3
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Yerabolu D, Weiss A, Kojonazarov B, Boehm M, Schlueter BC, Ruppert C, Günther A, Jonigk D, Grimminger F, Ghofrani HA, Seeger W, Weissmann N, Schermuly RT. Targeting Jak-Stat Signaling in Experimental Pulmonary Hypertension. Am J Respir Cell Mol Biol 2021; 64:100-114. [PMID: 33052714 DOI: 10.1165/rcmb.2019-0431oc] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
In pulmonary arterial hypertension (PAH), progressive structural remodeling accounts for the pulmonary vasculopathy including the obliteration of the lung vasculature that causes an increase in vascular resistance and mean blood pressure in the pulmonary arteries ultimately leading to right heart failure-mediated death. Deciphering the molecular details of aberrant signaling of pulmonary vascular cells in PAH is fundamental for the development of new therapeutic strategies. We aimed to identify kinases as new potential drug targets that are dysregulated in PAH by means of a peptide-based kinase activity assay. We performed a tyrosine kinase-dependent phosphorylation assay using 144 selected microarrayed substrate peptides. The differential signature of phosphopeptides was used to predict alterations in tyrosine kinase activities in human pulmonary arterial smooth muscle cells (HPASMCs) from patients with idiopathic PAH (IPAH) compared with healthy control cells. Thereby, we observed an overactivation and an increased expression of Jak2 (Janus kinase 2) in HPASMCs from patients with IPAH as compared with controls. In vitro, IL-6-induced proliferation and migration of HPASMCs from healthy individuals as well as from patients with IPAH were reduced in a dose-dependent manner by the U.S. Food and Drug Administration-approved Jak1 and Jak2 inhibitor ruxolitinib. In vivo, ruxolitinib therapy in two experimental models of pulmonary arterial hypertension dose-dependently attenuated the elevation in pulmonary arterial pressure, partially reduced right ventricular hypertrophy, and almost completely restored cardiac index without signs of adverse events on cardiac function. Therefore, we propose that ruxolitinib may present a novel therapeutic option for patients with PAH by reducing pulmonary vascular remodeling through effectively blocking Jak2-Stat3 (signal transducer of activators of transcription)-mediated signaling pathways.
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Affiliation(s)
- Dinesh Yerabolu
- Justus-Liebig-University Giessen, Giessen, Germany.,Universities of Giessen and Marburg Lung Center, Giessen, Germany.,Cardio-Pulmonary Institute, Giessen, Germany.,German Center for Lung Research, Giessen, Germany
| | - Astrid Weiss
- Justus-Liebig-University Giessen, Giessen, Germany.,Universities of Giessen and Marburg Lung Center, Giessen, Germany.,Cardio-Pulmonary Institute, Giessen, Germany.,German Center for Lung Research, Giessen, Germany
| | - Baktybek Kojonazarov
- Justus-Liebig-University Giessen, Giessen, Germany.,Universities of Giessen and Marburg Lung Center, Giessen, Germany.,Cardio-Pulmonary Institute, Giessen, Germany.,German Center for Lung Research, Giessen, Germany.,Institute for Lung Health, Giessen, Germany
| | - Mario Boehm
- Justus-Liebig-University Giessen, Giessen, Germany.,Universities of Giessen and Marburg Lung Center, Giessen, Germany.,Cardio-Pulmonary Institute, Giessen, Germany.,German Center for Lung Research, Giessen, Germany
| | - Beate Christiane Schlueter
- Justus-Liebig-University Giessen, Giessen, Germany.,Universities of Giessen and Marburg Lung Center, Giessen, Germany.,Cardio-Pulmonary Institute, Giessen, Germany.,German Center for Lung Research, Giessen, Germany
| | - Clemens Ruppert
- Justus-Liebig-University Giessen, Giessen, Germany.,Universities of Giessen and Marburg Lung Center, Giessen, Germany.,Cardio-Pulmonary Institute, Giessen, Germany.,German Center for Lung Research, Giessen, Germany.,Universities of Giessen and Marburg Lung Center Giessen Biobank, Part of the German Center for Lung Research Biobank, Giessen, Germany
| | - Andreas Günther
- Justus-Liebig-University Giessen, Giessen, Germany.,Universities of Giessen and Marburg Lung Center, Giessen, Germany.,Cardio-Pulmonary Institute, Giessen, Germany.,German Center for Lung Research, Giessen, Germany.,Universities of Giessen and Marburg Lung Center Giessen Biobank, Part of the German Center for Lung Research Biobank, Giessen, Germany.,Agaplesion Lung Clinic Waldhof-Elgershausen, Greifenstein, Germany
| | - Danny Jonigk
- German Center for Lung Research, Giessen, Germany.,Institute of Pathology, Hannover Medical School, Hannover, Germany; and
| | - Friedrich Grimminger
- Justus-Liebig-University Giessen, Giessen, Germany.,Universities of Giessen and Marburg Lung Center, Giessen, Germany.,Cardio-Pulmonary Institute, Giessen, Germany.,German Center for Lung Research, Giessen, Germany
| | - Hossein-Ardeschir Ghofrani
- Justus-Liebig-University Giessen, Giessen, Germany.,Universities of Giessen and Marburg Lung Center, Giessen, Germany.,Cardio-Pulmonary Institute, Giessen, Germany.,German Center for Lung Research, Giessen, Germany
| | - Werner Seeger
- Justus-Liebig-University Giessen, Giessen, Germany.,Universities of Giessen and Marburg Lung Center, Giessen, Germany.,Cardio-Pulmonary Institute, Giessen, Germany.,German Center for Lung Research, Giessen, Germany.,Institute for Lung Health, Giessen, Germany.,Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Norbert Weissmann
- Justus-Liebig-University Giessen, Giessen, Germany.,Universities of Giessen and Marburg Lung Center, Giessen, Germany.,Cardio-Pulmonary Institute, Giessen, Germany.,German Center for Lung Research, Giessen, Germany
| | - Ralph Theo Schermuly
- Justus-Liebig-University Giessen, Giessen, Germany.,Universities of Giessen and Marburg Lung Center, Giessen, Germany.,Cardio-Pulmonary Institute, Giessen, Germany.,German Center for Lung Research, Giessen, Germany.,Institute for Lung Health, Giessen, Germany
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6
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Heinig M, Adriaens ME, Schafer S, van Deutekom HWM, Lodder EM, Ware JS, Schneider V, Felkin LE, Creemers EE, Meder B, Katus HA, Rühle F, Stoll M, Cambien F, Villard E, Charron P, Varro A, Bishopric NH, George AL, Dos Remedios C, Moreno-Moral A, Pesce F, Bauerfeind A, Rüschendorf F, Rintisch C, Petretto E, Barton PJ, Cook SA, Pinto YM, Bezzina CR, Hubner N. Natural genetic variation of the cardiac transcriptome in non-diseased donors and patients with dilated cardiomyopathy. Genome Biol 2017; 18:170. [PMID: 28903782 PMCID: PMC5598015 DOI: 10.1186/s13059-017-1286-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 07/19/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Genetic variation is an important determinant of RNA transcription and splicing, which in turn contributes to variation in human traits, including cardiovascular diseases. RESULTS Here we report the first in-depth survey of heart transcriptome variation using RNA-sequencing in 97 patients with dilated cardiomyopathy and 108 non-diseased controls. We reveal extensive differences of gene expression and splicing between dilated cardiomyopathy patients and controls, affecting known as well as novel dilated cardiomyopathy genes. Moreover, we show a widespread effect of genetic variation on the regulation of transcription, isoform usage, and allele-specific expression. Systematic annotation of genome-wide association SNPs identifies 60 functional candidate genes for heart phenotypes, representing 20% of all published heart genome-wide association loci. Focusing on the dilated cardiomyopathy phenotype we found that eQTL variants are also enriched for dilated cardiomyopathy genome-wide association signals in two independent cohorts. CONCLUSIONS RNA transcription, splicing, and allele-specific expression are each important determinants of the dilated cardiomyopathy phenotype and are controlled by genetic factors. Our results represent a powerful resource for the field of cardiovascular genetics.
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Affiliation(s)
- Matthias Heinig
- Institute of Computational Biology, Helmholtz Zentrum München, München, Germany.,Department of Informatics, Technical University of Munich, Munich, Germany
| | - Michiel E Adriaens
- Department of Clinical and Experimental Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands.,Maastricht Centre for Systems Biology, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Schafer
- National Heart Research Institute Singapore, National Heart Centre Singapore, 168752, Singapore, Singapore.,Division of Cardiovascular & Metabolic Disorders, Duke-National University of Singapore, 169857, Singapore, Singapore
| | - Hanneke W M van Deutekom
- Department of Clinical and Experimental Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands
| | - Elisabeth M Lodder
- Department of Clinical and Experimental Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands
| | - James S Ware
- National Heart and Lung Institute, Imperial College London, London, UK.,NIHR Cardiovascular Biomedical Research Unit at Royal Brompton and Harefield Hospitals and Imperial College London, London, UK.,Medical Research Council (MRC) London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Valentin Schneider
- Cardiovascular and Metabolic Sciences, Max-Delbrück-Center for Molecular Medicine (MDC) in the Helmholtz Association, Robert-Rössle-Str. 10, 13125, Berlin, Germany
| | - Leanne E Felkin
- National Heart and Lung Institute, Imperial College London, London, UK.,NIHR Cardiovascular Biomedical Research Unit at Royal Brompton and Harefield Hospitals and Imperial College London, London, UK
| | - Esther E Creemers
- Department of Clinical and Experimental Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands
| | - Benjamin Meder
- Institute for Cardiomyopathies Heidelberg & Department of Cardiology, Angiology and Pneumology, University Heidelberg, Heidelberg, Germany.,Deutsches Zentrum für Herz-Kreislauf-Forschung, Heidelberg/Mannheim, Germany
| | - Hugo A Katus
- Institute for Cardiomyopathies Heidelberg & Department of Cardiology, Angiology and Pneumology, University Heidelberg, Heidelberg, Germany.,Deutsches Zentrum für Herz-Kreislauf-Forschung, Heidelberg/Mannheim, Germany
| | - Frank Rühle
- Institute of Human Genetics, Genetic Epidemiology, University of Münster, Münster, Germany
| | - Monika Stoll
- Institute of Human Genetics, Genetic Epidemiology, University of Münster, Münster, Germany.,Department of Biochemistry, Genetic Epidemiology and Statistical Genetics, CARIM School for Cardiovascular Diseases, Maastricht Center for Systems Biology (MaCSBio), Maastricht University, Maastricht, The Netherlands
| | - François Cambien
- Sorbonne Universités, UPMC Univ Paris 06, INSERM UMRS 1166, Team Genomics & Pathophysiology of Cardiovascular Diseases, F-75013, Paris, France.,ICAN Institute for Cardiometabolism and Nutrition, F-75013, Paris, France
| | - Eric Villard
- Sorbonne Universités, UPMC Univ Paris 06, INSERM UMRS 1166, Team Genomics & Pathophysiology of Cardiovascular Diseases, F-75013, Paris, France.,ICAN Institute for Cardiometabolism and Nutrition, F-75013, Paris, France
| | - Philippe Charron
- ICAN Institute for Cardiometabolism and Nutrition, F-75013, Paris, France.,Université Versailles Saint Quentin, AP-HP, CESP, INSERM U1018, Hôpital Ambroise Paré, Boulogne-Billancourt, France
| | - Andras Varro
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Nanette H Bishopric
- Department of Medicine, University of Miami School of Medicine, Miami, FL, USA.,Department of Molecular and Cellular Pharmacology, University of Miami School of Medicine, Miami, FL, USA
| | - Alfred L George
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University, Nashville, TN, USA.,Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Cristobal Dos Remedios
- Sydney Heart Bank, Department of Anatomy, Bosch Institute, The University of Sydney, Sydney, Australia
| | - Aida Moreno-Moral
- Program in Cardiovascular and Metabolic Disorders, Center for Computational Biology, DUKE-NUS Medical School, Singapore, 169857, Singapore
| | - Francesco Pesce
- National Heart and Lung Institute, Imperial College London, London, UK.,NIHR Cardiovascular Biomedical Research Unit at Royal Brompton and Harefield Hospitals and Imperial College London, London, UK
| | - Anja Bauerfeind
- Cardiovascular and Metabolic Sciences, Max-Delbrück-Center for Molecular Medicine (MDC) in the Helmholtz Association, Robert-Rössle-Str. 10, 13125, Berlin, Germany
| | - Franz Rüschendorf
- Cardiovascular and Metabolic Sciences, Max-Delbrück-Center for Molecular Medicine (MDC) in the Helmholtz Association, Robert-Rössle-Str. 10, 13125, Berlin, Germany
| | - Carola Rintisch
- Cardiovascular and Metabolic Sciences, Max-Delbrück-Center for Molecular Medicine (MDC) in the Helmholtz Association, Robert-Rössle-Str. 10, 13125, Berlin, Germany
| | - Enrico Petretto
- Program in Cardiovascular and Metabolic Disorders, Center for Computational Biology, DUKE-NUS Medical School, Singapore, 169857, Singapore
| | - Paul J Barton
- National Heart and Lung Institute, Imperial College London, London, UK.,NIHR Cardiovascular Biomedical Research Unit at Royal Brompton and Harefield Hospitals and Imperial College London, London, UK
| | - Stuart A Cook
- National Heart Research Institute Singapore, National Heart Centre Singapore, 168752, Singapore, Singapore.,Division of Cardiovascular & Metabolic Disorders, Duke-National University of Singapore, 169857, Singapore, Singapore.,National Heart and Lung Institute, Imperial College London, London, UK.,NIHR Cardiovascular Biomedical Research Unit at Royal Brompton and Harefield Hospitals and Imperial College London, London, UK.,Medical Research Council (MRC) London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Yigal M Pinto
- Department of Clinical and Experimental Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands
| | - Connie R Bezzina
- Department of Clinical and Experimental Cardiology, Heart Center, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands.
| | - Norbert Hubner
- Cardiovascular and Metabolic Sciences, Max-Delbrück-Center for Molecular Medicine (MDC) in the Helmholtz Association, Robert-Rössle-Str. 10, 13125, Berlin, Germany. .,Deutsches Zentrum für Herz-Kreislauf-Forschung, Heidelberg/Mannheim, Germany. .,Charité-Universitätsmedizin, Berlin, Germany. .,Deutsches Zentrum für Herz-Kreislauf-Forschung, Berlin, Germany.
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8
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Popa MO, Irimia AM, Papagheorghe MN, Vasile EM, Tircol SA, Negulescu RA, Toader C, Adam R, Dorobantu L, Caldararu C, Alexandrescu M, Onciul S. The mechanisms, diagnosis and management of mitral regurgitation in mitral valve prolapse and hypertrophic cardiomyopathy. Discoveries (Craiova) 2016; 4:e61. [PMID: 32309580 PMCID: PMC7159827 DOI: 10.15190/d.2016.8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Valvular disease is a frequent cardiac pathology leading to heart failure and, ultimately, death. Mitral regurgitation, defined as the inability of the two mitral leaflets to coapt, is a common valvular disease and a self sustained pathology. A better understanding of the mitral valve histological layers provides a better understanding of the leaflet and chordae changes in mitral valve prolapse.
Mitral valve prolapse may occur in myxomatous degenerative abnormalities, connective tissue disorders or in sporadic isolated cases. It is the most common mitral abnormality of non-ischemic cause leading to severe surgery-requiring mitral regurgitation. In addition to standard echocardiographic investigations, newly implemented three-dimensional techniques are being used and they permit a better visualisation, from the so-called ‘surgical view’, and an improved evaluation of the mitral valve.
Hypertrophic cardiomyopathy is the most frequent inherited myocardial disease caused by mutations in various genes encoding proteins of the cardiac sarcomere, leading to a marked left ventricular hypertrophy unexplained by other comorbidities. The pathological echocardiographic hallmarks of hypertrophic cardiomyopathy are left ventricular hypertrophy, left ventricular outflow tract obstruction and systolic anterior motion of the mitral valve. The systolic anterior motion of the mitral valve contributes to the development of mitral regurgitation and further narrows the left ventricular outflow tract, leading to more severe symptomatology. Cardiac magnetic resonance imaging accurately measures the left ventricular mass, the degree of diastolic function and it may also be used to distinguish phenotypic variants.
The clinical outcome of patients with these pathologies is mostly determined by the selected option of treatment. The purpose of surgical correction regarding mitral valve involvement is to restore valvular competence. Surgery has proven to be the only useful treatment in preventing heart failure, improving symptomatology and reducing mortality. Our approach wishes to enhance the understanding of the mitral valve’s involvement in hypertrophic cardiomyopathy and mitral valve prolapse from genetic, haemodynamic and clinical perspectives, as well as to present novelties in the grand field of treatment.
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Affiliation(s)
| | - Ana Maria Irimia
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | | | | | | | - Catalina Toader
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Robert Adam
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Lucian Dorobantu
- Department of Cardiovascular Surgery, Monza Hospital, Bucharest, Romania
| | | | - Maria Alexandrescu
- Department of Radiology and Imaging Sciences, Monza Hospital, Bucharest, Romania
| | - Sebastian Onciul
- Department of Cardiology, Floreasca Clinical Emergency Hospital, Bucharest, Romania
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