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Etebar N, Naderpour S, Akbari S, Zali A, Akhlaghdoust M, Daghighi SM, Baghani M, Sefat F, Hamidi SH, Rahimzadegan M. Impacts of SARS-CoV-2 on brain renin angiotensin system related signaling and its subsequent complications on brain: A theoretical perspective. J Chem Neuroanat 2024; 138:102423. [PMID: 38705215 DOI: 10.1016/j.jchemneu.2024.102423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 04/08/2024] [Accepted: 04/18/2024] [Indexed: 05/07/2024]
Abstract
Cellular ACE2 (cACE2), a vital component of the renin-angiotensin system (RAS), possesses catalytic activity to maintain AngII and Ang 1-7 balance, which is necessary to prevent harmful effects of AngII/AT2R and promote protective pathways of Ang (1-7)/MasR and Ang (1-7)/AT2R. Hemostasis of the brain-RAS is essential for maintaining normal central nervous system (CNS) function. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a viral disease that causes multi-organ dysfunction. SARS-CoV-2 mainly uses cACE2 to enter the cells and cause its downregulation. This, in turn, prevents the conversion of Ang II to Ang (1-7) and disrupts the normal balance of brain-RAS. Brain-RAS disturbances give rise to one of the pathological pathways in which SARS-CoV-2 suppresses neuroprotective pathways and induces inflammatory cytokines and reactive oxygen species. Finally, these impairments lead to neuroinflammation, neuronal injury, and neurological complications. In conclusion, the influence of RAS on various processes within the brain has significant implications for the neurological manifestations associated with COVID-19. These effects include sensory disturbances, such as olfactory and gustatory dysfunctions, as well as cerebrovascular and brain stem-related disorders, all of which are intertwined with disruptions in the RAS homeostasis of the brain.
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Affiliation(s)
- Negar Etebar
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Faculty of Pharmacy - Eastern Mediterranean University Famagusta, North Cyprus via Mersin 10, Turkey
| | - Saghi Naderpour
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Faculty of Pharmacy - Eastern Mediterranean University Famagusta, North Cyprus via Mersin 10, Turkey
| | - Setareh Akbari
- Neuroscience and Research Committee, School of Advanced Technology in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Zali
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Meisam Akhlaghdoust
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran; USERN Office, Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mojtaba Daghighi
- Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
| | - Matin Baghani
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farshid Sefat
- Department of Biomedical Engineering, School of Engineering, University of Bradford, Bradford, UK
| | - Seyed Hootan Hamidi
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Acharya BM Reddy College of Pharmacy, Rajiv Gandhi University of Health Sciences, Bangalore, India
| | - Milad Rahimzadegan
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Al‐Qahtani Z, Al‐kuraishy HM, Al‐Gareeb AI, Albuhadily AK, Ali NH, Alexiou A, Papadakis M, Saad HM, Batiha GE. The potential role of brain renin-angiotensin system in the neuropathology of Parkinson disease: Friend, foe or turncoat? J Cell Mol Med 2024; 28:e18495. [PMID: 38899551 PMCID: PMC11187740 DOI: 10.1111/jcmm.18495] [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] [Received: 11/04/2023] [Revised: 01/15/2024] [Accepted: 06/04/2024] [Indexed: 06/21/2024] Open
Abstract
Parkinson disease (PD) is one of the most common neurodegenerative diseases of the brain. Of note, brain renin-angiotensin system (RAS) is intricate in the PD neuropathology through modulation of oxidative stress, mitochondrial dysfunction and neuroinflammation. Therefore, modulation of brain RAS by angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) may be effective in reducing the risk and PD neuropathology. It has been shown that all components including the peptides and enzymes of the RAS are present in the different brain areas. Brain RAS plays a critical role in the regulation of memory and cognitive function, and in the controlling of central blood pressure. However, exaggerated brain RAS is implicated in the pathogenesis of different neurodegenerative diseases including PD. Two well-known pathways of brain RAS are recognized including; the classical pathway which is mainly mediated by AngII/AT1R has detrimental effects. Conversely, the non-classical pathway which is mostly mediated by ACE2/Ang1-7/MASR and AngII/AT2R has beneficial effects against PD neuropathology. Exaggerated brain RAS affects the viability of dopaminergic neurons. However, the fundamental mechanism of brain RAS in PD neuropathology was not fully elucidated. Consequently, the purpose of this review is to disclose the mechanistic role of RAS in in the pathogenesis of PD. In addition, we try to revise how the ACEIs and ARBs can be developed for therapeutics in PD.
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Affiliation(s)
- Zainah Al‐Qahtani
- Neurology Section, Internal Medicine Department, College of MedicineKing khaled universityAbhaSaudi Arabia
| | - Hayder M. Al‐kuraishy
- Clinical pharmacology and medicine, college of medicineMustansiriyah UniversityBaghdadIraq
| | - Ali I. Al‐Gareeb
- Clinical pharmacology and medicine, college of medicineMustansiriyah UniversityBaghdadIraq
| | - Ali K. Albuhadily
- Clinical pharmacology and medicine, college of medicineMustansiriyah UniversityBaghdadIraq
| | - Naif H. Ali
- Department of Internal Medicine, Medical CollegeNajran UniversityNajranSaudi Arabia
| | - Athanasios Alexiou
- University Centre for Research & DevelopmentChandigarh UniversityMohaliIndia
- Department of Science and EngineeringNovel Global Community Educational FoundationHebershamNew South WalesAustralia
- Department of Research & Development, FunogenAthensGreece
- Department of Research & DevelopmentAFNP MedWienAustria
| | - Marios Papadakis
- Department of Surgery IIUniversity Hospital Witten‐HerdeckeWuppertalGermany
| | - Hebatallah M. Saad
- Department of Pathology, Faculty of Veterinary MedicineMatrouh UniversityMatrouhEgypt
| | - Gaber El‐Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary MedicineDamanhour UniversityDamanhourAlBeheiraEgypt
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Kennard AL, Glasgow NJ, Rainsford SE, Talaulikar GS. Narrative Review: Clinical Implications and Assessment of Frailty in Patients With Advanced CKD. Kidney Int Rep 2024; 9:791-806. [PMID: 38765572 PMCID: PMC11101734 DOI: 10.1016/j.ekir.2023.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/12/2023] [Accepted: 12/21/2023] [Indexed: 05/22/2024] Open
Abstract
Frailty is a multidimensional clinical syndrome characterized by low physical activity, reduced strength, accumulation of multiorgan deficits, decreased physiological reserve, and vulnerability to stressors. Frailty has key social, psychological, and cognitive implications. Frailty is accelerated by uremia, leading to a high prevalence of frailty in patients with advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD) as well as contributing to adverse outcomes in this patient population. Frailty assessment is not routine in patients with CKD; however, a number of validated clinical assessment tools can assist in prognostication. Frailty assessment in nephrology populations supports shared decision-making and advanced communication and should inform key medical transitions. Frailty screening and interventions in CKD or ESKD are a developing research priority with a rapidly expanding literature base.
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Affiliation(s)
- Alice L. Kennard
- Department of Renal Medicine, Canberra Health Services, Australian Capital Territory, Australia
- Australian National University, Canberra, Australian Capital Territory, Australia
| | - Nicholas J. Glasgow
- Australian National University, Canberra, Australian Capital Territory, Australia
| | - Suzanne E. Rainsford
- Australian National University, Canberra, Australian Capital Territory, Australia
| | - Girish S. Talaulikar
- Department of Renal Medicine, Canberra Health Services, Australian Capital Territory, Australia
- Australian National University, Canberra, Australian Capital Territory, Australia
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4
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Abadir P, Cosarderelioglu C, Damarla M, Malinina A, Dikeman D, Marx R, Nader MM, Abadir M, Walston J, Neptune E. Unlocking the protective potential of the angiotensin type 2 receptor (AT 2R) in acute lung injury and age-related pulmonary dysfunction. Biochem Pharmacol 2024; 220:115978. [PMID: 38081369 PMCID: PMC10880333 DOI: 10.1016/j.bcp.2023.115978] [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] [Received: 07/30/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/26/2023]
Abstract
Despite its known importance in the cardiovascular system, the specific role and impact of the angiotensin type 2 receptor (AT2R) in lung physiology and pathophysiology remain largely elusive. In this study, we highlight the distinct and specialized lung-specific roles of AT2R, primarily localized to an alveolar fibroblast subpopulation, in contrast to the angiotensin type 1 receptor (AT1R), which is almost exclusively expressed in lung pericytes. Evidence from our research demonstrates that the disruption of AT2R (AT2R-/y), is associated with a surge in oxidative stress and impaired lung permeability, which were further intensified by Hyperoxic Acute Lung Injury (HALI). With aging, AT2R-/y mice show an increase in oxidative stress, premature enlargement of airspaces, as well as increased mortality when exposed to hyperoxia as compared to age-matched WT mice. Our investigation into Losartan, an AT1R blocker, suggests that its primary HALI lung-protective effects are channeled through AT2R, as its protective benefits are absent in AT2R-/y mice. Importantly, a non-peptide AT2R agonist, Compound 21 (C21), successfully reverses lung oxidative stress and TGFβ activation in wild-type (WT) mice exposed to HALI. These findings suggest a possible paradigm shift in the therapeutic approach for lung injury and age-associated pulmonary dysfunction, from targeting AT1R with angiotensin receptor blockers (ARBs) towards boosting the protective function of AT2R.
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Affiliation(s)
- Peter Abadir
- Johns Hopkins University, Division of Geriatrics Medicine and Gerontology, Department of Medicine, USA.
| | - Caglar Cosarderelioglu
- Johns Hopkins University, Division of Geriatrics Medicine and Gerontology, Department of Medicine, USA
| | - Mahendra Damarla
- Johns Hopkins University, Division of Pulmonary and Critical Care Medicine, USA
| | - Alla Malinina
- Johns Hopkins University, Division of Pulmonary and Critical Care Medicine, USA
| | - Dustin Dikeman
- Johns Hopkins University, Division of Pulmonary and Critical Care Medicine, USA
| | - Ruth Marx
- Johns Hopkins University, Division of Geriatrics Medicine and Gerontology, Department of Medicine, USA
| | - Monica M Nader
- Johns Hopkins University, Division of Geriatrics Medicine and Gerontology, Department of Medicine, USA; Urbana High School, USA
| | | | - Jeremy Walston
- Johns Hopkins University, Division of Geriatrics Medicine and Gerontology, Department of Medicine, USA
| | - Enid Neptune
- Johns Hopkins University, Division of Pulmonary and Critical Care Medicine, USA.
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5
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Ito A, Ohnuki Y, Suita K, Matsuo I, Ishikawa M, Mitsubayashi T, Mototani Y, Kiyomoto K, Tsunoda M, Morii A, Nariyama M, Hayakawa Y, Tomonari H, Okumura S. Effects of the angiotensin-converting enzyme inhibitor captopril on occlusal-disharmony-induced cardiac dysfunction in mice. Sci Rep 2023; 13:19927. [PMID: 37968296 PMCID: PMC10651878 DOI: 10.1038/s41598-023-43099-6] [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] [Received: 11/23/2022] [Accepted: 09/19/2023] [Indexed: 11/17/2023] Open
Abstract
Occlusal disharmony is known to affect not only the oral cavity environment, but also the autonomic nervous system in the heart. Since the renin-angiotensin system (RAS) inhibitor captopril (Cap) is one of the first-line drugs for preventing cardiac remodeling in patients with heart failure, we hypothesized that Cap might prevent cardiac dysfunction induced by occlusal disharmony. Here, to test this idea, we used our bite-opening (BO) mouse model, which was developed by cementing a suitable appliance onto the mandibular incisor. Mice were divided into four groups: (1) Control, (2) BO, (3) Cap, and (4) BO + Cap. After 2 weeks, we evaluated cardiac function by echocardiography and confirmed that cardiac function was significantly decreased in the BO group compared to the control, while Cap ameliorated the dysfunction. Cardiac fibrosis, myocyte apoptosis and oxidative stress-induced myocardial damage in the BO group were significantly increased versus the control, and these increases were suppressed by Cap. Cardiac dysfunction induced by BO was associated with dual phosphorylation on PKCδ (Tyr-311/Thr-505), leading to activation of CaMKII with increased phosphorylation of RyR2 and phospholamban. Our results suggest that the RAS might play an important role in the development of cardiac diseases induced by occlusal anomalies.
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Affiliation(s)
- Aiko Ito
- Department of Orthodontics, Tsurumi University School of Dental Medicine, Yokohama, 230-8501, Japan
| | - Yoshiki Ohnuki
- Department of Physiology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Kenji Suita
- Department of Physiology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Ichiro Matsuo
- Department of Periodontology, Tsurumi University School of Dental Medicine, Yokohama, 230-8501, Japan
| | - Misao Ishikawa
- Department of Oral Anatomy, Tsurumi University School of Dental Medicine, Yokohama, 230-8501, Japan
| | - Takao Mitsubayashi
- Department of Physiology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Yasumasa Mototani
- Department of Physiology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Kenichi Kiyomoto
- Department of Physiology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
- Department of Periodontology, Tsurumi University School of Dental Medicine, Yokohama, 230-8501, Japan
| | - Michinori Tsunoda
- Department of Physiology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
- Department of Periodontology, Tsurumi University School of Dental Medicine, Yokohama, 230-8501, Japan
| | - Akinaka Morii
- Department of Physiology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
- Department of Periodontology, Tsurumi University School of Dental Medicine, Yokohama, 230-8501, Japan
| | - Megumi Nariyama
- Department of Pediatric Dentistry, Tsurumi University School of Dental Medicine, Yokohama, 236-8501, Japan
| | - Yoshio Hayakawa
- Department of Dental Anesthesiology, Tsurumi University School of Dental Medicine, Yokohama, 230-8501, Japan
| | - Hiroshi Tomonari
- Department of Orthodontics, Tsurumi University School of Dental Medicine, Yokohama, 230-8501, Japan
| | - Satoshi Okumura
- Department of Physiology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan.
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6
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Cosarderelioglu C, Kreimer S, Plaza‐Rodriguez AI, Iglesias PA, Talbot CC, Siragy HM, Carey RM, Ubaida‐Mohien C, O'Rourke B, Ferrucci L, Bennett DA, Walston J, Abadir P. Decoding Angiotensin Receptors: TOMAHAQ-Based Detection and Quantification of Angiotensin Type-1 and Type-2 Receptors. J Am Heart Assoc 2023; 12:e030791. [PMID: 37681524 PMCID: PMC10547273 DOI: 10.1161/jaha.123.030791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/20/2023] [Indexed: 09/09/2023]
Abstract
Background The renin-angiotensin system plays a crucial role in human physiology, and its main hormone, angiotensin, activates 2 G-protein-coupled receptors, the angiotensin type-1 and type-2 receptors, in almost every organ. However, controversy exists about the location, distribution, and expression levels of these receptors. Concerns have been raised over the low sensitivity, low specificity, and large variability between lots of commercially available antibodies for angiotensin type-1 and type-2 receptors, which makes it difficult to reconciliate results of different studies. Here, we describe the first non-antibody-based sensitive and specific targeted quantitative mass spectrometry assay for angiotensin receptors. Methods and Results Using a technique that allows targeted analysis of multiple peptides across multiple samples in a single mass spectrometry analysis, known as TOMAHAQ (triggered by offset, multiplexed, accurate mass, high resolution, and absolute quantification), we have identified and validated specific human tryptic peptides that permit identification and quantification of angiotensin type-1 and type-2 receptors in biological samples. Several peptide sequences are conserved in rodents, making these mass spectrometry assays amenable to both preclinical and clinical studies. We have used this method to quantify angiotensin type-1 and type-2 receptors in postmortem frontal cortex samples of older adults (n=28) with Alzheimer dementia. We correlated levels of angiotensin receptors to biomarkers classically linked to renin-angiotensin system activation, including oxidative stress, inflammation, amyloid-β load, and paired helical filament-tau tangle burden. Conclusions These robust high-throughput assays will not only catalyze novel mechanistic studies in the angiotensin research field but may also help to identify patients with an unbalanced angiotensin receptor distribution who would benefit from angiotensin receptor blocker treatment.
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Affiliation(s)
- Caglar Cosarderelioglu
- Division of Geriatric Medicine and GerontologyJohns Hopkins University School of MedicineBaltimoreMD
- Division of Geriatrics, Department of Internal MedicineAnkara University School of MedicineAnkaraTurkey
| | - Simion Kreimer
- The Mass Spectrometry and Proteomics FacilityJohns Hopkins University School of MedicineBaltimoreMD
| | | | - Pablo A. Iglesias
- Department of Electrical and Computer Engineering, Whiting School of EngineeringJohns Hopkins UniversityBaltimoreMD
| | - C. Conover Talbot
- Institute for Basic Biomedical Sciences, Johns Hopkins University School of MedicineBaltimoreMD
| | - Helmy M. Siragy
- Division of Endocrinology and Metabolism, Department of MedicineUniversity of VirginiaCharlottesvilleVA
| | - Robert M. Carey
- Division of Endocrinology and Metabolism, Department of MedicineUniversity of VirginiaCharlottesvilleVA
| | | | - Brian O'Rourke
- Division of Cardiology, Department of MedicineJohns Hopkins UniversityBaltimoreMD
| | - Luigi Ferrucci
- National Institute on Aging, National Institutes of HealthBaltimoreMD
| | - David A. Bennett
- Rush Alzheimer’s Disease CenterRush University Medical CenterChicagoIL
| | - Jeremy Walston
- Division of Geriatric Medicine and GerontologyJohns Hopkins University School of MedicineBaltimoreMD
| | - Peter Abadir
- Division of Geriatric Medicine and GerontologyJohns Hopkins University School of MedicineBaltimoreMD
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7
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Ye Y, Noche RB, Szejko N, Both CP, Acosta JN, Leasure AC, Brown SC, Sheth KN, Gill TM, Zhao H, Falcone GJ. A genome-wide association study of frailty identifies significant genetic correlation with neuropsychiatric, cardiovascular, and inflammation pathways. GeroScience 2023; 45:2511-2523. [PMID: 36928559 PMCID: PMC10651618 DOI: 10.1007/s11357-023-00771-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
Frailty is an aging-related clinical phenotype defined as a state in which there is an increase in a person's vulnerability for dependency and/or mortality when exposed to a stressor. While underlying mechanisms leading to the occurrence of frailty are complex, the importance of genetic factors has not been fully investigated. We conducted a large-scale genome-wide association study (GWAS) of frailty, as defined by the five criteria (weight loss, exhaustion, physical activity, walking speed, and grip strength) captured in the Fried Frailty Score (FFS), in 386,565 European descent participants enrolled in the UK Biobank (mean age 57 [SD 8] years, 208,481 [54%] females). We identified 37 independent, novel loci associated with the FFS (p < 5 × 10-8), including seven loci without prior described associations with other traits. The variants associated with FFS were significantly enriched in brain tissues as well as aging-related pathways. Our post-GWAS bioinformatic analyses revealed significant genetic correlations between FFS and cardiovascular-, neurological-, and inflammation-related diseases/traits, and subsequent Mendelian Randomization analyses identified causal associations with chronic pain, obesity, diabetes, education-related traits, joint disorders, and depressive/neurological, metabolic, and respiratory diseases. The GWAS signals were replicated in the Health and Retirement Study (HRS, n = 9,720, mean age 73 [SD 7], 5,582 [57%] females), where the polygenic risk score built from UKB GWAS was significantly associated with the FFS in HRS individuals (OR per SD of the score 1.27, 95% CI 1.22-1.31, p = 1.3 × 10-11). These results provide new insight into the biology of frailty by comprehensively evaluating its genetic architecture.
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Affiliation(s)
- Yixuan Ye
- Program of Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA
| | - Rommell B Noche
- Department of Neurology, Yale School of Medicine, 15 York Street, LLCI Room 1004D, P.O. Box 20801, New Haven, CT, 06510, USA
| | - Natalia Szejko
- Department of Neurology, Yale School of Medicine, 15 York Street, LLCI Room 1004D, P.O. Box 20801, New Haven, CT, 06510, USA
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
- Department of Bioethics, Medical University of Warsaw, Warsaw, Poland
| | - Cameron P Both
- Department of Neurology, Yale School of Medicine, 15 York Street, LLCI Room 1004D, P.O. Box 20801, New Haven, CT, 06510, USA
| | - Julian N Acosta
- Department of Neurology, Yale School of Medicine, 15 York Street, LLCI Room 1004D, P.O. Box 20801, New Haven, CT, 06510, USA
| | - Audrey C Leasure
- Department of Neurology, Yale School of Medicine, 15 York Street, LLCI Room 1004D, P.O. Box 20801, New Haven, CT, 06510, USA
| | - Stacy C Brown
- University of Hawai'I, John A. Burns School of Medicine, Honolulu, HI, USA
| | - Kevin N Sheth
- Department of Neurology, Yale School of Medicine, 15 York Street, LLCI Room 1004D, P.O. Box 20801, New Haven, CT, 06510, USA
| | - Thomas M Gill
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Hongyu Zhao
- Program of Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA.
- Department of Biostatistics, Yale School of Public Health, 60 College Street, P.O. Box 208034, New Haven, CT, 06520, USA.
| | - Guido J Falcone
- Department of Neurology, Yale School of Medicine, 15 York Street, LLCI Room 1004D, P.O. Box 20801, New Haven, CT, 06510, USA.
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8
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Lee JL, Zhang C, Westbrook R, Gabrawy MM, Nidadavolu L, Yang H, Marx R, Wu Y, Anders NM, Ma L, Bichara MD, Kwak MJ, Buta B, Khadeer M, Yenokyan G, Tian J, Xue QL, Siragy HM, Carey RM, de Cabo R, Ferrucci L, Moaddel R, Rudek MA, Le A, Walston JD, Abadir PM. Serum Concentrations of Losartan Metabolites Correlate With Improved Physical Function in a Pilot Study of Prefrail Older Adults. J Gerontol A Biol Sci Med Sci 2022; 77:2356-2366. [PMID: 35511890 PMCID: PMC9799219 DOI: 10.1093/gerona/glac102] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Indexed: 01/20/2023] Open
Abstract
Losartan is an oral antihypertensive agent that is rapidly metabolized to EXP3174 (angiotensin-subtype-1-receptor blocker) and EXP3179 (peroxisome proliferator-activated receptor gamma [PPARγ] agonist), which was shown in animal studies to reduce inflammation, enhance mitochondrial energetics, and improve muscle repair and physical performance. We conducted an exploratory pilot study evaluating losartan treatment in prefrail older adults (age 70-90 years, N = 25). Participants were randomized to control (placebo) or treatment (daily oral losartan beginning at 25 mg per day and increasing every 8 weeks) for a total of 6 months. Fatigue, hyperkalemia, and hypotension were the most observed side effects of losartan treatment. Participants in the losartan group had an estimated 89% lower odds of frailty (95% confidence interval [CI]: 18% to 99% lower odds, p = .03), with a 0.3-point lower frailty score than the placebo group (95% CI: 0.01-0.5 lower odds, p = .04). Frailty score was also negatively associated with serum losartan and EXP3179 concentrations. For every one standard deviation increase in EXP3179 (ie, 0.0011 ng/μL, based on sample values above detection limit) and EXP3174 (ie, 0.27 ng/μL, based on sample values above detection limit), there was a 0.0035 N (95% CI: 0.0019-0.0051, p < .001) and a 0.0027 N (95% CI: 0.00054-0.0043, p = .007) increase in average knee strength, respectively.
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Affiliation(s)
- Jessica L Lee
- Department of Medicine, Division of Geriatric Medicine and Gerontology, The Johns Hopkins University School of Medicine, Baltimore, Maryland,USA
- Department of Internal Medicine, Division of Geriatric and Palliative Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Cissy Zhang
- Department of Oncology, Division of Cancer Chemical and Structural Biology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Reyhan Westbrook
- Department of Medicine, Division of Geriatric Medicine and Gerontology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mariann M Gabrawy
- Department of Medicine, Division of Geriatric Medicine and Gerontology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lolita Nidadavolu
- Department of Medicine, Division of Geriatric Medicine and Gerontology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Huanle Yang
- Department of Medicine, Division of Geriatric Medicine and Gerontology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ruth Marx
- Department of Medicine, Division of Geriatric Medicine and Gerontology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yuqiong Wu
- Department of Medicine, Division of Geriatric Medicine and Gerontology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nicole M Anders
- Department of Oncology, Division of Cancer Chemical and Structural Biology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- The Johns Hopkins Analytical Pharmacology Core Laboratory, Clinical Pharmacology, Baltimore, MD, USA
| | - Lina Ma
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, China National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Marcela-Dávalos Bichara
- Department of Medicine, Division of Geriatric Medicine and Gerontology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Min-Ji Kwak
- Department of Internal Medicine, Division of Geriatric and Palliative Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Brian Buta
- Department of Medicine, Division of Geriatric Medicine and Gerontology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mohammed Khadeer
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Gayane Yenokyan
- Johns Hopkins Biostatistics Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jing Tian
- Department of Medicine, Division of Geriatric Medicine and Gerontology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Qian-Li Xue
- Department of Medicine, Division of Geriatric Medicine and Gerontology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Helmy M Siragy
- Department of Medicine, Division of Endocrine and Metabolism, University of Virginia, Charlottesville, Virginia, USA
| | - Robert M Carey
- Department of Medicine, Division of Endocrine and Metabolism, University of Virginia, Charlottesville, Virginia, USA
| | - Rafael de Cabo
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Ruin Moaddel
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Michelle A Rudek
- The Johns Hopkins Analytical Pharmacology Core Laboratory, Clinical Pharmacology, Baltimore, MD, USA
- Department of Medicine, Division of Clinical Pharmacology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anne Le
- The Johns Hopkins Analytical Pharmacology Core Laboratory, Clinical Pharmacology, Baltimore, MD, USA
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jeremy D Walston
- Department of Medicine, Division of Geriatric Medicine and Gerontology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Peter M Abadir
- Department of Medicine, Division of Geriatric Medicine and Gerontology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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9
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Sánchez-Luquez KY, Carpena MX, Karam SM, Tovo-Rodrigues L. The contribution of whole-exome sequencing to intellectual disability diagnosis and knowledge of underlying molecular mechanisms: A systematic review and meta-analysis. MUTATION RESEARCH. REVIEWS IN MUTATION RESEARCH 2022; 790:108428. [PMID: 35905832 DOI: 10.1016/j.mrrev.2022.108428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 01/01/2023]
Abstract
Whole-exome sequencing (WES) is useful for molecular diagnosis, family genetic counseling, and prognosis of intellectual disability (ID). However, ID molecular diagnosis ascertainment based on WES is highly dependent on de novo mutations (DNMs) and variants of uncertain significance (VUS). The quantification of DNM frequency in ID molecular diagnosis ascertainment and the biological mechanisms common to genes with VUS may provide objective information about WES use in ID diagnosis and etiology. We aimed to investigate and estimate the rate of ID molecular diagnostic assessment by WES, quantify the contribution of DNMs to this rate, and biologically and functionally characterize the genes whose mutations were identified through WES. A PubMed/Medline, Web of Science, Scopus, Science Direct, BIREME, and PsycINFO systematic review and meta-analysis was performed, including studies published between 2010 and 2022. Thirty-seven articles with data on ID molecular diagnostic yield using the WES approach were included in the review. WES testing accounted for an overall diagnostic rate of 42% (Confidence interval (CI): 35-50%), while the estimate restricted to DNMs was 11% (CI: 6-18%). Genetic information on mutations and genes was extracted and split into two groups: (1) genes whose mutation was used for positive molecular diagnosis, and (2) genes whose mutation led to uncertain molecular diagnosis. After functional enrichment analysis, in addition to their expected roles in neurodevelopment, genes from the first group were enriched in epigenetic regulatory mechanisms, immune system regulation, and circadian rhythm control. Genes from uncertain diagnosis cases were enriched in the renin angiotensin pathway. Taken together, our results support WES as an important approach to the molecular diagnosis of ID. The results also indicated relevant pathways that may underlie the pathogenesis of ID with the renin-angiotensin pathway being suggested to be a potential pathway underlying the pathogenesis of ID.
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Affiliation(s)
| | - Marina Xavier Carpena
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil.
| | - Simone M Karam
- Postgraduate Program in Public Health, Universidade Federal do Rio Grande, Rio Grande, Brazil.
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10
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Yang Y, Yan M. Mechanisms of Cardiovascular System Injury Induced by COVID-19 in Elderly Patients With Cardiovascular History. Front Cardiovasc Med 2022; 9:859505. [PMID: 35600485 PMCID: PMC9116509 DOI: 10.3389/fcvm.2022.859505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/15/2022] [Indexed: 11/13/2022] Open
Abstract
The coronavirus disease-2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2), represents a great threat to healthcare and socioeconomics worldwide. In addition to respiratory manifestations, COVID-19 promotes cardiac injuries, particularly in elderly patients with cardiovascular history, leading to a higher risk of progression to critical conditions. The SARS-CoV-2 infection is initiated as virus binding to angiotensin-converting enzyme 2 (ACE2), which is highly expressed in the heart, resulting in direct infection and dysregulation of the renin-angiotensin system (RAS). Meanwhile, immune response and hyper-inflammation, as well as endothelial dysfunction and thrombosis implicate in COVID-19 infection. Herein, we provide an overview of the proposed mechanisms of cardiovascular injuries in COVID-19, particularly in elderly patients with pre-existing cardiovascular diseases, aiming to set appropriate management and improve their clinical outcomes.
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11
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The Pathophysiology of Long COVID throughout the Renin-Angiotensin System. Molecules 2022; 27:molecules27092903. [PMID: 35566253 PMCID: PMC9101946 DOI: 10.3390/molecules27092903] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 01/08/2023] Open
Abstract
COVID-19 has expanded across the world since its discovery in Wuhan (China) and has had a significant impact on people’s lives and health. Long COVID is a term coined by the World Health Organization (WHO) to describe a variety of persistent symptoms after acute SARS-CoV-2 infection. Long COVID has been demonstrated to affect various SARS-CoV-2-infected persons, independently of the acute disease severity. The symptoms of long COVID, like acute COVID-19, consist in the set of damage to various organs and systems such as the respiratory, cardiovascular, neurological, endocrine, urinary, and immune systems. Fatigue, dyspnea, cardiac abnormalities, cognitive and attention impairments, sleep disturbances, post-traumatic stress disorder, muscle pain, concentration problems, and headache were all reported as symptoms of long COVID. At the molecular level, the renin-angiotensin system (RAS) is heavily involved in the pathogenesis of this illness, much as it is in the acute phase of the viral infection. In this review, we summarize the impact of long COVID on several organs and tissues, with a special focus on the significance of the RAS in the disease pathogenesis. Long COVID risk factors and potential therapy approaches are also explored.
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12
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Cook JR, Ausiello J. Functional ACE2 deficiency leading to angiotensin imbalance in the pathophysiology of COVID-19. Rev Endocr Metab Disord 2022; 23:151-170. [PMID: 34195965 PMCID: PMC8245275 DOI: 10.1007/s11154-021-09663-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2021] [Indexed: 02/07/2023]
Abstract
SARS-CoV-2, the virus responsible for COVID-19, uses angiotensin converting enzyme 2 (ACE2) as its primary cell-surface receptor. ACE2 is a key enzyme in the counter-regulatory pathway of the broader renin-angiotensin system (RAS) that has been implicated in a broad array of human pathology. The RAS is composed of two competing pathways that work in opposition to each other: the "conventional" arm involving angiotensin converting enzyme (ACE) generating angiotensin-2 and the more recently identified ACE2 pathway that generates angiotensin (1-7). Following the original SARS pandemic, additional studies suggested that coronaviral binding to ACE2 resulted in downregulation of the membrane-bound enzyme. Given the similarities between the two viruses, many have posited a similar process with SARS-CoV-2. Proponents of this ACE2 deficiency model argue that downregulation of ACE2 limits its enzymatic function, thereby skewing the delicate balance between the two competing arms of the RAS. In this review we critically examine this model. The available data remain incomplete but are consistent with the possibility that the broad multisystem dysfunction of COVID-19 is due in large part to functional ACE2 deficiency leading to angiotensin imbalance with consequent immune dysregulation and endothelial cell dysfunction.
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Affiliation(s)
- Joshua R Cook
- New York-Presbyterian Hospital and the Columbia University Irving Medical Center, New York, NY, USA
| | - John Ausiello
- New York-Presbyterian Hospital and the Columbia University Irving Medical Center, New York, NY, USA.
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13
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Chang PK, Chao YP, Wu LW. Proteinuria as a Nascent Predictor of Frailty Among People With Metabolic Syndrome: A Retrospective Observational Study. Front Public Health 2022; 10:847533. [PMID: 35359757 PMCID: PMC8960196 DOI: 10.3389/fpubh.2022.847533] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 02/10/2022] [Indexed: 11/29/2022] Open
Abstract
Frailty is a commonly occurring geriatric condition that increases the risk of adverse health outcomes. The factors and predictors behind frailty are not yet well understood. A better understanding of these factors can enable prevention of frailty in elderly patients. The objective of this study was to determine the association between proteinuria and frailty in US individuals with metabolic syndrome (MetS). Data from the National Health and Nutrition Examination Survey III (NHANES III, 1988–1994) conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. This is a cross-sectional study, and proteinuria and frailty were measured only once at enrollment. The study included 2,272 participants with MetS aged 40–90 years from the NHANES III. The participants underwent assessments to evaluate frailty and frailty components (low body weight, weakness, exhaustion, low physical activity, and slow walking). Proteinuria was represented as albumin-to-creatinine ratio (ACR) (mg/g) and divided into tertiles: T1-normal range (ACR <30 mg/g), T2-microalbuminuria (ACR 30–299 mg/g), and T3-macroalbuminuria (ACR ≥ 300 mg/g). We applied multiple logistic regression to determine the odds ratios (ORs) of frailty for T2 vs. T1 and T3 vs. T1 in both sexes. In the adjusted analysis for male participants, the ORs of frailty for T2 and T3 vs. T1 were 3.106 (95% confidence interval [CI] = 1.078–8.948, P = 0.036) and 14.428 (95% CI = 4.231–49.193, P < 0.001), respectively. For female participants, the ORs of frailty for T2 and T3 vs. T1 were 1.811 (95% CI = 1.071–3.063, P = 0.027) and 2.926 (95% CI = 1.202–7.124, P = 0.018), respectively. The positive association between T2 and T3 vs. T1, and frailty were statistically significant. The trends of higher likelihood of every frailty component were also statistically significant across increasing tertiles of proteinuria after multiple levels of adjustment for covariates (P < 0.05). Increased proteinuria levels were positively associated with frailty and each frailty component. Proteinuria might be a useful maker for frailty in individuals with MetS.
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Affiliation(s)
- Pi-Kai Chang
- Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Yuan-Ping Chao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Li-Wei Wu
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; and School of Medicine, National Defense Medical Center, Taipei, Taiwan
- *Correspondence: Li-Wei Wu
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14
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Quarleri J, Delpino MV. SARS-CoV-2 interacts with renin-angiotensin system: impact on the central nervous system in elderly patients. GeroScience 2022; 44:547-565. [PMID: 35157210 PMCID: PMC8853071 DOI: 10.1007/s11357-022-00528-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/08/2022] [Indexed: 01/18/2023] Open
Abstract
SARS-CoV-2 is a recently identified coronavirus that causes the current pandemic disease known as COVID-19. SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE2) as a receptor, suggesting that the initial steps of SARS-CoV-2 infection may have an impact on the renin-angiotensin system (RAS). Several processes are influenced by RAS in the brain. The neurological symptoms observed in COVID-19 patients, including reduced olfaction, meningitis, ischemic stroke, cerebral thrombosis, and delirium, could be associated with RAS imbalance. In this review, we focus on the potential role of disturbances in the RAS as a cause for central nervous system sequelae of SARS-CoV-2 infection in elderly patients.
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Affiliation(s)
- Jorge Quarleri
- Instituto de Investigaciones Biomédicas en Retrovirus Y Sida (INBIRS), Universidad de Buenos Aires-CONICET, Paraguay 2155-Piso 11 (1121), Buenos Aires, Argentina.
| | - M Victoria Delpino
- Instituto de Investigaciones Biomédicas en Retrovirus Y Sida (INBIRS), Universidad de Buenos Aires-CONICET, Paraguay 2155-Piso 11 (1121), Buenos Aires, Argentina.
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15
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Sanz B, Rezola-Pardo C, Arrieta H, Fernández-Atutxa A, Lora-Diaz I, Gil-Goikouria J, Rodriguez-Larrad A, Irazusta J. High serum angiotensin-converting enzyme 2 activity as a biomarker of frailty in nursing home residents. Exp Gerontol 2021; 158:111655. [PMID: 34915109 DOI: 10.1016/j.exger.2021.111655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 11/19/2021] [Accepted: 12/07/2021] [Indexed: 02/07/2023]
Abstract
Angiotensin-converting enzyme (ACE) and angiotensin-converting enzyme 2 (ACE2) are two of the main components of the renin-angiotensin system (RAS). Imbalanced RAS showing lower ACE2 has been associated with increased cardiovascular risk, muscular pathologies, sarcopenia, frailty, other age-related pathologies and a poorer health status. However, its role in aging remains unclear. Thus, the aim of this work was to analyze the serum enzymatic activity of ACE and ACE2, the ACE/ACE2 ratio and its association with anthropometric parameters, blood pressure, physical function, dependence and frailty in older people living in nursing homes. This study is a secondary analysis of baseline data from two randomized clinical trials in a population of 228 older individuals living in nursing homes (Spain). Serum ACE and ACE2 enzymatic activities were measured by fluorimetry. Variables linked to cardiovascular risk, physical function, dependence and frailty were measured using validated tests, indexes and scales. Association between ACE, ACE2 serum activities, the ACE/ACE2 ratio and the rest of the quantitative variables were assessed by Pearson's correlations and by partial correlations controlled by age and sex. The association between serum ACE and ACE2 activities, the ACE/ACE2 ratio and frailty scores was analyzed by generalized linear models with and without controlling for sex and age. Differences in enzymatic activities between sexes and between frail and non-frail individuals were analyzed using Student's t-test and general linear models to control analysis by age and sex. We found that higher serum ACE2 activity was associated with a higher body mass index, worse physical function, greater dependence and increased frailty. This association is consistent with the elevation of circulating ACE2 in certain pathological conditions and in line with RAS deregulation in muscular dystrophies. Serum ACE2 activity, in combination with other molecules, could be proposed as a biomarker of poor physical function, higher dependence and frailty.
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Affiliation(s)
- Begoña Sanz
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain.
| | - Chloe Rezola-Pardo
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain.
| | - Haritz Arrieta
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 20014 Donostia-San Sebastián, Gipuzkoa, Spain.
| | - Ainhoa Fernández-Atutxa
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain.
| | - Inmaculada Lora-Diaz
- DomusVi Berra, Berratxo Bidea, 2, 20017 Donostia-San Sebastián, Gipuzkoa, Spain.
| | - Javier Gil-Goikouria
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain.
| | - Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain.
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Bizkaia, Spain; Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain.
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16
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Joshi B, Wagh G, Kaur H, Patra C. Zebrafish Model to Study Angiotensin II-Mediated Pathophysiology. BIOLOGY 2021; 10:1177. [PMID: 34827169 PMCID: PMC8614710 DOI: 10.3390/biology10111177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/31/2021] [Accepted: 11/04/2021] [Indexed: 11/16/2022]
Abstract
Hypertension, a common chronic condition, may damage multiple organs, including the kidney, heart, and brain. Thus, it is essential to understand the pathology upon ectopic activation of the molecular pathways involved in mammalian hypertension to develop strategies to manage hypertension. Animal models play a crucial role in unraveling the disease pathophysiology by allowing incisive experimental procedures impossible in humans. Zebrafish, a small freshwater fish, have emerged as an important model system to study human diseases. The primary effector, Angiotensin II of the RAS pathway, regulates hemodynamic pressure overload mediated cardiovascular pathogenesis in mammals. There are various established mammalian models available to study pathophysiology in Angiotensin II-induced hypertension. Here, we have developed a zebrafish model to study pathogenesis by Angiotensin II. We find that intradermal Angiotensin II injection every 12 h can induce cardiac remodeling in seven days. We show that Angiotensin II injection in adult zebrafish causes cardiomyocyte hypertrophy and enhances cardiac cell proliferation. In addition, Angiotensin II induces ECM protein-coding gene expression and fibrosis in the cardiac ventricles. Thus, this study can conclude that Angiotensin II injection in zebrafish has similar implications as mammals, and zebrafish can be a model to study pathophysiology associated with AngII-RAS signaling.
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Affiliation(s)
- Bhagyashri Joshi
- Developmental Biology, Agharkar Research Institute, Pune 411004, India; (B.J.); (G.W.)
- Science and Technology, SP Pune University, Pune 411007, India
| | - Ganesh Wagh
- Developmental Biology, Agharkar Research Institute, Pune 411004, India; (B.J.); (G.W.)
- Science and Technology, SP Pune University, Pune 411007, India
| | - Harmandeep Kaur
- Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5C 2T2, Canada;
| | - Chinmoy Patra
- Developmental Biology, Agharkar Research Institute, Pune 411004, India; (B.J.); (G.W.)
- Science and Technology, SP Pune University, Pune 411007, India
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17
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Sunanda T, Ray B, Mahalakshmi AM, Bhat A, Rashan L, Rungratanawanich W, Song BJ, Essa MM, Sakharkar MK, Chidambaram SB. Mitochondria-Endoplasmic Reticulum Crosstalk in Parkinson's Disease: The Role of Brain Renin Angiotensin System Components. Biomolecules 2021; 11:1669. [PMID: 34827667 PMCID: PMC8615717 DOI: 10.3390/biom11111669] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/29/2021] [Accepted: 11/04/2021] [Indexed: 12/12/2022] Open
Abstract
The past few decades have seen an increased emphasis on the involvement of the mitochondrial-associated membrane (MAM) in various neurodegenerative diseases, particularly in Parkinson's disease (PD) and Alzheimer's disease (AD). In PD, alterations in mitochondria, endoplasmic reticulum (ER), and MAM functions affect the secretion and metabolism of proteins, causing an imbalance in calcium homeostasis and oxidative stress. These changes lead to alterations in the translocation of the MAM components, such as IP3R, VDAC, and MFN1 and 2, and consequently disrupt calcium homeostasis and cause misfolded proteins with impaired autophagy, distorted mitochondrial dynamics, and cell death. Various reports indicate the detrimental involvement of the brain renin-angiotensin system (RAS) in oxidative stress, neuroinflammation, and apoptosis in various neurodegenerative diseases. In this review, we attempted to update the reports (using various search engines, such as PubMed, SCOPUS, Elsevier, and Springer Nature) demonstrating the pathogenic interactions between the various proteins present in mitochondria, ER, and MAM with respect to Parkinson's disease. We also made an attempt to speculate the possible involvement of RAS and its components, i.e., AT1 and AT2 receptors, angiotensinogen, in this crosstalk and PD pathology. The review also collates and provides updated information on the role of MAM in calcium signaling, oxidative stress, neuroinflammation, and apoptosis in PD.
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Affiliation(s)
- Tuladhar Sunanda
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru 570015, Karnataka, India; (T.S.); (B.R.); (A.M.M.); (A.B.)
- Centre for Experimental Pharmacology and Toxicology, JSS Academy of Higher Education & Research, Mysuru 570015, Karnataka, India
| | - Bipul Ray
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru 570015, Karnataka, India; (T.S.); (B.R.); (A.M.M.); (A.B.)
- Centre for Experimental Pharmacology and Toxicology, JSS Academy of Higher Education & Research, Mysuru 570015, Karnataka, India
| | - Arehally M. Mahalakshmi
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru 570015, Karnataka, India; (T.S.); (B.R.); (A.M.M.); (A.B.)
| | - Abid Bhat
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru 570015, Karnataka, India; (T.S.); (B.R.); (A.M.M.); (A.B.)
- Centre for Experimental Pharmacology and Toxicology, JSS Academy of Higher Education & Research, Mysuru 570015, Karnataka, India
| | - Luay Rashan
- Biodiversity Research Centre, Dohfar University, Salalah 2059, Oman;
| | - Wiramon Rungratanawanich
- Section of Molecular Pharmacology and Toxicology, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, 9000 Rockville Pike, Bethesda, MD 20892, USA; (W.R.); (B.-J.S.)
| | - Byoung-Joon Song
- Section of Molecular Pharmacology and Toxicology, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, 9000 Rockville Pike, Bethesda, MD 20892, USA; (W.R.); (B.-J.S.)
| | - Musthafa Mohamed Essa
- Department of Food Science and Nutrition, CAMS, Sultan Qaboos University, Muscat 123, Oman;
- Ageing and Dementia Research Group, Sultan Qaboos University, Muscat 123, Oman
| | - Meena Kishore Sakharkar
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5A2, Canada
| | - Saravana Babu Chidambaram
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru 570015, Karnataka, India; (T.S.); (B.R.); (A.M.M.); (A.B.)
- Centre for Experimental Pharmacology and Toxicology, JSS Academy of Higher Education & Research, Mysuru 570015, Karnataka, India
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18
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Zucchelli A, Bologna E, Marengoni A. Why data on frailty and SARS-CoV-2 infection are basic to progress. Aging Clin Exp Res 2021; 33:1429-1432. [PMID: 33797742 PMCID: PMC8017512 DOI: 10.1007/s40520-021-01846-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 03/23/2021] [Indexed: 12/12/2022]
Abstract
Several studies showed that frailty was a predictor of in-hospital death in older adults with COVID-19. The mechanisms through which frailty increases the severity of COVID-19 are several, including immunosenescense and dysregulated inflammation. Whether individuals affected by frailty exhibit a higher susceptibility to SARS-CoV-2 infection remains an open question. Here we report the case series of 40 older persons that in February 2020, before the first case of COVID-19 was detected in Italy, went together on a winter holiday. Back home, 7 of them developed influenza-like symptoms and one was hospitalized due to COVID-19 pneumonia. Between May and July, the seniors were offered the possibility to be tested for SARS-CoV-2 antibody positivity. Twenty-seven of them accepted: 13 had a positive serological test whereas no active infection was found. Comparing the characteristics of those who tested positive and the others, we found that the former group was frailer, exhibiting higher Clinical Frailty Scale scores.
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Affiliation(s)
- A Zucchelli
- Department of Information Engineering, Università degli Studi di Brescia, vle Branze 38, 25123, Brescia, Italy.
| | - E Bologna
- Fondazione Piera, Pietro e Giovanni Ferrero, Alba, Italy
| | - A Marengoni
- Department of Clinical and Experimental Sciences, Università degli Studi di Brescia, Brescia, Italy
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19
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The Tissue Renin-Angiotensin System and Its Role in the Pathogenesis of Major Human Diseases: Quo Vadis? Cells 2021; 10:cells10030650. [PMID: 33804069 PMCID: PMC7999456 DOI: 10.3390/cells10030650] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/09/2021] [Accepted: 03/13/2021] [Indexed: 01/18/2023] Open
Abstract
Evidence has arisen in recent years suggesting that a tissue renin-angiotensin system (tRAS) is involved in the progression of various human diseases. This system contains two regulatory pathways: a pathological pro-inflammatory pathway containing the Angiotensin Converting Enzyme (ACE)/Angiotensin II (AngII)/Angiotensin II receptor type 1 (AGTR1) axis and a protective anti-inflammatory pathway involving the Angiotensin II receptor type 2 (AGTR2)/ACE2/Ang1–7/MasReceptor axis. Numerous studies reported the positive effects of pathologic tRAS pathway inhibition and protective tRAS pathway stimulation on the treatment of cardiovascular, inflammatory, and autoimmune disease and the progression of neuropathic pain. Cell senescence and aging are known to be related to RAS pathways. Further, this system directly interacts with SARS-CoV 2 and seems to be an important target of interest in the COVID-19 pandemic. This review focuses on the involvement of tRAS in the progression of the mentioned diseases from an interdisciplinary clinical perspective and highlights therapeutic strategies that might be of major clinical importance in the future.
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20
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Nidadavolu LS, Walston JD. Underlying Vulnerabilities to the Cytokine Storm and Adverse COVID-19 Outcomes in the Aging Immune System. J Gerontol A Biol Sci Med Sci 2021; 76:e13-e18. [PMID: 32841329 PMCID: PMC7546042 DOI: 10.1093/gerona/glaa209] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Indexed: 12/20/2022] Open
Abstract
Older adults are far more vulnerable to adverse health outcomes and mortality after contracting COVID-19. There are likely multiple age-related biological, clinical, and environmental reasons for this increased risk, all of which are exacerbated by underlying age-associated changes to the immune system as well as increased prevalence of chronic disease states in older adults. Innate immune system overactivity, termed the cytokine storm, appears to be critical in the development of the worst consequences of COVID-19 infection. Pathophysiology suggests that viral stimulation of the innate immune system, augmented by inflammatory signals sent from dying cells, ramps up into a poorly controlled outpouring of inflammatory mediators. Other aging-related changes in cells such as senescence as well as higher prevalence of chronic disease states also likely ramp up inflammatory signaling. This in turn drives downstream pathophysiological changes to pulmonary, cardiovascular, skeletal muscle, and brain tissues that drive many of the adverse health outcomes observed in older adults. This article provides an overview of the underlying etiologies of innate immune system activation and adaptive immune system dysregulation in older adults and how they potentiate the consequences of the COVID-19-related cytokine storm, and possible uses of this knowledge to develop better risk assessment and treatment monitoring strategies.
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Affiliation(s)
- Lolita S Nidadavolu
- Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jeremy D Walston
- Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Medicine, Kyung Hee University, Seoul, South Korea
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21
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Wang M, Sun X, Zhang W, Zhang Q, Qian J, Chen W, Yao S, Jin L, Kalantar-Zadeh K, Wang X, Chen J. Frailty and the risk of kidney function decline in the elderly population: the Rugao Longevity and Ageing Study. Nephrol Dial Transplant 2021; 36:2274-2281. [PMID: 33537782 DOI: 10.1093/ndt/gfaa323] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The diverse risk factors for kidney impairments suggest that kidney function decline is more likely to occur in individuals with a broadly constituted health deficit. Here we conducted a longitudinal cohort study to evaluate the association of baseline frailty status with the risk of estimated glomerular filtration rate (eGFR) decline. METHODS Overall, 1269 participants aged 70-84 years from Rugao Longevity and Ageing cohort with 3-year follow-up were included. Frailty was measured using a modified Fried frailty assessment. GFR was estimated using the Chronic Kidney Disease Epidemiology Collaboration equation. Associations between baseline frailty status and rapid eGFR decline were examined by multinomial logistic analysis. A linear mixed-effect model was used to determine eGFR decline in mL/min/1.73 m2 over the study period comparing those with frail or prefrail at baseline versus those with robust status. RESULTS The mean (± standard deviation) age of participants was 75.1 ± 3.8 years. A total of 144 (11%) participants had rapid eGFR decline by at least 10% during the 3-year follow-up. Compared with robust status, baseline frail status was associated with a 2.48-fold [95% confidence interval (CI) 1.24-4.95] increased risk of rapid eGFR decline after multiple adjustments. In multivariate linear mixed model analysis, subjects with frail status but not prefrail status at baseline had a significant coefficient of -1.70 (95% CI -3.35 to -0.04) for the frail × visit term, which indicates an accelerated eGFR decline compared with robust subjects over the study period (P = 0.044). CONCLUSIONS Frailty may serve as an independent biomarker to predict the decline of kidney function.
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Affiliation(s)
- Mengjing Wang
- Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xuehui Sun
- Ministry of Education Key Laboratory of Contemporary Anthropology and State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China
| | - Weichen Zhang
- Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qian Zhang
- Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jing Qian
- Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Weisheng Chen
- Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Shun Yao
- Ministry of Education Key Laboratory of Contemporary Anthropology and State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China
| | - Li Jin
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology and State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology and Hypertension, Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California Irvine Medical Center, Orange, CA, USA
- Fielding School of Public Health at UCLA, Los Angeles, CA, USA
- Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA, USA
| | - Xiaofeng Wang
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology and State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China
| | - Jing Chen
- Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
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22
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Yang X, Jiang Y, Li J, Yang M, Liu Y, Dong B, Li Y. Association between Frailty and Albuminuria among Older Chinese Inpatients. J Nutr Health Aging 2021; 25:197-200. [PMID: 33491034 DOI: 10.1007/s12603-020-1481-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Older adults with frailty are vulnerable to cardiovascular event and subsequent mortality. Frailty and albuminuria share atherosclerotic risk factors. The present study investigated the association of frailty and albuminuria among elderly Chinese inpatients. DESIGN Cross-sectional study. SETTINGS AND PARTICIPANTS A total of 202 patients aged over 60 years from the Center of Gerontology and Geriatric, West China Hospital. MEASUREMENTS Frailty was defined using the five-item FRAIL scale. This included measurements of fatigue, resistance, ambulation, illness, and loss of weight. We further determined the random urine albumin/creatinine ratio (UACR) of all patients. Random UACR ≥30 mg/g was defined as albuminuria, and < 30mg/g as normoalbuminuria. The relationship between albuminuria and frailty was assessed through multiple regression analysis. RESULTS The 202 participants (156 men, 77.2%) had an average age of 78.99±7.60 years, which ranged from 60 to 95. Compared to those without albuminuria, elderly patients with albuminuria were of an older age, had a higher prevalence of diabetes and poorer renal function. The prevalence of frailty, pre-frailty and ambulation (one of the FRAIL components) were higher in the albuminuria group than the normoalbuminuria group (23.9% vs. 12.2%, 47.9% vs.37.4%, 33.8% vs. 16.0%, respectively, P<0.05). Following the adjustment for age, eGFR, hypertension, diabetes and using ACEI/ARB, being frail or pre-frail led to an enhanced risk of albuminuria (OR frail 2.60, 95% CI frail 1.01-6.72; OR pre-frail 2.14, 95% CI pre-frail 1.03-4.44). CONCLUSIONS Frailty is independently associated with albuminuria when adjusted for classic cardiovascular risk factors.
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Affiliation(s)
- X Yang
- Ying Li, MD, The Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University. 37 Guoxuexiang, Chengdu, Sichuan providence, PR. China, 610041; Tel: 86-028-8542 2321; Fax: 86-028-8542 2321; E-mail:
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Stein RA, Young LM. From ACE2 to COVID-19: A multiorgan endothelial disease. Int J Infect Dis 2020; 100:425-430. [PMID: 32896660 PMCID: PMC7832810 DOI: 10.1016/j.ijid.2020.08.083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 08/31/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- Richard A Stein
- NYU Tandon School of Engineering, Department of Chemical and Biomolecular Engineering, 6 MetroTech Center, Brooklyn, NY 11201, USA; LaGuardia Community College, Department of Natural Sciences, City University of New York, New York, NY 11101, USA.
| | - Lauren M Young
- University of Chicago, Department of Internal Medicine, 5841 S Maryland Ave, Chicago, IL 60637, USA.
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24
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Xue QL. Frailty as an integrative marker of physiological vulnerability in the era of COVID-19. BMC Med 2020; 18:333. [PMID: 33092582 PMCID: PMC7581466 DOI: 10.1186/s12916-020-01809-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 10/07/2020] [Indexed: 02/07/2023] Open
Affiliation(s)
- Qian-Li Xue
- Department of Medicine Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA. .,Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
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25
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Cosarderelioglu C, Nidadavolu LS, George CJ, Oh ES, Bennett DA, Walston JD, Abadir PM. Brain Renin-Angiotensin System at the Intersect of Physical and Cognitive Frailty. Front Neurosci 2020; 14:586314. [PMID: 33117127 PMCID: PMC7561440 DOI: 10.3389/fnins.2020.586314] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 08/25/2020] [Indexed: 12/15/2022] Open
Abstract
The renin–angiotensin system (RAS) was initially considered to be part of the endocrine system regulating water and electrolyte balance, systemic vascular resistance, blood pressure, and cardiovascular homeostasis. It was later discovered that intracrine and local forms of RAS exist in the brain apart from the endocrine RAS. This brain-specific RAS plays essential roles in brain homeostasis by acting mainly through four angiotensin receptor subtypes; AT1R, AT2R, MasR, and AT4R. These receptors have opposing effects; AT1R promotes vasoconstriction, proliferation, inflammation, and oxidative stress while AT2R and MasR counteract the effects of AT1R. AT4R is critical for dopamine and acetylcholine release and mediates learning and memory consolidation. Consequently, aging-associated dysregulation of the angiotensin receptor subtypes may lead to adverse clinical outcomes such as Alzheimer’s disease and frailty via excessive oxidative stress, neuroinflammation, endothelial dysfunction, microglial polarization, and alterations in neurotransmitter secretion. In this article, we review the brain RAS from this standpoint. After discussing the functions of individual brain RAS components and their intracellular and intracranial locations, we focus on the relationships among brain RAS, aging, frailty, and specific neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease, and vascular cognitive impairment, through oxidative stress, neuroinflammation, and vascular dysfunction. Finally, we discuss the effects of RAS-modulating drugs on the brain RAS and their use in novel treatment approaches.
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Affiliation(s)
- Caglar Cosarderelioglu
- Division of Geriatrics, Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey.,Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Lolita S Nidadavolu
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Claudene J George
- Division of Geriatrics, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States
| | - Esther S Oh
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States
| | - Jeremy D Walston
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Peter M Abadir
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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26
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Czick M, Shapter C, Shapter R. COVID's Razor: RAS Imbalance, the Common Denominator Across Disparate, Unexpected Aspects of COVID-19. Diabetes Metab Syndr Obes 2020; 13:3169-3192. [PMID: 32982349 PMCID: PMC7495349 DOI: 10.2147/dmso.s265518] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/04/2020] [Indexed: 12/25/2022] Open
Abstract
A modern iteration of Occam's Razor posits that "the simplest explanation is usually correct." Coronavirus Disease 2019 involves widespread organ damage and uneven mortality demographics, deemed unexpected from what was originally thought to be "a straightforward respiratory virus." The simplest explanation is that both the expected and unexpected aspects of COVID-19 share a common mechanism. Silent hypoxia, atypical acute respiratory distress syndrome (ARDS), stroke, olfactory loss, myocarditis, and increased mortality rates in the elderly, in men, in African-Americans, and in patients with obesity, diabetes, and cancer-all bear the fingerprints of the renin-angiotensin system (RAS) imbalance, suggesting that RAS is the common culprit. This article examines what RAS is and how it works, then from that baseline, the article presents the evidence suggesting RAS involvement in the disparate manifestations of COVID-19. Understanding the deeper workings of RAS helps one make sense of severe COVID-19. In addition, recognizing the role of RAS imbalance suggests potential routes to mitigate COVID-19 severity.
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Affiliation(s)
- Maureen Czick
- University of Connecticut, Department of Anesthesia, Farmington, CT, USA
| | | | - Robert Shapter
- Independent Consultant ( Medical Research, Medical Communications, and Medical Education), Hartford, CT, USA
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27
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Huang HL, Chang CH, Chen CY, Peng JK, Wang YT, Chen CY, Hsu CC, Lee CS, Tsai JS. Plasma vascular adhesion protein-1 levels correlate positively with frailty severity in older adults. Medicine (Baltimore) 2020; 99:e21192. [PMID: 32791695 PMCID: PMC7386979 DOI: 10.1097/md.0000000000021192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Geriatric frailty is associated with increased mortality and links to increased inflammatory activity. Vascular adhesion protein-1 (VAP-1) is important in inflammatory process. This study investigates the relationship between plasma VAP-1 level and frailty in older adults.The cross-sectional study recruited community dwelling older adults from a hospital-based comprehensive geriatric assessment program. The demographic data, Fried Frailty Index, metabolic and inflammatory parameters were assessed.A total of 151 participants (76 women, 50.3%) were included in the analysis, and the age (mean ± standard deviation) was 77.1 ± 6.1 years. The mean plasma VAP-1 level (ng/mL) was significantly different (P = .029) among different frailty groups (346.3 ± 86.5 in the robust older adults, 371.6 ± 107.9 in the pre-frail older adults, and 416.6 ± 141.1 in the frail older adults). Multivariate ordered logistic regression analysis also demonstrated that plasma VAP-1 levels were positively associated with frailty severity (P = .039). Analysis of the frailty components with plasma VAP-1 levels showed that the elderly who had "exhaustion" (P = .016) or "weakness" (P = .025) tended to have higher plasma VAP-1 levels.The data support that VAP-1 might represent a potential plasma biomarker of frailty.
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Affiliation(s)
- Hsien-Liang Huang
- Department of Family Medicine, National Taiwan University Hospital
- Department of Family Medicine, College of Medicine, National Taiwan University
| | | | - Chin-Ying Chen
- Department of Family Medicine, National Taiwan University Hospital
- Department of Family Medicine, College of Medicine, National Taiwan University
| | - Jen-Kuei Peng
- Department of Family Medicine, National Taiwan University Hospital
- Department of Family Medicine, College of Medicine, National Taiwan University
| | - Yu-Ting Wang
- Clinical Trial Center, Department of Medical Research, National Taiwan University Hospital, Taipei
| | - Ching-Yu Chen
- Department of Family Medicine, National Taiwan University Hospital
- Department of Family Medicine, College of Medicine, National Taiwan University
- Division of Geriatric Research, Institute of Population Health Science, National Health Research Institutes, Miaoli
| | - Chih-Cheng Hsu
- Department of Family Medicine, National Taiwan University Hospital
- Division of Geriatric Research, Institute of Population Health Science, National Health Research Institutes, Miaoli
| | - Chung-Sheng Lee
- Department of Nutrition and Health Sciences, Kainan University, Luzhu, Taoyuan County
| | - Jaw-Shiun Tsai
- Department of Family Medicine, National Taiwan University Hospital
- Department of Family Medicine, College of Medicine, National Taiwan University
- Center for Complementary and Integrated Medicine, National Taiwan University Hospital, Taipei, Taiwan
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28
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Garófolo A, Qiao L, Maia-Lemos PDS. Approach to Nutrition in Cancer Patients in the Context of the Coronavirus Disease 2019 (COVID-19) Pandemic: Perspectives. Nutr Cancer 2020; 73:1293-1301. [PMID: 32696665 DOI: 10.1080/01635581.2020.1797126] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Coronavirus Disease 2019 (COVID-19) is a new pandemic that originated in China in December 2019. Cancer patients are immunosuppressed and very susceptive to acquiring infections; thus, they are at greater risk of developing more severe forms of COVID-19. People infected with COVID-19 display increased plasma levels of pro-inflammatory cytokines. Excessive inflammation may cause damage to the body's tissues, thereby potentially contributing to alveolar damage and the severity of COVID-19. We hypothesize that since a pro-inflammatory state may worsen COVID-19 prognosis, modulating systemic inflammation through dietary modification may be efficacious in improving the clinical sequelae of COVID-19. The aim of this review is to present current nutritional and dietary approaches in the context of inflammation with a specific focus on cancer patients with and without COVID-19. The main topics reviewed include nutrition in inflammation and immunity. A systematic literature search on Google Scholar, Medline, and PubMed databases was performed between March 22, 2020 and May 6, 2020 using the keywords "COVID-19," "coronavirus," "cancer," "inflammation," "probiotics," "vitamin D," and "nutrition prevention." Healthy dietary habits, omega-3-rich diets, probiotics use, and vitamin D supplementation, as well as obesity prevention, are likely the most efficacious preventive approaches to controlling hyperinflammation, improving immune function, and decreasing the severity of inflammatory diseases.
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Affiliation(s)
- Adriana Garófolo
- Support Group for Adolescents and Children with Cancer (GRAACC), Department of Pediatrics, Federal University of São Paulo (UNIFESP), Vila Clementino, São Paulo, Brazil
| | - Lyon Qiao
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Abstract
Understanding geriatric physiology is critical for successful perioperative management of older surgical patients. The frailty syndrome is evolving as an important, potentially modifiable process capturing a patient's biologic age and is more predictive of adverse perioperative outcomes than chronologic age. Use of frailty in risk stratification and perioperative decision-making allows providers to effectively diagnose, risk stratify, and treat patients in the perioperative setting. Further study is needed to develop a universal definition of frailty, to identify comprehensive yet feasible screening tools that allow for accurate detection of frailty in the perioperative setting, and to refine treatment programs for frail surgical patients.
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Trendelenburg A, Scheuren A, Potter P, Müller R, Bellantuono I. Geroprotectors: A role in the treatment of frailty. Mech Ageing Dev 2019; 180:11-20. [DOI: 10.1016/j.mad.2019.03.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 03/12/2019] [Accepted: 03/14/2019] [Indexed: 12/25/2022]
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31
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Inglés M, Mas-Bargues C, Gimeno-Mallench L, Cruz-Guerrero R, García-García FJ, Gambini J, Borrás C, Rodríguez-Mañas L, Viña J. Relation Between Genetic Factors and Frailty in Older Adults. J Am Med Dir Assoc 2019; 20:1451-1457. [PMID: 31078485 DOI: 10.1016/j.jamda.2019.03.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/03/2019] [Accepted: 03/16/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Frailty is a geriatric syndrome that identifies individuals at higher risk of disability, institutionalization, and death. We previously reported that frailty is related to oxidative stress and cognitive impairment-related biomarkers. The aim of this study was to determine whether frailty is associated with genetic variants. DESIGN Longitudinal population-based cohort of 2488 community-dwelling people from Toledo, Spain, aged 65 years or older. SETTING AND PARTICIPANTS We obtained blood samples from 78 individuals with frailty and 74 nonfrail individuals who were nonfrail (according to Fried criteria) from the Toledo Study of Healthy Ageing and extracted DNA using the Chemagic DNA blood kit. MEASURES Sample genotyping was carried out by means of Axiom Exome 319 Genotyping Array (Thermo Fisher Scientific), which contains 295,988 markers [single-nucleotide polymorphisms (SNPs) and rare variants], and transferred to the GeneTitan Instrument (Affymetrix). RESULTS We found 15 SNPs (P < .001), 18 genes (P < .005), and 4 pathways (P < .05) related to cytokine-cytokine receptor interaction, natural killer cell-mediated cytotoxicity, regulation of autophagy, and renin-angiotensin system as the most strongly associated with frailty. CONCLUSIONS/IMPLICATIONS The specific genetic features related to energy metabolism, biological processes regulation, cognition, and inflammation highlighted by this preliminary analysis offer useful insights for finding biologically meaningful biomarkers of frailty that allow early diagnosis and treatment. Further research is needed to confirm our novel findings in a larger population. Indeed, the EU-funded FRAILOMICS research effort will address this question.
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Affiliation(s)
- Marta Inglés
- Freshage Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - Cristina Mas-Bargues
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - Lucia Gimeno-Mallench
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - Raquel Cruz-Guerrero
- CIBERER- Genomic Medicine Group, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Juan Gambini
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - Consuelo Borrás
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain.
| | - Leocadio Rodríguez-Mañas
- Department of Geriatric Medicine, Hospital Universitario de Getafe and CIBERFES (CIBER of Frailty and Healthy Ageing), Getafe, Spain
| | - Jose Viña
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
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Age- and Genotype-Specific Effects of the Angiotensin-Converting Enzyme Inhibitor Lisinopril on Mitochondrial and Metabolic Parameters in Drosophila melanogaster. Int J Mol Sci 2018; 19:ijms19113351. [PMID: 30373167 PMCID: PMC6274988 DOI: 10.3390/ijms19113351] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 10/18/2018] [Accepted: 10/24/2018] [Indexed: 12/18/2022] Open
Abstract
The angiotensin-converting enzyme (ACE) is a peptidase that is involved in the synthesis of Angiotensin II, the bioactive component of the renin-angiotensin system. A growing body of literature argues for a beneficial impact of ACE inhibitors (ACEi) on age-associated metabolic disorders, mediated by cellular changes in reactive oxygen species (ROS) that improve mitochondrial function. Yet, our understanding of the relationship between ACEi therapy and metabolic parameters is limited. Here, we used three genetically diverse strains of Drosophila melanogaster to show that Lisinopril treatment reduces thoracic ROS levels and mitochondrial respiration in young flies, and increases mitochondrial content in middle-aged flies. Using untargeted metabolomics analysis, we also showed that Lisinopril perturbs the thoracic metabolic network structure by affecting metabolic pathways involved in glycogen degradation, glycolysis, and mevalonate metabolism. The Lisinopril-induced effects on mitochondrial and metabolic parameters, however, are genotype-specific and likely reflect the drug's impact on nutrient-dependent fitness traits. Accordingly, we found that Lisinopril negatively affects survival under nutrient starvation, an effect that can be blunted by genotype and age in a manner that partially mirrors the drug-induced changes in mitochondrial respiration. In conclusion, our results provide novel and important insights into the role of ACEi in cellular metabolism.
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De Luca M. The role of the cell-matrix interface in aging and its interaction with the renin-angiotensin system in the aged vasculature. Mech Ageing Dev 2018; 177:66-73. [PMID: 29626500 DOI: 10.1016/j.mad.2018.04.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/22/2018] [Accepted: 04/03/2018] [Indexed: 12/11/2022]
Abstract
The extracellular matrix (ECM) is an intricate network that provides structural and anchoring support to cells in order to stabilize cell morphology and tissue architecture. The ECM also controls many aspects of the cell's dynamic behavior and fate through its ongoing, bidirectional interaction with cells. These interactions between the cell and components of the surrounding ECM are implicated in several biological processes, including development and adult tissue repair in response to injury, throughout the lifespan of multiple species. The present review gives an overview of the growing evidence that cell-matrix interactions play a pivotal role in the aging process. The focus of the first part of the article is on recent studies using cell-derived decellularized ECM, which strongly suggest that age-related changes in the ECM induce cellular senescence, a well-recognized hallmark of aging. This is followed by a review of findings from genetic studies indicating that changes in genes involved in cell-ECM adhesion and matrix-mediated intracellular signaling cascades affect longevity. Finally, mention is made of novel data proposing an intricate interplay between cell-matrix interactions and the renin-angiotensin system that may have a significant impact on mammalian arterial stiffness with age.
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Affiliation(s)
- Maria De Luca
- Department of Nutrition Sciences, University of Alabama at Birmingham, Webb 451-1720 2nd Ave S, Birmingham, AL, 35294-3360, USA.
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34
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Abadir PM, Jain A, Powell LJ, Xue QL, Tian J, Hamilton RG, Bennett DA, Finucane T, Walston JD, Fedarko NS. Discovery and Validation of Agonistic Angiotensin Receptor Autoantibodies as Biomarkers of Adverse Outcomes. Circulation 2016; 135:449-459. [PMID: 27903588 DOI: 10.1161/circulationaha.116.022385] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 11/11/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Agonistic angiotensin II type 1 receptor autoantibodies (AT1RaAbs) have not been associated with functional measures or risk for adverse health outcomes. AT1RaAbs could be used to stratify patient risk and to identify patients who can benefit from angiotensin receptor blocker treatment. METHODS Demographic and physiological covariates were measured in a discovery set of community-dwelling adults from Baltimore (N=255) and AT1RaAb associations with physical function tests and outcomes assessed. A group from Chicago (N=60) was used for validation of associations and to explore the impact of angiotensin receptor blocker treatment. RESULTS The Baltimore group had 28 subjects with falls, 32 frail subjects, and 5 deaths. Higher AT1RaAbs correlated significantly with interleukin-6 (Spearman r=0.33, P<0.0001), systolic blood pressure (Spearman r=0.28, P<0.0001), body mass index (Spearman r=0.28, P<0.0001), weaker grip strength (Spearman r=-0.34, P<0.01), and slower walking speed (Spearman r=-0.30, P<0.05). Individuals with high AT1RaAbs were 3.9 (95% confidence interval, 1.38-11.0) times more likely to be at high risk after adjusting for age (P<0.05). Every 1 µg/mL increase in AT1RaAbs increased the odds of falling 30% after adjusting for age, sex, body mass index, and blood pressure. The Chicago group had 46 subjects with falls and 60 deaths. Serum AT1RaAb levels were significantly correlated with grip strength (Spearman r=-0.57, P<0.005), walking speed (Spearman r=-0.47, P<0.005), and falls (Spearman r=0.30, P<0.05). Every 1 µg/mL increase in AT1RaAbs, decreased time to death by 9% after adjusting for age, sex, body mass index, and blood pressure. Chronic treatment with angiotensin receptor blockers was associated with better control of systolic blood pressure and attenuation of decline in both grip strength and time to death. CONCLUSIONS In older individuals, higher AT1RaAb levels were associated with inflammation, hypertension, and adverse outcomes. Angiotensin receptor blocker treatment may blunt the harm associated with high levels of AT1RaAb.
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Affiliation(s)
- Peter M Abadir
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Alka Jain
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Laura J Powell
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Qian-Li Xue
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Jing Tian
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Robert G Hamilton
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - David A Bennett
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Thomas Finucane
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Jeremy D Walston
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.)
| | - Neal S Fedarko
- From Biology of Healthy Aging Program, Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD (P.M.A., A.A.J., L.J.P., Q.-L.X., J.D.W., N.S.F.); Center on Aging and Health, Johns Hopkins University, Baltimore, MD (P.M.A., Q.-L.X., J.D.W., N.S.F.); Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (J.T.); Departments of Medicine and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (R.G.H.); and Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL (D.A.B.).
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Li BL, Li W, Bi JQ, Meng QG, Fei JF. Predicting factors associated with frailty in aged patients with bone-arthrosis pain in the clinic. PHYSICIAN SPORTSMED 2016; 44:391-396. [PMID: 27762636 DOI: 10.1080/00913847.2016.1247678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To identify frail and pre-frail patients in a group of patients older than 60 years. METHODS The phenotype model of Fried's method was used to identify frailty and pre-frailty in total of 78 participants. Cognitive ability and psychosocial function tests were also given to 59 of the 78 patients. RESULTS Prevalence of frailty and pre-frailty was 14.1% (11/78) and 46.2% (36/78), respectively. Of the 5 phenotype variables, weak grip strength was the most commonly seen variable with 53.8% of all participants and 100% in the frail group. Low energy expenditure, however, was not self-reported by any participant in the current study (0%). Prevalence of frailty in the present study is associated with chronological age. The current study indicates that 4 phenotypic variables (unintentional weight loss, self-reported exhaustion, gait speed and grip strength) contribute to the development to frailty, and that cognitive impairment and psychosocial frailty also predict frailty or pre-frailty in the patients older than 60 years old irrespective of chronic pain or osteoarthritis. The findings of the current study suggest frailty and pre-frailty are common in senior Chinese patients with chronic diseases. CONCLUSION Recognition and identification of frailty in a rehabilitation clinic or hospital might help physicians to provide appropriate counseling to patients and families about adverse outcomes of certain treatments such as surgery, and could optimize management of coexisting chronic diseases that might contribute to or be affected by frailty.
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Affiliation(s)
- Bao-Lin Li
- a Department of Orthopaedic Surgery , The First Hospital of Harbin City, Harbin Medical University , Harbin , China
| | - Wei Li
- a Department of Orthopaedic Surgery , The First Hospital of Harbin City, Harbin Medical University , Harbin , China
| | - Jia-Qi Bi
- a Department of Orthopaedic Surgery , The First Hospital of Harbin City, Harbin Medical University , Harbin , China
| | - Qing-Gang Meng
- a Department of Orthopaedic Surgery , The First Hospital of Harbin City, Harbin Medical University , Harbin , China
| | - Jian-Feng Fei
- a Department of Orthopaedic Surgery , The First Hospital of Harbin City, Harbin Medical University , Harbin , China
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Abstract
Wounds are among the most common, painful, debilitating and costly conditions in older adults. Disruption of the angiotensin type 1 receptors (AT1R), has been associated with impaired wound healing, suggesting a critical role for AT1R in this repair process. Biological functions of angiotensin type 2 receptors (AT2R) are less studied. We investigated effects of genetically disrupting AT2R on rate and quality of wound healing. Our results suggest that AT2R effects on rate of wound closure depends on the phase of wound healing. We observed delayed healing during early phase of wound healing (inflammation). An accelerated healing rate was seen during later stages (proliferation and remodeling). By day 12, fifty percent of AT2R−/− mice had complete wound closure as compared to none in either C57/BL6 or AT1R−/− mice. There was a significant increase in AT1R, TGFβ1 and TGFβ2 expression during the proliferative and remodeling phases in AT2R−/− mice. Despite the accelerated closure rate, AT2R−/− mice had more fragile healed skin. Our results suggest that in the absence of AT2R, wound healing rate is accelerated, but yielded worse skin quality. Elucidating the contribution of both of the angiotensin receptors may help fine tune future intervention aimed at wound repair in older individuals.
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Amblàs-Novellas J, Espaulella-Panicot J, Inzitari M, Rexach L, Fontecha B, Romero-Ortuno R. [The challenge of clinical complexity in the 21st century: Could frailty indexes be the answer?]. Rev Esp Geriatr Gerontol 2016; 52:159-166. [PMID: 27544014 DOI: 10.1016/j.regg.2016.07.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 07/07/2016] [Accepted: 07/13/2016] [Indexed: 12/14/2022]
Abstract
The number of older people with complex clinical conditions and complex care needs continues to increase in the population. This is presenting many challenges to healthcare professionals and healthcare systems. In the face of these challenges, approaches are required that are practical and feasible. The frailty paradigm may be an excellent opportunity to review and establish some of the principles of comprehensive Geriatric Assessment in specialties outside Geriatric Medicine. The assessment of frailty using Frailty Indexes provides an aid to the 'situational diagnosis' of complex clinical situations, and may help in tackling uncertainty in a person-centred approach.
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Affiliation(s)
- Jordi Amblàs-Novellas
- Unidad Geriátrica de Agudos, Hospital Universitari de Vic/Consorci Hospitalari de Vic, Vic, Barcelona, España; Unidad Territorial de Geriatría y Cuidados Paliativos, Consorci Hospitalari de Vic/Hospital Universitari de la Santa Creu de Vic, Vic, Barcelona, España; Centro de Estudios Sociales y Sanitarios (CESS)/Cátedra de Cuidados Paliativos, Universitat de Vic-Universitat Central de Catalunya, Vic, Barcelona, España.
| | - Joan Espaulella-Panicot
- Unidad Territorial de Geriatría y Cuidados Paliativos, Consorci Hospitalari de Vic/Hospital Universitari de la Santa Creu de Vic, Vic, Barcelona, España; Centro de Estudios Sociales y Sanitarios (CESS)/Cátedra de Cuidados Paliativos, Universitat de Vic-Universitat Central de Catalunya, Vic, Barcelona, España
| | - Marco Inzitari
- Parc Sanitari Pere Virgili, Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España
| | - Lourdes Rexach
- Unidad de Cuidados Paliativos, Hospital Ramón y Cajal, Madrid, España
| | - Benito Fontecha
- Servicio de Geriatría y Cuidados Paliativos, Consorci Sanitari Integral, l'Hospitalet de Llobregat, Barcelona, España
| | - Roman Romero-Ortuno
- Department of Medicine for the Elderly, Addenbrooke's Hospital, Cambridge, Reino Unido; Clinical Gerontology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, Reino Unido
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Drost D, Kalf A, Vogtlander N, van Munster BC. High prevalence of frailty in end-stage renal disease. Int Urol Nephrol 2016; 48:1357-1362. [PMID: 27165401 PMCID: PMC4949293 DOI: 10.1007/s11255-016-1306-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 04/23/2016] [Indexed: 01/22/2023]
Abstract
Purpose Prognosis of the increasing number of elderly patients with end-stage renal disease (ESRD) is poor with high risk of functional decline and mortality. Frailty seems to be a good predictor for those patients that will not benefit from dialysis. Varying prevalences between populations are probably related to the instrument used. The aim of this study was to measure the prevalence of frailty among ESRD patients with two different validated instruments. Methods This cross-sectional study was conducted among patients, aged ≥18 years, receiving hemodialysis, peritoneal dialysis and pre-dialysis care between September 2013 and December 2013 in a single dialysis center in Apeldoorn, the Netherlands. Frailty was measured with the frailty index (FI) and frailty phenotype (FP).
Results Prevalence of frailty by the FI was 36.8 % among 95 participants with ESRD (age: 65.2 years, SD ± 12.0). Frailty prevalence among participants aged ≥65 and <65 years was 43.6 and 27.5 %, respectively. Female sex [odds ratio (OR) 3.3, 95 % confidence interval (CI) 1.3–8.0] and a Charlson comorbidity index score of ≥5 (OR 2.6, 95 % CI 1.0–6.6) were associated with frailty. The FI identified different but overlapping participants as frail compared with the FP; 62.5 % of frail participants according to FI were also frail according to the FP. Conclusions Prevalence of frailty among young and elderly ESRD patients is high; being female and having more comorbidity was associated with frailty. Use of a broader definition of frailty, like the FI, gives a higher estimation of prevalence among ESRD patients compared with a physical frailty assessment. Electronic supplementary material The online version of this article (doi:10.1007/s11255-016-1306-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Diederik Drost
- Department of Geriatrics, Gelre Hospitals, Apeldoorn, The Netherlands
| | - Annette Kalf
- Department of Geriatrics, Gelre Hospitals, Apeldoorn, The Netherlands
| | - Nils Vogtlander
- Division of Nephrology, Department of Medicine, Gelre Hospitals, Apeldoorn, The Netherlands
| | - Barbara C van Munster
- Department of Geriatrics, Gelre Hospitals, Apeldoorn, The Netherlands. .,Department of Medicine, University Medical Center Groningen, Groningen, The Netherlands.
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Sanchis J, Núñez E, Ruiz V, Bonanad C, Fernández J, Cauli O, García-Blas S, Mainar L, Valero E, Rodríguez-Borja E, Chorro FJ, Hermenegildo C, Núñez J. Usefulness of Clinical Data and Biomarkers for the Identification of Frailty After Acute Coronary Syndromes. Can J Cardiol 2015; 31:1462-8. [PMID: 26514748 DOI: 10.1016/j.cjca.2015.07.737] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 07/21/2015] [Accepted: 07/21/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Frailty predicts mortality after acute coronary syndrome (ACS). The standard frailty scales, such as the Fried score, consist of a variety of questionnaires and physical tests. Our aim was to investigate easily available clinical data and blood markers to predict frailty at discharge, in elderly patients after ACS. METHODS A total of 342 patients older than 65 years, survivors after ACS, were included. A high number of clinical variables were collected. In addition, blood markers potentially linked to frailty and related to the processes of inflammation, coagulation, hormonal dysregulation, nutrition, renal dysfunction, and heart dysfunction were determined. Frailty was evaluated using the Fried score at discharge. The main outcome was frailty defined by a Fried score ≥ 3 points. Secondary endpoints were mortality and myocardial infarction at 30-month median follow-up. RESULTS A total of 116 patients were frail. Seven clinical variables or biomarkers predicted frailty: age ≥ 75 years, female, prior ischemic heart disease, admission heart failure, haemoglobin ≤ 12.5 g/dL, vitamin D ≤ 9 ng/mL, and cystatin-C ≥ 1.2 mg/L. This model based on clinical data and biomarkers showed an excellent discrimination accuracy for frailty (C-statistic = 0.818). During the follow-up, 105 patients died and 137 died or suffered myocardial infarction. The clinical data and biomarker model (C-statistics = 0.730 and 0.691) performed better than the Fried score (C-statistics = 0.676 and 0.650) for death and death or myocardial infarction, respectively. CONCLUSIONS Easy available clinical data and biomarkers can identify frail patients at discharge after ACS and predict outcomes better than the standard Fried's frailty scale.
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Affiliation(s)
- Juan Sanchis
- Department of Cardiology, Hospital Clínico Universitario, Valencia, School of Medicine, University of Valencia, Valencia, Spain.
| | - Eduardo Núñez
- Department of Cardiology, Hospital Clínico Universitario, Valencia, School of Medicine, University of Valencia, Valencia, Spain
| | - Vicente Ruiz
- Nursing School, University of Valencia, Valencia, Spain
| | - Clara Bonanad
- Department of Cardiology, Hospital Clínico Universitario, Valencia, School of Medicine, University of Valencia, Valencia, Spain
| | | | - Omar Cauli
- Nursing School, University of Valencia, Valencia, Spain
| | - Sergio García-Blas
- Department of Cardiology, Hospital Clínico Universitario, Valencia, School of Medicine, University of Valencia, Valencia, Spain
| | - Luis Mainar
- Department of Cardiology, Hospital Clínico Universitario, Valencia, School of Medicine, University of Valencia, Valencia, Spain
| | - Ernesto Valero
- Department of Cardiology, Hospital Clínico Universitario, Valencia, School of Medicine, University of Valencia, Valencia, Spain
| | | | - Francisco J Chorro
- Department of Cardiology, Hospital Clínico Universitario, Valencia, School of Medicine, University of Valencia, Valencia, Spain
| | | | - Julio Núñez
- Department of Cardiology, Hospital Clínico Universitario, Valencia, School of Medicine, University of Valencia, Valencia, Spain
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Guo H, Liu B, Hou L, The E, Li G, Wang D, Jie Q, Che W, Wei Y. The role of mAKAPβ in the process of cardiomyocyte hypertrophy induced by angiotensin II. Int J Mol Med 2015; 35:1159-68. [PMID: 25739102 PMCID: PMC4380120 DOI: 10.3892/ijmm.2015.2119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 02/04/2015] [Indexed: 12/16/2022] Open
Abstract
Angiotensin II (AngII) is the central product of the renin-angiotensin system (RAS) and this octapeptide contributes to the pathophysiology of cardiac hypertrophy and remodeling. mAKAPβ is an A-kinase anchoring protein (AKAP) that has the function of binding to the regulatory subunit of protein kinase A (PKA) and confining the holoenzyme to discrete locations within the cell. In this study, we aimed to investigate the role of mAKAPβ in AngII‑induced cardiomyocyte hypertrophy and the possible mechanisms involved. Cultured cardiomyocytes from neonatal rats were treated with AngII. Subsequently, the morphology of the cardiomyocytes was observed and the expression of mAKAPβ and cardiomyocyte hypertrophic markers was measured. mAKAPβ‑shRNA was constructed for RNA interference; the expression of mAKAPβ and hypertrophic markers, the cell surface area and the [3H]Leucine incorporation rate in the AngII‑treated rat cardiomyocytes were detected following RNA interference. Simultaneously, changes in the expression levels of phosphorylated extracellular signal-regulated kinase (p-ERK)2 in the cardiomyocytes were assessed. The cell size of the AngII-treated cardiaomyocytes was significantly larger than that of the untreated cardiomyocytes. The expression of hypertrophic markers and p-ERK2, the cell surface area and the [3H]Leucine incorporation rate were all significantly increased in the AngII‑treated cells. However, the expression of mAKAPβ remained unaltered in this process. RNA interference simultaneously inhibited the protein expression of mAKAPβ and p‑ERK2, and the hypertrophy of the cardiomyocytes induced by AngII was attenuated. These results demonstrate that AngII induces hypertrophy in cardiomyocytes, and mAKAPβ is possibly involved in this process. The effects of mAKAPβ on AngII‑induced cardiomyocyte hypertrophy may be associated with p-ERK2 expression.
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Affiliation(s)
- Huixin Guo
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Baoxin Liu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Lei Hou
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Erlinda The
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Gang Li
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Dongzhi Wang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Qiqiang Jie
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Wenliang Che
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Yidong Wei
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
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Simon CB, Lee-McMullen B, Phelan D, Gilkes J, Carter CS, Buford TW. The renin-angiotensin system and prevention of age-related functional decline: where are we now? AGE (DORDRECHT, NETHERLANDS) 2015; 37:9753. [PMID: 25663422 PMCID: PMC4320995 DOI: 10.1007/s11357-015-9753-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 01/27/2015] [Indexed: 05/19/2023]
Abstract
Declining physical function is a major health problem for older adults as it is associated with multiple comorbidities and mortality. Exercise has been shown to improve physical function, though response to exercise is variable. Conversely, drugs targeting the renin-angiotensin system (RAS) pathway, including angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs), are also reported to improve physical function. In the past decade, significant strides have been made to understand the complexity and specificity of the RAS system as it pertains to physical function in older adults. Prior findings have also determined that interactions between antihypertensive medications and exercise may influence physical function above and beyond either factor alone. We review the latest research on RAS, exercise, and physical function for older adults. We also outline future research aims in this area, including genetic influences and clinical phenotyping, for the purpose of maintaining or improving physical function through tailored treatments.
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Affiliation(s)
- Corey B. Simon
- />Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL USA
| | - Brittany Lee-McMullen
- />Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, FL USA
| | - Dane Phelan
- />Department of Molecular Genetics and Microbiology, College of Medicine, University of Florida, Gainesville, FL USA
| | - Janine Gilkes
- />Department of Medicine, College of Medicine, University of Florida, Gainesville, FL USA
| | - Christy S. Carter
- />Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, FL USA
| | - Thomas W. Buford
- />Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, FL USA
- />Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL USA
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Wang YJ, Wang Y, Zhan JK, Tang ZY, He JY, Tan P, Deng HQ, Huang W, Liu YS. Sarco-Osteoporosis: Prevalence and Association with Frailty in Chinese Community-Dwelling Older Adults. Int J Endocrinol 2015; 2015:482940. [PMID: 26273298 PMCID: PMC4530239 DOI: 10.1155/2015/482940] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 01/15/2015] [Accepted: 02/16/2015] [Indexed: 11/17/2022] Open
Abstract
The aim was to apply AWGS criteria to estimate the prevalence of sarco-osteoporosis and investigate its relationship with frailty, in a sample of 316 community-dwelling Chinese older people. Regression analysis was performed using frailty as the dependent variable. The results showed that the prevalence rate of sarco-osteoporosis was 10.4% in older men and 15.1% in older women. ≧80 years old (OR 4.8; 95% CI, 3.05-10.76; P = 0.027), women (OR 2.6; 95% CI, 1.18-2.76; P = 0.036), and higher level of comorbidity (OR 3.71; 95% CI, 1.61-10.43; P = 0.021) were independently associated with the likelihood of being sarco-osteoporosis. In the frail group, sarco-osteoporosis occurred in 26.3% of men, in 38.5% of women, and in lower proportion in the prefrail (13.6% of men; 16.2% of women) and nonfrail group (1.6% of men; 1.9% of women) (P < 0.05, resp.). Furthermore, the likelihood of being frail/prefrail was substantially higher in the presence of sarco-osteoporosis (OR 4.16; 95% CI, 2.17-17.65; P = 0.019 in men; and OR 4.67; 95% CI, 2.42-18.86; P = 0.007 in women). The results indicate that patients with sarco-osteoporosis are more likely to be ≧80 yrs with higher burden of comorbidities and to have frailty/prefrailty, especially for women.
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Affiliation(s)
- Yan-Jiao Wang
- Geriatric Department, The Second Xiang-Ya Hospital, Institute of Aging and Geriatric, Central South University, No. 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Yi Wang
- Geriatric Department, The Second Xiang-Ya Hospital, Institute of Aging and Geriatric, Central South University, No. 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Jun-Kun Zhan
- Geriatric Department, The Second Xiang-Ya Hospital, Institute of Aging and Geriatric, Central South University, No. 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Zhi-Yong Tang
- Geriatric Department, The Second Xiang-Ya Hospital, Institute of Aging and Geriatric, Central South University, No. 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Jie-Yu He
- Geriatric Department, The Second Xiang-Ya Hospital, Institute of Aging and Geriatric, Central South University, No. 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Pan Tan
- Geriatric Department, The Second Xiang-Ya Hospital, Institute of Aging and Geriatric, Central South University, No. 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Hui-Qian Deng
- Geriatric Department, The Second Xiang-Ya Hospital, Institute of Aging and Geriatric, Central South University, No. 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Wu Huang
- Geriatric Department, The Second Xiang-Ya Hospital, Institute of Aging and Geriatric, Central South University, No. 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - You-Shuo Liu
- Geriatric Department, The Second Xiang-Ya Hospital, Institute of Aging and Geriatric, Central South University, No. 139 Middle Renmin Road, Changsha, Hunan 410011, China
- *You-Shuo Liu:
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Vajapey R, Rini D, Walston J, Abadir P. The impact of age-related dysregulation of the angiotensin system on mitochondrial redox balance. Front Physiol 2014; 5:439. [PMID: 25505418 PMCID: PMC4241834 DOI: 10.3389/fphys.2014.00439] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 10/27/2014] [Indexed: 12/13/2022] Open
Abstract
Aging is associated with the accumulation of various deleterious changes in cells. According to the free radical and mitochondrial theory of aging, mitochondria initiate most of the deleterious changes in aging and govern life span. The failure of mitochondrial reduction-oxidation (redox) homeostasis and the formation of excessive free radicals are tightly linked to dysregulation in the Renin Angiotensin System (RAS). A main rate-controlling step in RAS is renin, an enzyme that hydrolyzes angiotensinogen to generate angiotensin I. Angiotensin I is further converted to Angiotensin II (Ang II) by angiotensin-converting enzyme (ACE). Ang II binds with equal affinity to two main angiotensin receptors—type 1 (AT1R) and type 2 (AT2R). The binding of Ang II to AT1R activates NADPH oxidase, which leads to increased generation of cytoplasmic reactive oxygen species (ROS). This Ang II-AT1R–NADPH-ROS signal triggers the opening of mitochondrial KATP channels and mitochondrial ROS production in a positive feedback loop. Furthermore, RAS has been implicated in the decrease of many of ROS scavenging enzymes, thereby leading to detrimental levels of free radicals in the cell. AT2R is less understood, but evidence supports an anti-oxidative and mitochondria-protective function for AT2R. The overlap between age related changes in RAS and mitochondria, and the consequences of this overlap on age-related diseases are quite complex. RAS dysregulation has been implicated in many pathological conditions due to its contribution to mitochondrial dysfunction. Decreased age-related, renal and cardiac mitochondrial dysfunction was seen in patients treated with angiotensin receptor blockers. The aim of this review is to: (a) report the most recent information elucidating the role of RAS in mitochondrial redox hemostasis and (b) discuss the effect of age-related activation of RAS on generation of free radicals.
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Affiliation(s)
- Ramya Vajapey
- School of Medicine, Northeast Ohio Medical University Rootstown, OH, USA
| | - David Rini
- Division of Cellular and Molecular Medicine, Art as Applied to Medicine, Johns Hopkins University Baltimore, MD, USA
| | - Jeremy Walston
- Division of Geriatrics Medicine and Gerontology, Department of Medicine, Johns Hopkins University Baltimore, MD, USA
| | - Peter Abadir
- Division of Geriatrics Medicine and Gerontology, Department of Medicine, Johns Hopkins University Baltimore, MD, USA
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Balakumar P, Jagadeesh G. A century old renin-angiotensin system still grows with endless possibilities: AT1 receptor signaling cascades in cardiovascular physiopathology. Cell Signal 2014; 26:2147-60. [PMID: 25007996 DOI: 10.1016/j.cellsig.2014.06.011] [Citation(s) in RCA: 128] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 06/27/2014] [Indexed: 12/25/2022]
Abstract
Ang II, the primary effector pleiotropic hormone of the renin-angiotensin system (RAS) cascade, mediates physiological control of blood pressure and electrolyte balance through its action on vascular tone, aldosterone secretion, renal sodium absorption, water intake, sympathetic activity and vasopressin release. It affects the function of most of the organs far beyond blood pressure control including heart, blood vessels, kidney and brain, thus, causing both beneficial and deleterious effects. However, the protective axis of the RAS composed of ACE2, Ang (1-7), alamandine, and Mas and MargD receptors might oppose some harmful effects of Ang II and might promote beneficial cardiovascular effects. Newly identified RAS family peptides, Ang A and angioprotectin, further extend the complexities in understanding the cardiovascular physiopathology of RAS. Most of the diverse actions of Ang II are mediated by AT1 receptors, which couple to classical Gq/11 protein and activate multiple downstream signals, including PKC, ERK1/2, Raf, tyrosine kinases, receptor tyrosine kinases (EGFR, PDGF, insulin receptor), nuclear factor κB and reactive oxygen species (ROS). Receptor activation via G12/13 stimulates Rho-kinase, which causes vascular contraction and hypertrophy. The AT1 receptor activation also stimulates G protein-independent signaling pathways such as β-arrestin-mediated MAPK activation and Src-JAK/STAT. AT1 receptor-mediated activation of NADPH oxidase releases ROS, resulting in the activation of pro-inflammatory transcription factors and stimulation of small G proteins such as Ras, Rac and RhoA. The components of the RAS and the major Ang II-induced signaling cascades of AT1 receptors are reviewed.
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Affiliation(s)
- Pitchai Balakumar
- Pharmacology Unit, Faculty of Pharmacy, AIMST University, Semeling, 08100 Bedong, Kedah Darul Aman, Malaysia.
| | - Gowraganahalli Jagadeesh
- Division of Cardiovascular and Renal Products, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD 20993, USA.
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45
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Iritani O, Koizumi Y, Hamazaki Y, Yano H, Morita T, Himeno T, Okuno T, Okuro M, Iwai K, Morimoto S. Association between blood pressure and disability-free survival among community-dwelling elderly patients receiving antihypertensive treatment. Hypertens Res 2014; 37:772-8. [PMID: 24671015 DOI: 10.1038/hr.2014.67] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 11/30/2013] [Accepted: 12/05/2013] [Indexed: 11/09/2022]
Abstract
A reduction of elevated blood pressure (BP) is an important treatment goal in elderly hypertensive patients. However, excessive reduction of systolic BP (SBP) and/or diastolic BP (DBP) might be harmful in such patients. We investigated whether this was the case with regard to risk of incident disability or death in community-dwelling elderly subjects. We analyzed 570 patients receiving antihypertensive treatment aged 65-94 years. The endpoint was the composite outcome of incident disability, defined as first certification of a support/care need or death. Relationships among each of the four classes of SBP or DBP and the risk of incident disability or death were estimated using the Cox proportional hazards model. Over four years, 77 (13.5%) incident disabilities or deaths occurred. After adjustment for age, sex and variables selected according to their univariate analysis P-value <0.20, the risk of events was significantly higher in subjects with baseline SBP<120 mm Hg (hazard ratio (HR)=2.81, P=0.023) and ⩾160 mm Hg (HR=4.32, P<0.001), compared with subjects with baseline SBP of 140-159 mm Hg, who showed the lowest incidence of events. This J-curve relationship was observed in very elderly patients (⩾75 years) but not in younger patients. Patients with SBP<120 mm Hg tended to have a higher risk of incident disability caused by cerebral events, and those with SBP⩾160 mm Hg had a higher risk of incident disability caused by falls/bone fractures. These observations indicate that excessive BP reduction could cause discontinuance of disability-free survival in community-dwelling elderly patients.
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Affiliation(s)
- Osamu Iritani
- Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Yumi Koizumi
- School of Nursing, Kanazawa Medical University, Ishikawa, Japan
| | - Yuko Hamazaki
- School of Nursing, Kanazawa Medical University, Ishikawa, Japan
| | - Hiroshi Yano
- Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Takuro Morita
- Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Taroh Himeno
- Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Tazuo Okuno
- Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Masashi Okuro
- Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Kunimitsu Iwai
- Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Shigeto Morimoto
- Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan
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46
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Marcus Y, Shefer G, Stern N. Adipose tissue renin-angiotensin-aldosterone system (RAAS) and progression of insulin resistance. Mol Cell Endocrinol 2013; 378:1-14. [PMID: 22750719 DOI: 10.1016/j.mce.2012.06.021] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 06/24/2012] [Indexed: 12/31/2022]
Abstract
This review focuses on the expression of the key components of the renin-angiotensin-aldosterone axis in fat tissue. At the center of this report is the role of RAAS in normal and excessive fat mass enlargement, the leading etiology of insulin resistance. Understanding the expression and regulation of RAAS components in various fat depots allows insight not only into the processes by which these complex patterns are modified by the enlargement of adipose tissue, but also into their impact on local and systemic response to insulin.
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Affiliation(s)
- Yonit Marcus
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel
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47
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Fu Z, Wang M, Everett A, Lakatta E, Van Eyk J. Can proteomics yield insight into aging aorta? Proteomics Clin Appl 2013; 7:477-89. [PMID: 23788441 DOI: 10.1002/prca.201200138] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Revised: 06/13/2013] [Accepted: 06/14/2013] [Indexed: 12/16/2022]
Abstract
The aging aorta exhibits structural and physiological changes that are reflected in the proteome of its component cells types. The advance in proteomic technologies has made it possible to analyze the quantity of proteins associated with the natural history of aortic aging. These alterations reflect the molecular and cellular mechanisms of aging and could provide an opportunity to predict vascular health. This paper focuses on whether discoveries stemming from the application of proteomic approaches of the intact aging aorta or vascular smooth muscle cells can provide useful insights. Although there have been limited studies to date, a number of interesting proteins have been identified that are closely associated with aging in the rat aorta. Such proteins, including milk fat globule-EGF factor 8, matrix metalloproteinase type-2, and vitronectin, could be used as indicators of vascular health, or even explored as therapeutic targets for aging-related vascular diseases.
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Affiliation(s)
- Zongming Fu
- Department of Pediatrics, The Johns Hopkins University, Baltimore, MD 21224, USA
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48
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Snyder R, Thekkumkara T. Interplay between EGR1 and SP1 is critical for 13-cis retinoic acid-mediated transcriptional repression of angiotensin type 1A receptor. J Mol Endocrinol 2013; 50:361-74. [PMID: 23475749 PMCID: PMC3740742 DOI: 10.1530/jme-12-0154] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Recently, we have demonstrated that 13-cis retinoic acid (13cRA) downregulates rat angiotensin type 1A receptor (Agtr1a) gene transcription through a MAP kinase (ERK1/2)-dependent mechanism in rat liver epithelial and aortic smooth muscle cells. However, the exact mechanism remained unknown. In this study, we determined the signaling intermediates activated by ERK1/2 involved in 13cRA-mediated Agtr1a downregulation. Rat Agtr1a chloramphenicol acetyltransferase (CAT) promoter construct containing a sequence -2541 and -1836 bp upstream of the start site demonstrated reduced CAT activity; this region possesses a specificity protein 1 (SP1) consensus sequence (5'-TGGGGCGGGGCGGGG-3'). Mobility shift analysis using untreated nuclear extracts in the presence of mithramycin A suggests that the trans-acting factor binding to this cis-acting element is SP1. 13cRA significantly reduced specific binding without any change in SP1 protein expression. Studies showed that 13cRA treatment maximally phosphorylates ERK1/2 within 5-10 min, which translocates to the nucleus, activating early growth response protein 1 (Egr1) mRNA expression at 20 min followed by de novo protein synthesis, leading to an EGR1/SP1 interaction. siRNA silencing of Egr1 restored Agtr1a mRNA and protein expression in 13cRA-treated cells, and Sp1 silencing results in complete loss of Agtr1a expression. Our study suggests that 13cRA-mediated activation of ERK1/2, through EGR1, is capable of disrupting SP1, the requisite trans-activator for Agtr1a expression, providing a novel paradigm in Agtr1a gene transcription.
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Affiliation(s)
- Russell Snyder
- Department of Biomedical Sciences, Texas Tech University Health Sciences Center, 1300 South Coulter, Amarillo, Texas 79106
| | - Thomas Thekkumkara
- Department of Biomedical Sciences, Texas Tech University Health Sciences Center, 1300 South Coulter, Amarillo, Texas 79106
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49
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Abstract
Frailty is the most problematic expression of population ageing. It is a state of vulnerability to poor resolution of homoeostasis after a stressor event and is a consequence of cumulative decline in many physiological systems during a lifetime. This cumulative decline depletes homoeostatic reserves until minor stressor events trigger disproportionate changes in health status. In landmark studies, investigators have developed valid models of frailty and these models have allowed epidemiological investigations that show the association between frailty and adverse health outcomes. We need to develop more efficient methods to detect frailty and measure its severity in routine clinical practice, especially methods that are useful for primary care. Such progress would greatly inform the appropriate selection of elderly people for invasive procedures or drug treatments and would be the basis for a shift in the care of frail elderly people towards more appropriate goal-directed care.
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Affiliation(s)
- Andrew Clegg
- Academic Unit of Elderly Care and Rehabilitation, University of Leeds, Leeds, UK.
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50
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Koizumi Y, Hamazaki Y, Okuro M, Iritani O, Yano H, Higashikawa T, Iwai K, Morimoto S. Association between hypertension status and the screening test for frailty in elderly community-dwelling Japanese. Hypertens Res 2013; 36:639-44. [PMID: 23446774 DOI: 10.1038/hr.2013.7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 12/14/2012] [Accepted: 12/16/2012] [Indexed: 11/09/2022]
Abstract
To clarify the possible association of frailty with hypertension prevalence, treatment and blood pressure (BP) control in the elderly, we conducted a screening survey of 1091 elderly community-dwelling subjects aged ≥65 years, using data from public health check-ups and frailty was determined by a 25-item questionnaire, the Basic Checklist for Frailty (BCF). The significance of differences in the association of BCF categories or BCF items with each hypertension status was analyzed using multiple logistic regression analysis after adjusting for age, sex and possible confounding underlying chronic conditions. A total of 63% of subjects were hypertensive (BP≥140/90 mm Hg), and of those, 85% were receiving antihypertensive treatment, and 56.0% of those receiving treatment had controlled BP (<140/90 mm Hg). BCF categories that showed an independent association with hypertension status were 'impaired walking status' and absence of 'impaired nutritional status' for prevalence of hypertension, 'impaired instrumental activity of daily living status' and 'impaired nutritional status' for untreated hypertension among hypertensives and 'impaired oral function' for BP-uncontrolled hypertension among treated hypertensives. In addition, BCF items that showed an independent association were 'inability to walk for more than 15 min without rest' and absence of 'Body mass index (BMI) <18.5 kg m(-2') for prevalence of hypertension, 'weight loss of more than 2-3 kg in the past 6 months' for untreated hypertension, and 'difficulty eating hard food' for BP-uncontrolled hypertension. These observations indicate that assessment of these specified frailty categories and/or items may be useful for evaluating hypertension status in elderly community-dwelling subjects.
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Affiliation(s)
- Yumi Koizumi
- Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan
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