopic lipid accumulation in the kidney promote insulin resistance of podocytes and maladaptive responses to cope with the mechanical forces of renal hyperfiltration. Although most patients have stable or slowly progressive proteinuria, up to one-third develop progressive renal failure and end-stage renal disease. Renin-angiotensin-aldosterone blockade is effective in the short-term but weight loss by hypocaloric diet or bariatric surgery has induced more consistent and dramatic antiproteinuric effects and reversal of hyperfiltration. Altered fatty acid and cholesterol metabolism are increasingly recognized as key mediators of renal lipid accumulation, inflammation, oxidative stress and fibrosis. Newer therapies directed to lipid metabolism, including SREBP antagonists, PPARα agonists, FXR and TGR5 agonists, and LXR agonists, hold therapeutic promise.
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17
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Jia G, Habibi J, DeMarco VG, Martinez-Lemus LA, Ma L, Whaley-Connell AT, Aroor AR, Domeier TL, Zhu Y, Meininger GA, Mueller KB, Jaffe IZ, Sowers JR. Endothelial Mineralocorticoid Receptor Deletion Prevents Diet-Induced Cardiac Diastolic Dysfunction in Females. Hypertension 2015; 66:1159-1167. [PMID: 26441470 DOI: 10.1161/hypertensionaha.115.06015] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 09/11/2015] [Indexed: 01/31/2023]
Abstract
Overnutrition and insulin resistance are especially prominent risk factors for the development of cardiac diastolic dysfunction in females. We recently reported that consumption of a Western diet (WD) containing excess fat (46%), sucrose (17.5%), and high fructose corn syrup (17.5%) for 16 weeks resulted in cardiac diastolic dysfunction and aortic stiffening in young female mice and that these abnormalities were prevented by mineralocorticoid receptor blockade. Herein, we extend those studies by testing whether WD-induced diastolic dysfunction and factors contributing to diastolic impairment, such as cardiac fibrosis, hypertrophy, inflammation, and impaired insulin signaling, are modulated by excess endothelial cell mineralocorticoid receptor signaling. Four-week-old female endothelial cell mineralocorticoid receptor knockout and wild-type mice were fed mouse chow or WD for 4 months. WD feeding resulted in prolonged relaxation time, impaired diastolic septal wall motion, and increased left ventricular filling pressure indicative of diastolic dysfunction. This occurred in concert with myocardial interstitial fibrosis and cardiomyocyte hypertrophy that were associated with enhanced profibrotic (transforming growth factor β1/Smad) and progrowth (S6 kinase-1) signaling, as well as myocardial oxidative stress and a proinflammatory immune response. WD also induced cardiomyocyte stiffening, assessed ex vivo using atomic force microscopy. Conversely, endothelial cell mineralocorticoid receptor deficiency prevented WD-induced diastolic dysfunction, profibrotic, and progrowth signaling, in conjunction with reductions in macrophage proinflammatory polarization and improvements in insulin metabolic signaling. Therefore, our findings indicate that increased endothelial cell mineralocorticoid receptor signaling associated with consumption of a WD plays a key role in the activation of cardiac profibrotic, inflammatory, and growth pathways that lead to diastolic dysfunction in female mice.
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Affiliation(s)
- Guanghong Jia
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA
| | - Javad Habibi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA
| | - Vincent G DeMarco
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA.,Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO, 65212, USA
| | - Luis A Martinez-Lemus
- Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA.,Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, 65212, USA
| | - Lixin Ma
- Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA.,Department of Radiology, University of Missouri School of Medicine, Columbia, MO, 65212, USA
| | - Adam T Whaley-Connell
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Division of Nephrology and Hypertension, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA
| | - Annayya R Aroor
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA
| | - Timothy L Domeier
- Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO, 65212, USA
| | - Yi Zhu
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, 65212, USA
| | - Gerald A Meininger
- Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, 65212, USA
| | | | - Iris Z Jaffe
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA 02111, USA
| | - James R Sowers
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA.,Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, MO, 65212, USA.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, 65212, USA
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