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Nudy M, Buerger J, Dreibelbis S, Jiang X, Hodis HN, Schnatz PF. Menopausal hormone therapy and coronary heart disease: the roller-coaster history. Climacteric 2024; 27:81-88. [PMID: 38054425 DOI: 10.1080/13697137.2023.2282690] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/31/2023] [Indexed: 12/07/2023]
Abstract
In the USA it is estimated that more than one million women become menopausal each year. Coronary heart disease (CHD) is the leading cause of mortality in menopausal woman globally. The majority of perimenopausal to postmenopausal women experience bothersome symptoms including hot flashes, night sweats, mood liability, sleep disturbances, irregular bleeding and sexual dysfunction. While menopausal hormone therapy (HT) effectively treats most of these symptoms, use of HT has become confusing, especially related to CHD risk. Despite years of observational and retrospective studies supporting a CHD benefit and improved survival among HT users, the Heart and Estrogen/Progestin Replacement Study (HERS) and the Women's Health Initiative (WHI) raised doubts about this long-held premise. The timing hypothesis has since emerged and states that when HT is initiated in younger women, soon after menopause onset, there may be cardiovascular benefit. The following review discusses the roller-coaster history of HT use as it pertains to CHD in postmenopausal women. Studies that highlight HT's CHD benefit are reviewed and provide reassurance that HT utilized in appropriately selected younger postmenopausal women close to the onset of menopause is safe from a cardiovascular perspective, in line with consensus recommendations.
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Affiliation(s)
- M Nudy
- Division of Cardiology, Heart and Vascular Institute, Penn State Hershey Medical Center, Hershey, PA, USA
- Department of Public Health Sciences, Penn State Hershey Medical Center, Hershey, PA, USA
| | - J Buerger
- Department of ObGyn, Reading Hospital/Tower Health, Reading, PA, USA
| | - S Dreibelbis
- Department of ObGyn, Reading Hospital/Tower Health, Reading, PA, USA
| | - X Jiang
- Department of ObGyn, Reading Hospital/Tower Health, Reading, PA, USA
- Department of Obgyn, Drexel University, Philadelphia, PA, USA
| | - H N Hodis
- Atherosclerosis Research Unit, Keck School of Medicine, University of Southern CA, Los Angeles, CA, USA
| | - P F Schnatz
- Department of ObGyn, Reading Hospital/Tower Health, Reading, PA, USA
- Department of Obgyn, Drexel University, Philadelphia, PA, USA
- Department of Internal Medicine, Reading Hospital/Tower Health, Reading, PA, USA
- Department of Internal Medicine, Drexel University, Philadelphia, PA, USA
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Pan H, Guo Z, Lv P, Hu K, Wu T, Lin Z, Xue Y, Zhang Y, Guo Z. Proline/serine-rich coiled-coil protein 1 inhibits macrophage inflammation and delays atherosclerotic progression by binding to Annexin A2. Clin Transl Med 2023; 13:e1220. [PMID: 36932468 PMCID: PMC10023832 DOI: 10.1002/ctm2.1220] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 02/21/2023] [Accepted: 02/28/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Atherosclerosis (AS), the main pathological basis of life-threatening cardiovascular disease, is essentially caused by chronic macrophage inflammation. Overexpression of proline/serine-rich coiled-coil protein 1 (PSRC1) reduces macrophage inflammatory responses and delays AS development. However, the exact mechanism of PSRC1 is unclear. METHODS Proteins interacting with PSRC1 were screened by proteomics in RAW264.7 cells, followed by RT-qPCR, immunoprecipitation and immunofluorescence to explore the specific mechanistic pathways affecting inflammation. CRISPR-Cas9 constructs for PSRC1-/- ApoE-/- (DKO) mice and high-fat diet-fed ApoE-/- and DKO mice were used for AS models for in vivo experiments. Upstream transcription factors of PSRC1 were predicted by ATAC-seq, ChIP-seq and UCSC, and the regulatory mechanism was verified by ChIP-qPCR and dual luciferase assays. Peripheral blood serum and monocytes were collected from coronary artery disease (CAD) patients and non-CAD patients. RESULTS Increased binding of ANXA2 to PSRC1 in macrophages under oxidized low-density lipoprotein stimulation and decreased release of ANXA2 to the extracellular compartment were observed. Knockdown of ANXA2 in AS model mice delayed AS progression. Knockdown of ANXA2 in DKO mice reversed the AS-promoting effect of PSRC1 knockdown. Mechanistically, ANXA2 promotes STAT3 phosphorylation, which in turn promotes inflammatory responses. In addition, SP1 is a PSRC1 upstream repressive transcription factor, and the SP1 inhibitor mithramycin (Mith) elevated PSRC1 expression and exerted anti-AS effects in AS model mice. Patients with CAD had considerably greater serum levels of ANXA2 than those without CAD, and Mith reduced the secretion of ANXA2 in peripheral blood monocytes of CAD patients. CONCLUSION In macrophages, PSRC1 can interact with ANXA2 to inhibit its extracellular release and delay AS development. SP1 is an upstream transcription factor of PSRC1 and inhibits the transcription of PSRC1. The SP1 inhibitor Mith can elevate PSRC1 levels and slow AS progression while reducing ANXA2 release from monocytes in CAD patients. Mith is expected to be a new agent for AS treatment.
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Affiliation(s)
- Hangyu Pan
- Department of CardiologyState Key Laboratory of Organ Failure ResearchNanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Zhongzhou Guo
- Department of PharmacyZhujiang HospitalSouthern Medical UniversityGuangzhouChina
| | - Ping Lv
- Department of Cardiovascular SurgeryNanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Kexin Hu
- Department of CardiologyState Key Laboratory of Organ Failure ResearchNanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Tongwei Wu
- Department of Medicine UltrasonicsNanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Zixiang Lin
- Department of CardiologyShenzhen HospitalHuazhong University of Science and Technology UnionShenzhenChina
| | - Yazhi Xue
- Department of General PracticeNanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Yanan Zhang
- Department of CardiologyState Key Laboratory of Organ Failure ResearchNanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Zhigang Guo
- Department of CardiologyHuiqiao Medical CenterNanfang HospitalSouthern Medical UniversityGuangzhouChina
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Nasiri-Ansari N, Spilioti E, Kyrou I, Kalotychou V, Chatzigeorgiou A, Sanoudou D, Dahlman-Wright K, Randeva HS, Papavassiliou AG, Moutsatsou P, Kassi E. Estrogen Receptor Subtypes Elicit a Distinct Gene Expression Profile of Endothelial-Derived Factors Implicated in Atherosclerotic Plaque Vulnerability. Int J Mol Sci 2022; 23:ijms231810960. [PMID: 36142876 PMCID: PMC9506323 DOI: 10.3390/ijms231810960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 11/21/2022] Open
Abstract
In the presence of established atherosclerosis, estrogens are potentially harmful. MMP-2 and MMP-9, their inhibitors (TIMP-2 and TIMP-1), RANK, RANKL, OPG, MCP-1, lysyl oxidase (LOX), PDGF-β, and ADAMTS-4 play critical roles in plaque instability/rupture. We aimed to investigate (i) the effect of estradiol on the expression of the abovementioned molecules in endothelial cells, (ii) which type(s) of estrogen receptors mediate these effects, and (iii) the role of p21 in the estrogen-mediated regulation of the aforementioned factors. Human aortic endothelial cells (HAECs) were cultured with estradiol in the presence or absence of TNF-α. The expression of the aforementioned molecules was assessed by qRT-PCR and ELISA. Zymography was also performed. The experiments were repeated in either ERα- or ERβ-transfected HAECs and after silencing p21. HAECs expressed only the GPR-30 estrogen receptor. Estradiol, at low concentrations, decreased MMP-2 activity by 15-fold, increased LOX expression by 2-fold via GPR-30, and reduced MCP-1 expression by 3.5-fold via ERβ. The overexpression of ERα increased MCP-1 mRNA expression by 2.5-fold. In a low-grade inflammation state, lower concentrations of estradiol induced the mRNA expression of MCP-1 (3.4-fold) and MMP-9 (7.5-fold) and increased the activity of MMP-2 (1.7-fold) via GPR-30. Moreover, p21 silencing resulted in equivocal effects on the expression of the abovementioned molecules. Estradiol induced different effects regarding atherogenic plaque instability through different ERs. The balance of the expression of the various ER subtypes may play an important role in the paradoxical characterization of estrogens as both beneficial and harmful.
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Affiliation(s)
- Narjes Nasiri-Ansari
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Eliana Spilioti
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Laboratory of Toxicological Control of Pesticides, Scientific Directorate of Pesticides’ Control and Phytopharmacy, Benaki Phytopathological Institute, 14561 Athens, Greece
| | - Ioannis Kyrou
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 11855 Athens, Greece
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK
| | - Vassiliki Kalotychou
- Department of Internal Medicine, Laikon General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Antonios Chatzigeorgiou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Despina Sanoudou
- Clinical Genomics and Pharmacogenomics Unit, 4th Department of Internal Medicine, Attikon Hospital Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Center for New Biotechnologies and Precision Medicine, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - Karin Dahlman-Wright
- Department of Biosciences and Nutrition, Novum, Karolinska Institute, SE-14183 Huddinge, Sweden
| | - Harpal S. Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Athanasios G. Papavassiliou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Paraskevi Moutsatsou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Eva Kassi
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Endocrine Unit, 1st Department of Propaedeutic Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence: ; Tel.: +30-21-0746-2699; Fax: +30-21-0746-2703
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Manwani B, Finger C, Lisabeth L. Strategies for Maintaining Brain Health: The Role of Stroke Risk Factors Unique to Elderly Women. Stroke 2022; 53:2662-2672. [PMID: 35652344 PMCID: PMC10911965 DOI: 10.1161/strokeaha.121.036894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Stroke risk and prevalence increase with advanced age and women tend to be older than men at the time of their first stroke. Advanced age in women confers unique stroke risks that are beyond reproductive factors. Previous reviews and guidelines have largely focused on risk factors specific to women, with a predominant focus on reproductive factors and, therefore, younger to middle-aged women. This review aims to specifically describe stroke risk factors in elderly women, the population of women where the majority of strokes occur, with a focus on atrial fibrillation, hormone therapy, psychosocial risk factors, and cognitive impairment. Our review suggests that prevention and management of stroke risks that are unique or more prevalent in elderly women needs a coordinated system of care from general physicians, general neurologists, vascular and cognitive neurologists, psychologists, cardiologists, patients, and their caretakers. Early identification and management of the elderly woman-specific and traditional stroke risk factors is key for decreasing stroke burden in elderly women. Increased education among elderly women regarding stroke risk factors and their identification should be considered, and an update to the guidelines for prevention of stroke in women is strongly encouraged.
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Affiliation(s)
- Bharti Manwani
- Department of Neurology, University of Texas Health Science Center at Houston (B.M., C.F.)
| | - Carson Finger
- Department of Neurology, University of Texas Health Science Center at Houston (B.M., C.F.)
| | - Lynda Lisabeth
- Department of Epidemiology, University of Michigan, Ann Arbor (L.L.)
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Hermansyah D, Putra A, Munir D, Lelo A, Amalina ND, Alif I. Synergistic Effect of Curcuma longa Extract in Combination with Phyllanthus niruri Extract in Regulating Annexin A2, Epidermal Growth Factor Receptor, Matrix Metalloproteinases, and Pyruvate Kinase M1/2 Signaling Pathway on Breast Cancer Stem Cell. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
AIM: This study aimed to investigate the synergistic effects of the combination between Curcuma longa extract (CL) and Phyllanthus niruri extract (PN) in inhibiting optimally the MDA-MB-231 breast cancer stem cells (BCSCs) growth and metastatic by exploring the target and molecular mechanism using integrative bioinformatics approaches and in vitro.
METHODS: CL and PN extracts were prepared by maceration method using ethanol 70%. The antiproliferative effect of CL and PN single and combination treatment was examined by 3-[4,5-dimethyl-2-thiazolyl]-2,5-diphenyl-2H-tetrazolium bromide assay. The bioinformatic approach was performed to identify molecular targets, key proteins, and molecular mechanism of curcumin and phyllanthin as CL and PN secondary metabolite, respectively, targeted at stemness and migration pathway of BCSCs.
RESULTS: The in vitro study showed that CL and PN possess cytotoxic activity in time- and dose-dependent manner. The combination of CL and PN has a synergistic effect by modulating the sensitivity of cells. Using a bioinformatics approach, the annexin A2 (ANXA2), epidermal growth factor receptor (EGFR), matrix metalloproteinases (MMPs), and pyruvate kinase M1/2 (PKM) as potential targets of curcumin and phyllanthin correlated with metastatic inhibition of BC. In addition, molecular docking showed that curcumin and phyllanthin performed similar or better interaction to stemness differentiation regulator pathway particularly histone deacetylase 1, EGFR, Heat Shock Protein 90 Alpha Family Class B Member 1, Hypoxia Inducible Factor 1 Subunit Alpha, and MMP9.
CONCLUSION: Combination of CL and PN has potential for the treatment of metastatic BCSCs by targeting ANXA2, EGFR, MMPs, and PKM to resolve stemness and inhibit of BCSCs.
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Abstract
Hormone replacement therapy (HRT) was the standard of care for menopause management until 2002, when perceptions changed following release of the initial results from the Women's Health Initiative (WHI) trial. Fears of breast cancer and heart attacks engendered by that report were not supported by the data, especially for recently menopausal women. Clinically, HRT is usually initiated near menopause. The WHI tested something different - the effects of HRT started a decade or more after menopause. As it turned out, age at starting HRT is critical in determining benefit/risk. HRT use plummeted following the WHI in 2002 and has remained low, prompting strong interest in alternative treatments. None provide the range of benefits across multiple organ systems offered by estrogen. Most have concerning adverse effects in their own right. HRT can provide effective relief for a wide range of health conditions, potentially avoiding the need for multiple treatments for separate problems. Unfortunately, among many women and clinicians, the perception of HRT benefit/risk is distorted, and its use avoided, leading to unnecessary distress. Following the WHI, many clinicians have not received adequate training to feel comfortable prescribing HRT. When initiated within 10 years of menopause, HRT reduces all-cause mortality and risks of coronary disease, osteoporosis, and dementias.
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Affiliation(s)
- R D Langer
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - H N Hodis
- Department of Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - R A Lobo
- Department of Obstetrics and Gynecology, Colombia University Irving Medical Center, New York, NY, USA
| | - M A Allison
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
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George CN, Canuas-Landero V, Theodoulou E, Muthana M, Wilson C, Ottewell P. Oestrogen and zoledronic acid driven changes to the bone and immune environments: Potential mechanisms underlying the differential anti-tumour effects of zoledronic acid in pre- and post-menopausal conditions. J Bone Oncol 2020; 25:100317. [PMID: 32995253 PMCID: PMC7516134 DOI: 10.1016/j.jbo.2020.100317] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/03/2020] [Accepted: 09/09/2020] [Indexed: 12/11/2022] Open
Abstract
Late stage breast cancer commonly metastasises to bone and patient survival averages 2-3 years following diagnosis of bone involvement. One of the most successful treatments for bone metastases is the bisphosphonate, zoledronic acid (ZOL). ZOL has been used in the advanced setting for many years where it has been shown to reduce skeletal complications associated with bone metastasis. More recently, several large adjuvant clinical trials have demonstrated that administration of ZOL can prevent recurrence and improve survival when given in early breast cancer. However, these promising effects were only observed in post-menopausal women with confirmed low concentrations of circulating ovarian hormones. In this review we focus on potential interactions between the ovarian hormone, oestrogen, and ZOL to establish credible hypotheses that could explain why anti-tumour effects are specific to post-menopausal women. Specifically, we discuss the molecular and immune cell driven mechanisms by which ZOL and oestrogen affect the tumour microenvironment to inhibit/induce tumour growth and how oestrogen can interact with zoledronic acid to inhibit its anti-tumour actions.
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Affiliation(s)
- Christopher N. George
- Department of Oncology and Metabolism, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, United Kingdom
| | - Victor Canuas-Landero
- Department of Oncology and Metabolism, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, United Kingdom
| | - Elizavet Theodoulou
- Department of Oncology and Metabolism, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, United Kingdom
| | - Munitta Muthana
- Department of Oncology and Metabolism, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, United Kingdom
| | - Caroline Wilson
- Department of Oncology and Metabolism, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, United Kingdom
| | - Penelope Ottewell
- Department of Oncology and Metabolism, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, United Kingdom
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Estrogen effects on arteries vary with stage of reproductive life and extent of subclinical atherosclerosis progression. Menopause 2019; 25:1262-1274. [PMID: 30358722 DOI: 10.1097/gme.0000000000001228] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The past several years have been marked by confusion and controversy concerning whether estrogens are cardioprotective. The issue is of utmost public health importance because coronary heart disease (CHD) remains the leading cause of death among postmenopausal women. Fortunately, a unifying hypothesis has emerged that reproductive stage is a major determinant of the effect of estrogens on atherosclerosis progression, complications, and plaque vulnerability. PREMENOPAUSAL YEARS Premenopausal atherosclerosis progression seems to be an important determinant of postmenopausal atherosclerosis and thus the risk for CHD. Clearly, plasma lipids/lipoproteins influence this progression; however, estradiol deficiency seems to be the major modulator. Both monkeys and women with premenopausal estrogen deficiency develop premature atherosclerosis, an effect that can be prevented in both species by estrogen-containing oral contraceptives. PERIMENOPAUSAL/EARLY POSTMENOPAUSAL YEARS During this stage, there are robust estrogen benefits. Monkeys given estrogens immediately after surgical menopause have a 70% inhibition in coronary atherosclerosis progression. Estrogen treatment prevented progression of atherosclerosis of women in the Estrogen in the Prevention of Atherosclerosis Trial. A meta-analysis of women younger than 60 years given hormone therapy had reduced total mortality (relative risk = 0.61, 95% CI: 0.39-0.95). LATE POSTMENOPAUSAL YEARS This stage is one in which there are no or possible deleterious estrogen effects. Monkeys lose CHD benefits of estrogens when treatment is delayed. The increase in CHD events associated with initiating hormone therapy 10 or more years after menopause seems to be related to up-regulation of the plaque inflammatory processes and plaque instability and may be down-regulated by statin pretreatment.
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Cui L, Song J, Wu L, Cheng L, Chen A, Wang Y, Huang Y, Huang L. Role of Annexin A2 in the EGF-induced epithelial-mesenchymal transition in human CaSki cells. Oncol Lett 2016; 13:377-383. [PMID: 28123570 DOI: 10.3892/ol.2016.5406] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 10/18/2016] [Indexed: 01/08/2023] Open
Abstract
The epidermal growth factor receptor (EGF-R) signaling pathway is thought to have an important role in the development and progression of several carcinomas, as it is associated with cell proliferation, differentiation and migration. Activation of EGF-R signaling regulates epithelial-mesenchymal transition (EMT)-associated invasion and migration in normal and malignant epithelial cells. However, the specific mechanisms have not yet been fully elucidated. The present study utilized wound healing assays, western blotting, flow cytometry and MTT assays to demonstrate that Annexin A2 (ANXA2) is a key regulatory factor in EGF-induced EMT in CaSki cervical cancer cells. Moreover, the increased expression levels of ANXA2 promoted cell viability and migration in human CaSki cells. It was also found that silencing ANXA2 partially reverses EGF-induced EMT and inhibits cell viability and migration in CaSki cells. These findings suggest that ANXA2 is a key regulator of EGF-induced EMT in CaSki cervical cancer cells.
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Affiliation(s)
- Lei Cui
- Department of General Surgery, Yichang Central People's Hospital, The First College of Clinical Medical Science, Three Gorges University, Yichang, Hubei 443002, P.R. China
| | - Jian Song
- Department of Biochemistry, School of Basic Medical Sciences, Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Liting Wu
- Institute of Molecular Biology of Three Gorges University, Yichang, Hubei 443002, P.R. China
| | - Luhui Cheng
- Department of General Surgery, Yichang Central People's Hospital, The First College of Clinical Medical Science, Three Gorges University, Yichang, Hubei 443002, P.R. China
| | - Aijun Chen
- Department of General Surgery, Yichang Central People's Hospital, The First College of Clinical Medical Science, Three Gorges University, Yichang, Hubei 443002, P.R. China
| | - Yanlin Wang
- Institute of Molecular Biology of Three Gorges University, Yichang, Hubei 443002, P.R. China
| | - Yingdi Huang
- Institute of Molecular Biology of Three Gorges University, Yichang, Hubei 443002, P.R. China
| | - Liming Huang
- Institute of Molecular Biology of Three Gorges University, Yichang, Hubei 443002, P.R. China
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Lobo RA, Pickar JH, Stevenson JC, Mack WJ, Hodis HN. Back to the future: Hormone replacement therapy as part of a prevention strategy for women at the onset of menopause. Atherosclerosis 2016; 254:282-290. [PMID: 27745704 DOI: 10.1016/j.atherosclerosis.2016.10.005] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 07/29/2016] [Accepted: 10/04/2016] [Indexed: 11/27/2022]
Abstract
In the late 1980s, several observational studies and meta-analyses suggested that hormone replacement therapy (HRT) was beneficial for prevention of osteoporosis, coronary heart disease, dementia and decreased all-cause mortality. In 1992, the American College of Physicians recommended HRT for prevention of coronary disease. In the late 1990s and early 2000s, several randomized trials in older women suggested coronary harm and that the risks, including breast cancer, outweighed any benefit. HRT stopped being prescribed at that time, even for women who had severe symptoms of menopause. Subsequently, reanalyzes of the randomized trial data, using age stratification, as well as newer studies, and meta-analyses have been consistent in showing that younger women, 50-59 years or within 10 years of menopause, have decreased coronary disease and all-cause mortality; and did not have the perceived risks including breast cancer. These newer findings are consistent with the older observational data. It has also been reported that many women who abruptly stopped HRT had more risks, including more osteoporotic fractures. The current data confirm a "timing" hypothesis for benefits and risks of HRT, showing that younger have many benefits and few risks, particularly if therapy is predominantly focused on the estrogen component. We discuss these findings and put into perspective the potential risks of treatment, and suggest that we may have come full circle regarding the use of HRT. In so doing we propose that HRT should be considered as part of a general prevention strategy for women at the onset of menopause.
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Affiliation(s)
- Roger A Lobo
- Department of Obstetrics and Gynecology, Columbia University, New York, NY 10032, USA.
| | - James H Pickar
- Department of Obstetrics and Gynecology, Columbia University, New York, NY 10032, USA
| | - John C Stevenson
- National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
| | - Wendy J Mack
- Atherosclerosis Research Unit, Departments of Medicine and Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90022, USA
| | - Howard N Hodis
- Atherosclerosis Research Unit, Departments of Medicine and Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90022, USA
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11
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Hodis HN, Mack WJ, Henderson VW, Shoupe D, Budoff MJ, Hwang-Levine J, Li Y, Feng M, Dustin L, Kono N, Stanczyk FZ, Selzer RH, Azen SP. Vascular Effects of Early versus Late Postmenopausal Treatment with Estradiol. N Engl J Med 2016; 374:1221-31. [PMID: 27028912 PMCID: PMC4921205 DOI: 10.1056/nejmoa1505241] [Citation(s) in RCA: 442] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Data suggest that estrogen-containing hormone therapy is associated with beneficial effects with regard to cardiovascular disease when the therapy is initiated temporally close to menopause but not when it is initiated later. However, the hypothesis that the cardiovascular effects of postmenopausal hormone therapy vary with the timing of therapy initiation (the hormone-timing hypothesis) has not been tested. METHODS A total of 643 healthy postmenopausal women were stratified according to time since menopause (<6 years [early postmenopause] or ≥10 years [late postmenopause]) and were randomly assigned to receive either oral 17β-estradiol (1 mg per day, plus progesterone [45 mg] vaginal gel administered sequentially [i.e., once daily for 10 days of each 30-day cycle] for women with a uterus) or placebo (plus sequential placebo vaginal gel for women with a uterus). The primary outcome was the rate of change in carotid-artery intima-media thickness (CIMT), which was measured every 6 months. Secondary outcomes included an assessment of coronary atherosclerosis by cardiac computed tomography (CT), which was performed when participants completed the randomly assigned regimen. RESULTS After a median of 5 years, the effect of estradiol, with or without progesterone, on CIMT progression differed between the early and late postmenopause strata (P=0.007 for the interaction). Among women who were less than 6 years past menopause at the time of randomization, the mean CIMT increased by 0.0078 mm per year in the placebo group versus 0.0044 mm per year in the estradiol group (P=0.008). Among women who were 10 or more years past menopause at the time of randomization, the rates of CIMT progression in the placebo and estradiol groups were similar (0.0088 and 0.0100 mm per year, respectively; P=0.29). CT measures of coronary-artery calcium, total stenosis, and plaque did not differ significantly between the placebo group and the estradiol group in either postmenopause stratum. CONCLUSIONS Oral estradiol therapy was associated with less progression of subclinical atherosclerosis (measured as CIMT) than was placebo when therapy was initiated within 6 years after menopause but not when it was initiated 10 or more years after menopause. Estradiol had no significant effect on cardiac CT measures of atherosclerosis in either postmenopause stratum. (Funded by the National Institute on Aging, National Institutes of Health; ELITE ClinicalTrials.gov number, NCT00114517.).
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Affiliation(s)
- Howard N Hodis
- From the Atherosclerosis Research Unit (H.N.H., W.J.M., J.H.-L., Y.L., M.F., L.D., N.K., R.H.S., S.P.A.) and the Departments of Medicine (H.N.H.), Preventive Medicine (H.N.H., W.J.M., L.D., N.K., F.Z.S., S.P.A.), Molecular Pharmacology and Toxicology (H.N.H., J.H.-L.), and Obstetrics and Gynecology (D.S., F.Z.S.), Keck School of Medicine, University of Southern California, Los Angeles, the Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences, Stanford University, Stanford (V.W.H.),and the Los Angeles Biomedical Research Institute, Harbor-University of California, Los Angeles Medical Center, Torrance (M.J.B.) - all in California
| | - Wendy J Mack
- From the Atherosclerosis Research Unit (H.N.H., W.J.M., J.H.-L., Y.L., M.F., L.D., N.K., R.H.S., S.P.A.) and the Departments of Medicine (H.N.H.), Preventive Medicine (H.N.H., W.J.M., L.D., N.K., F.Z.S., S.P.A.), Molecular Pharmacology and Toxicology (H.N.H., J.H.-L.), and Obstetrics and Gynecology (D.S., F.Z.S.), Keck School of Medicine, University of Southern California, Los Angeles, the Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences, Stanford University, Stanford (V.W.H.),and the Los Angeles Biomedical Research Institute, Harbor-University of California, Los Angeles Medical Center, Torrance (M.J.B.) - all in California
| | - Victor W Henderson
- From the Atherosclerosis Research Unit (H.N.H., W.J.M., J.H.-L., Y.L., M.F., L.D., N.K., R.H.S., S.P.A.) and the Departments of Medicine (H.N.H.), Preventive Medicine (H.N.H., W.J.M., L.D., N.K., F.Z.S., S.P.A.), Molecular Pharmacology and Toxicology (H.N.H., J.H.-L.), and Obstetrics and Gynecology (D.S., F.Z.S.), Keck School of Medicine, University of Southern California, Los Angeles, the Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences, Stanford University, Stanford (V.W.H.),and the Los Angeles Biomedical Research Institute, Harbor-University of California, Los Angeles Medical Center, Torrance (M.J.B.) - all in California
| | - Donna Shoupe
- From the Atherosclerosis Research Unit (H.N.H., W.J.M., J.H.-L., Y.L., M.F., L.D., N.K., R.H.S., S.P.A.) and the Departments of Medicine (H.N.H.), Preventive Medicine (H.N.H., W.J.M., L.D., N.K., F.Z.S., S.P.A.), Molecular Pharmacology and Toxicology (H.N.H., J.H.-L.), and Obstetrics and Gynecology (D.S., F.Z.S.), Keck School of Medicine, University of Southern California, Los Angeles, the Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences, Stanford University, Stanford (V.W.H.),and the Los Angeles Biomedical Research Institute, Harbor-University of California, Los Angeles Medical Center, Torrance (M.J.B.) - all in California
| | - Matthew J Budoff
- From the Atherosclerosis Research Unit (H.N.H., W.J.M., J.H.-L., Y.L., M.F., L.D., N.K., R.H.S., S.P.A.) and the Departments of Medicine (H.N.H.), Preventive Medicine (H.N.H., W.J.M., L.D., N.K., F.Z.S., S.P.A.), Molecular Pharmacology and Toxicology (H.N.H., J.H.-L.), and Obstetrics and Gynecology (D.S., F.Z.S.), Keck School of Medicine, University of Southern California, Los Angeles, the Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences, Stanford University, Stanford (V.W.H.),and the Los Angeles Biomedical Research Institute, Harbor-University of California, Los Angeles Medical Center, Torrance (M.J.B.) - all in California
| | - Juliana Hwang-Levine
- From the Atherosclerosis Research Unit (H.N.H., W.J.M., J.H.-L., Y.L., M.F., L.D., N.K., R.H.S., S.P.A.) and the Departments of Medicine (H.N.H.), Preventive Medicine (H.N.H., W.J.M., L.D., N.K., F.Z.S., S.P.A.), Molecular Pharmacology and Toxicology (H.N.H., J.H.-L.), and Obstetrics and Gynecology (D.S., F.Z.S.), Keck School of Medicine, University of Southern California, Los Angeles, the Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences, Stanford University, Stanford (V.W.H.),and the Los Angeles Biomedical Research Institute, Harbor-University of California, Los Angeles Medical Center, Torrance (M.J.B.) - all in California
| | - Yanjie Li
- From the Atherosclerosis Research Unit (H.N.H., W.J.M., J.H.-L., Y.L., M.F., L.D., N.K., R.H.S., S.P.A.) and the Departments of Medicine (H.N.H.), Preventive Medicine (H.N.H., W.J.M., L.D., N.K., F.Z.S., S.P.A.), Molecular Pharmacology and Toxicology (H.N.H., J.H.-L.), and Obstetrics and Gynecology (D.S., F.Z.S.), Keck School of Medicine, University of Southern California, Los Angeles, the Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences, Stanford University, Stanford (V.W.H.),and the Los Angeles Biomedical Research Institute, Harbor-University of California, Los Angeles Medical Center, Torrance (M.J.B.) - all in California
| | - Mei Feng
- From the Atherosclerosis Research Unit (H.N.H., W.J.M., J.H.-L., Y.L., M.F., L.D., N.K., R.H.S., S.P.A.) and the Departments of Medicine (H.N.H.), Preventive Medicine (H.N.H., W.J.M., L.D., N.K., F.Z.S., S.P.A.), Molecular Pharmacology and Toxicology (H.N.H., J.H.-L.), and Obstetrics and Gynecology (D.S., F.Z.S.), Keck School of Medicine, University of Southern California, Los Angeles, the Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences, Stanford University, Stanford (V.W.H.),and the Los Angeles Biomedical Research Institute, Harbor-University of California, Los Angeles Medical Center, Torrance (M.J.B.) - all in California
| | - Laurie Dustin
- From the Atherosclerosis Research Unit (H.N.H., W.J.M., J.H.-L., Y.L., M.F., L.D., N.K., R.H.S., S.P.A.) and the Departments of Medicine (H.N.H.), Preventive Medicine (H.N.H., W.J.M., L.D., N.K., F.Z.S., S.P.A.), Molecular Pharmacology and Toxicology (H.N.H., J.H.-L.), and Obstetrics and Gynecology (D.S., F.Z.S.), Keck School of Medicine, University of Southern California, Los Angeles, the Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences, Stanford University, Stanford (V.W.H.),and the Los Angeles Biomedical Research Institute, Harbor-University of California, Los Angeles Medical Center, Torrance (M.J.B.) - all in California
| | - Naoko Kono
- From the Atherosclerosis Research Unit (H.N.H., W.J.M., J.H.-L., Y.L., M.F., L.D., N.K., R.H.S., S.P.A.) and the Departments of Medicine (H.N.H.), Preventive Medicine (H.N.H., W.J.M., L.D., N.K., F.Z.S., S.P.A.), Molecular Pharmacology and Toxicology (H.N.H., J.H.-L.), and Obstetrics and Gynecology (D.S., F.Z.S.), Keck School of Medicine, University of Southern California, Los Angeles, the Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences, Stanford University, Stanford (V.W.H.),and the Los Angeles Biomedical Research Institute, Harbor-University of California, Los Angeles Medical Center, Torrance (M.J.B.) - all in California
| | - Frank Z Stanczyk
- From the Atherosclerosis Research Unit (H.N.H., W.J.M., J.H.-L., Y.L., M.F., L.D., N.K., R.H.S., S.P.A.) and the Departments of Medicine (H.N.H.), Preventive Medicine (H.N.H., W.J.M., L.D., N.K., F.Z.S., S.P.A.), Molecular Pharmacology and Toxicology (H.N.H., J.H.-L.), and Obstetrics and Gynecology (D.S., F.Z.S.), Keck School of Medicine, University of Southern California, Los Angeles, the Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences, Stanford University, Stanford (V.W.H.),and the Los Angeles Biomedical Research Institute, Harbor-University of California, Los Angeles Medical Center, Torrance (M.J.B.) - all in California
| | - Robert H Selzer
- From the Atherosclerosis Research Unit (H.N.H., W.J.M., J.H.-L., Y.L., M.F., L.D., N.K., R.H.S., S.P.A.) and the Departments of Medicine (H.N.H.), Preventive Medicine (H.N.H., W.J.M., L.D., N.K., F.Z.S., S.P.A.), Molecular Pharmacology and Toxicology (H.N.H., J.H.-L.), and Obstetrics and Gynecology (D.S., F.Z.S.), Keck School of Medicine, University of Southern California, Los Angeles, the Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences, Stanford University, Stanford (V.W.H.),and the Los Angeles Biomedical Research Institute, Harbor-University of California, Los Angeles Medical Center, Torrance (M.J.B.) - all in California
| | - Stanley P Azen
- From the Atherosclerosis Research Unit (H.N.H., W.J.M., J.H.-L., Y.L., M.F., L.D., N.K., R.H.S., S.P.A.) and the Departments of Medicine (H.N.H.), Preventive Medicine (H.N.H., W.J.M., L.D., N.K., F.Z.S., S.P.A.), Molecular Pharmacology and Toxicology (H.N.H., J.H.-L.), and Obstetrics and Gynecology (D.S., F.Z.S.), Keck School of Medicine, University of Southern California, Los Angeles, the Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences, Stanford University, Stanford (V.W.H.),and the Los Angeles Biomedical Research Institute, Harbor-University of California, Los Angeles Medical Center, Torrance (M.J.B.) - all in California
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12
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Zhang L, Xiong W, Xiong Y, Liu H, Li N, Du Y, Liu Y. Intracellular Wnt/Beta-Catenin Signaling Underlying 17beta-Estradiol-Induced Matrix Metalloproteinase 9 Expression in Human Endometriosis. Biol Reprod 2016; 94:70. [PMID: 26888969 DOI: 10.1095/biolreprod.115.135574] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 02/02/2016] [Indexed: 12/31/2022] Open
Abstract
Extracellular matrix remodeling is necessary for ectopic endometrium implantation. Many studies have shown an increased expression of matrix metalloproteinase 9 (MMP9) in the ectopic endometrium of endometriosis. However, the signaling pathways and cellular effects related to this process remain incompletely elucidated. The objective of our study was to investigate the association between MMP9 and the Wnt signaling pathway under the regulation of 17beta-estradiol (E2) in endometrial stromal cells. We found that MMP9 was elevated in tissues from women with endometriosis compared with normal women. Furthermore, MMP9 and beta-catenin increased concurrently in a time- and dose-dependent manner after E2 treatment. To clarify the relationship between MMP9 and beta-catenin, we performed luciferase promoter reporter and chromatin immunoprecipitation assays. A beta-catenin/TCF3/LEF1 complex bound to a specific site on the MMP9 promoter that promoted MMP9 gene and protein expression. The promotion of MMP9 by the Wnt signaling pathway under the regulation of E2 may contribute to the pathophysiology of this disease.
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Affiliation(s)
- Ling Zhang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenqian Xiong
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yao Xiong
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hengwei Liu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Na Li
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Du
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Liu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Abstract
Objective This work aims to study the effects of hormone therapy (HT) on the risk of cardiovascular outcomes and all-cause mortality in women treated with statins. Methods We included women aged 40 to 74 years and living in Sweden who filled a first statin prescription between 2006 and 2007. Women were categorized as HT users or as nonusers. Information on dispensed drugs, comorbidity, cardiovascular outcomes, and all-cause mortality was obtained from national health registers. Results A total of 40,958 statin users—2,862 (7%) HT users and 38,096 nonusers—were followed for a mean of 4.0 years. In total, 70% of the women used statins as primary prevention. Among HT users, there were five cardiovascular deaths per 10,000 person-years. The corresponding rate among nonusers was 18, which yielded a hazard ratio of 0.38 (95% CI, 0.12-1.19). The all-cause mortality rates were 33 and 87, respectively, and the hazard ratio was 0.53 (95% CI, 0.34-0.81). There were no associations with cardiovascular events. A similar pattern was found for both primary and secondary prevention. Conclusions HT is associated with a reduced risk of all-cause mortality in women treated with statins. Although confounding factors, such as lifestyle and disease severity, might have influenced the results, HT does not seem to be detrimental to statin-treated women.
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15
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Zhu G, Chen X, Mao Y, Kang L, Ma X, Jiang Y. Characterization of annexin A2 in chicken follicle development: Evidence for its involvement in angiogenesis. Anim Reprod Sci 2015; 161:104-11. [DOI: 10.1016/j.anireprosci.2015.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 08/13/2015] [Accepted: 08/25/2015] [Indexed: 01/22/2023]
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16
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Harman SM. Menopausal hormone treatment cardiovascular disease: another look at an unresolved conundrum. Fertil Steril 2014; 101:887-97. [PMID: 24680648 DOI: 10.1016/j.fertnstert.2014.02.042] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 02/22/2014] [Accepted: 02/25/2014] [Indexed: 10/25/2022]
Abstract
Cardiovascular disease (CVD) is the most common cause of death in women. Before the Women's Health Initiative (WHI) hormone trials, evidence favored the concept that menopausal hormone treatment (MHT) protects against CVD. WHI studies failed to demonstrate CVD benefit, with worse net outcomes for MHT versus placebo in the population studied. We review evidence regarding the relationship between MHT and CVD with consideration of mechanisms and risk factors for atherogenesis and cardiac events, results of observational case-control and cohort studies, and outcomes of randomized trials. Estrogen effects on CVD risk factors favor delay or amelioration of atherosclerotic plaque development but may increase risk of acute events when at-risk plaque is present. Long-term observational studies have shown ∼40% reductions in risk of myocardial infarction and all-cause mortality. Analyses of data from randomized control trials other than the WHI show a ∼30% cardioprotective effect in recently menopausal women. Review of the literature as well as WHI data suggests that younger and/or more recently menopausal women may have a better risk-benefit ratio than older or remotely menopausal women and that CVD protection may only occur after >5 years; WHI women averaged 63 years of age (12 years postmenopausal) and few were studied for >6 years. Thus, a beneficial effect of long-term MHT on CVD and mortality is still an open question and is likely to remain controversial for the foreseeable future.
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17
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Zhang W, Zhao P, Xu XL, Cai L, Song ZS, Cao DY, Tao KS, Zhou WP, Chen ZN, Dou KF. Annexin A2 promotes the migration and invasion of human hepatocellular carcinoma cells in vitro by regulating the shedding of CD147-harboring microvesicles from tumor cells. PLoS One 2013; 8:e67268. [PMID: 23950866 PMCID: PMC3741296 DOI: 10.1371/journal.pone.0067268] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 05/13/2013] [Indexed: 12/25/2022] Open
Abstract
It has been reported that Annexin A2 (ANXA2) is up-regulated in hepatocellular carcinoma (HCC), but the roles of ANXA2 in the migration and invasion of HCC cells have not been determined. In this study, we found that ANXA2-specific siRNA (si-ANXA2) significantly inhibited the migration and invasion of HCC cells co-cultured with fibroblasts in vitro. In addition, the production of MMP-2 by fibroblasts cultured in supernatant collected from si-ANXA2-transfected HCC cells was notably down-regulated. ANXA2 was also found to be co-localized and co-immunoprecipitated with CD147. Further investigation revealed that the expression of ANXA2 in HCC cells affected the shedding of CD147-harboring membrane microvesicles, acting as a vehicle for CD147 in tumor-stromal interactions and thereby regulating the production of MMP-2 by fibroblasts. Together, these results suggest that ANXA2 enhances the migration and invasion potential of HCC cells in vitro by regulating the trafficking of CD147-harboring membrane microvesicles.
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Affiliation(s)
- Wei Zhang
- Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China
- Department of Hepatobiliary Surgery, General Hospital of Shenyang Military Area Command, Shenyang, Liaoning Province, China
| | - Pu Zhao
- College of Life and Health Sciences, Northeastern University, Shenyang, Liaoning Province, China
- Cell Engineering Research Center and Department of Cell Biology, State Key Laboratory of Cancer Biology, State Key Discipline of Cell University, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Xiu-Li Xu
- Center of Clinical Laboratory Medicine of People's Liberation Army, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Lei Cai
- Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Zhen-Shun Song
- Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Da-Yong Cao
- Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Kai-Shan Tao
- Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Wen-Ping Zhou
- Department of Hepatobiliary Surgery, General Hospital of Shenyang Military Area Command, Shenyang, Liaoning Province, China
- * E-mail: (WPZ); (ZNC); (KFD)
| | - Zhi-Nan Chen
- Cell Engineering Research Center and Department of Cell Biology, State Key Laboratory of Cancer Biology, State Key Discipline of Cell University, Fourth Military Medical University, Xi'an, Shaanxi Province, China
- * E-mail: (WPZ); (ZNC); (KFD)
| | - Ke-Feng Dou
- Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China
- * E-mail: (WPZ); (ZNC); (KFD)
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Jayachandran M, Litwiller RD, Lahr BD, Bailey KR, Owen WG, Mulvagh SL, Heit JA, Hodis HN, Harman SM, Miller VM. Alterations in platelet function and cell-derived microvesicles in recently menopausal women: relationship to metabolic syndrome and atherogenic risk. J Cardiovasc Transl Res 2011; 4:811-22. [PMID: 21786187 PMCID: PMC3219869 DOI: 10.1007/s12265-011-9296-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 06/13/2011] [Indexed: 12/31/2022]
Abstract
A woman's risk for metabolic syndrome (MS) increases at menopause, with an associated increase in risk for cardiovascular disease. We hypothesized that early menopause-related changes in platelet activity and concentrations of microvesicles derived from activated blood and vascular cells provide a mechanistic link to the early atherothrombotic process. Thus, platelet functions and cellular origin of blood-borne microvesicles in recently menopausal women (n = 118) enrolled in the Kronos Early Estrogen Prevention Study were correlated with components of MS and noninvasive measures of cardiovascular disease [carotid artery intima medial thickness (CIMT), coronary artery calcium (CAC) score, and endothelial reactive hyperemic index (RHI)]. Specific to individual components of the MS pentad, platelet number increased with increasing waist circumference, and platelet secretion of ATP and expression of P-selectin decreased with increasing blood glucose (p = 0.005) and blood pressure (p < 0.05), respectively. Waist circumference and systolic blood pressure were independently associated with monocyte- and endothelium-derived microvesicles (p < 0.05). Platelet-derived and total procoagulant phosphatidylserine-positive microvesicles, and systolic blood pressure correlated with CIMT (p < 0.05), but not with CAC or RHI. In summary, among recently menopausal women, specific platelet functions and concentrations of circulating activated cell membrane-derived procoagulant microvesicles change with individual components of MS. These cellular changes may explain in part how menopause contributes to MS and, eventually, to cardiovascular disease.
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Affiliation(s)
- Muthuvel Jayachandran
- Department of Physiology & Biomedical Engineering, Mayo Clinic, 200 First St. SW, Rochester, MN 55905 USA
| | - Robert D. Litwiller
- Department of Internal Medicine Division of Hematology, Mayo Clinic, Rochester, MN 55905 USA
| | - Brian D. Lahr
- Department of Health Sciences Research Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN 55905 USA
| | - Kent R. Bailey
- Department of Health Sciences Research Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN 55905 USA
| | - Whyte G. Owen
- Department of Internal Medicine Division of Hematology, Mayo Clinic, Rochester, MN 55905 USA
- Department of Biochemistry & Molecular Biology, Mayo Clinic, Rochester, MN 55905 USA
| | - Sharon L. Mulvagh
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905 USA
| | - John A. Heit
- Department of Internal Medicine Division of Hematology, Mayo Clinic, Rochester, MN 55905 USA
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905 USA
| | - Howard N. Hodis
- Atherosclerosis Research Unit, University of Southern California, Los Angeles, CA 90033 USA
| | | | - Virginia M. Miller
- Department of Physiology & Biomedical Engineering, Mayo Clinic, 200 First St. SW, Rochester, MN 55905 USA
- Department of Surgery, Mayo Clinic, Rochester, MN 55905 USA
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19
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Hwang-Levine J, Stanczyk FZ, Hodis HN. The Role of Progestogens in Regulating Matrix Metalloproteinase Activity in Macrophages and Microglial Cells. Neurochem Res 2011; 36:1870-5. [DOI: 10.1007/s11064-011-0508-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2011] [Indexed: 11/27/2022]
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Abstract
Cardiovascular disease is the leading cause of morbidity and mortality for both men and women in the USA. However, there are differences between the sexes in age-dependent onset, severity, symptoms and outcomes. Basic research into the causes of sex-dependent differences in cardiovascular disease is ongoing and includes investigation into genetic variation in expression and distribution of receptors for the sex steroids; specificity of natural and synthetic ligands that activate the sex steroid receptors; and intracellular mechanisms that are activated by the receptors in all components of the vessel wall and blood elements, which integrate to regulate vascular tone, vascular repair and remodeling in health and disease. In this era of personalized medicine, basic research into mechanisms of sex differences in vascular function will result in improved prevention, detection and treatment of cardiovascular disease in both men and women.
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Affiliation(s)
- V M Miller
- Departments of Surgery & Physiology & Biomedical Engineering, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
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21
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Barderas MG, Tuñón J, Dardé VM, De la Cuesta F, Jiménez-Nácher JJ, Tarín N, López-Bescós L, Egido J, Vivanco F. Atorvastatin modifies the protein profile of circulating human monocytes after an acute coronary syndrome. Proteomics 2009; 9:1982-93. [PMID: 19294693 DOI: 10.1002/pmic.200700583] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Aggressive treatment with high-dose atorvastatin reduces more effectively the incidence of cardiovascular events than moderate statin therapy. The mechanism of this benefit has not been fully elucidated. In order to know the potential effects of statin treatment on the protein expression of circulating monocytes in acute coronary syndrome (ACS) patients, a proteomic analysis of these cells was carried out by 2-DE and MS. Twenty-five patients with non-ST-elevation acute coronary syndrome (NSTEACS) were randomized, the fourth day after admission, to receive ATV 80 mg/dL (n = 14) or conventional treatment (CT) (n = 11), for two months. Blood was withdrawn at the end of the treatment, and monocytes were extracted for proteomic analysis and their protein expression patterns determined. Age, sex, total cholesterol, LDL, HDL, triglycerides, body mass index, presence of hypertension, diabetes, and smoking status were not significantly different between the two groups of patients. The expression of 20 proteins was modified by intensive ATV. Among the most relevant results stand out the normalization by intensive ATV treatment of the expression of proteins that modulate inflammation and thrombosis such as protein disulfide isomerase ER60 (PDI), Annexin I, and prohibitin, or that have other protective effects as HSP-70. Thus, this approach shed light at the molecular level of the beneficial mechanisms of anti-atherothrombotic drugs.
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22
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Bao H, Jiang M, Zhu M, Sheng F, Ruan J, Ruan C. Overexpression of Annexin II affects the proliferation, apoptosis, invasion and production of proangiogenic factors in multiple myeloma. Int J Hematol 2009; 90:177-185. [PMID: 19585213 DOI: 10.1007/s12185-009-0356-8] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2008] [Revised: 04/22/2009] [Accepted: 05/17/2009] [Indexed: 12/31/2022]
Abstract
The abnormal expression of Annexin II (AnxA2, A2) has been associated with the development of tumors; however, its expression and function in multiple myeloma (MM) is less known. We compared the expression of AnxA2 in primary myeloma cells from MM patients with that in normal plasma cells from normal subjects and found that myeloma cells from patients had higher expression of AnxA2. Expression of AnxA2 was also significantly higher in MM cell lines U266 and RPMI8226, compared with other hematologic tumor cell lines. Transfecting U266 and RPMI8226 cells with the small interfering RNA (siRNA) that targets human AnxA2 led to significant downregulation of AnxA2 expression, which resulted in the decreased proliferation, invasive potential and increased apoptosis of U266 and RPMI8226 cell lines. Silencing AnxA2 gene by siRNA also inhibited the expression of pro-angiogenic molecules including VEGF-C, VEGF-R2, MMP-2, MMP-9, MT1-MMP and TIMP-2 in the two cell lines. Our data suggested that the AnxA2 is overexpressed in MM patients and myeloma cell lines U266 and RPMI8226, and that AnxA2 overexpression appeared to affect the proliferation, apoptosis, invasive potential and production of pro-angiogenic factors in MM cell lines U266 and RPMI8226.
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Affiliation(s)
- Hongyu Bao
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 708 Renmin Road, Suzhou, 215007, China.,Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou, China
| | - Miao Jiang
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 708 Renmin Road, Suzhou, 215007, China.,Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou, China
| | - Mingqing Zhu
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 708 Renmin Road, Suzhou, 215007, China.,Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou, China
| | - Fei Sheng
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 708 Renmin Road, Suzhou, 215007, China.,Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou, China
| | - Jia Ruan
- Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medical College and New York-Presbyterian Hospital, New York, USA
| | - Changgeng Ruan
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 708 Renmin Road, Suzhou, 215007, China.
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23
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Need for research on estrogen receptor function: importance for postmenopausal hormone therapy and atherosclerosis. ACTA ACUST UNITED AC 2008; 5 Suppl A:S19-33. [PMID: 18395680 DOI: 10.1016/j.genm.2008.03.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2007] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cardiovascular disease is the leading cause of morbidity and mortality in men and women worldwide. Although rare in premenopausal women, its incidence rises sharply after menopause, indicating atheroprotective effects of endogenous estrogens. OBJECTIVE This review discusses the differential effects of estrogen receptor function on atherosclerosis progression in pre- and postmenopausal women, including aspects of gender differences in vascular physiology of estrogens and androgens. METHODS Recent advances in the understanding of the pathogenesis of atherosclerosis, estrogen receptor function, and hormone therapy are reviewed, with particular emphasis on clinical and molecular issues. RESULTS Whether hormone therapy can improve cardiovascular health in postmenopausal women remains controversial. Current evidence suggests that the vascular effects of estrogen are affected by the stage of reproductive life, the time since menopause, and the extent of subclinical atherosclerosis. The mechanisms of vascular responsiveness to sex steroids during different stages of atherosclerosis development remain poorly understood in women and men. CONCLUSION In view of the expected increase in the prevalence of atherosclerotic vascular disease worldwide due to population aging, research is needed to determine the vascular mechanism of endogenous and exogenous sex steroids in patients with atherosclerosis. Such research may help to define new strategies to improve cardiovascular health in women and possibly also in men.
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24
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Brinton EA, Hodis HN, Merriam GR, Harman SM, Naftolin F. Can menopausal hormone therapy prevent coronary heart disease? Trends Endocrinol Metab 2008; 19:206-12. [PMID: 18450469 DOI: 10.1016/j.tem.2008.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2007] [Revised: 02/19/2008] [Accepted: 03/04/2008] [Indexed: 11/21/2022]
Abstract
Observational studies show that women who take menopausal hormone therapy (MHT) have a greatly reduced risk of coronary heart disease (CHD). But in some large randomized controlled trials, MHT failed to decrease CHD and so has been deemed inappropriate for long-term prophylaxis against atherosclerosis or other chronic diseases associated with the menopause. Despite the apparent strength of this conclusion, several recent reports suggest that MHT could be atheroprotective when started close to the menopause, and effects of early discontinuation of MHT have never been studied in randomized trials. Here, we examine these reports and highlight existing uncertainty regarding the effects of long-term continuation versus early discontinuation of early-start MHT on atherosclerosis and CHD risk. We call for new research on this question, and an evidence-based review of existing recommendations for MHT.
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Affiliation(s)
- Eliot A Brinton
- Cardiovascular Genetics, University of Utah School of Medicine, Salt Lake City, UT 84108, USA.
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25
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Clarkson TB, Karas RH. Do the cardiovascular disease risks and benefits of oral versus transdermal estrogen therapy differ between perimenopausal and postmenopausal women? Menopause 2007; 14:963-7. [PMID: 17909452 DOI: 10.1097/gme.0b013e318157ac70] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Clarkson TB. Estrogen effects on arteries vary with stage of reproductive life and extent of subclinical atherosclerosis progression. Menopause 2007; 14:373-84. [PMID: 17438515 DOI: 10.1097/gme.0b013e31803c764d] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The past several years have been marked by confusion and controversy concerning whether estrogens are cardioprotective. The issue is of utmost public health importance because coronary heart disease (CHD) remains the leading cause of death among postmenopausal women. Fortunately, a unifying hypothesis has emerged that reproductive stage is a major determinant of the effect of estrogens on atherosclerosis progression, complications, and plaque vulnerability. PREMENOPAUSAL YEARS: Premenopausal atherosclerosis progression seems to be an important determinant of postmenopausal atherosclerosis and thus the risk for CHD. Clearly, plasma lipids/lipoproteins influence this progression; however, estradiol deficiency seems to be the major modulator. Both monkeys and women with premenopausal estrogen deficiency develop premature atherosclerosis, an effect that can be prevented in both species by estrogen-containing oral contraceptives. PERIMENOPAUSAL/EARLY POSTMENOPAUSAL YEARS: During this stage, there are robust estrogen benefits. Monkeys given estrogens immediately after surgical menopause have a 70% inhibition in coronary atherosclerosis progression. Estrogen treatment prevented progression of atherosclerosis of women in the Estrogen in the Prevention of Atherosclerosis Trial. A meta-analysis of women younger than 60 years given hormone therapy had reduced total mortality (relative risk = 0.61, 95% CI: 0.39-0.95). LATE POSTMENOPAUSAL YEARS: This stage is one in which there are no or possible deleterious estrogen effects. Monkeys lose CHD benefits of estrogens when treatment is delayed. The increase in CHD events associated with initiating hormone therapy 10 or more years after menopause seems to be related to up-regulation of the plaque inflammatory processes and plaque instability and may be down-regulated by statin pretreatment.
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Affiliation(s)
- Thomas B Clarkson
- Comparative Medicine Clinical Research Center, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1040, USA.
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27
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Tanaka Y, Ishii H, Hiraoka M, Miyasaka N, Kuroiwa T, Hajjar KA, Nagaoka T, Duong TQ, Ohno K, Yoshida M. Efficacy of recombinant annexin 2 for fibrinolytic therapy in a rat embolic stroke model: a magnetic resonance imaging study. Brain Res 2007; 1165:135-43. [PMID: 17651708 PMCID: PMC2900767 DOI: 10.1016/j.brainres.2007.06.039] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2007] [Revised: 06/02/2007] [Accepted: 06/05/2007] [Indexed: 11/19/2022]
Abstract
Efficacy of recombinant annexin 2 (rAN II) in a rat model of embolic stroke was examined using a magnetic resonance imaging (MRI) and histology. The right middle cerebral artery of male Wistar rats was occluded by autologous clots under anesthesia. Four doses of rAN II (0.125, 0.25, 0.5 and 1.0 mg/kg, n=10 for each group) or saline (1 ml/kg, n=10) were administrated intravenously within 5 min before clot infusion. Serial changes in apparent diffusion coefficient (ADC) and relative blood flow (CBF) were measured with the use of MRI in half of the animals in each group. The remaining half of the animals in each group was evaluated for hemorrhage and final infarct size by histology at 48 h after embolization. At 3 h after embolization, lesion volumes with ADC were abnormality and CBF in the peripheral lesion was improved in groups treated with 0.25, 0.5 and 1.0 mg/kg, but not 0.125 mg/kg, of rAN II in comparison with the saline-treated group (P<0.05). Histological analyses were consistent with MRI findings. More importantly, no hemorrhagic transformation was documented in rats treated with 0.125 and 0.25 mg/kg of rAN II, whereas it was observed at higher doses. We concluded that rAN II at 0.25 mg/kg significantly reduced infarct size and improved CBF without hemorrhagic complications. rAN II is a novel compound that has the potential to be a promising fibrinolytic agent to treat embolic stroke.
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Affiliation(s)
- Yoji Tanaka
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
- Yerkes Imaging Center, Departments of Neurology and Radiology, Emory University, Atlanta, Georgia, USA
| | - Hideto Ishii
- Department of Medical Biochemistry and Vascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
- Life Science and Bioethics Research Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Megumi Hiraoka
- Department of Medical Biochemistry and Vascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Naoyuki Miyasaka
- Department of Reproductive Comprehensive Medicine, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshihiko Kuroiwa
- Department of Neuropathology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katherine A. Hajjar
- Department of Cell and Developmental Biology, Weill Medical College of Cornell University, New York, USA
| | - Tsukasa Nagaoka
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
- Yerkes Imaging Center, Departments of Neurology and Radiology, Emory University, Atlanta, Georgia, USA
| | - Timothy Q. Duong
- Yerkes Imaging Center, Departments of Neurology and Radiology, Emory University, Atlanta, Georgia, USA
| | - Kikuo Ohno
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masayuki Yoshida
- Department of Medical Biochemistry and Vascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
- Life Science and Bioethics Research Center, Tokyo Medical and Dental University, Tokyo, Japan
- Corresponding author. Life Science and Bioethics Research Center, Tokyo Medical and Dental University, 1-5-45, Yushima Bldg D-9, Bunkyo-ku, Tokyo 113-8519, Japan. Fax: +81 3 5803 4725. (M. Yoshida)
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