1
|
Cai J, Jiang Y, Chen F, Wu S, Ren H, Wang P, Wang J, Liu W. PCSK9 promotes T helper 1 and T helper 17 cell differentiation by activating the nuclear factor-κB pathway in ankylosing spondylitis. Immun Inflamm Dis 2023; 11:e870. [PMID: 37249282 PMCID: PMC10214583 DOI: 10.1002/iid3.870] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 02/10/2023] [Accepted: 05/02/2023] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVE Our previous study reveals that proprotein convertase subtilisin/kexin type 9 (PCSK9) is positively related to inflammatory markers, T helper (Th)-17 cells, and treatment response in ankylosing spondylitis (AS) patients. Subsequently, this study aimed to explore the effect of PCSK9 on Th cell differentiation and its potential molecular mechanism in AS. METHODS Serum PCSK9 was determined by enzyme-linked immunosorbent assay in 20 AS patients and 20 healthy controls (HCs). Then naïve CD4+ T cells were isolated from AS patients and infected with PCSK9 overexpression or knockdown adenovirus followed by polarization assay. Afterward, PMA (an NF-κB activator) was administrated. RESULTS PCSK9 was increased in AS patients compared to HCs (p < .001), and it was positively related to Th1 cells (p = .050) and Th17 cells (p = .039) in AS patients. PCSK9 overexpression increased the CD4+ IFN-γ+ cells (p < .05), CD4+ IL-17A+ cells (p < .01), IFN-γ (p < .01), and IL-17A (p < .01), while it exhibited no effect on CD4+ IL-4+ cells or IL-4 (both p > .05); its knockdown displayed the opposite function on them. Moreover, PCSK9 overexpression upregulated the p-NF-κB p65/NF-κB p65 (p < .01), while it had no effect on p-ERK/ERK or p-JNK/JNK (both p > .05); its knockdown decreased p-NF-κB p65/NF-κB p65 (p < .01) and p-JNK/JNK (p < .05). Then, PMA upregulates p-NF-κB p65/NF-κB p65 (p < .001) and increased CD4+ IFN-γ+ cells, CD4+ IL-17A+ cells, IFN-γ, and IL-17A (all p < .01), also it alleviated the effect of PCSK9 knockdown on NF-κB inhibition and Th cell differentiation (all p < .01). CONCLUSION PCSK9 enhances Th1 and Th17 cell differentiation in an NF-κB-dependent manner in AS, while further validation is necessary.
Collapse
Affiliation(s)
- Jianfei Cai
- Department of Rheumatology and ImmunologyHuadong Hospital Affiliated with Fudan UniversityShanghaiChina
| | - Yinghui Jiang
- Department of Traditional Chinese Medicine and PharmacyChina Pharmaceutical UniversityNanjingChina
| | - Fucai Chen
- Department of Rheumatology and ImmunologyShanghai Qiang‐zhi HospitalShanghaiChina
| | - Shubin Wu
- Department of Rheumatology and ImmunologyShanghai Qiang‐zhi HospitalShanghaiChina
| | - Hongjun Ren
- Department of Rheumatology and ImmunologyShanghai Qiang‐zhi HospitalShanghaiChina
| | - Pingping Wang
- Department of Rheumatology and ImmunologyShanghai Qiang‐zhi HospitalShanghaiChina
| | - Jiayong Wang
- Department of Rheumatology and ImmunologyShanghai Qiang‐zhi HospitalShanghaiChina
| | - Wei Liu
- Department of Rheumatology and ImmunologyShanghai Qiang‐zhi HospitalShanghaiChina
| |
Collapse
|
2
|
Pan W, Jie W, Huang H. Vascular calcification: Molecular mechanisms and therapeutic interventions. MedComm (Beijing) 2023; 4:e200. [PMID: 36620697 PMCID: PMC9811665 DOI: 10.1002/mco2.200] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 01/05/2023] Open
Abstract
Vascular calcification (VC) is recognized as a pathological vascular disorder associated with various diseases, such as atherosclerosis, hypertension, aortic valve stenosis, coronary artery disease, diabetes mellitus, as well as chronic kidney disease. Therefore, it is a life-threatening state for human health. There were several studies targeting mechanisms of VC that revealed the importance of vascular smooth muscle cells transdifferentiating, phosphorous and calcium milieu, as well as matrix vesicles on the progress of VC. However, the underlying molecular mechanisms of VC need to be elucidated. Though there is no acknowledged effective therapeutic strategy to reverse or cure VC clinically, recent evidence has proved that VC is not a passive irreversible comorbidity but an active process regulated by many factors. Some available approaches targeting the underlying molecular mechanism provide promising prospects for the therapy of VC. This review aims to summarize the novel findings on molecular mechanisms and therapeutic interventions of VC, including the role of inflammatory responses, endoplasmic reticulum stress, mitochondrial dysfunction, iron homeostasis, metabolic imbalance, and some related signaling pathways on VC progression. We also conclude some recent studies on controversial interventions in the clinical practice of VC, such as calcium channel blockers, renin-angiotensin system inhibitions, statins, bisphosphonates, denosumab, vitamins, and ion conditioning agents.
Collapse
Affiliation(s)
- Wei Pan
- Department of Cardiology, the Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenGuangdongChina
- Joint Laboratory of Guangdong‐Hong Kong‐Macao Universities for Nutritional Metabolism and Precise Prevention and Control of Major Chronic DiseaseSun Yat‐sen UniversityShenzhenGuangdongChina
| | - Wei Jie
- Department of Cardiology, the Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenGuangdongChina
- Joint Laboratory of Guangdong‐Hong Kong‐Macao Universities for Nutritional Metabolism and Precise Prevention and Control of Major Chronic DiseaseSun Yat‐sen UniversityShenzhenGuangdongChina
| | - Hui Huang
- Department of Cardiology, the Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenGuangdongChina
- Joint Laboratory of Guangdong‐Hong Kong‐Macao Universities for Nutritional Metabolism and Precise Prevention and Control of Major Chronic DiseaseSun Yat‐sen UniversityShenzhenGuangdongChina
| |
Collapse
|
3
|
Bélanger AM, Akioyamen LE, Ruel I, Hales L, Genest J. Aortic stenosis in homozygous familial hypercholesterolaemia: a paradigm shift over a century. Eur Heart J 2022; 43:3227-3239. [PMID: 35776569 DOI: 10.1093/eurheartj/ehac339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 05/13/2022] [Accepted: 06/09/2022] [Indexed: 01/31/2023] Open
Abstract
AIMS Homozygous familial hypercholesterolaemia (HoFH) is an orphan disease defined by extreme elevations in low-density lipoprotein cholesterol, cutaneous xanthomas, and pre-mature atherosclerotic cardiovascular disease. Survival has more than doubled over the past three decades. Aortic stenosis (AS) [supravalvular aortic stenosis (SVAS) or valvular aortic stenosis (VAS)] is commonly encountered. There are no medical treatments available and complex high-risk surgeries represent the only available option in severe cases. A systematic review was performed to summarize the current evidence on AS in HoFH and to determine whether pharmacological treatment (statins) have had an impact on clinical presentation, phenotype and clinical course over the past nine decades (PROSPERO CRD42021250565). METHODS AND RESULTS MEDLINE, Embase Classic + Embase, Cochrane Central Register of Controlled Trials, PubMed, AfricaWide, and Scopus were searched from inception to 10 November 2021. Searches identified 381 publications, of which 19 were retained; they were cross-sectional or retrospective studies. Separately, 108 individual case reports were described. Within the 424 HoFH cases, AS was identified in 57% of patients in the pre-statin era vs. 35% in patients reported more recently (>2000, long-term statin period). With an increase in longevity due to statins and lipoprotein apheresis, a change in the proportion of patients with SVAS and VAS with a SVAS:VAS ratio of 47:53 and 10:90 for HoFH patients not on statin and on long-term statin, respectively, was noted. CONCLUSION These data suggest that SVAS and VAS are frequent in HoFH and that the phenotype has shifted towards calcific VAS as statins and lipoprotein apheresis improve survival in these patients.
Collapse
Affiliation(s)
- Alexandre M Bélanger
- Research Institute of the McGill University Health Centre, 1001, Boul. Décarie, Office EM1.2212, Montréal, Québec, Canada
| | - Leo E Akioyamen
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Isabelle Ruel
- Research Institute of the McGill University Health Centre, 1001, Boul. Décarie, Office EM1.2212, Montréal, Québec, Canada
| | - Lindsay Hales
- McGill University Health Centre Medical Libraries, Montréal, Québec, Canada
| | - Jacques Genest
- Research Institute of the McGill University Health Centre, 1001, Boul. Décarie, Office EM1.2212, Montréal, Québec, Canada
| |
Collapse
|
4
|
Awan Z, Al-Rayes N, Khan Z, Al Mansouri M, Ibrahim H. Bima A, Almukadi H, Ibrahim Kutbi H, Jayasheela Shetty P, Ahmad Shaik N, Banaganapalli B. Identifying Significant Genes and Functionally Enriched Pathways in Familial Hypercholesterolemia Using Integrated Gene Co-Expression Network Analysis. Saudi J Biol Sci 2022; 29:3287-3299. [PMID: 35844366 PMCID: PMC9280244 DOI: 10.1016/j.sjbs.2022.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 12/20/2022] Open
Abstract
Familial hypercholesterolemia (FH) is a monogenic lipid disorder which promotes atherosclerosis and cardiovascular diseases. Owing to the lack of sufficient published information, this study aims to identify the potential genetic biomarkers for FH by studying the global gene expression profile of blood cells. The microarray expression data of FH patients and controls was analyzed by different computational biology methods like differential expression analysis, protein network mapping, hub gene identification, functional enrichment of biological pathways, and immune cell restriction analysis. Our results showed the dysregulated expression of 115 genes connected to lipid homeostasis, immune responses, cell adhesion molecules, canonical Wnt signaling, mucin type O-glycan biosynthesis pathways in FH patients. The findings from expanded protein interaction network construction with known FH genes and subsequent Gene Ontology (GO) annotations have also supported the above findings, in addition to identifying the involvement of dysregulated thyroid hormone and ErbB signaling pathways in FH patients. The genes like CSNK1A1, JAK3, PLCG2, RALA, and ZEB2 were found to be enriched under all GO annotation categories. The subsequent phenotype ontology results have revealed JAK3I, PLCG2, and ZEB2 as key hub genes contributing to the inflammation underlying cardiovascular and immune response related phenotypes. Immune cell restriction findings show that above three genes are highly expressed by T-follicular helper CD4+ T cells, naïve B cells, and monocytes, respectively. These findings not only provide a theoretical basis to understand the role of immune dysregulations underlying the atherosclerosis among FH patients but may also pave the way to develop genomic medicine for cardiovascular diseases.
Collapse
|
5
|
Shen J, Zhao M, Zhang C, Sun X. IL-1β in atherosclerotic vascular calcification: From bench to bedside. Int J Biol Sci 2021; 17:4353-4364. [PMID: 34803503 PMCID: PMC8579452 DOI: 10.7150/ijbs.66537] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/11/2021] [Indexed: 01/19/2023] Open
Abstract
Atherosclerotic vascular calcification contributes to increased risk of death in patients with cardiovascular diseases. Assessing the type and severity of inflammation is crucial in the treatment of numerous cardiovascular conditions. IL-1β, a potent proinflammatory cytokine, plays diverse roles in the pathogenesis of atherosclerotic vascular calcification. Several large-scale, population cohort trials have shown that the incidence of cardiovascular events is clinically reduced by the administration of anti-IL-1β therapy. Anti-IL-1β therapy might reduce the incidence of cardiovascular events by affecting atherosclerotic vascular calcification, but the mechanism underlying this effect remains unclear. In this review, we summarize current knowledge on the role of IL-1β in atherosclerotic vascular calcification, and describe the latest results reported in clinical trials evaluating anti-IL-1β therapies for the treatment of cardiovascular diseases. This review will aid in improving current understanding of the pathophysiological roles of IL-1β and mechanisms underlying its activity.
Collapse
Affiliation(s)
- Jialing Shen
- Department of General Surgery (Vascular Surgery), the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Ming Zhao
- Department of Interventional Medicine, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Chunxiang Zhang
- Laboratory of Nucleic Acids in Medicine for National high-level talents, Southwest Medical University, Luzhou 646000, China.,Key Laboratory of Medical Electrophysiology, Ministry of Education & Medical Electrophysiological Key Laboratory of Sichuan Province, Collaborative Innovation Center for Prevention and Treatment of Cardiovascular Disease of Sichuan Province, Institute of Cardiovascular Research, Southwest Medical University, Luzhou 646000, China
| | - Xiaolei Sun
- Department of General Surgery (Vascular Surgery), the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.,Department of Interventional Medicine, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.,Laboratory of Nucleic Acids in Medicine for National high-level talents, Southwest Medical University, Luzhou 646000, China.,School of Cardiovascular Medicine and Sciences, King's College London British Heart Foundation Centre of Research Excellence, Faculty of Life Science and Medicine, King's College London, London SE5 9NU, United Kingdom.,Centre for Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, United Kingdom.,Key Laboratory of Medical Electrophysiology, Ministry of Education & Medical Electrophysiological Key Laboratory of Sichuan Province, Collaborative Innovation Center for Prevention and Treatment of Cardiovascular Disease of Sichuan Province, Institute of Cardiovascular Research, Southwest Medical University, Luzhou 646000, China.,Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, 646000, China.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou 646000, China
| |
Collapse
|
6
|
SOYLU Aİ, SOYLU K, AYDIN R, UZUNKAYA F, ASLAN K, POLAT AV. Calcification of breast artery as detected by mammography: association with coronary and aortic calcification. Turk J Med Sci 2019; 49:190-197. [PMID: 30764597 PMCID: PMC7350865 DOI: 10.3906/sag-1807-275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background/aim https://orcid.org/0000-0002-9740-3580 Materials and methods A total of 404 female patients above 40 years of age who, within a 6-month period, had undergone thoracic computed tomography and mammography for various reasons were screened retrospectively at our clinic. Mammographies were assessed for BAC and thoracic CT investigations were assessed for CAC and AC. Patients included in the study were scored as 0 (none), 1 (mild), 2 (moderate), or 3 (severe) depending on the number and shape of CAC, AC, and BAC lesions observed. Results Four hundred and four females were enrolled in the study. While BAC was detected in 123 patients, no BAC was observed in the other 281 patients. In the BAC-positive patients, the rates of CAC (45.5% vs. 19.9%, P < 0.001) and AC (67.5% vs. 32.4%, P < 0.001) were notably higher than in the BAC-negative patients. In addition, multivariate regression analysis detected the presence of BAC as an independent variable for both CAC and AC. Conclusion The presence of BAC appeared to be a significant risk factor for CAC and AC, and the BAC grade was considered an independent risk factor for CAC.
Collapse
Affiliation(s)
- Ayşegül İdil SOYLU
- Department of Radiology, Faculty of Medicine, Ondokuz Mayıs University, SamsunTurkey
| | - Korhan SOYLU
- Department of Cardiology, Faculty of Medicine, Ondokuz Mayıs University, SamsunTurkey
| | - Ramazan AYDIN
- Clinic of Radiology, Kırıkkale Yüksek İhtisas Hospital, KırıkkaleTurkey
| | - Fatih UZUNKAYA
- Department of Radiology, Faculty of Medicine, Ondokuz Mayıs University, SamsunTurkey
| | - Kerim ASLAN
- Department of Radiology, Faculty of Medicine, Ondokuz Mayıs University, SamsunTurkey
| | - Ahmet Veysel POLAT
- Department of Radiology, Faculty of Medicine, Ondokuz Mayıs University, SamsunTurkey
| |
Collapse
|
7
|
Gałąska R, Kulawiak-Gałąska D, Chmara M, Chlebus K, Studniarek M, Fijałkowski M, Wasąg B, Rynkiewicz A, Gruchała M. Aortic valve calcium score in hypercholesterolemic patients with and without low-density lipoprotein receptor gene mutation. PLoS One 2018; 13:e0209229. [PMID: 30592719 PMCID: PMC6310281 DOI: 10.1371/journal.pone.0209229] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/30/2018] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was a comparison of aortic valve calcium score (AVCS) between patients with hypercholesterolemia and genetic diagnosis of familial hypercholesterolemia with low-density lipoprotein receptor gene mutation (LDLR-M group), versus patients with hypercholesterolemia without LDLR gene mutation (LDLR-WT group). A total of 72 LDLR-M patients and 50 LDLR-WT patients were enrolled in the study and underwent CT as a part of an assessment of coronary calcium scoring. AVCS was determined and compared between the two patient groups. AVCS was significantly higher in the LDLR-M group in comparison to the LDLR-WT group (13.8 ± 37.9 vs. 0.94 ± 3.1, p = 0.03). The Yates' chi-squared test for independence revealed that LDLR mutation and AVCS were significantly dependable (Chi^2 = 6.106, p = 0.013). The LDLR mutation was a strong predictor of a high AVCS (OR 7.83, 95% CI 2.08–29.50, p = 0.002) on multivariate regression analysis. Among the traditional risk factors, age (odds ratio 1.12, 95% CI 1.05–1.18, p<0.001) and SBP (OR 1.04, 95% CI 1.00–1.07, p = 0.045) were also significant for high result of AVCS. An assessment of computed tomography calcium scores showed that LDLR-M patients have increased AVCS in comparison to those with LDLR-WT. In addition, LDLR mutation can be considered as an independent risk factor of having high AVSC even after adjustment for risk factors including cholesterol levels. This may result from the associated process connected with the regulatory role of LDLR in evolution of aortic valve calcifications.
Collapse
Affiliation(s)
- Rafal Gałąska
- 1st Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
- * E-mail:
| | | | - Magdalena Chmara
- Department of Biology and Genetics, Medical University of Gdansk, Gdansk, Poland
| | - Krzysztof Chlebus
- 1st Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Michał Studniarek
- Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Marcin Fijałkowski
- 1st Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Bartosz Wasąg
- Department of Biology and Genetics, Medical University of Gdansk, Gdansk, Poland
| | - Andrzej Rynkiewicz
- Department of Cardiology and Cardiosurgery, University of Warmia and Mazury, Olsztyn, Poland
| | - Marcin Gruchała
- 1st Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| |
Collapse
|
8
|
Abstract
Clinical trials have unequivocally shown that inhibition of proprotein convertase subtilisin/kexin type 9 (PCSK9) efficaciously and safely prevents cardiovascular events by lowering levels of LDL cholesterol. PCSK9 in the circulation is derived mainly from the liver, but the protein is also expressed in the pancreas, the kidney, the intestine and the central nervous system. Although PCSK9 modulates cholesterol metabolism by regulating LDL receptor expression in the liver, in vitro and in vivo studies have suggested that PCSK9 is involved in various other physiological processes. Although therapeutic PCSK9 inhibition could theoretically have undesired effects by interfering with these non-cholesterol-related processes, studies of individuals with genetically determined reduced PCSK9 function and clinical trials of PCSK9 inhibitors have not revealed clinically meaningful adverse consequences of almost completely eradicating PCSK9 from the circulation. The clinical implications of PCSK9 functions beyond lipid metabolism in terms of wanted or unwanted effects of therapeutic PCSK9 inhibition therefore appear to be limited. The objective of this Review is to describe the physiological role of PCSK9 beyond the LDL receptor to provide a rational basis for monitoring the effects of PCSK9 inhibition as these drugs gain traction in the clinic.
Collapse
Affiliation(s)
| | - Gilles Lambert
- Inserm UMR 1188 DéTROI, Université de La Réunion, Saint-Denis de La Réunion, France
| | - Bertrand Cariou
- L'institut du thorax, INSERM, CNRS, Université de Nantes, CHU Nantes, Nantes, France
| | - G Kees Hovingh
- Department of Vascular Medicine, Academisch Medisch Centrum, Amsterdam, Netherlands.
| |
Collapse
|
9
|
Bo L, Fu H, Yang J. Comprehensive analysis of gene expression profiles provides insight into the pathogenesis of Crohn's disease. Mol Med Rep 2018; 18:2643-2650. [PMID: 30015893 PMCID: PMC6102736 DOI: 10.3892/mmr.2018.9267] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 05/18/2018] [Indexed: 12/21/2022] Open
Abstract
Crohn's disease (CD) is a type of inflammatory bowel disease that cannot be fully cured by medication or surgery. In the present study, the aim was to understand the underlying mechanisms of CD. Two CD microarray datasets were downloaded from The Gene Expression Omnibus database: GSE36807 (13 CD and 7 normal samples) and GSE59071 (8 CD and 11 normal samples). A series of bioinformatics analyses were conducted, including weighted gene co‑expression network analysis to identify stable modules, and analysis of differentially expressed genes (DEGs) between CD and normal samples. The common DEGs in the GSE36807 and GSE59071 datasets were screened. Subsequently, overlapping genes in the stable modules and the DEGs were selected to construct a protein‑protein interaction (PPI) network using Cytoscape software. Enrichment analysis of genes in the network was performed to explore their biological functions. A total of 10 stable modules and 927 DEGs were identified, of which 234 genes were shared in the stable modules and the DEGs. After removal of 32 uncharacterized genes, 202 genes were selected to build the PPI network. Low density lipoprotein receptor (LDLR), toll‑like receptor 2 (TLR2), lipoprotein lipase (LPL), forkhead box protein M1 (FOXM1) and neuropeptide Y (NPY) were revealed as key nodes with high degree. Pathway enrichment analysis demonstrated that LPL was enriched in the peroxisome proliferator‑activated receptor (PPAR) signaling pathway. In conclusion, LDLR, TLR2, FOXM1 and NPY, as well as LPL in the PPAR signaling pathway may serve critical roles in the pathogenesis of CD.
Collapse
Affiliation(s)
- Lumin Bo
- Department of Gastroenterology, Changhai Hospital, Shanghai 200433, P.R. China
| | - Hongyu Fu
- Department of Gastroenterology, Changhai Hospital, Shanghai 200433, P.R. China
| | - Junchi Yang
- Department of Gastrointestinal Surgery, Changhai Hospital, Shanghai 200433, P.R. China
| |
Collapse
|
10
|
Elseweidy MM, Mohamed HE, Elrashidy RA, Atteia HH, Elnagar GM. Inhibition of Aortic Calcification by Policosanol in Dyslipidemic Rabbits Is Enhanced by Pentoxifylline. J Cardiovasc Pharmacol Ther 2018; 23:551-560. [PMID: 29742924 DOI: 10.1177/1074248418775377] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Policosanol (POL) is a hypocholesterolemic drug of natural origin and has been shown to reduce circulating levels of proprotein convertase subtilisin/kexin type 9 (PCSK9) in healthy participants. Recently, we have reported that POL can attenuate aortic calcification in diabetic dyslipidemic rats; however, the underlying mechanism is not fully elucidated. We aimed to investigate the effect of POL on aortic calcification and whether PCSK9 has a contributory role and also to examine whether the combination of POL with pentoxifylline (PTX) as anti–tumor necrosis factor α would offer additional benefits. Thirty adult male New Zealand rabbits weighing 1.5 to 2 kg were randomly assigned to 5 groups. One group received standard chow diet and served as normal control group (NC). The other 4 groups received 0.5% wt/wt cholesterol-rich diet for 12 weeks and concurrently treated with placebo, POL, PTX, or a combination of POL and PTX. Sera samples and aortic tissue were collected for biochemical measurements and histological assessment. Rabbits fed a cholesterol-rich diet demonstrated dyslipidemia, increased inflammatory state, and elevated serum levels of PCSK9, compared to the NC group. Aortic calcification was evident in dyslipidemic rabbits, represented by increased calcium deposition and osteopontin expression in aortic tissue, along with elevated serum levels of alkaline phosphatase and osteocalcin. Dyslipidemic rabbits showed a significant upregulation of wingless-type MMTV integration site family 3A and bone morphogenetic protein 2 genes in their aortic tissue. Policosanol significantly reduced circulating PCSK9 levels, suppressed calcification markers, and attenuated aortic calcification. Combination of POL with PTX alleviated aortic calcification to a greater extent than either monotherapy, which may be attributed to further suppression of PCSK9 and calcification markers. These findings suggested that POL exerted anticalcifying effect partly via inhibition of PCSK9. Combination of POL and PTX offered additional benefits and might represent a promising therapeutic option for aortic calcification.
Collapse
Affiliation(s)
- Mohamed M. Elseweidy
- Department of Biochemistry, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Hoda E. Mohamed
- Department of Biochemistry, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Rania A. Elrashidy
- Department of Biochemistry, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Hebatallah H. Atteia
- Department of Biochemistry, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Gehad M. Elnagar
- Department of Biochemistry, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| |
Collapse
|
11
|
Zamparini JM, Immelman AR, Raal FJ. Fibroblast growth factor-23 in patients with homozygous familial hypercholesterolemia. J Clin Lipidol 2018; 12:767-772. [PMID: 29550495 DOI: 10.1016/j.jacl.2018.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 02/10/2018] [Accepted: 02/13/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Patients with homozygous familial hypercholesterolemia (HoFH) develop significant vascular calcification early in life, the cause of which is not yet fully understood. Patients with chronic kidney disease have similar vascular calcification, with fibroblast growth factor-23 (FGF23) implicated in these patients. OBJECTIVE To determine whether there was a difference in FGF23 between patients with HoFH and age- and gender-matched controls and whether there is a correlation between FGF23 and serum low-density lipoprotein, total cholesterol, and carotid intima-media thickness in patients with HoFH. METHODS The study was a cross-sectional review involving 30 patients with HoFH attending the Charlotte Maxeke Johannesburg Academic Hospital Lipid Clinic in Parktown, South Africa, as well as 30 age- and gender-matched healthy controls. FGF23, fasting lipid profiles, calcium, and phosphate were measured. B-mode ultrasonography of the carotid arteries was done to assess the extent and severity of arterial calcification. RESULTS There was no difference in mean FGF23 between the patient and control groups (62.07 ± 26.42 pg/mL vs 63.69 ± 19.84 pg/mL; P = .4621) nor was there any correlation between FGF23 and low-density lipoprotein cholesterol (P = .9483 and .8474) or total cholesterol (P = .9261 and .859). In the HoFH patients, FGF23 did not correlate significantly with any cardiovascular disease. CONCLUSIONS Serum FGF23 is not elevated in patients with HoFH when compared to non-familial hypercholesterolemia age- and gender-matched controls, and there is no correlation between serum FGF23 and cardiovascular disease in patients with HoFH. FGF23 does not appear to be a major factor for arterial calcification in HoFH.
Collapse
Affiliation(s)
- Jarrod M Zamparini
- Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa.
| | - Andrew R Immelman
- Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa; Carbohydrate & Lipid Metabolism Research Unit, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| | - Frederick J Raal
- Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa; Carbohydrate & Lipid Metabolism Research Unit, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| |
Collapse
|
12
|
Iida Y, Tanaka H, Sano H, Suzuki Y, Shimizu H, Urano T. Ectopic Expression of PCSK9 by Smooth Muscle Cells Contributes to Aortic Dissection. Ann Vasc Surg 2017; 48:195-203. [PMID: 29197601 DOI: 10.1016/j.avsg.2017.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 10/10/2017] [Accepted: 10/15/2017] [Indexed: 01/25/2023]
Abstract
BACKGROUND Acute aortic dissection (AAD) is a common disease among the elderly. Although several risk factors of AAD have been reported, the molecular mechanism underlying AAD development remains to be elucidated. Proprotein convertase subtilisin/kexin type 9 (PCSK9) increases low-density lipoprotein cholesterol levels in blood by preventing its clearance. Therefore, PCSK9 inhibition is a promising therapeutic approach to treat cardiovascular diseases (CVDs). The objective of this study was to elucidate the role of PCSK9 in the pathogenesis of AAD. METHODS We used fluorescence immunohistochemistry to assess PCSK9 expression in aortic tissues resected from 10 AAD patients and in the normal aorta from 5 autopsy samples as well as in spontaneously hyperlipidemic apolipoprotein E-deficient mice used as an experimental AD model. RESULTS We revealed a characteristic distribution pattern of PCSK9 in atherosclerotic plaques and the degenerated tunica media in AAD tissues, which was rarely observed in normal aortic tissues. Furthermore, PCSK9 was notably expressed around calcification areas formed by vascular smooth muscle cells, especially those of the synthetic phenotype. The results obtained in the animal model were consistent with PCSK9 expression in AAD tissues. CONCLUSIONS Our findings suggest that PCSK9 overexpression in the aorta may promote AAD. This study adds to the growing body of evidence supporting the use of PCSK9 inhibitors for the management of CVDs.
Collapse
Affiliation(s)
- Yasunori Iida
- Department of Cardiovascular Surgery, Keio University, Tokyo, Japan; Department of Cardiovascular Surgery, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan
| | - Hiroki Tanaka
- Department of Medical Physiology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
| | - Hideto Sano
- Department of Medical Physiology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yuko Suzuki
- Department of Medical Physiology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hideyuki Shimizu
- Department of Cardiovascular Surgery, Keio University, Tokyo, Japan.
| | - Tetsumei Urano
- Department of Medical Physiology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| |
Collapse
|
13
|
Aortic Calcification Progression in Heterozygote Familial Hypercholesterolemia. Can J Cardiol 2017; 33:658-665. [DOI: 10.1016/j.cjca.2017.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 01/31/2017] [Accepted: 02/01/2017] [Indexed: 01/14/2023] Open
|
14
|
Mazur P, Wypasek E, Gawęda B, Sobczyk D, Kapusta P, Natorska J, Malinowski KP, Tarasiuk J, Bochenek M, Wroński S, Chmielewska K, Kapelak B, Undas A. Stenotic Bicuspid and Tricuspid Aortic Valves - Micro-Computed Tomography and Biological Indices of Calcification. Circ J 2017; 81:1043-1050. [PMID: 28344201 DOI: 10.1253/circj.cj-16-1166] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Valve calcification is well estimated by ex-vivo micro-computed tomography (micro-CT). The objective of this study was to investigate the associations between micro-CT findings and biological indices of calcification in aortic stenosis (AS), as well as differences between bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV).Methods and Results:Aortic valves and plasma were obtained from patients undergoing valve surgery. Valves were dissected and underwent micro-CT, genetic analyses, and calcium content assessment. Plasma levels of calcification markers were measured. Forty-two patients with isolated severe AS, including 22 with BAV, were studied. BAV patients had a lower median CT value (140.0 [130.0-152.0] vs. 157.0 [147.0-176.0], P=0.002) and high-density calcification (HDC) fraction (9.3 [5.7-23.3] % vs. 21.3 [14.3-31.2] %, P=0.01), as compared with TAV. Calcification fraction (CF) correlated with AS severity (measured as maximal transvalvular pressure gradient [r=0.34, P=0.03], maximal flow velocity [r=0.38, P=0.02], and indexed aortic valve area [r=-0.37, P=0.02]). For TAV patients only, mRNA expression of integrin-binding sialoprotein correlated with CF (r=0.45, P=0.048), and the receptor activator of the nuclear factor κ-B ligand transcript correlated with HDC corrugation (r=0.54, P=0.01). CONCLUSIONS TAV patients with AS present more mineralized calcifications in micro-CT than BAV subjects. The relative volume of calcifications increases with the AS severity. In TAV patients, upregulated expression of genes involved in osteoblastogenesis in AS correlates with leaflet mineralization in micro-CT.
Collapse
Affiliation(s)
- Piotr Mazur
- John Paul II Hospital.,Institute of Cardiology, Jagiellonian University Medical College Krakow
| | - Ewa Wypasek
- John Paul II Hospital.,Institute of Cardiology, Jagiellonian University Medical College Krakow
| | - Bogusław Gawęda
- Institute of Cardiology, Jagiellonian University Medical College Krakow
| | - Dorota Sobczyk
- Institute of Cardiology, Jagiellonian University Medical College Krakow
| | - Przemysław Kapusta
- John Paul II Hospital.,Institute of Cardiology, Jagiellonian University Medical College Krakow
| | - Joanna Natorska
- John Paul II Hospital.,Institute of Cardiology, Jagiellonian University Medical College Krakow
| | | | - Jacek Tarasiuk
- Department of Condensed Matter Physics, Faculty of Physics and Applied Computer Science, AGH University of Science and Technology
| | - Maciej Bochenek
- John Paul II Hospital.,Institute of Cardiology, Jagiellonian University Medical College Krakow
| | - Sebastian Wroński
- Department of Condensed Matter Physics, Faculty of Physics and Applied Computer Science, AGH University of Science and Technology
| | - Katarzyna Chmielewska
- Department of Condensed Matter Physics, Faculty of Physics and Applied Computer Science, AGH University of Science and Technology
| | - Bogusław Kapelak
- John Paul II Hospital.,Institute of Cardiology, Jagiellonian University Medical College Krakow
| | - Anetta Undas
- John Paul II Hospital.,Institute of Cardiology, Jagiellonian University Medical College Krakow
| |
Collapse
|
15
|
Greco M, Robinson JD, Eltayeb O, Benuck I. Progressive Aortic Stenosis in Homozygous Familial Hypercholesterolemia After Liver Transplant. Pediatrics 2016; 138:peds.2016-0740. [PMID: 27940769 DOI: 10.1542/peds.2016-0740] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2016] [Indexed: 11/24/2022] Open
Abstract
Early onset coronary artery disease and aortic calcifications are characteristic features of patients with homozygous familial hypercholesterolemia. Standard medical therapy includes dietary modification, pharmacotherapy, and lipoprotein apheresis to lower serum low-density lipoprotein cholesterol (LDL-C). Liver transplant is a surgical option for the treatment of homozygous familial hypercholesterolemia and can lead to normal cholesterol levels. Vascular calcifications are known to progress despite standard medical therapy and have been reported after liver transplant in the setting of rejection. We present the first report of progressive severe aortic valve stenosis in a patient despite liver transplant with normalization of lipid levels and no history of graft rejection.
Collapse
Affiliation(s)
| | - Joshua D Robinson
- Divisions of Cardiology and.,Departments of Pediatrics.,Radiology, and
| | - Osama Eltayeb
- Cardiothoracic Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; and.,Surgery, Northwestern University Feinberg School of Medicine, Chicago Illinois
| | - Irwin Benuck
- Divisions of Cardiology and.,Departments of Pediatrics
| |
Collapse
|
16
|
Langsted A, Nordestgaard BG, Benn M, Tybjærg-Hansen A, Kamstrup PR. PCSK9 R46L Loss-of-Function Mutation Reduces Lipoprotein(a), LDL Cholesterol, and Risk of Aortic Valve Stenosis. J Clin Endocrinol Metab 2016; 101:3281-7. [PMID: 27218270 DOI: 10.1210/jc.2016-1206] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
CONTEXT Novel, low-density lipoprotein (LDL) cholesterol-lowering proprotein convertase subtilisin/kexin type-9 (PCSK9) inhibitors also lower lipoprotein(a) levels, but the effect on aortic valve stenosis and myocardial infarction is unknown. OBJECTIVE We tested the hypothesis that the PCSK9 R46L loss-of-function mutation is associated with lower levels of lipoprotein(a) and with reduced risk of aortic valve stenosis and myocardial infarction. DESIGN We used two prospective cohort studies of the general population and one patient-based cohort. SETTING Cohort studies selected at random individuals of Danish descent. PARTICIPANTS We studied 103 083 individuals from the Copenhagen General Population Study, the Copenhagen City Heart Study, and the Copenhagen Ischemic Heart Disease Study. MAIN OUTCOME MEASURES Lipoprotein(a), LDL cholesterol, and PCSK9 R46L genotype and diagnoses of aortic valve stenosis and myocardial infarction from national registries; lipoprotein(a) was measured from 49,617 individuals. RESULTS Median (interquartile range) lipoprotein(a) levels were 10 (5-30) mg/dl for PCSK9 R46L noncarriers, 9 (4-32) mg/dl for heterozygotes, and 8 (4-42) mg/dl for homozygotes (trend P = .02). The corresponding values for LDL cholesterol levels were 124 (101-147) mg/dl, 104 (85-132) mg/dl, and 97 (85-128) mg/dl, respectively (trend P = 2 × 10(-52)). PCSK9 R46L carriers vs noncarriers had an age- and sex-adjusted odds ratio of 0.64 (95% confidence interval, 0.44-0.95) for aortic valve stenosis, 0.77 (0.65-0.92) for myocardial infarction, and 0.76 (0.64-0.89) for aortic valve stenosis or myocardial infarction. CONCLUSIONS PCSK9 R46L carriers have lower levels of lipoprotein(a) and LDL cholesterol as well as reduced risk of aortic valve stenosis and myocardial infarction. This indirectly suggests that PCSK9 inhibitors may have a role in patients with aortic valve stenosis.
Collapse
Affiliation(s)
- Anne Langsted
- Department of Clinical Biochemistry (A.L., B.G.N., M.B., P.R.K.) and The Copenhagen General Population Study (A.L., B.G.N., M.B., A.T.-H., P.R.K.), Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark; The Copenhagen City Heart Study (B.G.N., M.B., A.T.-H.), Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Biochemistry (A.T.-H.), Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences (A.L., B.G.N., A.T.-H., P.R.K.), University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry (A.L., B.G.N., M.B., P.R.K.) and The Copenhagen General Population Study (A.L., B.G.N., M.B., A.T.-H., P.R.K.), Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark; The Copenhagen City Heart Study (B.G.N., M.B., A.T.-H.), Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Biochemistry (A.T.-H.), Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences (A.L., B.G.N., A.T.-H., P.R.K.), University of Copenhagen, Copenhagen, Denmark
| | - Marianne Benn
- Department of Clinical Biochemistry (A.L., B.G.N., M.B., P.R.K.) and The Copenhagen General Population Study (A.L., B.G.N., M.B., A.T.-H., P.R.K.), Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark; The Copenhagen City Heart Study (B.G.N., M.B., A.T.-H.), Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Biochemistry (A.T.-H.), Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences (A.L., B.G.N., A.T.-H., P.R.K.), University of Copenhagen, Copenhagen, Denmark
| | - Anne Tybjærg-Hansen
- Department of Clinical Biochemistry (A.L., B.G.N., M.B., P.R.K.) and The Copenhagen General Population Study (A.L., B.G.N., M.B., A.T.-H., P.R.K.), Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark; The Copenhagen City Heart Study (B.G.N., M.B., A.T.-H.), Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Biochemistry (A.T.-H.), Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences (A.L., B.G.N., A.T.-H., P.R.K.), University of Copenhagen, Copenhagen, Denmark
| | - Pia R Kamstrup
- Department of Clinical Biochemistry (A.L., B.G.N., M.B., P.R.K.) and The Copenhagen General Population Study (A.L., B.G.N., M.B., A.T.-H., P.R.K.), Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark; The Copenhagen City Heart Study (B.G.N., M.B., A.T.-H.), Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Biochemistry (A.T.-H.), Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences (A.L., B.G.N., A.T.-H., P.R.K.), University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
17
|
Martinez M, Brodlie S, Griesemer A, Kato T, Harren P, Gordon B, Parker T, Levine D, Tyberg T, Starc T, Cho I, Min J, Elmore K, Lobritto S, Hudgins LC. Effects of Liver Transplantation on Lipids and Cardiovascular Disease in Children With Homozygous Familial Hypercholesterolemia. Am J Cardiol 2016; 118:504-10. [PMID: 27365335 DOI: 10.1016/j.amjcard.2016.05.042] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 05/23/2016] [Accepted: 05/23/2016] [Indexed: 12/12/2022]
Abstract
Homozygous familial hypercholesterolemia (HoFH) is a rare, inherited, life-threatening, metabolic disorder of low-density lipoprotein (LDL) receptor function characterized by elevated serum LDL cholesterol (LDL-C) and rapidly progressive atherosclerotic cardiovascular disease (ACVD). Since LDL receptors are predominantly found on hepatocytes, orthotopic liver transplantation (OLT) has emerged as a viable intervention for HoFH because LDL receptor activity is restored. This study assessed the effects of OLT on ACVD and ACVD risk factors in pediatric patients with HoFH. We analyzed lipids, lipoproteins, body mass index, glucose, blood pressure, and cardiovascular imaging in 8 pediatric patients who underwent OLT for HoFH. Total serum cholesterol, LDL-C, lipoprotein (a), and apolipoprotein B/apolipoprotein A1 ratio decreased to normal values in all subjects (p values <0.001) at 1 month after OLT and were maintained for the length of follow-up (2 to 6 years). There were few complications related to surgery or immunosuppressive therapy. Two patients developed mild hypertension. In the first 4 subjects monitored for 4 to 6 years after OLT, coronary artery disease did not develop or progress except in 1 minor artery in 1 subject and actually regressed in 2 subjects with >50% stenosis. However, aortic valve stenosis progressed in 2 of 4 subjects. In conclusion, OLT is an effective therapeutic option for patients with HoFH with coronary artery disease and persistently elevated serum LDL-C despite maximum medical therapy. Aortic valvular disease may progress. Long-term data are needed to evaluate the true risk-benefit ratio of this surgical approach.
Collapse
|
18
|
Abstract
Calcific aortic valve disease (CAVD) is a common cardiovascular disease in the elderly individuals associated with major morbidity and mortality. The process is characterized by multiple steps: lipid infiltration, inflammation, fibrosis, and calcification. Inhibitors of proprotein convertase subtilisin/kexin type 9 (PCSK9) represent a new therapeutic category of drugs for the treatment of dyslipidemia and atherosclerotic cardiovascular disease. Monoclonal antibodies of PCSK9 can result in substantial reductions in atherogenic lipoprotein cholesterol-carrying particles, especially lipoprotein(a), and thereby hold the potential for further reducing events associated with atherosclerotic cardiovascular disease. In this article, we reviewed the clinical and experimental studies in order to find the evidence of the involvement of PCSK9 in CAVD and the potential benefits of PCSK9 monoclonal antibodies in clinical therapeutics.
Collapse
Affiliation(s)
- Wenguang Wang
- Graduate School, Tianjin Medical University, Tianjin, China
- Department of Cardiology, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Chao Liu
- Department of Cardiology, Tianjin Chest Hospital, Tianjin Medical University, Tianjin, China
| | - Hongliang Cong
- Department of Cardiology, Tianjin Chest Hospital, Tianjin Medical University, Tianjin, China
| |
Collapse
|
19
|
Yiu AJ, Callaghan D, Sultana R, Bandyopadhyay BC. Vascular Calcification and Stone Disease: A New Look towards the Mechanism. J Cardiovasc Dev Dis 2015; 2:141-164. [PMID: 26185749 PMCID: PMC4501032 DOI: 10.3390/jcdd2030141] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Calcium phosphate (CaP) crystals are formed in pathological calcification as well as during stone formation. Although there are several theories as to how these crystals can develop through the combined interactions of biochemical and biophysical factors, the exact mechanism of such mineralization is largely unknown. Based on the published scientific literature, we found that common factors can link the initial stages of stone formation and calcification in anatomically distal tissues and organs. For example, changes to the spatiotemporal conditions of the fluid flow in tubular structures may provide initial condition(s) for CaP crystal generation needed for stone formation. Additionally, recent evidence has provided a meaningful association between the active participation of proteins and transcription factors found in the bone forming (ossification) mechanism that are also involved in the early stages of kidney stone formation and arterial calcification. Our review will focus on three topics of discussion (physiological influences-calcium and phosphate concentration-and similarities to ossification, or bone formation) that may elucidate some commonality in the mechanisms of stone formation and calcification, and pave the way towards opening new avenues for further research.
Collapse
Affiliation(s)
- Allen J. Yiu
- Calcium Signaling Laboratory, Research Service, Veterans Affairs Medical Center, 50 Irving Street, NW, Washington, DC 20422, USA; E-Mails: (A.J.Y.); (D.C.); (R.S.)
| | - Daniel Callaghan
- Calcium Signaling Laboratory, Research Service, Veterans Affairs Medical Center, 50 Irving Street, NW, Washington, DC 20422, USA; E-Mails: (A.J.Y.); (D.C.); (R.S.)
- Department of Pharmacology and Physiology, Georgetown University, 3900 Reservoir Road, NW, Washington, DC 20007, USA
| | - Razia Sultana
- Calcium Signaling Laboratory, Research Service, Veterans Affairs Medical Center, 50 Irving Street, NW, Washington, DC 20422, USA; E-Mails: (A.J.Y.); (D.C.); (R.S.)
| | - Bidhan C. Bandyopadhyay
- Calcium Signaling Laboratory, Research Service, Veterans Affairs Medical Center, 50 Irving Street, NW, Washington, DC 20422, USA; E-Mails: (A.J.Y.); (D.C.); (R.S.)
- Department of Pharmacology and Physiology, Georgetown University, 3900 Reservoir Road, NW, Washington, DC 20007, USA
- Department of Pharmacology and Physiology, School of Medicine, George Washington University, Ross Hall 2300 Eye Street, NW, Washington, DC 20037, USA
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-202-745-8622; Fax: +1-202-462-2006
| |
Collapse
|
20
|
Awan Z, Denis M, Roubtsova A, Essalmani R, Marcinkiewicz J, Awan A, Gram H, Seidah NG, Genest J. Reducing Vascular Calcification by Anti-IL-1β Monoclonal Antibody in a Mouse Model of Familial Hypercholesterolemia. Angiology 2015; 67:157-67. [PMID: 25904765 DOI: 10.1177/0003319715583205] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Given the link between cholesterol and activation of inflammation via interleukin 1β (IL-1β), we tested the effects of IL-1β inhibition on atherosclerotic calcification in mice. Patients with familial hypercholesterolemia develop extensive aortic calcification and calcific aortic stenosis. Although statins delay this process, low-density lipoprotein (LDL) cholesterol lowering alone is not enough to avert it. Data suggest that vascular inflammation initiated by hypercholesterolemia is followed by unchecked mineralization at sites of atherosclerotic plaques. The LDL-receptor (LDLR)-deficient (Ldlr(-/-)) and LDLR-attenuated Pcsk9(Tg) mice are available animal models for pharmacological testing. METHODS A mouse monoclonal antibody (mAb) against IL-1β or placebo was administered subcutaneously in Ldlr(-/-) and Pcsk9(Tg) models fed a Western diet. Drug level, anthropometric, lipid, and glucose profiles were determined. Expressions of proprotein convertase subtilisin/kexin type 9 (PCSK9), serum amyloid A1, and cytokine were measured by enzyme-linked immunosorbent assay. Aortic calcification was determined by microcomputerized tomography (micro-CT) and X-ray densitometry, and aortic flow velocity was assessed by ultrasound. RESULTS Circulating levels of IL-1β in Ldlr(-/-) mice were significantly greater (2-fold) than observed in Pcsk9(Tg) mice. Placebo- and mAb-treated mice did not differ in their growth, lipid, glucose profiles, and other cytokines. Calcifications were significantly diminished in mAb-treatment Ldlr(-/-) mice (a reduction of ∼ 75% by X-ray and ∼ 90% by micro-CT) and reduced insignificantly in mAb-treatment Pcsk9(Tg) mice, whereas aortic flow velocity was unchanged in both models. CONCLUSIONS Herein, we demonstrate that aortic calcifications can be inhibited by an IL-1β mAb in LDLR-deficient mice. These results have a translational component to prevent vascular calcification in human and represent new evidence to rationalize targeting inflammation in cardiovascular disease.
Collapse
Affiliation(s)
- Zuhier Awan
- Division of Clinical Biochemistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Maxime Denis
- The Department Cardiology, McGill University, Montréal, Québec, Canada
| | - Anna Roubtsova
- Institut de Recherches Cliniques de Montréal, Montréal, Québec, Canada
| | - Rachid Essalmani
- Institut de Recherches Cliniques de Montréal, Montréal, Québec, Canada
| | | | - Amani Awan
- Division of Clinical Biochemistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hermann Gram
- Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Nabil G Seidah
- Institut de Recherches Cliniques de Montréal, Montréal, Québec, Canada
| | - Jacques Genest
- The Department Cardiology, McGill University, Montréal, Québec, Canada
| |
Collapse
|
21
|
Natorska J, Undas A. Blood coagulation and fibrinolysis in aortic valve stenosis: links with inflammation and calcification. Thromb Haemost 2015; 114:217-27. [PMID: 25809537 DOI: 10.1160/th14-10-0861] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 01/25/2015] [Indexed: 11/05/2022]
Abstract
Aortic valve stenosis (AS) increasingly afflicts our aging population. However, the pathobiology of the disease is still poorly understood and there is no effective pharmacotherapy for treating those at risk for clinical progression. The progression of AS involves complex inflammatory and fibroproliferative processes that resemble to some extent atherosclerosis. Accumulating evidence indicates that several coagulation proteins and its inhibitors, including tissue factor, tissue factor pathway inhibitor, prothrombin, factor XIII, von Willebrand factor, display increased expression within aortic stenotic valves, predominantly on macrophages and myofibroblasts around calcified areas. Systemic impaired fibrinolysis, along with increased plasma and valvular expression of plasminogen activator inhibitor-1, has also been observed in patients with AS in association with the severity of the disease. There is an extensive cross-talk between inflammation and coagulation in stenotic valve tissue which contributes to the calcification and mineralisation of the aortic valve leaflets. This review summarises the available data on blood coagulation and fibrinolysis in AS with the emphasis on their interactions with inflammation and calcification.
Collapse
Affiliation(s)
| | - A Undas
- Anetta Undas, Institute of Cardiology, Jagiellonian University School of Medicine, 80 Pradnicka St., 31-202 Cracow, Poland, Tel.: +48 12 6143004, Fax: +48 12 6143143, E-mail:
| |
Collapse
|
22
|
Raggi P. Inflammation and calcification: the chicken or the hen? Atherosclerosis 2014; 238:173-4. [PMID: 25525745 DOI: 10.1016/j.atherosclerosis.2014.10.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 10/17/2014] [Indexed: 12/18/2022]
Affiliation(s)
- Paolo Raggi
- Mazankowski Alberta Heart Institute, Division of Cardiology and Department of Medicine, University of Alberta, Edmonton, AB, Canada.
| |
Collapse
|
23
|
Is there a link between proprotein convertase PC7 activity and human lipid homeostasis? FEBS Open Bio 2014; 4:741-5. [PMID: 25349778 PMCID: PMC4208093 DOI: 10.1016/j.fob.2014.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 08/08/2014] [Accepted: 08/26/2014] [Indexed: 11/23/2022] Open
Abstract
A R504H mutation in human proprotein convertase PC7 is associated with increased HDL and reduced triglycerides. Wild-type PC7 and its R504H mutant have identical cellular enzymatic activities. In situ hybridization revealed co-localization of mouse ApoF and PC7 mRNAs in liver. WT and PC7 KO mice do not exhibit changes in circulating levels of insulin or glucose. WT and PC7 KO mice do not exhibit changes in circulating levels of HDL, TG and LDL.
A genome-wide association study suggested that a R504H mutation in the proprotein convertase PC7 is associated with increased circulating levels of HDL and reduced triglycerides in black Africans. Our present results show that PC7 and PC7-R504H exhibit similar processing of transferrin receptor-1, proSortilin, and apolipoprotein-F. Plasma analyses revealed no change in the lipid profiles, insulin or glucose of wild type and PC7 KO mice. Thus, the R504H mutation does not modify the proteolytic activity of PC7. The mechanisms behind the implication of PC7 in the regulation of human HDL, triglycerides and in modifying the levels of atherogenic small dense LDL remain to be elucidated.
Collapse
Key Words
- ANGPTL3, angiopoietin-like 3
- ANGPTL4, angiopoietin-like 4
- ApoF, apolipoprotein-F
- Apolipoprotein F
- GOF, gain of function
- GWAS, genome-wide association study
- HDL, high-density lipoprotein
- HDL/LDL
- KO, knockout
- LDL, low-density lipoprotein
- PCs, proprotein convertases
- Proprotein convertase PC7
- SNP, single nucleotide polymorphism
- Sortilin
- TGN, trans Golgi network
- TMD, transmembrane domain
- Transferrin receptor 1
- Triglycerides
- VLDL, very low-density lipoprotein
- hTfR1, human PC7-substrates: transferrin receptor 1
Collapse
|
24
|
Wasilewski J, Głowacki J, Poloński L. Not at random location of atherosclerotic lesions in thoracic aorta and their prognostic significance in relation to the risk of cardiovascular events. Pol J Radiol 2013; 78:38-42. [PMID: 23807883 PMCID: PMC3693835 DOI: 10.12659/pjr.883944] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 02/14/2013] [Indexed: 11/18/2022] Open
Abstract
Thoracic aortic calcium deposits are frequently detected on tomography of the chest, and in other imaging modalities. Numerous studies indicated the correlation of hemodynamic parameters such as wall shear stress in relation to distribution aortic calcifications. This publication discusses similarities and differences of two distinct pathomechanisms of arterial calcifications: intimal associated with atherosclerosis and medial knows as Mönckeberg’s arteriosclerosis. This review also analyzes the frequent coexistence of aortic calcification and coronary artery disease in terms of risk of cardiovascular events.
Collapse
Affiliation(s)
- Jarosław Wasilewski
- III Department of Cardiology, Medical University of Silesia, Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | | | | |
Collapse
|