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Beetler DJ, Bruno KA, Watkins MM, Xu V, Chekuri I, Giresi P, Di Florio DN, Whelan ER, Edenfield BH, Walker SA, Morales-Lara AC, Hill AR, Jain A, Auda ME, Macomb LP, Shapiro KA, Keegan KC, Wolfram J, Behfar A, Stalboerger PG, Terzic A, Farres H, Cooper LT, Fairweather D. Reconstituted Extracellular Vesicles from Human Platelets Decrease Viral Myocarditis in Mice. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023; 19:e2303317. [PMID: 37612820 PMCID: PMC10840864 DOI: 10.1002/smll.202303317] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/11/2023] [Indexed: 08/25/2023]
Abstract
Patients with viral myocarditis are at risk of sudden death and may progress to dilated cardiomyopathy (DCM). Currently, no disease-specific therapies exist to treat viral myocarditis. Here it is examined whether reconstituted, lyophilized extracellular vesicles (EVs) from platelets from healthy men and women reduce acute or chronic myocarditis in male mice. Human-platelet-derived EVs (PEV) do not cause toxicity, damage, or inflammation in naïve mice. PEV administered during the innate immune response significantly reduces myocarditis with fewer epidermal growth factor (EGF)-like module-containing mucin-like hormone receptor-like 1 (F4/80) macrophages, T cells (cluster of differentiation molecules 4 and 8, CD4 and CD8), and mast cells, and improved cardiac function. Innate immune mediators known to increase myocarditis are decreased by innate PEV treatment including Toll-like receptor (TLR)4 and complement. PEV also significantly reduces perivascular fibrosis and remodeling including interleukin 1 beta (IL-1β), transforming growth factor-beta 1, matrix metalloproteinase, collagen genes, and mast cell degranulation. PEV given at days 7-9 after infection reduces myocarditis and improves cardiac function. MicroRNA (miR) sequencing reveals that PEV contains miRs that decrease viral replication, TLR4 signaling, and T-cell activation. These data show that EVs from the platelets of healthy individuals can significantly reduce myocarditis and improve cardiac function.
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Affiliation(s)
- Danielle J. Beetler
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota 55902, USA; Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida 32224, USA; Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, Minnesota 55902, USA
| | - Katelyn A. Bruno
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida 32224, USA; Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, 32608
| | - Molly M. Watkins
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota 55902, USA; Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida 32224, USA; Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, Minnesota 55902, USA
| | - Vivian Xu
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida 32224, USA
| | - Isha Chekuri
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida 32224, USA
| | - Presley Giresi
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida 32224, USA
| | - Damian N. Di Florio
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota 55902, USA; Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida 32224, USA; Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, Minnesota 55902, USA
| | - Emily R. Whelan
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota 55902, USA; Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida 32224, USA; Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, Minnesota 55902, USA
| | | | - Sierra A. Walker
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, Minnesota 55902, USA; Department of Biochemistry and Molecular Biology, Rochester, Minnesota 55902, USA
| | | | - Anneliese R. Hill
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida 32224, USA
| | - Angita Jain
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota 55902, USA; Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida 32224, USA
| | - Matthew E. Auda
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida 32224, USA
| | - Logan P. Macomb
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida 32224, USA
| | - Kathryn A. Shapiro
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida 32224, USA
| | - Kevin C. Keegan
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida 32224, USA
| | - Joy Wolfram
- School of Chemical Engineering, Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Atta Behfar
- Department of Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota 55905, USA; Van Cleve Cardiac Regenerative Medicine Program, Mayo Clinic Center for Regenerative Medicine, Rochester, MN, USA
| | - Paul G. Stalboerger
- Van Cleve Cardiac Regenerative Medicine Program, Mayo Clinic Center for Regenerative Medicine, Rochester, MN, USA
| | - Andre Terzic
- Van Cleve Cardiac Regenerative Medicine Program, Mayo Clinic Center for Regenerative Medicine, Rochester, MN, USA; Department of Clinical Genomics, Mayo Clinic, Rochester, Minnesota 55905, USA
| | - Houssam Farres
- Department of Vascular Surgery, Mayo Clinic, Jacksonville, Florida 32224, USA
| | - Leslie T. Cooper
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida 32224, USA
| | - DeLisa Fairweather
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota 55902, USA; Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida 32224, USA; Department of Immunology, Mayo Clinic, Jacksonville, Florida 32224, USA
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Gryglewska-Wawrzak K, Cienkowski K, Cienkowska A, Banach M, Bielecka-Dabrowa A. The Role of Multidisciplinary Approaches in the Treatment of Patients with Heart Failure and Coagulopathy of COVID-19. J Cardiovasc Dev Dis 2023; 10:245. [PMID: 37367410 PMCID: PMC10299062 DOI: 10.3390/jcdd10060245] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/28/2023] [Accepted: 06/01/2023] [Indexed: 06/28/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a severe respiratory syndrome caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Heart failure (HF) is associated with a worse prognosis for patients with this viral infection, highlighting the importance of early detection and effective treatment strategies. HF can also be a consequence of COVID-19-related myocardial damage. To optimise the treatment of these patients, one needs to understand the interactions between this disease and viruses. Until now, the validity of the screening for cardiovascular complications after COVID-19 has not been confirmed. There were also no patients in whom such diagnostics seemed appropriate. Until appropriate recommendations are made, diagnosis procedures must be individualised based on the course of the acute phase and clinical symptoms reported or submitted after COVID-19. Clinical phenomena are the criteria for determining the recommended test panel. We present a structured approach to COVID-19 patients with heart involvement.
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Affiliation(s)
- Katarzyna Gryglewska-Wawrzak
- Department of Cardiology and Congenital Diseases of Adults, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), 93338 Lodz, Poland; (M.B.); (A.B.-D.)
| | | | - Alicja Cienkowska
- Faculty of Biology and Environmental Protection, University of Lodz, 90136 Lodz, Poland;
| | - Maciej Banach
- Department of Cardiology and Congenital Diseases of Adults, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), 93338 Lodz, Poland; (M.B.); (A.B.-D.)
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz, 90419 Lodz, Poland
| | - Agata Bielecka-Dabrowa
- Department of Cardiology and Congenital Diseases of Adults, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), 93338 Lodz, Poland; (M.B.); (A.B.-D.)
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz, 90419 Lodz, Poland
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3
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Rohrbeck M, Hoerr V, Piccini I, Greber B, Schulte JS, Hübner SS, Jeworutzki E, Theiss C, Matschke V, Stypmann J, Unger A, Ho HT, Disse P, Strutz-Seebohm N, Faber C, Müller FU, Ludwig S, Rescher U, Linke WA, Klingel K, Busch K, Peischard S, Seebohm G. Pathophysiological Mechanisms of Cardiac Dysfunction in Transgenic Mice with Viral Myocarditis. Cells 2023; 12:cells12040550. [PMID: 36831217 PMCID: PMC9954433 DOI: 10.3390/cells12040550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/21/2023] [Accepted: 01/30/2023] [Indexed: 02/11/2023] Open
Abstract
Viral myocarditis is pathologically associated with RNA viruses such as coxsackievirus B3 (CVB3), or more recently, with SARS-CoV-2, but despite intensive research, clinically proven treatment is limited. Here, by use of a transgenic mouse strain (TG) containing a CVB3ΔVP0 genome we unravel virus-mediated cardiac pathophysiological processes in vivo and in vitro. Cardiac function, pathologic ECG alterations, calcium homeostasis, intracellular organization and gene expression were significantly altered in transgenic mice. A marked alteration of mitochondrial structure and gene expression indicates mitochondrial impairment potentially contributing to cardiac contractile dysfunction. An extended picture on viral myocarditis emerges that may help to develop new treatment strategies and to counter cardiac failure.
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Affiliation(s)
- Matthias Rohrbeck
- Institute for Genetics of Heart Diseases (IfGH), Department of Cardiovascular Medicine, University Hospital Münster, D-48149 Münster, Germany
| | - Verena Hoerr
- Translational Research Imaging Center, Clinic of Radiology, University Hospital Münster, D-48149 Münster, Germany
| | - Ilaria Piccini
- Institute for Genetics of Heart Diseases (IfGH), Department of Cardiovascular Medicine, University Hospital Münster, D-48149 Münster, Germany
| | - Boris Greber
- Human Stem Cell Pluripotency Laboratory, Max Planck Institute for Molecular Biomedicine, D-48149 Münster, Germany
- Chemical Genomics Centre of the Max Planck Society, 44227 Dortmund, Germany
| | - Jan Sebastian Schulte
- Institute of Pharmacology and Toxicology, University Hospital Münster, D-48149 Münster, Germany
| | - Sara-Sophie Hübner
- Translational Research Imaging Center, Clinic of Radiology, University Hospital Münster, D-48149 Münster, Germany
| | - Elena Jeworutzki
- Institute for Genetics of Heart Diseases (IfGH), Department of Cardiovascular Medicine, University Hospital Münster, D-48149 Münster, Germany
| | - Carsten Theiss
- Department of Cytology, Institute of Anatomy, Ruhr-University Bochum, D-44780 Bochum, Germany
| | - Veronika Matschke
- Department of Cytology, Institute of Anatomy, Ruhr-University Bochum, D-44780 Bochum, Germany
| | - Jörg Stypmann
- Department of Cardiovascular Medicine, Division of Cardiology, University Clinic Münster, 48149 Münster, Germany
| | - Andreas Unger
- Institute of Physiology II, Faculty of Medicine, University of Münster, D-48149 Münster, Germany
| | - Huyen Tran Ho
- Institute for Genetics of Heart Diseases (IfGH), Department of Cardiovascular Medicine, University Hospital Münster, D-48149 Münster, Germany
| | - Paul Disse
- Institute for Genetics of Heart Diseases (IfGH), Department of Cardiovascular Medicine, University Hospital Münster, D-48149 Münster, Germany
| | - Nathalie Strutz-Seebohm
- Institute for Genetics of Heart Diseases (IfGH), Department of Cardiovascular Medicine, University Hospital Münster, D-48149 Münster, Germany
| | - Cornelius Faber
- Translational Research Imaging Center, Clinic of Radiology, University Hospital Münster, D-48149 Münster, Germany
| | - Frank Ulrich Müller
- Institute of Pharmacology and Toxicology, University Hospital Münster, D-48149 Münster, Germany
| | - Stephan Ludwig
- Institute of Virology Münster (IVM), Centre for Molecular Biology of Inflammation (ZMBE), University of Münster, D-48149 Münster, Germany
| | - Ursula Rescher
- Research Group Regulatory Mechanisms of Inflammation, Institute of Medical Biochemistry, Centre for Molecular Biology of Inflammation, University of Muenster, 48149 Muenster, Germany
| | - Wolfgang A. Linke
- Institute of Physiology II, Faculty of Medicine, University of Münster, D-48149 Münster, Germany
| | - Karin Klingel
- Cardiopathology, Institute for Pathology and Neuropathology, University Hospital of Tübingen, D-72076 Tübingen, Germany
| | - Karin Busch
- Institute of Integrative Cell Biology and Physiology, Faculty of Biology, University of Muenster, Schlossplatz 5, 48149 Muenster, Germany
| | - Stefan Peischard
- Institute for Genetics of Heart Diseases (IfGH), Department of Cardiovascular Medicine, University Hospital Münster, D-48149 Münster, Germany
- Correspondence: (S.P.); (G.S.); Tel.: +49-(0)-251/83-58255 (S.P.); +49-(0)-251/83-58251 (G.S.); Fax: +49-(0)-251/83-58257 (S.P. & G.S.)
| | - Guiscard Seebohm
- Institute for Genetics of Heart Diseases (IfGH), Department of Cardiovascular Medicine, University Hospital Münster, D-48149 Münster, Germany
- Correspondence: (S.P.); (G.S.); Tel.: +49-(0)-251/83-58255 (S.P.); +49-(0)-251/83-58251 (G.S.); Fax: +49-(0)-251/83-58257 (S.P. & G.S.)
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Sharma M, Jagirdhar GSK, Guntupalli KK, Kashyap R, Surani S. Heart failure in general and cardiac transplant patients with COVID-19. World J Cardiol 2022; 14:392-402. [PMID: 36161057 PMCID: PMC9350602 DOI: 10.4330/wjc.v14.i7.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/19/2022] [Accepted: 06/24/2022] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is primarily an infection of the respiratory tract, but it can have multisystem manifestations. Cardiac complications of COVID-19 can range from acute myocardial injury, cardiac arrhythmias, or heart failure, amongst others. Heart failure (HF) in COVID-19 can be a de novo process or due to worsening of pre-existing cardiovascular ailment. HF in a patient with COVID-19 not only poses challenges in clinical presentation and management of COVID-19 but also affect prognosis of the patient. This article aims to succinctly revisit the implications of this pandemic regarding pre-existing HF or new-onset HF based on prevailing data. It also focuses on the management and special recommendations from prior studies and guidelines.
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Affiliation(s)
- Munish Sharma
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, United States
| | | | - Kalpalatha K Guntupalli
- Department of Pulmonary, Critical Care and Sleep, Baylor College of Medicine, Houston, TX 77030, United States
| | - Rahul Kashyap
- Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, United States
| | - Salim Surani
- Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, United States
- Department of Medicine, Texas A&M University, Bryan, TX 77807, United States.
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Bryniarski P, Nazimek K, Marcinkiewicz J. Immunomodulatory properties of antihypertensive drugs and digitalis glycosides. Expert Rev Cardiovasc Ther 2022; 20:111-121. [PMID: 35130796 DOI: 10.1080/14779072.2022.2039627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The role of chronic inflammatory process in the pathogenesis or exacerbation of hypertension has been already acknowledged. AREAS COVERED Therefore, one can speculate that hypotensive drugs may exert some of their therapeutic effects due to immunomodulatory properties. So far, this assumption has been tested in different studies, and the resulting knowledge is summarized in the current review article that is dedicated to different groups of antihypertensives, namely calcium channel blockers, beta blockers, as well as other less commonly used medications, such as hydralazine, agonists of alfa-2 receptor, diazoxide, doxazosin, aliskiren, and sodium nitroprusside. Articles were found in the Pubmed database by entering the name of a specific drug (or group of drugs) together with the words: immunology, cellular response, humoral response, inflammation, interleukin. The 2000-2021 range was used to search for all drugs except propranolol (1980-2021) and calcium blockers (1990-2021). EXPERT OPINION Observed decrease in serum/plasma concentration of proinflammatory cytokines, and CRP along with lower expression of adhesion molecules on immune cells strongly suggest that these drugs possess immunomodulatory properties, which seems to be crucial in the medical practice, especially in the therapy of hypertensive patients with other accompanying inflammatory-based diseases, such as type II diabetes, developed metabolic syndrome, allergies or autoimmunity.
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Affiliation(s)
- Paweł Bryniarski
- Department of Immunology, Jagiellonian University in Kraków Medical College Ringgold standard institution, Krakow, Poland
| | - Katarzyna Nazimek
- Department of Immunology, Jagiellonian University in Kraków Medical College Ringgold standard institution, Krakow, Poland
| | - Janusz Marcinkiewicz
- Department of Immunology, Jagiellonian University in Kraków Medical College Ringgold standard institution, Krakow, Poland
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Matrix Metalloproteinase-2 Inhibition in Acute Ischemia-Reperfusion Heart Injury-Cardioprotective Properties of Carvedilol. Pharmaceuticals (Basel) 2021; 14:ph14121276. [PMID: 34959676 PMCID: PMC8704387 DOI: 10.3390/ph14121276] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 11/20/2022] Open
Abstract
Matrix metalloproteinase 2 (MMP-2) is activated in hearts upon ischemia-reperfusion (IR) injury and cleaves sarcomeric proteins. It was shown that carvedilol and nebivolol reduced the activity of different MMPs. Hence, we hypothesized that they could reduce MMPs activation in myocytes, and therefore, protect against cardiac contractile dysfunction related with IR injury. Isolated rat hearts were subjected to either control aerobic perfusion or IR injury: 25 min of aerobic perfusion, followed by 20 min global, no-flow ischemia, and reperfusion for 30 min. The effects of carvedilol, nebivolol, or metoprolol were evaluated in hearts subjected to IR injury. Cardiac mechanical function and MMP-2 activity in the heart homogenates and coronary effluent were assessed along with troponin I content in the former. Only carvedilol improved the recovery of mechanical function at the end of reperfusion compared to IR injury hearts. IR injury induced the activation and release of MMP-2 into the coronary effluent during reperfusion. MMP-2 activity in the coronary effluent increased in the IR injury group and this was prevented by carvedilol. Troponin I levels decreased by 73% in IR hearts and this was abolished by carvedilol. Conclusions: These data suggest that the cardioprotective effect of carvedilol in myocardial IR injury may be mediated by inhibiting MMP-2 activation.
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Ji W, Zhu P, Liang R, Zhang L, Zhang Y, Wang Y, Zhang W, Tao L, Chen S, Yang H, Jin Y, Duan G. Coxsackievirus A2 Leads to Heart Injury in a Neonatal Mouse Model. Viruses 2021; 13:v13081588. [PMID: 34452454 PMCID: PMC8402683 DOI: 10.3390/v13081588] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 12/12/2022] Open
Abstract
Coxsackievirus A2 (CVA2) has emerged as an active pathogen that has been implicated in hand, foot, and mouth disease (HFMD) and herpangina outbreaks worldwide. It has been reported that severe cases with CVA2 infection develop into heart injury, which may be one of the causes of death. However, the mechanisms of CVA2-induced heart injury have not been well understood. In this study, we used a neonatal mouse model of CVA2 to investigate the possible mechanisms of heart injury. We detected CVA2 replication and apoptosis in heart tissues from infected mice. The activity of total aspartate transaminase (AST) and lactate dehydrogenase (LDH) was notably increased in heart tissues from infected mice. CVA2 infection also led to the disruption of cell-matrix interactions in heart tissues, including the increases of matrix metalloproteinase (MMP)3, MMP8, MMP9, connective tissue growth factor (CTGF) and tissue inhibitors of metalloproteinases (TIMP)4. Infiltrating leukocytes (CD45+ and CD11b+ cells) were observed in heart tissues of infected mice. Correspondingly, the expression levels of inflammatory cytokines in tissue lysates of hearts, including tumor necrosis factor alpha (TNF-α), interleukin-1beta (IL-1β), IL6 and monocyte chemoattractant protein-1 (MCP-1) were significantly elevated in CVA2 infected mice. Inflammatory signal pathways in heart tissues, including phosphatidylinositol 3-kinase (PI3K)-AKT, mitogen-activated protein kinases (MAPK) and nuclear factor kappa B (NF-κB), were also activated after infection. In summary, CVA2 infection leads to heart injury in a neonatal mouse model, which might be related to viral replication, increased expression levels of MMP-related enzymes and excessive inflammatory responses.
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Affiliation(s)
- Wangquan Ji
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
| | - Peiyu Zhu
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
| | - Ruonan Liang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
| | - Liang Zhang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
| | - Yu Zhang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
| | - Yuexia Wang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
| | - Weiguo Zhang
- Department of Immunology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Ling Tao
- School of Public Health, Xinxiang Medical University, Xinxiang 453003, China;
| | - Shuaiyin Chen
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
| | - Haiyan Yang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
| | - Yuefei Jin
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
- Correspondence: (Y.J.); (G.D.)
| | - Guangcai Duan
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (W.J.); (P.Z.); (R.L.); (L.Z.); (Y.Z.); (Y.W.); (S.C.); (H.Y.)
- Henan Key Laboratory of Molecular Medicine, Zhengzhou University, Zhengzhou 450001, China
- Correspondence: (Y.J.); (G.D.)
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Zhang Y, Coats AJ, Zheng Z, Adamo M, Ambrosio G, Anker SD, Butler J, Xu D, Mao J, Khan MS, Bai L, Mebazaa A, Ponikowski P, Tang Q, Ruschitzka F, Seferovic P, Tschöpe C, Zhang S, Gao C, Zhou S, Senni M, Zhang J, Metra M. Management of heart failure patients withCOVID‐19: a joint position paper of the Chinese Heart Failure Association & National Heart Failure Committee and the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2020; 22:941-956. [PMID: 32463543 DOI: 10.1002/ejhf.1915] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 05/22/2020] [Accepted: 05/24/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- Yuhui Zhang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences & Peking Union Medical College Beijing China
| | | | - Zhe Zheng
- Department of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences & Peking Union Medical College Beijing China
| | - Marianna Adamo
- Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public HealthUniversity of Brescia Brescia Italy
| | - Giuseppe Ambrosio
- Division of CardiologyUniversity of Perugia School of Medicine Perugia Italy
| | - Stefan D. Anker
- Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site BerlinCharité Universitätsmedizin Berlin Berlin Germany
| | - Javed Butler
- Department of MedicineUniversity of Mississippi Medical Center Jackson MS USA
| | - Dingli Xu
- Key Laboratory for Organ Failure Research, Department of CardiologyNanfang Hospital, Southern Medical University, Guangzhou Regenerative Medicine and Health Guangdong Laboratory Guangzhou China
| | - Jingyuan Mao
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine Tianjin China
| | | | - Ling Bai
- Department of Cardiovascular MedicineThe First Affiliated Hospital of Xi'an Jiaotong University Xi'an China
| | - Alexandre Mebazaa
- Université de Paris, Paris, France; U942 Inserm – MASCOT and Department of Anaesthesia and Critical CareUniversity Hospitals Saint Louis‐Lariboisière, APHP Paris France
| | - Piotr Ponikowski
- Center for Heart DiseasesUniversity Hospital, Medical University Wroclaw Poland
| | - Qizhu Tang
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research InstituteWuhan University, Hubei Key Laboratory of Cardiology Wuhan China
| | - Frank Ruschitzka
- University Heart CentreUniversity Hospital Zurich Zurich Switzerland
| | - Petar Seferovic
- Clinic of Endocrinology, Diabetes and Metabolic DiseasesBelgrade University Medical Center Belgrade Serbia
| | - Carsten Tschöpe
- Department of Cardiology, Campus Virchow KlinikumCharite ‐ Universitaetsmedizin Berlin Berlin Germany
| | - Shuyang Zhang
- Department of Cardiology, Peking Union Medical College & Chinese Academy of Medical SciencePeking Union Medical College Hospital Beijing China
| | - Chuanyu Gao
- Department of Cardiology, Henan Provincial People's HospitalFuwai Central China Cardiovascular Hospital Zhengzhou China
| | - Shenghua Zhou
- Department of CardiologyThe Second Xiangya Hospital of Central South University Changsha China
| | - Michele Senni
- Cardiology Division, Cardiovascular DepartmentPapa Giovanni XXIII Hospital Bergamo Italy
| | - Jian Zhang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences & Peking Union Medical College Beijing China
| | - Marco Metra
- Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public HealthUniversity of Brescia Brescia Italy
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Müller I, Vogl T, Kühl U, Krannich A, Banks A, Trippel T, Noutsias M, Maisel AS, van Linthout S, Tschöpe C. Serum alarmin S100A8/S100A9 levels and its potential role as biomarker in myocarditis. ESC Heart Fail 2020; 7:1442-1451. [PMID: 32462801 PMCID: PMC7373886 DOI: 10.1002/ehf2.12760] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/20/2020] [Accepted: 04/27/2020] [Indexed: 12/30/2022] Open
Abstract
Aims The alarmin S100A8/S100A9 (S100A8/A9) is released by activated monocytes/macrophages and neutrophils in the setting lymphocytic myocarditis (MC). We recently demonstrated its therapeutic potential in experimental acute MC. Now, we investigated the diagnostic relevance of S100A8/A9 serum levels in patients with suspected acute and chronic MC and in patients with heart failure without cardiac inflammation. Methods and Results Serum S100A8/A9 levels were analysed in patients with a recent onset of MC [≤ 30 days, n = 32; ejection fraction (EF): 45.4 ± 12.9%], dilated cardiomyopathy patients with inflammation (n = 112; EF: 29.0 ± 11.4%), or without inflammation (n = 58; EF: 26.6 ± 9.3%), and controls (n = 25; EF: 68.5 ± 4.6%), by using specific ELISAs. Blood samples were collected at Time Point 1 (T1), where also endomyocardial biopsies (EMBs) were withdrawn. Patients with a recent onset of MC showed a 4.6‐fold increase in serum S100A8/A9 levels vs. controls (MC: 1948 ± 1670 ng/mL vs. controls: 426 ± 307 ng/mL; P < 0.0001). Serum S100A8/A9 correlated with the disease activity, represented by EMB‐derived counts of inflammatory cells (CD3: r = 0.486, P = 0.0047, lymphocyte function‐associated antigen‐1: r = 0.558, P = 0.0009, macrophage‐1 antigen: r = 0.434, P = 0.013), the EMB mRNA levels of S100A8, S100A9 (r = 0.541, P = 0.002), and left ventricular ejection fraction (LVEF: r = 0.498, P = 0.0043). EMB immunofluorescence co‐stainings display macrophages/monocytes and neutrophils as the main source of S100A8 and S100A9 in recent onset MC. The diagnostic value of serum alarmin levels (cut‐off 583 ng/mL) was characterized by a specificity of 92%, a sensitivity of 90.6%, positive predictive value of 93.5%, negative predictive value of 88.5%, and an accuracy of 0.949 (95% confidence interval [0.89–1]). In a subgroup of MC patients, S100A8/A9 serum levels and EMBs at T1 (n = 12) and a follow‐up visit (T2, n = 12, mean follow‐up 8.5 months) were available. A fall of serum S100A8/A9 (T1: 2208 ± 1843 ng/mL vs. T2: 888.8 ± 513.7 ng/mL; P = 0.00052) was associated with a reduced cardiac inflammation (CD3 T1: 70.02 ± 107.4 cells per square millimetre vs. T2: 59.18 ± 182.5 cells per square millimetre; P = 0.0342, lymphocyte function‐associated antigen‐1 T1: 133.5 ± 187.1 cells per square millimetre vs. T2: 74.12 ± 190.5 cells per square millimetre; P = 0.0186, and macrophage‐1 antigen T1: 132.6 ± 129.5 cells per square millimetre vs. T2: 54.41 ± 65.16 cells per square millimetre; P = 0.0015). Serum S100A8/A9 levels were only slightly increased in patients within the chronic phase of MC and in heart failure patients without inflammation vs. controls. Conclusions Serum S100A8/A9 might serve as an additional tool in the diagnostic workup of suspected acute MC patients.
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Affiliation(s)
- Irene Müller
- Berlin Institute of Health (BIH) & Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany.,DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Thomas Vogl
- Department of Immunology, University of Münster, Münster, Germany
| | - Uwe Kühl
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany
| | - Alexander Krannich
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Tobias Trippel
- Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany
| | - Michel Noutsias
- Mid-German Heart Center, Division of Cardiology, Angiology and Intensive Medical Care, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Alan S Maisel
- FACC, University of California San Diego, San Diego, CA, USA
| | - Sophie van Linthout
- Berlin Institute of Health (BIH) & Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany.,DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Carsten Tschöpe
- Berlin Institute of Health (BIH) & Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany.,DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany.,Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany
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Hu XM, Ren S, Li K, Li XT. Tacrine modulates Kv2.1 channel gene expression and cell proliferation. Int J Neurosci 2020; 130:781-787. [PMID: 31847645 DOI: 10.1080/00207454.2019.1705811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Purpose/Aim: Besides as a cholinesterase (ChE) inhibitor, tacrine is able to act on multiple targets such as nicotinic receptors (nAChRs) and voltage-gated K+ (Kv) channels. Kv2.1, a Kv channel subunit underlying delayed rectifier currents with slow kinetics of inactivation, is highly expressed in the mammalian brain, especially in the hippocampus. Nevertheless, limited data are available concerning the relationship between tacrine and Kv2.1 channels. In the present study, we explore the possible effects of tacrine on Kv2.1 channels in heterologous expression systems and N2A cells.Materials and methods: The change of expression and currents of Kv2.1 after treatment with tacrine was detected by PCR and whole-cell recordings, respectively. WST-8 experiments were performed to reveal the effects of tacrine on cell proliferation.Results: Incubation with tacrine induced a significant reduction of the mRNA level of Kv2.1 channels in HEK293 cells. The decline of corresponding currents carried by Kv2.1 was also observed. Moreover, the proliferation rates of HEK293 cells with Kv2.1 channel were substantially enhanced after treatment with this chemical for 24 h. Similar results were also detected after exposure to tacrine in N2A cells with native expression of Kv2.1 channels.Conclusion: These lines of evidence indicate that application of tacrine downregulates the expression of Kv2.1 channels and increase cell proliferation. The effect of tacrine on Kv2.1 channels may provide an alternative explanation for its neuroprotective action.
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Affiliation(s)
- Xi-Mu Hu
- Graduate Institute of South-Central University for Nationalities, Wuhan, China
| | - Sheng Ren
- College of Life Science, South-Central University for Nationalities, Wuhan, China
| | - Kai Li
- Graduate Institute of South-Central University for Nationalities, Wuhan, China
| | - Xian-Tao Li
- College of Life Science, South-Central University for Nationalities, Wuhan, China
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11
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Ali M, Rigopoulos AG, Ali K, Ikonomidis I, Makavos G, Matiakis M, Melnyk H, Abate E, Mammadov M, Prüser JL, de Vecchis R, Wohlgemuth W, Manginas A, Bigalke B, Mavrogeni S, Sedding D, Noutsias M. Advancements in the diagnostic workup, prognostic evaluation, and treatment of takotsubo syndrome. Heart Fail Rev 2019; 25:757-771. [PMID: 31372789 DOI: 10.1007/s10741-019-09843-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Takotsubo syndrome (TTS) is an acute and mostly reversible cardiomyopathy that mimics an acute coronary syndrome with left ventricular (LV) systolic dysfunction without relevant obstructive coronary artery disease. Its prevalence is probably underestimated and reaches 1.2-2% in patients with acute coronary syndrome undergoing coronary catheterization. Although supraphysiological epinephrine levels have been associated with TTS, the detailed pathophysiology is incompletely understood. Chest pain is the most common clinical presentation; however, cardiac decompensation, cardiogenic shock, and sudden cardiac death due to ventricular fibrillation may also be the first clinical manifestations. Patients are mostly postmenopausal women, in whom the condition is commonly associated with emotional triggers; however, men have a higher prevalence of TTS being associated with physical triggers, which has a worse prognosis compared with TTS associated with emotional triggers. As a diagnosis of exclusion, TTS has no single definitive diagnostic test. According to the distribution of LV wall motion abnormalities, various morphological subtypes have been identified. The final diagnosis depends on cardiac imaging with left ventricular angiography during acute heart catheterization, as well as on echocardiography and cardiac magnetic resonance. Most patients recover completely, albeit several factors have been associated with worse prognosis. Management is based on observational data, while randomized multicenter studies are still lacking. This review provides a general overview of TTS and focuses on the hypothesized pathophysiology, and especially on current practices in diagnosis, prognosis, and treatment.
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Affiliation(s)
- Muhammad Ali
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Angelos G Rigopoulos
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Khaldoun Ali
- Department of Thoracic and Cardiovascular Surgery, Klinikum Braunschweig, Brunswick, Germany
| | - Ignatios Ikonomidis
- 2nd Cardiology Department, National and Kapodistrian University of Athens, Attikon Hospital, Rimini 1, Haidari, GR-12462, Athens, Greece
| | - George Makavos
- 2nd Cardiology Department, National and Kapodistrian University of Athens, Attikon Hospital, Rimini 1, Haidari, GR-12462, Athens, Greece
| | - Marios Matiakis
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Hannes Melnyk
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Elena Abate
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Mammad Mammadov
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Jan Lukas Prüser
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Renato de Vecchis
- Preventive Cardiology and Rehabilitation Unit, DSB 29 "S. Gennaro dei Poveri Hospital", I-80136, Naples, Italy
| | - Walter Wohlgemuth
- Department of Radiology, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Athanassios Manginas
- Interventional Cardiology and Cardiology Department, Mediterraneo Hospital, Ilias Street 8-12, Glyfada, GR-16675, Athens, Greece
| | - Boris Bigalke
- Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany
| | - Sophie Mavrogeni
- Onassis Cardiac Surgery Center, 50 Esperou Street, Palaeo Faliro, GR-17561, Athens, Greece
| | - Daniel Sedding
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
| | - Michel Noutsias
- Mid-German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany.
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Myopericarditis with preserved left ventricular function secondary to Neisseria meningitidis. Diagn Microbiol Infect Dis 2018; 92:241-244. [DOI: 10.1016/j.diagmicrobio.2018.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 06/08/2018] [Accepted: 06/10/2018] [Indexed: 11/17/2022]
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β-Blocker use is associated with a higher relapse risk of inflammatory bowel disease: a Dutch retrospective case-control study. Eur J Gastroenterol Hepatol 2018; 30:161-166. [PMID: 29111997 DOI: 10.1097/meg.0000000000001016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Inflammatory bowel disease (IBD) is a multifactorial disease and many factors may influence the disease course, like the concomitant use of medication. An example thereof is the use of β-blockers, antagonizing β-adrenergic receptors. β-adrenergic receptor activation has potent anti-inflammatory effects on the immune system. We addressed whether an association exists between the use of beta-blockers and the course of IBD, defined by the risk of a disease relapse in patients with IBD. PATIENTS AND METHODS In this retrospective case-control study, we used a population-based cohort of patients with IBD. We identified colitis relapses using IBD medication prescriptions as a proxy. We calculated the number of relapses per 100 person-years and compared this between patients with IBD using β-blockers and patients with IBD not using β-blockers. We used Cox proportional hazards models with shared frailty to compare the relative relapse risk between both groups. RESULTS A total of 250 patients with IBD were included, of which 30 patients used a β-blocker for at least 3 months. With the Cox proportional hazards model with shared frailty, adjusted for age and sex, we observed a 54% (hazard ratio: 1.54; 95% confidence interval: 1.05-2.25; P=0.03) higher risk of a relapse in the group of patients with IBD using β-blockers versus the group not using β-blockers. CONCLUSION Even in this limited cohort study, we show that patients with IBD using β-blockers have an increased relapse risk. Indeed, concomitant medication use seems to be a factor that can influence the course of IBD, and this should be acknowledged while making decisions about treatment of IBD and follow-up.
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Müller I, Vogl T, Pappritz K, Miteva K, Savvatis K, Rohde D, Most P, Lassner D, Pieske B, Kühl U, Van Linthout S, Tschöpe C. Pathogenic Role of the Damage-Associated Molecular Patterns S100A8 and S100A9 in Coxsackievirus B3-Induced Myocarditis. Circ Heart Fail 2017; 10:CIRCHEARTFAILURE.117.004125. [PMID: 29158436 DOI: 10.1161/circheartfailure.117.004125] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 10/23/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND The alarmins S100A8 and S100A9 are damage-associated molecular patterns, which play a pivotal role in cardiovascular diseases, inflammation, and viral infections. We aimed to investigate their role in Coxsackievirus B3 (CVB3)-induced myocarditis. METHODS AND RESULTS S100A8 and S100A9 mRNA expression was 13.0-fold (P=0.012) and 5.1-fold (P=0.038) higher in endomyocardial biopsies from patients with CVB3-positive myocarditis compared with controls, respectively. Elimination of CVB3 led to a downregulation of these alarmins. CVB3-infected mice developed an impaired left ventricular function and displayed an increased left ventricular S100A8 and S100A9 protein expression versus controls. In contrast, CVB3-infected S100A9 knockout mice, which are also a complete knockout for S100A8 on protein level, showed an improved left ventricular function, which was associated with a reduced cardiac inflammatory and oxidative response, and lower CVB3 copy number compared with wild-type CVB3 mice. Exogenous application of S100A8 to S100A9 knockout CVB3 mice induced a severe myocarditis similar to wild-type CVB3 mice. In CVB3-infected HL-1 cells, S100A8 and S100A9 enhanced oxidative stress and CVB3 copy number compared with unstimulated infected cells. In CVB3-infected RAW macrophages, both alarmins increased MIP-2 (macrophage inflammatory protein-2) chemokine expression, which was reduced in CVB3 S100A8 knockdown versus scrambled siRNA CVB3 cells. CONCLUSIONS S100A8 and S100A9 aggravate CVB3-induced myocarditis and might serve as therapeutic targets in inflammatory cardiomyopathies.
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Affiliation(s)
- Irene Müller
- From the Department of Cardiology and Pneumology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Germany (I.M., K.P., K.M., B.P., U.K., S.V.L., C.T., K.S.); Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Germany (I.M., K.P., K.M., K.S., S.V.L., C.T.); DZHK (German Center for Cardiovascular Research), Partner Site Berlin (I.M., K.P., B.P., S.V.L., C.T.); Department of Immunology, University of Münster, Germany (T.V.); Inherited Cardiovascular Diseases Unit, Barts Health NHS Trust, Barts Heart Centre, London, United Kingdom (K.S.); William Harvey Research Institute, Queen Mary University London, United Kingdom (K.S.); Department of Internal Medicine III, Center for Molecular and Translational Cardiology, University of Heidelberg, Germany (D.R., P.M.); DZHK, (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany (P.M.); Institut Kardiale Diagnostik und Therapie (IKDT), Berlin, Germany (D.L.); and Department of Cardiology, Deutsches Herzzentrum Berlin (DHZB), Germany (B.P.)
| | - Thomas Vogl
- From the Department of Cardiology and Pneumology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Germany (I.M., K.P., K.M., B.P., U.K., S.V.L., C.T., K.S.); Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Germany (I.M., K.P., K.M., K.S., S.V.L., C.T.); DZHK (German Center for Cardiovascular Research), Partner Site Berlin (I.M., K.P., B.P., S.V.L., C.T.); Department of Immunology, University of Münster, Germany (T.V.); Inherited Cardiovascular Diseases Unit, Barts Health NHS Trust, Barts Heart Centre, London, United Kingdom (K.S.); William Harvey Research Institute, Queen Mary University London, United Kingdom (K.S.); Department of Internal Medicine III, Center for Molecular and Translational Cardiology, University of Heidelberg, Germany (D.R., P.M.); DZHK, (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany (P.M.); Institut Kardiale Diagnostik und Therapie (IKDT), Berlin, Germany (D.L.); and Department of Cardiology, Deutsches Herzzentrum Berlin (DHZB), Germany (B.P.)
| | - Kathleen Pappritz
- From the Department of Cardiology and Pneumology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Germany (I.M., K.P., K.M., B.P., U.K., S.V.L., C.T., K.S.); Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Germany (I.M., K.P., K.M., K.S., S.V.L., C.T.); DZHK (German Center for Cardiovascular Research), Partner Site Berlin (I.M., K.P., B.P., S.V.L., C.T.); Department of Immunology, University of Münster, Germany (T.V.); Inherited Cardiovascular Diseases Unit, Barts Health NHS Trust, Barts Heart Centre, London, United Kingdom (K.S.); William Harvey Research Institute, Queen Mary University London, United Kingdom (K.S.); Department of Internal Medicine III, Center for Molecular and Translational Cardiology, University of Heidelberg, Germany (D.R., P.M.); DZHK, (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany (P.M.); Institut Kardiale Diagnostik und Therapie (IKDT), Berlin, Germany (D.L.); and Department of Cardiology, Deutsches Herzzentrum Berlin (DHZB), Germany (B.P.)
| | - Kapka Miteva
- From the Department of Cardiology and Pneumology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Germany (I.M., K.P., K.M., B.P., U.K., S.V.L., C.T., K.S.); Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Germany (I.M., K.P., K.M., K.S., S.V.L., C.T.); DZHK (German Center for Cardiovascular Research), Partner Site Berlin (I.M., K.P., B.P., S.V.L., C.T.); Department of Immunology, University of Münster, Germany (T.V.); Inherited Cardiovascular Diseases Unit, Barts Health NHS Trust, Barts Heart Centre, London, United Kingdom (K.S.); William Harvey Research Institute, Queen Mary University London, United Kingdom (K.S.); Department of Internal Medicine III, Center for Molecular and Translational Cardiology, University of Heidelberg, Germany (D.R., P.M.); DZHK, (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany (P.M.); Institut Kardiale Diagnostik und Therapie (IKDT), Berlin, Germany (D.L.); and Department of Cardiology, Deutsches Herzzentrum Berlin (DHZB), Germany (B.P.)
| | - Konstantinos Savvatis
- From the Department of Cardiology and Pneumology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Germany (I.M., K.P., K.M., B.P., U.K., S.V.L., C.T., K.S.); Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Germany (I.M., K.P., K.M., K.S., S.V.L., C.T.); DZHK (German Center for Cardiovascular Research), Partner Site Berlin (I.M., K.P., B.P., S.V.L., C.T.); Department of Immunology, University of Münster, Germany (T.V.); Inherited Cardiovascular Diseases Unit, Barts Health NHS Trust, Barts Heart Centre, London, United Kingdom (K.S.); William Harvey Research Institute, Queen Mary University London, United Kingdom (K.S.); Department of Internal Medicine III, Center for Molecular and Translational Cardiology, University of Heidelberg, Germany (D.R., P.M.); DZHK, (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany (P.M.); Institut Kardiale Diagnostik und Therapie (IKDT), Berlin, Germany (D.L.); and Department of Cardiology, Deutsches Herzzentrum Berlin (DHZB), Germany (B.P.)
| | - David Rohde
- From the Department of Cardiology and Pneumology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Germany (I.M., K.P., K.M., B.P., U.K., S.V.L., C.T., K.S.); Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Germany (I.M., K.P., K.M., K.S., S.V.L., C.T.); DZHK (German Center for Cardiovascular Research), Partner Site Berlin (I.M., K.P., B.P., S.V.L., C.T.); Department of Immunology, University of Münster, Germany (T.V.); Inherited Cardiovascular Diseases Unit, Barts Health NHS Trust, Barts Heart Centre, London, United Kingdom (K.S.); William Harvey Research Institute, Queen Mary University London, United Kingdom (K.S.); Department of Internal Medicine III, Center for Molecular and Translational Cardiology, University of Heidelberg, Germany (D.R., P.M.); DZHK, (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany (P.M.); Institut Kardiale Diagnostik und Therapie (IKDT), Berlin, Germany (D.L.); and Department of Cardiology, Deutsches Herzzentrum Berlin (DHZB), Germany (B.P.)
| | - Patrick Most
- From the Department of Cardiology and Pneumology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Germany (I.M., K.P., K.M., B.P., U.K., S.V.L., C.T., K.S.); Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Germany (I.M., K.P., K.M., K.S., S.V.L., C.T.); DZHK (German Center for Cardiovascular Research), Partner Site Berlin (I.M., K.P., B.P., S.V.L., C.T.); Department of Immunology, University of Münster, Germany (T.V.); Inherited Cardiovascular Diseases Unit, Barts Health NHS Trust, Barts Heart Centre, London, United Kingdom (K.S.); William Harvey Research Institute, Queen Mary University London, United Kingdom (K.S.); Department of Internal Medicine III, Center for Molecular and Translational Cardiology, University of Heidelberg, Germany (D.R., P.M.); DZHK, (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany (P.M.); Institut Kardiale Diagnostik und Therapie (IKDT), Berlin, Germany (D.L.); and Department of Cardiology, Deutsches Herzzentrum Berlin (DHZB), Germany (B.P.)
| | - Dirk Lassner
- From the Department of Cardiology and Pneumology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Germany (I.M., K.P., K.M., B.P., U.K., S.V.L., C.T., K.S.); Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Germany (I.M., K.P., K.M., K.S., S.V.L., C.T.); DZHK (German Center for Cardiovascular Research), Partner Site Berlin (I.M., K.P., B.P., S.V.L., C.T.); Department of Immunology, University of Münster, Germany (T.V.); Inherited Cardiovascular Diseases Unit, Barts Health NHS Trust, Barts Heart Centre, London, United Kingdom (K.S.); William Harvey Research Institute, Queen Mary University London, United Kingdom (K.S.); Department of Internal Medicine III, Center for Molecular and Translational Cardiology, University of Heidelberg, Germany (D.R., P.M.); DZHK, (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany (P.M.); Institut Kardiale Diagnostik und Therapie (IKDT), Berlin, Germany (D.L.); and Department of Cardiology, Deutsches Herzzentrum Berlin (DHZB), Germany (B.P.)
| | - Burkert Pieske
- From the Department of Cardiology and Pneumology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Germany (I.M., K.P., K.M., B.P., U.K., S.V.L., C.T., K.S.); Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Germany (I.M., K.P., K.M., K.S., S.V.L., C.T.); DZHK (German Center for Cardiovascular Research), Partner Site Berlin (I.M., K.P., B.P., S.V.L., C.T.); Department of Immunology, University of Münster, Germany (T.V.); Inherited Cardiovascular Diseases Unit, Barts Health NHS Trust, Barts Heart Centre, London, United Kingdom (K.S.); William Harvey Research Institute, Queen Mary University London, United Kingdom (K.S.); Department of Internal Medicine III, Center for Molecular and Translational Cardiology, University of Heidelberg, Germany (D.R., P.M.); DZHK, (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany (P.M.); Institut Kardiale Diagnostik und Therapie (IKDT), Berlin, Germany (D.L.); and Department of Cardiology, Deutsches Herzzentrum Berlin (DHZB), Germany (B.P.)
| | - Uwe Kühl
- From the Department of Cardiology and Pneumology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Germany (I.M., K.P., K.M., B.P., U.K., S.V.L., C.T., K.S.); Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Germany (I.M., K.P., K.M., K.S., S.V.L., C.T.); DZHK (German Center for Cardiovascular Research), Partner Site Berlin (I.M., K.P., B.P., S.V.L., C.T.); Department of Immunology, University of Münster, Germany (T.V.); Inherited Cardiovascular Diseases Unit, Barts Health NHS Trust, Barts Heart Centre, London, United Kingdom (K.S.); William Harvey Research Institute, Queen Mary University London, United Kingdom (K.S.); Department of Internal Medicine III, Center for Molecular and Translational Cardiology, University of Heidelberg, Germany (D.R., P.M.); DZHK, (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany (P.M.); Institut Kardiale Diagnostik und Therapie (IKDT), Berlin, Germany (D.L.); and Department of Cardiology, Deutsches Herzzentrum Berlin (DHZB), Germany (B.P.)
| | - Sophie Van Linthout
- From the Department of Cardiology and Pneumology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Germany (I.M., K.P., K.M., B.P., U.K., S.V.L., C.T., K.S.); Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Germany (I.M., K.P., K.M., K.S., S.V.L., C.T.); DZHK (German Center for Cardiovascular Research), Partner Site Berlin (I.M., K.P., B.P., S.V.L., C.T.); Department of Immunology, University of Münster, Germany (T.V.); Inherited Cardiovascular Diseases Unit, Barts Health NHS Trust, Barts Heart Centre, London, United Kingdom (K.S.); William Harvey Research Institute, Queen Mary University London, United Kingdom (K.S.); Department of Internal Medicine III, Center for Molecular and Translational Cardiology, University of Heidelberg, Germany (D.R., P.M.); DZHK, (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany (P.M.); Institut Kardiale Diagnostik und Therapie (IKDT), Berlin, Germany (D.L.); and Department of Cardiology, Deutsches Herzzentrum Berlin (DHZB), Germany (B.P.)
| | - Carsten Tschöpe
- From the Department of Cardiology and Pneumology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Germany (I.M., K.P., K.M., B.P., U.K., S.V.L., C.T., K.S.); Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Germany (I.M., K.P., K.M., K.S., S.V.L., C.T.); DZHK (German Center for Cardiovascular Research), Partner Site Berlin (I.M., K.P., B.P., S.V.L., C.T.); Department of Immunology, University of Münster, Germany (T.V.); Inherited Cardiovascular Diseases Unit, Barts Health NHS Trust, Barts Heart Centre, London, United Kingdom (K.S.); William Harvey Research Institute, Queen Mary University London, United Kingdom (K.S.); Department of Internal Medicine III, Center for Molecular and Translational Cardiology, University of Heidelberg, Germany (D.R., P.M.); DZHK, (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany (P.M.); Institut Kardiale Diagnostik und Therapie (IKDT), Berlin, Germany (D.L.); and Department of Cardiology, Deutsches Herzzentrum Berlin (DHZB), Germany (B.P.).
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15
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Potential Role of Carvedilol in the Cardiac Immune Response Induced by Experimental Infection with Trypanosoma cruzi. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9205062. [PMID: 28377930 PMCID: PMC5362721 DOI: 10.1155/2017/9205062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 02/06/2017] [Accepted: 02/19/2017] [Indexed: 12/16/2022]
Abstract
Trypanosoma cruzi causes a cardiac infection characterized by an inflammatory imbalance that could become the inciting factor of the illness. To this end, we evaluated the role of carvedilol, a beta-blocker with potential immunomodulatory properties, on the immune response in C57BL/6 mice infected with VL-10 strain of T. cruzi in the acute phase. Animals (n = 40) were grouped: (i) not infected, (ii) infected, (iii) infected + carvedilol, and (iv) not infected + carvedilol. We analyzed parameters related to parasitemia, plasma levels of TNF, IL-10, and CCL2, and cardiac histopathology after the administration of carvedilol for 30 days. We did not observe differences in the maximum peaks of parasitemia in the day of their detection among the groups. The plasma TNF was elevated at 60 days of infection in mice treated or not with carvedilol. However, we observed a decreased CCL2 level and increased IL-10 levels in those infected animals treated with carvedilol, which impacted the reduction of the inflammatory infiltration in cardiac tissue. For this experimental model, carvedilol therapy was not able to alter the levels of circulating parasites but modulates the pattern of CCL2 and IL-10 mediators when the VL10 strain of T. cruzi was used in C57BL6 mice.
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16
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Krejci J, Hude P, Ozabalova E, Mlejnek D, Zampachova V, Svobodova I, Stepanova R, Spinarova L. Improvement of left ventricular systolic function in inflammatory cardiomyopathy: What plays a role? Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2016; 160:524-532. [PMID: 27345734 DOI: 10.5507/bp.2016.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 06/06/2016] [Indexed: 12/12/2022] Open
Abstract
AIMS To compare the differences between patients with inflammatory cardiomyopathy (ICM) with and without improvement in left ventricular (LV) systolic function and to identify the relevant predictors of LV improvement. PATIENTS AND METHODS The study included 63 patients with biopsy-proven ICM and heart failure symptoms of at least NYHA II, symptom duration ≤ 6 months, LV ejection fraction (LVEF) ≤ 40% assessed by echocardiography and presence of >14 mononuclear leukocytes (LCA+ cells)/mm2 in biopsy samples. Patients were evaluated at baseline and after 6 months. RESULTS In the group with LVEF improvement of ≥ 10% (I+ group, n = 41), LVEF increased from 24 ± 7% to 47 ± 8% (P < 0.001). In 22 patients (group I-), there was no or minimal LVEF increase (< 10%). In the I+ group, there were more LCA+ cells/mm2 at baseline (25.1 ± 16.5 vs. 18.5 ± 4.4 cells/mm2; P = 0.032) and a more significant decrease in LCA+ cells in the follow-up (reduction of 13.6 ± 14.3 cells/mm2 vs. 5.0 ± 7.7 cells/mm2 in the I- group; P = 0.009). The univariate logistic regression showed a possible association of number of LCA+ cells, LV end-diastolic diameter and N-terminal fragment of pro-brain natriuretic peptide (NTproBNP) value with LVEF improvement. In the multivariate analysis, only NTproBNP at diagnosis was confirmed as an independent predictor of LVEF improvement (OR=1.2; 1.003 to 1.394; P = 0.046). CONCLUSION The LV systolic function improvement was observed in 65% of the patients. In these patients, the number of inflammatory cells at baseline was higher and decreased more but the higher baseline NTproBNP value was the only independent predictor of LVEF improvement.
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Affiliation(s)
- Jan Krejci
- Department of Cardiovascular Diseases, St. Anne's University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Petr Hude
- Department of Cardiovascular Diseases, St. Anne's University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Eva Ozabalova
- Department of Cardiovascular Diseases, St. Anne's University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Dalibor Mlejnek
- Department of Cardiovascular Diseases, St. Anne's University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Vita Zampachova
- First Department of Pathological Anatomy, St. Anne's University Hospital in Brno and Masaryk University, Brno, Czech Republic
| | - Iva Svobodova
- First Department of Pathological Anatomy, St. Anne's University Hospital in Brno and Masaryk University, Brno, Czech Republic
| | - Radka Stepanova
- Department of Internal Medicine and Cardiology, University Hospital Brno, Czech Republic
| | - Lenka Spinarova
- Department of Cardiovascular Diseases, St. Anne's University Hospital Brno and Masaryk University, Brno, Czech Republic
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17
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Inflammatory Cardiomyopathy: A Current View on the Pathophysiology, Diagnosis, and Treatment. BIOMED RESEARCH INTERNATIONAL 2016; 2016:4087632. [PMID: 27382566 PMCID: PMC4921131 DOI: 10.1155/2016/4087632] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 03/20/2016] [Indexed: 12/31/2022]
Abstract
Inflammatory cardiomyopathy is defined as inflammation of the heart muscle associated with impaired function of the myocardium. In our region, its etiology is most often viral. Viral infection is a possible trigger of immune and autoimmune mechanisms which contributed to the damage of myocardial function. Myocarditis is considered the most common cause of dilated cardiomyopathy. Typical manifestation of this disease is heart failure, chest pain, or arrhythmias. The most important noninvasive diagnostic method is magnetic resonance imaging, but the gold standard of diagnostics is invasive examination, endomyocardial biopsy. In a significant proportion of cases with impaired left ventricular systolic function, recovery occurs spontaneously in several weeks and therefore it is appropriate to postpone critical therapeutic decisions about 3–6 months after start of the treatment. Therapy is based on standard heart failure treatment; immunosuppressive or antimicrobial treatment may be considered in some cases depending on the results of endomyocardial biopsy. If severe dysfunction of the left ventricle persists, device therapy may be needed.
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18
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Li-Sha G, Jing-Lin Z, Li L, Guang-Yi C, Xiao-Wei L, Yue-Chun L. Nicotine inhibits the production of proinflammatory cytokines of mice infected with coxsackievirus B3. Life Sci 2016; 148:9-16. [PMID: 26851533 DOI: 10.1016/j.lfs.2016.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 01/21/2016] [Accepted: 02/02/2016] [Indexed: 01/07/2023]
Abstract
AIMS Although excessive sympathetic activation in viral myocarditis and the protective effects of sympathetic inhibition with β-blockers are clear, the effects of enhancing vagal tone on viral myocarditis remain unclear. In several models, vagus nerve activation with the α7 nicotinic acetylcholine receptor (α7-nAChR) agonists has been demonstrated to ameliorate inflammation. This study was therefore designed to examine the effects of cholinergic stimulation with α7-nAChR agonist nicotine in a murine model of acute viral myocarditis. MATERIALS AND METHODS BALB/C mice were infected by an intraperitoneally injection with coxsackievirus B3. Nicotine and methyllycaconitine (an α7-nAChR antagonist) were administered at doses of 0.4mg/kg and 0.8mg/kg three times per day for 7 or 14 consecutive days, respectively. The effects of nicotine and methyllycaconitine on survival rate, myocardial histopathological changes, cardiac function, cytokine levels, viral RNA, malondialdehyde, and superoxide dismutase contents were investigated. KEY FINDINGS Nicotine significantly increased survival rate of the infected mice, decreased myocardial inflammation, and improved the impairment of left ventricular function in murine coxsackievirus B3-induced myocarditis compared with methyllycaconitine. The proinflammatory cytokines TNF-α, IL-1β, IL-6 and IL-17A were significantly decreased in the infected mice treated with nicotine compared with methyllycaconitine. Nicotine had no significant anti-oxidative and antiviral effects in coxsackievirus B3-infected mice. SIGNIFICANCE The results indicate that cholinergic stimulation with nicotine significantly reduced the severity of viral myocarditis in mice. The findings suggest that alpha7 nAChR agonists may be a promising new strategy for patients with myocarditis.
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Affiliation(s)
- Ge Li-Sha
- Department of Pediatrics, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Zhao Jing-Lin
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Liu Li
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Chen Guang-Yi
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Li Xiao-Wei
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Li Yue-Chun
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
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Carvalho Rodrigues MA, dos Santos NAG, da Silva Faria MC, Rodrigues JL, Kinoshita A, Baffa O, Antunes LMG, Barbosa F, Gobe GC, dos Santos AC. Carvedilol protects the kidneys of tumor-bearing mice without impairing the biodistribution or the genotoxicity of cisplatin. Chem Biol Interact 2016; 245:59-65. [PMID: 26751708 DOI: 10.1016/j.cbi.2015.12.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 12/23/2015] [Accepted: 12/29/2015] [Indexed: 10/22/2022]
Abstract
Cisplatin (Cisp) is an effective antitumor drug; however, it causes severe nephrotoxicity. Minimization of renal toxicity is essential, but the interference of nephroprotective agents, particularly antioxidants, with the antitumor activity of cisplatin is a general concern. We have recently demonstrated that the anti-hypertensive and antioxidant drug carvedilol (CV) protects against the renal damage and increases the survival of tumor-bearing mice without impairing the tumor reduction by cisplatin. So far, reports on the antioxidant mechanism of CV are controversial and there are no data on the impact of CV on the antitumor mechanisms of cisplatin. Therefore, this study addresses the effect of CV on mechanisms underlying the tumor control by cisplatin. CV did not interfere with the biodistribution or the genotoxicity of cisplatin. We also addressed the antioxidant mechanisms of CV and demonstrated that it does not neutralize free radicals, but is an efficient chelator of ferrous ions that are relevant catalyzers in cisplatin nephrotoxicity. The present data suggest that oxidative damage and genotoxicity play different roles in the toxicity of cisplatin on kidneys and tumors and therefore, some antioxidants might be safe as chemoprotectors. Altogether, our studies provide consistent evidence of the beneficial effect of CV on animals treated with cisplatin and might encourage clinical trials.
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Affiliation(s)
- Maria A Carvalho Rodrigues
- Centro Universitário do Distrito Federal, UDF, SEP/SUL EQ704/904 Conj.A, Brasilia/DF, CEP 70390-045, Brazil
| | - Neife A G dos Santos
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto-USP, Av. do Café s/n, 14040-903, Ribeirão Preto, SP, Brazil
| | - Marcia C da Silva Faria
- Universidade Federal do Vale do Jequitinhona e Mucuri, UFVJM, Campus do Mucuri, Teófilo Otoni/MG, Rua do Cruzeiro, nº 01 - Jardim, São Paulo, CEP 39803-371, Brazil
| | - Jairo Lisboa Rodrigues
- Universidade Federal do Vale do Jequitinhona e Mucuri, UFVJM, Campus do Mucuri, Teófilo Otoni/MG, Rua do Cruzeiro, nº 01 - Jardim, São Paulo, CEP 39803-371, Brazil
| | - Angela Kinoshita
- Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto - USP, Avenida do Café s/n, 14040-901, Ribeirão Preto, SP, Brazil
| | - Oswaldo Baffa
- Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto - USP, Avenida do Café s/n, 14040-901, Ribeirão Preto, SP, Brazil
| | - Lusania M Greggi Antunes
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto-USP, Av. do Café s/n, 14040-903, Ribeirão Preto, SP, Brazil
| | - Fernando Barbosa
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto-USP, Av. do Café s/n, 14040-903, Ribeirão Preto, SP, Brazil
| | - Glenda C Gobe
- Centre for Kidney Disease Research, School of Medicine, The University of Queensland at Princess Alexandra Hospital, Brisbane, QLD, 4102, Australia
| | - Antonio Cardozo dos Santos
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto-USP, Av. do Café s/n, 14040-903, Ribeirão Preto, SP, Brazil.
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20
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Correlations of the changes in bioptic findings with echocardiographic, clinical and laboratory parameters in patients with inflammatory cardiomyopathy. Heart Vessels 2014; 31:416-26. [PMID: 25539624 DOI: 10.1007/s00380-014-0618-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 12/12/2014] [Indexed: 01/06/2023]
Abstract
Patients with myocarditis and left ventricular (LV) dysfunction may improve after standard heart failure therapy. This improvement seems to be related to retreat of myocardial inflammation. The aim of the present study was to assess changes in clinical, echocardiographic and some laboratory parameters and to correlate them with changes in the number of inflammatory infiltrating cells in endomyocardial biopsy (EMB) samples during the 6-month follow-up, and to define predictors of LV function improvement among baseline parameters. Forty patients with biopsy-proven myocarditis and impaired LV function (LV ejection fraction-LVEF <40 %) with heart failure symptoms ≤ 6 months were evaluated. Myocarditis was defined as the presence of >14 mononuclear leukocytes/mm(2) and/or >7 T-lymphocytes/mm(2) in the baseline EMB. The EMB, echocardiography and clinical evaluation were repeated after 6 months of standard heart failure therapy. LVEF improved on average from 25 ± 9 to 42 ± 12 % (p < 0.001); LV end-systolic volume and LV end-diastolic volume (LVEDV) decreased from 158 ± 61 to 111 ± 58 ml and from 211 ± 69 to 178 ± 63 ml (both p < 0.001). NYHA class decreased from 2.6 ± 0.5 to 1.6 ± 0.6 (p < 0.001) and NTproBNP from 2892 ± 3227 to 851 ± 1835 µg/ml (p < 0.001). A decrease in the number of infiltrating leukocytes (CD45+/LCA+) from 23 ± 15 to 13 ± 8 cells/mm(2) and in the number of infiltrating T lymphocytes (CD3+) from 7 ± 5 to 4 ± 3 cells/mm(2) (both p < 0.001) was observed. The decline in the number of infiltrating CD45+ cells significantly correlated with the change in LVEF (R = -0.43; p = 0.006), LVEDV (R = 0.39; p = 0.012), NYHA classification (R = 0.35; p = 0.025), and NTproBNP (R = 0.33; p = 0.045). The decrease in the number of CD3+ cells correlated with the change of systolic and diastolic diameters of the left ventricle (R = -0.33; p = 0.038 and R = -0.45; p = 0.003) and with the change in LVEDV (R = -0.43; p = 0.006). Tricuspid annular plane systolic excursion (TAPSE) (OR 0.61; p = 0.005) and early transmitral diastolic flow velocity (E wave) (OR 0.89; p = 0.002) were identified as predictors of LVEF improvement. Improvements in clinical status, LV function and NTproBNP levels correlated with decrease in the number of infiltrating inflammatory cells. TAPSE and E wave velocity were significant predictors of improvement in multivariate regression. Our observations suggest that contemporary guidelines-based therapy of heart failure is an effective treatment option in patients with recent onset biopsy-proven inflammatory cardiomyopathy.
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21
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Wang D, Chen Y, Jiang J, Zhou A, Pan L, Chen Q, Qian Y, Chu M, Chen C. Carvedilol has stronger anti-inflammation and anti-virus effects than metoprolol in murine model with coxsackievirus B3-induced viral myocarditis. Gene 2014; 547:195-201. [PMID: 24905653 DOI: 10.1016/j.gene.2014.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 05/16/2014] [Accepted: 06/02/2014] [Indexed: 12/26/2022]
Abstract
AIMS This study aims to compare the effects of carvedilol and metoprolol in alleviating viral myocarditis (VMC) induced by coxsackievirus B3 (CVB3) in mice. METHODS A total of 116 Balb/c mice were included in this study. Ninety-six mice were inoculated intraperitoneally with CVB3 to induce VMC. The CVB3 inoculated mice were evenly divided into myocarditis group (n=32), carvedilol group (n=32) and metoprolol group (n=32). Twenty mice (control group) were inoculated intraperitoneally with normal saline. Hematoxylin and eosin staining and histopathologic scoring were used to investigate the effects of carvedilol and metoprolol on myocardial histopathologic changes on days 3 and 5. In addition, serum cTn-I levels, cytokine levels and virus titers were determined using chemiluminescence immunoassay, enzyme-linked immunosorbent assay and plaque assay, respectively, on days 3 and 5. Finally, the levels of phosphorylated p38MAPK were studied using immunohistochemical staining and Western blotting on day 5. RESULTS Carvedilol had a stronger effect than metoprolol in reducing the pathological scores of VMC induced by CVB3. Both carvedilol and metoprolol reduced the levels of cTn-I, but the effect of carvedilol was stronger. Carvedilol and metoprolol decreased the levels of myocardial pro-inflammatory cytokines and increased the expression of anti-inflammatory cytokine, with the effects of carvedilol being stronger than those of metoprolol. Carvedilol had a stronger effect in reducing myocardial virus concentration compared with metoprolol. Carvedilol was stronger than metoprolol in decreasing the levels of myocardial phosphorylated p38MAPK. CONCLUSIONS In conclusion, carvedilol was more potent than metoprolol in ameliorating myocardial lesions in VMC, probably due to its stronger modulation of the balance between pro- and anti-inflammatory cytokines by inhibiting the activation of p38MAPK pathway through β1- and β2-adrenoreceptors.
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Affiliation(s)
- Dan Wang
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, PR China; Department of Pediatrics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, PR China
| | - Yiming Chen
- Department of Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, PR China
| | - Jianbin Jiang
- Department of Pediatrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, PR China
| | - Aihua Zhou
- Department of Pediatrics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, PR China
| | - Lulu Pan
- Department of Pediatrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, PR China
| | - Qi Chen
- Department of Pediatrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, PR China
| | - Yan Qian
- Department of Pediatrics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, PR China
| | - Maoping Chu
- Department of Pediatrics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, PR China.
| | - Chao Chen
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, PR China.
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Iyer RP, de Castro Brás LE, Jin YF, Lindsey ML. Translating Koch's postulates to identify matrix metalloproteinase roles in postmyocardial infarction remodeling: cardiac metalloproteinase actions (CarMA) postulates. Circ Res 2014; 114:860-71. [PMID: 24577966 DOI: 10.1161/circresaha.114.301673] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The first matrix metalloproteinase (MMP) was described in 1962; and since the 1990s, cardiovascular research has focused on understanding how MMPs regulate many aspects of cardiovascular pathology from atherosclerosis formation to myocardial infarction and stroke. Although much information has been gleaned by these past reports, to a large degree MMP cardiovascular biology remains observational, with few studies homing in on cause and effect relationships. Koch's postulates were first developed in the 19th century as a way to establish microorganism function and were modified in the 20th century to include methods to establish molecular causality. In this review, we outline the concept for establishing a similar approach to determine causality in terms of MMP functions. We use left ventricular remodeling postmyocardial infarction as an example, but this approach will have broad applicability across both the cardiovascular and the MMP fields.
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Affiliation(s)
- Rugmani Padmanabhan Iyer
- From the San Antonio Cardiovascular Proteomics Center and Mississippi Center for Heart Research (R.P.I., L.E.d.C.B., Y.-F.J., M.L.L.) and Department of Biophysics and Physiology (R.P.I., L.E.d.C.B., M.L.L.), University of Mississippi Medical Center, Jackson; Department of Electrical and Computer Engineering, University of Texas at San Antonio (Y.-F.J.); and Research Service, G.V. (Sonny) Department of Physiology and Biophysics, Montgomery Veterans Affairs Medical Center, Jackson, MS (M.L.L.)
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Yabluchanskiy A, Ma Y, Iyer RP, Hall ME, Lindsey ML. Matrix metalloproteinase-9: Many shades of function in cardiovascular disease. Physiology (Bethesda) 2014; 28:391-403. [PMID: 24186934 DOI: 10.1152/physiol.00029.2013] [Citation(s) in RCA: 331] [Impact Index Per Article: 33.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Matrix metalloproteinase (MMP)-9, one of the most widely investigated MMPs, regulates pathological remodeling processes that involve inflammation and fibrosis in cardiovascular disease. MMP-9 directly degrades extracellular matrix (ECM) proteins and activates cytokines and chemokines to regulate tissue remodeling. MMP-9 deletion or inhibition has proven overall beneficial in multiple animal models of cardiovascular disease. As such, MMP-9 expression and activity is a common end point measured. MMP-9 cell-specific overexpression, however, has also proven beneficial and highlights the fact that little information is available on the underlying mechanisms of MMP-9 function. In this review, we summarize our current understanding of MMP-9 physiology, including structure, regulation, activation, and downstream effects of increased MMP-9. We discuss MMP-9 roles during inflammation and fibrosis in cardiovascular disease. By concentrating on the substrates of MMP-9 and their roles in cardiovascular disease, we explore the overall function and discuss future directions on the translational potential of MMP-9 based therapies.
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24
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Riad A, Bien S, Gratz M, Escher F, Heimesaat MM, Bereswill S, Krieg T, Felix SB, Schultheiss HP, Kroemer HK, Tschöpe C. Toll-like receptor-4 deficiency attenuates doxorubicin-induced cardiomyopathy in mice. Eur J Heart Fail 2014; 10:233-43. [DOI: 10.1016/j.ejheart.2008.01.004] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2007] [Revised: 11/19/2007] [Accepted: 01/07/2008] [Indexed: 11/29/2022] Open
Affiliation(s)
- Alexander Riad
- Department of Cardiology and Pneumology; Charité - Universitätsmedizin Berlin, Germany, Campus Benjamin Franklin; Hindenburgdamm 30 12200 Berlin Germany
| | - Sandra Bien
- Department of Pharmacology; University of Greifswald; Germany
| | - Matthias Gratz
- Department of Pharmacology; University of Greifswald; Germany
| | - Felicitas Escher
- Department of Cardiology and Pneumology; Charité - Universitätsmedizin Berlin, Germany, Campus Benjamin Franklin; Hindenburgdamm 30 12200 Berlin Germany
| | - Markus M. Heimesaat
- Department of Microbiology; Charité - Universitätsmedizin Berlin, Germany, Campus Benjamin Franklin; Hindenburgdamm 30 12200 Berlin Germany
| | - Stefan Bereswill
- Department of Microbiology; Charité - Universitätsmedizin Berlin, Germany, Campus Benjamin Franklin; Hindenburgdamm 30 12200 Berlin Germany
| | - Thomas Krieg
- Department of Cardiology; University of Greifswald; Germany
| | | | - Heinz P. Schultheiss
- Department of Cardiology and Pneumology; Charité - Universitätsmedizin Berlin, Germany, Campus Benjamin Franklin; Hindenburgdamm 30 12200 Berlin Germany
| | - Heyo K. Kroemer
- Department of Pharmacology; University of Greifswald; Germany
| | - Carsten Tschöpe
- Department of Cardiology and Pneumology; Charité - Universitätsmedizin Berlin, Germany, Campus Benjamin Franklin; Hindenburgdamm 30 12200 Berlin Germany
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Roubille F, Tournoux F, Roubille C, Merlet N, Davy JM, Rhéaume E, Busseuil D, Tardif JC. Management of pericarditis and myocarditis: could heart-rate-reducing drugs hold a promise? Arch Cardiovasc Dis 2013; 106:672-9. [PMID: 24070595 DOI: 10.1016/j.acvd.2013.06.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 06/18/2013] [Accepted: 06/20/2013] [Indexed: 12/22/2022]
Abstract
Rest is usually recommended in acute pericarditis and acute myocarditis. Given that myocarditis often leads to hospitalization, this task seems easy to carry out in hospital practice; however, it could be a real challenge at home in daily life. Heart rate-lowering treatments (mainly beta-blockers) are usually recommended in case of acute myocarditis, especially in case of heart failure or arrhythmias, but level of proof remains weak. Calcium channel inhibitors and digoxin are sometimes proposed, albeit in limited situations. It is possible that rest or even heart rate-lowering treatments could help to manage these patients by preventing heart failure as well as by limiting "mechanical inflammation" and controlling arrhythmias, especially life-threatening ones. Whether heart rate has an effect on inflammation remains unclear. Several questions remain unsolved, such as the duration of such treatments, especially in light of new heart rate-lowering treatments, such as ivabradine. In this review, we discuss rest and heart-rate lowering medications for the treatment of pericarditis and myocarditis. We also highlight some work in experimental models that indicates the beneficial effects of such treatments for these conditions. Finally, we suggest certain experimental avenues, through the use of animal models and clinical studies, which could lead to improved management of these patients.
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Affiliation(s)
- François Roubille
- Montreal Heart Institute, Université de Montréal, Montreal, Canada; Cardiology Department, University Hospital of Montpellier, Montpellier, France.
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26
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Kadoglou NPE, Moustardas P, Kapelouzou A, Katsimpoulas M, Giagini A, Dede E, Kostomitsopoulos N, Karayannacos PE, Kostakis A, Liapis CD. The anti-inflammatory effects of exercise training promote atherosclerotic plaque stabilization in apolipoprotein E knockout mice with diabetic atherosclerosis. Eur J Histochem 2013; 57:e3. [PMID: 23549462 PMCID: PMC3683610 DOI: 10.4081/ejh.2013.e3] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Revised: 10/12/2012] [Accepted: 07/27/2012] [Indexed: 01/30/2023] Open
Abstract
Physical exercise is the cornerstone of cardiovascular disease treatment. The present study investigated whether exercise training affects atherosclerotic plaque composition through the modification of inflammatoryrelated pathways in apolipoprotein E knockout (apoE−/−) mice with diabetic atherosclerosis. Forty-five male apoE−/− mice were randomized into three equivalent (n=15) groups: control (CO), sedentary (SED), and exercise (EX). Diabetes was induced by streptozotocin administration. High-fat diet was administered to all groups for 12 weeks. Afterwards, CO mice were euthanatized, while the sedentary and exercise groups continued high-fat diet for 6 additional weeks. Exercising mice followed an exercise program on motorizedtreadmill (5 times/week, 60 min/session). Then, blood samples and atherosclerotic plaques in the aortic root were examined. A considerable (P<0.001) regression of the atherosclerotic lesions was observed in the exercise group (180.339±75.613×103µm2) compared to the control (325.485±72.302×103 µm2) and sedentary (340.188±159.108×103µm2) groups. We found decreased macrophages, matrix metalloproteinase-2 (MMP-2), MMP-3, MMP-8 and interleukin-6 (IL-6) concentrations (P<0.05) in the atherosclerotic plaques of the exercise group. Compared to both control and sedentary groups, exercise training significantly increased collagen (P<0.05), elastin (P<0.001), and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2) (P<0.001) content in the atherosclerotic plaques. Those effects paralleled with increased fibrous cap thickness and less internal elastic lamina ruptures after exercise training (P<0.05), while body-weight and lipid parameters did not significantly change. Plasma MMP-2 and MMP-3 concentrations in atherosclerotic tissues followed a similar trend. From our study we can conclude that exercise training reduces and stabilizes atherosclerotic lesions in apoE−/− mice with diabetic atherosclerosis. A favorable modification of the inflammatory regulators seems to explain those beneficial effects.
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Affiliation(s)
- N P E Kadoglou
- Biomedical Research Foundation, Academy of Athens, Athens, Greece.
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27
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Rietz A, Spiers J. The relationship between the MMP system, adrenoceptors and phosphoprotein phosphatases. Br J Pharmacol 2012; 166:1225-43. [PMID: 22364165 DOI: 10.1111/j.1476-5381.2012.01917.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The MMPs and their inhibitors [tissue inhibitor of MMPs (TIMPs)] form the mainstay of extracellular matrix homeostasis. They are expressed in response to numerous stimuli including cytokines and GPCR activation. This review highlights the importance of adrenoceptors and phosphoprotein phosphatases (PPP) in regulating MMPs in the cardiovascular system, which may help explain some of the beneficial effects of targeting the adrenoceptor system in tissue remodelling and will establish emerging crosstalk between these three systems. Although α- and β-adrenoceptor activation increases MMP but decreases TIMP expression, MMPs are implicated in the growth stimulatory effects of adrenoceptor activation through transactivation of epidermal growth factor receptor. Furthermore, they have recently been found to catalyse the proteolysis of β-adrenoceptors and modulate vascular tone. While the mechanisms underpinning these effects are not well defined, reversible protein phosphorylation by kinases and phosphatases may be key. In particular, PPP (Ser/Thr phosphatases) are not only critical in resensitization and internalization of adrenoceptors but also modulate MMP expression. The interrelationship is complex as isoprenaline (ISO) inhibits okadaic acid [phosphoprotein phosphatase type 1/phosphoprotein phosphatase type 2A (PP2A) inhibitor]-mediated MMP expression. While this may be simply due to its ability to transiently increase PP2A activity, there is evidence for MMP-9 that ISO prevents okadaic acid-mediated expression of MMP-9 through a β-arrestin, NF-κB-dependent pathway, which is abolished by knock-down of PP2A. It is essential that crosstalk between MMPs, adrenoceptors and PPP are investigated further as it will provide important insight into how adrenoceptors modulate cardiovascular remodelling, and may identify new targets for pharmacological manipulation of the MMP system.
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Affiliation(s)
- A Rietz
- Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin, Ireland
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28
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Mesenchymal stromal cells but not cardiac fibroblasts exert beneficial systemic immunomodulatory effects in experimental myocarditis. PLoS One 2012; 7:e41047. [PMID: 22815907 PMCID: PMC3398879 DOI: 10.1371/journal.pone.0041047] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 06/21/2012] [Indexed: 12/17/2022] Open
Abstract
Systemic application of mesenchymal stromal cells (MSCs) in inflammatory cardiomyopathy exerts cardiobeneficial effects. The mode of action is unclear since a sufficient and long-acting cardiac homing of MSCs is unlikely. We therefore investigated the regulation of the immune response in coxsackievirus B3 (CVB3)-induced acute myocarditis after intravenous application of MSCs. Wildtype mice were infected with CVB3 and treated with either PBS, human MSCs or human cardiac fibroblasts intravenously 1 day after infection. Seven days after infection, MSCs could be detected in the spleen, heart, pancreas, liver, lung and kidney, whereby the highest presence was observed in the lung. MSCs increased significantly the myocardial expression of HGF and decreased the expression of the proinflammatory cytokines TNFα, IL1β and IL6 as well as the severity of myocarditis and ameliorated the left ventricular dysfunction measured by conductance catheter. MSCs upregulated the production of IFNγ in CD4+ and CD8+ cells, the number of IL10-producing regulatory T cells and the apoptosis rate of T cells in the spleen. An increased number of CD4+CD25+FoxP3 could be found in the spleen as well as in the circulation. In contrast, application of human cardiac fibroblasts had no effect on the severity of myocarditis and the systemic immune response observed after MSCs-administration. In conclusion, modulation of the immune response in extracardiac organs is associated with cardiobeneficial effects in experimental inflammatory cardiomyopathy after systemic application of MSCs.
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Yue-Chun L, Teng Z, Na-Dan Z, Li-Sha G, Qin L, Xue-Qiang G, Jia-Feng L. Comparison of effects of ivabradine versus carvedilol in murine model with the Coxsackievirus B3-induced viral myocarditis. PLoS One 2012; 7:e39394. [PMID: 22761780 PMCID: PMC3386276 DOI: 10.1371/journal.pone.0039394] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 05/19/2012] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Elevated heart rate is associated with increased cardiovascular morbidity. The selective I(f) current inhibitor ivabradine reduces heart rate without affecting cardiac contractility, and has been shown to be cardioprotective in the failing heart. Ivabradine also exerts some of its beneficial effects by decreasing cardiac proinflammatory cytokines and inhibiting peroxidants and collagen accumulation in atherosclerosis or congestive heart failure. However, the effects of ivabradine in the setting of acute viral myocarditis and on the cytokines, oxidative stress and cardiomyocyte apoptosis have not been investigated. METHODOLOGY/PRINCIPAL FINDINGS The study was designed to compare the effects of ivabradine and carvedilol in acute viral myocarditis. In a coxsackievirus B3 murine myocarditis model (Balb/c), effects of ivabradine and carvedilol (a nonselective β-adrenoceptor antagonist) on myocardial histopathological changes, cardiac function, plasma noradrenaline, cytokine levels, cardiomyocyte apoptosis, malondialdehyde and superoxide dismutase contents were studied. Both ivabradine and carvedilol similarly and significantly reduced heart rate, attenuated myocardial lesions and improved the impairment of left ventricular function. In addition, ivabradine treatment as well as carvedilol treatment showed significant effects on altered myocardial cytokines with a decrease in the amount of plasma noradrenaline. The increased myocardial MCP-1, IL-6, and TNF-α. in the infected mice was significantly attenuated in the ivabradine treatment group. Only carvedilol had significant anti-oxidative and anti-apoptoic effects in coxsackievirus B3-infected mice. CONCLUSIONS/SIGNIFICANCE These results show that the protective effects of heart rate reduction with ivabradine and carvedilol observed in the acute phase of coxsackievirus B3 murine myocarditis may be due not only to the heart rate reduction itself but also to the downregulation of inflammatory cytokines.
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Affiliation(s)
- Li Yue-Chun
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Zhang Teng
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Zhou Na-Dan
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Ge Li-Sha
- Department of Pediatrics, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Luo Qin
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Guan Xue-Qiang
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Lin Jia-Feng
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
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Carvalho Rodrigues MA, Gobe G, Santos NAG, Santos AC. Carvedilol protects against apoptotic cell death induced by cisplatin in renal tubular epithelial cells. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2012; 75:981-990. [PMID: 22852848 DOI: 10.1080/15287394.2012.696512] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Cisplatin is a highly effective chemotherapeutic drug; however, its use is limited by nephrotoxicity. Studies showed that the renal injury produced by cisplatin involves oxidative stress and cell death mediated by apoptosis and necrosis in proximal tubular cells. The use of antioxidants to decrease cisplatin-induced renal cell death was suggested as a potential therapeutic measure. In this study the possible protective effects of carvedilol, a beta blocker with antioxidant activity, was examined against cisplatin-induced apoptosis in HK-2 human kidney proximal tubular cells. The mitochondrial events involved in this protection were also investigated. Four groups were used: controls (C), cisplatin alone at 25 μM (CIS), cisplatin 25 μM plus carvedilol 50 μM (CV + CIS), and carvedilol alone 50 μM (CV). Cell viability, apoptosis, caspase-9, and caspase-3 were determined. Data demonstrated that carvedilol effectively increased cell viability and minimized caspase activation and apoptosis in HK-2 cells, indicating this may be a promising drug to reduce nephrotoxicity induced by cisplatin.
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Affiliation(s)
- M A Carvalho Rodrigues
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto-USP, Ribeirão Preto, SP, Brasil
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31
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Gaebel R, Ma N, Liu J, Guan J, Koch L, Klopsch C, Gruene M, Toelk A, Wang W, Mark P, Wang F, Chichkov B, Li W, Steinhoff G. Patterning human stem cells and endothelial cells with laser printing for cardiac regeneration. Biomaterials 2011; 32:9218-30. [PMID: 21911255 DOI: 10.1016/j.biomaterials.2011.08.071] [Citation(s) in RCA: 203] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 08/23/2011] [Indexed: 12/14/2022]
Abstract
Recent study showed that mesenchymal stem cells (MSC) could inhibit apoptosis of endothelial cells in hypoxic condition, increase their survival, and stimulate the angiogenesis process. In this project we applied Laser-Induced-Forward-Transfer (LIFT) cell printing technique and prepared a cardiac patch seeded with human umbilical vein endothelial cells (HUVEC) and human MSC (hMSC) in a defined pattern for cardiac regeneration. We seeded HUVEC and hMSC in a defined pattern on a Polyester urethane urea (PEUU) cardiac patch. On control patches an equal amount of cells was randomly seeded without LIFT. Patches were cultivated in vitro or transplanted in vivo to the infarcted zone of rat hearts after LAD-ligation. Cardiac performance was measured by left ventricular catheterization 8 weeks post infarction. Thereafter hearts were perfused with fluorescein tomato lectin for the assessment of functional blood vessels and stored for histology analyses. We demonstrated that LIFT-derived cell seeding pattern definitely modified growth characteristics of co-cultured HUVEC and hMSC leading to increased vessel formation and found significant functional improvement of infarcted hearts following transplantation of a LIFT-tissue engineered cardiac patch. Further, we could show enhanced capillary density and integration of human cells into the functionally connected vessels of murine vascular system. LIFT-based Tissue Engineering of cardiac patches for the treatment of myocardial infarction might improve wound healing and functional preservation.
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Affiliation(s)
- Ralf Gaebel
- Reference- and Translation Center for Cardiac Stem Cell Therapy, Department of Cardiac Surgery, University of Rostock, 18057 Rostock, Germany
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32
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Polyakova V, Loeffler I, Hein S, Miyagawa S, Piotrowska I, Dammer S, Risteli J, Schaper J, Kostin S. Fibrosis in endstage human heart failure: severe changes in collagen metabolism and MMP/TIMP profiles. Int J Cardiol 2011; 151:18-33. [PMID: 20546954 DOI: 10.1016/j.ijcard.2010.04.053] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2009] [Revised: 03/01/2010] [Accepted: 04/17/2010] [Indexed: 11/22/2022]
Abstract
OBJECTIVES We studied fibrosis, collagen metabolism, MMPs/TIMPs and cytokine expression in various forms of human heart failure (HF) by quantitative immunofluorescent microscopy, Western blot, zymography, RT-PCR and in situ hybridization. In explanted human hearts with HF due to either dilated (DCM, n=6) or ischemic (ICM-BZ-borderzone, ICM-RZ-remote zone, n=7) or inflammatory (myocarditis, MYO, n=6) cardiomyopathy and 8 controls MMP2, 8, 9, 19, and TIMP1, 2, 3, 4 as well as procollagens I and III (PINP, PIIINP), mature collagen III (IIINTP) and the cross-linked collagen I degradation product (ICTP) were measured. RESULTS In comparison with controls, MMPs and TIMPs were significantly upregulated ranging (from highest to lowest) from ICM-BZ, DCM, ICM-RZ, MYO for all MMPs with the exception of MMP9 (highest in DCM), and for TIMPs from ICM-BZ, ICM-RZ, DCM and MYO. MMP2 and 9 were activated in all groups. The TIMP/MMP ratio was 1.3 for control, 1.9 in ICM-BZ (TIMP>MMP) and lowered to 1.0 in the other groups. Collagen I/collagen III ratio correlated significantly with the decrease in LVEDP. PINP was higher than ICTP in all groups. PIIINP elevation was present in DCM and ICM-RZ and IIINTP was up to 4-fold augmented in all groups. Fibrosin mRNA was upregulated in ICM-BZ, activin A in MYO but FGF1 and FGF2 remained unchanged. ANP mRNA was increased in all groups. CONCLUSIONS Although different degrees of severity of collagen metabolism, MMP/TIMP imbalance and cytokine expression in diverse forms of HF are present, the end product is collagen deposition. These findings suggest multiple mechanisms acting alone or in concert in fibrosis development in HF.
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Affiliation(s)
- Victoria Polyakova
- Core Lab for Molecular and Cellular Biology, Max-Planck-Institute for Heart and Lung Research, Bad Nauheim, Germany
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33
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Interactions between the extracellular matrix and inflammation during viral myocarditis. Immunobiology 2011; 217:503-10. [PMID: 21907443 DOI: 10.1016/j.imbio.2011.07.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 06/24/2011] [Accepted: 07/05/2011] [Indexed: 01/17/2023]
Abstract
Viral myocarditis is a life-threatening disease characterized by severe cardiac inflammation that can result in heart failure or sudden cardiac death in previously healthy adults. In a subset of patients, it may result in the development of dilated cardiomyopathy due to the chronic inflammatory process. Despite its clinical need, specific treatments for myocarditis are currently not available. The extracellular matrix (ECM) under normal conditions, functions to maintain the mechanical and structural integrity of the heart but can adapt under pathological circumstances to preserve cardiac function. Recent studies have revealed a crucial role of the ECM in the reparative process after cardiac insult, not only as a key component in cardiac remodeling but also as a regulator of the inflammatory process. Increasing our understanding of the impact the ECM has in the disease pathogenesis and progression of viral myocarditis, might lead to much needed therapeutic interventions. In this review we will describe the pathology of viral myocarditis and illustrate the interplay between inflammation and the ECM in general terms, and during viral myocarditis.
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Teixeira ARL, Hecht MM, Guimaro MC, Sousa AO, Nitz N. Pathogenesis of chagas' disease: parasite persistence and autoimmunity. Clin Microbiol Rev 2011; 24:592-630. [PMID: 21734249 PMCID: PMC3131057 DOI: 10.1128/cmr.00063-10] [Citation(s) in RCA: 147] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Acute Trypanosoma cruzi infections can be asymptomatic, but chronically infected individuals can die of Chagas' disease. The transfer of the parasite mitochondrial kinetoplast DNA (kDNA) minicircle to the genome of chagasic patients can explain the pathogenesis of the disease; in cases of Chagas' disease with evident cardiomyopathy, the kDNA minicircles integrate mainly into retrotransposons at several chromosomes, but the minicircles are also detected in coding regions of genes that regulate cell growth, differentiation, and immune responses. An accurate evaluation of the role played by the genotype alterations in the autoimmune rejection of self-tissues in Chagas' disease is achieved with the cross-kingdom chicken model system, which is refractory to T. cruzi infections. The inoculation of T. cruzi into embryonated eggs prior to incubation generates parasite-free chicks, which retain the kDNA minicircle sequence mainly in the macrochromosome coding genes. Crossbreeding transfers the kDNA mutations to the chicken progeny. The kDNA-mutated chickens develop severe cardiomyopathy in adult life and die of heart failure. The phenotyping of the lesions revealed that cytotoxic CD45, CD8(+) γδ, and CD8α(+) T lymphocytes carry out the rejection of the chicken heart. These results suggest that the inflammatory cardiomyopathy of Chagas' disease is a genetically driven autoimmune disease.
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Affiliation(s)
- Antonio R L Teixeira
- Chagas Disease Multidisciplinary Research Laboratory, University of Brasilia, Federal District, Brazil.
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The Role of Carvedilol in the Treatment of Dilated and Anthracyclines-Induced Cardiomyopathy. Pharmaceuticals (Basel) 2011. [PMCID: PMC4055878 DOI: 10.3390/ph4050770] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Although chronic sympathetic activation provides inotropic and chronotropic support to the failing heart, such activation may also have deleterious effects, including the direct cardiotoxic effects of catecholamines, activation of the renin-angiotensin-aldosterone system and an increase in myocardial oxygen demand. These observations indicate that β-blockade might be beneficial in the treatment of heart failure resulting from dilated cardiomyopathy or ischaemic heart disease. Carvedilol is a non-selective β-blocker acting on β1-, β2-, and α1-adrenoceptors. It possesses potent anti-oxidant and anti-apoptotic properties, along with neuroprotective, vasculoprotective, cardioprotective effects, and it has reduced overall mortality in patients with heart failure in controlled clinical trials. Its role in treating cardiomyopathy requires focus. The fact that anthracyclines are cardiotoxic seriously narrows their therapeutic index in cancer therapy. The cardiotoxic risk increases with the cumulative dose and may lead to congestive heart failure and dilated cardiomyopathy in adults and in children. This review focuses on recent research regarding the beneficial effects of carvedilol in the treatment of dilated cardiomyopathy and to revisit the available evidence on the cardioprotection of carvedilol when associated with anthracycline and to explain the mechanisms underlying the benefits of their co-administration.
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Glück B, Dahlke K, Zell R, Krumbholz A, Decker M, Lehmann J, Wutzler P. Cardioprotective effect of NO-metoprolol in murine coxsackievirus B3-induced myocarditis. J Med Virol 2011; 82:2043-52. [PMID: 20981792 DOI: 10.1002/jmv.21928] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The effect of NO-metoprolol, that is, 3-nitrooxypivaloyl metoprolol-amide, a novel NO-releasing derivative of the β1-blocking drug metoprolol was investigated in A.CA/SnJ mice infected with coxsackievirus B3 (CVB3) and compared to metoprolol and placebo. Daily treatment of mice with the respective drug started immediately (experiment A) or 3 days after virus infection (experiment B) and was continued until day 13 post-infection (p.i.). Two doses of NO-metoprolol were administered. Body mass differences, viral load, and histopathological signs of myocarditis were compared between the several groups. As a result, NO-metoprolol diminished significantly the body weight loss, the viral load and the histopathology, whereas metoprolol treatment led solely to a significant attenuation of myocardial damage. In experiment A, low dose NO-metoprolol decreased significantly enteroviral copy numbers. Both doses of NO-metoprolol had a significant effect on reduction of myocardial infiltrates and fibrosis. The data suggest that delayed drug administration might more advantageous. Both doses of NO-metoprolol reduced significantly the scores of four tested parameters compared to placebo. Body weight loss, virus titers, plus-strand as well as minus-strand enteroviral RNA levels, infiltration and fibrosis scores were diminished significantly when NO-metoprolol was given 3 days p.i. In addition, a significant difference regarding the enteroviral copy numbers was observed between low dose NO-metoprolol- and metoprolol-treated mice. Treatment with metoprolol reduced insignificantly the viral load and body weight loss (experiment A and B) but led to a significant reduction of myocardial histopathology in experiment A. The results indicate that NO-metoprolol treatment has a greater therapeutic benefit than metoprolol.
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Affiliation(s)
- Brigitte Glück
- Department of Virology and Antiviral Therapy, Jena University Hospital, Jena, Germany.
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Li YC, Ge LS, Yang PL, Tang JF, Lin JF, Chen P, Guan XQ. Carvedilol treatment ameliorates acute coxsackievirus B3-induced myocarditis associated with oxidative stress reduction. Eur J Pharmacol 2010; 640:112-6. [PMID: 20457150 DOI: 10.1016/j.ejphar.2010.04.037] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Revised: 04/04/2010] [Accepted: 04/24/2010] [Indexed: 01/02/2023]
Abstract
Oxidative stress has been implicated in the pathogenesis of acute myocarditis. The imbalance between the occurrence of reactive oxygen species and the cellular antioxidant defense mechanism plays a key role in myocardial injury of viral myocarditis. Carvedilol, a nonselective beta-adrenoceptor antagonist with additional alpha1-adrenergic blocking and antioxidant properties, has been shown to be cardioprotective in experimental myocarditis. However, the expression of 4-hydroxy-2-nonenal (4-HNE), the most reliable marker of lipid peroxidation, has not been studied, and the antioxidative effects of carvedilol have not been investigated in the setting of acute viral myocarditis. This study was therefore designed to determine whether levels of lipid peroxides are elevated in the myocardium and whether carvedilol reduces the lipid peroxidation level and increases antioxidant enzyme activities. In a coxsackievirus B3 murine myocarditis model (Balb/c), effects of carvedilol and metoprolol on 14-day survival rate, myocardial histopathological changes, cardiac function, the expression of 4-HNE, virus titers, malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidases (GSH-Px) activities were studied. Lipid peroxidations including 4-HNE and MDA, were elevated in murine coxsackievirus-induced acute viral myocarditis. Carvedilol, but not metoprolol, improved survival, reduced lipid peroxidations including 4-HNE and MDA, and increased antioxidant enzyme activities including SOD and GSH-Px with amelioration of acute viral myocarditis. These results show that carvedilol but not metoprolol exerts some of its beneficial effects by inhibiting peroxidants.
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Affiliation(s)
- Yue-Chun Li
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, China.
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Riad A, Westermann D, Escher F, Becher PM, Savvatis K, Lettau O, Heimesaat MM, Bereswill S, Volk HD, Schultheiss HP, Tschöpe C. Myeloid differentiation factor-88 contributes to TLR9-mediated modulation of acute coxsackievirus B3-induced myocarditis in vivo. Am J Physiol Heart Circ Physiol 2010; 298:H2024-31. [PMID: 20228254 DOI: 10.1152/ajpheart.01188.2009] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Toll-like receptor 9 (TLR9) is a member of the innate immune system and has been shown to influence myocardial function, but its role in myocarditis is hitherto unknown. We therefore investigated whether or not TLR9 plays a role in this disease in coxsackievirus B3 (CVB3)-induced myocarditis in mice. Left ventricular (LV) function, cardiac immune cell infiltration, virus mRNA, and components of the TLR9 downstream pathway were investigated in TLR9-deficient [knockout (KO)] and wild-type (WT) mice after infection with CVB3. Murine cardiac TLR9 expression was significantly increased in WT mice with acute CVB3 infection but not in WT mice with chronic myocarditis. Furthermore, in the acute phase of CVB3-induced myocarditis, CVB3-infected KO mice displayed improved LV function associated with reduced cardiac inflammation indexed by reduced amounts of immune cells compared with CVB3-infected WT mice. In contrast, in the chronic phase, LV function and inflammation were not seen to differ among the infected groups. The cardioprotective effects due to TLR9 deficiency were associated with suppression of the TLR9 downstream pathway as indexed by reduced cardiac levels of the adapter protein myeloid differentiation factor (MyD)-88 and the proinflammatory cytokine TNF-alpha. In addition, TLR9 deficiency led to an activation of the antiviral cytokine interferon-beta in the heart as a result from viral infection. In conclusion, the MyD88/TNF-alpha axis due to TLR9 activation in the heart contributes the development of acute myocarditis but not of chronic myocarditis.
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Affiliation(s)
- Alexander Riad
- Dept. of Cardiology, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, Berlin 12203, Germany.
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39
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Blyszczuk P, Kania G, Dieterle T, Marty RR, Valaperti A, Berthonneche C, Pedrazzini T, Berger CT, Dirnhofer S, Matter CM, Penninger JM, Lüscher TF, Eriksson U. Myeloid differentiation factor-88/interleukin-1 signaling controls cardiac fibrosis and heart failure progression in inflammatory dilated cardiomyopathy. Circ Res 2009; 105:912-20. [PMID: 19762681 DOI: 10.1161/circresaha.109.199802] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
RATIONALE The myeloid differentiation factor (MyD)88/interleukin (IL)-1 axis activates self-antigen-presenting cells and promotes autoreactive CD4(+) T-cell expansion in experimental autoimmune myocarditis, a mouse model of inflammatory heart disease. OBJECTIVE The aim of this study was to determine the role of MyD88 and IL-1 in the progression of acute myocarditis to an end-stage heart failure. METHODS AND RESULTS Using alpha-myosin heavy chain peptide (MyHC-alpha)-loaded, activated dendritic cells, we induced myocarditis in wild-type and MyD88(-/-) mice with similar distributions of heart-infiltrating cell subsets and comparable CD4(+) T-cell responses. Injection of complete Freund's adjuvant (CFA) or MyHC-alpha/CFA into diseased mice promoted cardiac fibrosis, induced ventricular dilation, and impaired heart function in wild-type but not in MyD88(-/-) mice. Experiments with chimeric mice confirmed the bone marrow origin of the fibroblasts replacing inflammatory infiltrates and showed that MyD88 and IL-1 receptor type I signaling on bone marrow-derived cells was critical for development of cardiac fibrosis during progression to heart failure. CONCLUSIONS Our findings indicate a critical role of MyD88/IL-1 signaling in the bone marrow compartment in postinflammatory cardiac fibrosis and heart failure and point to novel therapeutic strategies against inflammatory cardiomyopathy.
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40
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Shaw SM, Coppinger T, Waywell C, Dunne L, Archer LD, Critchley WR, Yonan N, Fildes JE, Williams SG. The Effect of Beta-Blockers on the Adaptive Immune System in Chronic Heart Failure. Cardiovasc Ther 2009; 27:181-6. [DOI: 10.1111/j.1755-5922.2009.00089.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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41
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Abstract
Matrix metalloproteinases (MMPs) are enzymes that digest the extracellular matrix and regulate the immune response by cleavage of chemokines and cytokines into products with altered activities. Matrix metalloproteinase expression in viral heart disease has been linked to the onset of myocarditis and the long-term sequelae associated with this illness. However, MMPs are also expressed as a functional part of the immune response, and it was recently shown that MMP-9 is a beneficial part of the antiviral immune response in viral myocarditis. In this review, we will attempt to reconcile the studies that claim MMPs inflict damage in viral myocarditis with those studies that report a protective role for MMPs in this cardiac disease.
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42
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43
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Ebermann L, Piper C, Kühl U, Klingel K, Schlattner U, Siafarikas N, Zeichhardt H, Schultheiss HP, Dörner A. Impact of myocardial inflammation on cytosolic and mitochondrial creatine kinase activity and expression. Basic Res Cardiol 2009; 104:247-57. [PMID: 19190956 DOI: 10.1007/s00395-008-0773-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2008] [Accepted: 12/05/2008] [Indexed: 11/26/2022]
Abstract
The disturbance of myocardial energy metabolism has been discussed as contributing to the progression of heart failure. Little however is known about the cardiac mitochondrial/cytosolic energy transfer in murine and human inflammatory heart disease. We examined the myocardial creatine kinase (CK) system, which connects mitochondrial ATP-producing and cytosolic ATP-consuming processes and is thus of central importance to the cellular energy homeostasis. The time course of expression and enzymatic activity of mitochondrial (mtCK) and cytosolic CK (cytCK) was investigated in Coxsackievirus B3 (CVB3)-infected SWR mice, which are susceptible to the development of chronic myocarditis. In addition, cytCK activity and isoform expression were analyzed in biopsies from patients with chronic inflammatory heart disease (n = 22). Cardiac CVB3 titer in CVB3-infected mice reached its maximum at 4 days post-infection (pi) and became undetectable at 28 days pi; cardiac inflammation cumulated 14 days pi but persisted through the 28-day survey. MtCK enzymatic activity was reduced by 40% without a concurrent decrease in mtCK protein during early and acute MC. Impaired mtCK activity was correlated with virus replication and increased level of interleukine 1beta (IL-1beta), tumor necrosis factor alpha (TNFalpha), and elevated catalase expression, a marker for intracellular oxidative stress. A reduction in cytCK activity of 48% was observed at day 14 pi and persisted to day 28 pi. This restriction was caused by a decrease in cytCK subunit expression but also by direct inhibition of specific cytCK activity. CytCK activity and expression were also reduced in myocardial biopsies from enterovirus genome-negative patients with inflammatory heart disease. The decrease in cytCK activity correlated with the number of infiltrating macrophages. Thus, viral infection and myocardial inflammation significantly influence the myocardial CK system via restriction of specific CK activity and down-regulation of cytCK protein. These changes may contribute to the progression of chronic inflammatory heart disease and malfunction of the heart.
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Affiliation(s)
- Linda Ebermann
- Centrum 11, Cardiology, Charité, University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
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44
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Halapas A, Pissimissis N, Lembessis P, Rizos I, Rigopoulos AG, Kremastinos DT, Koutsilieris M. Molecular diagnosis of the viral component in cardiomyopathies: pathophysiological, clinical and therapeutic implications. Expert Opin Ther Targets 2008; 12:821-36. [PMID: 18554151 DOI: 10.1517/14728222.12.7.821] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Myocarditis is defined as the inflammation of myocardium associated with cardiac dysfunction. Despite this clear-cut definition, diagnosis and etiologic treatment continue to create considerable debate. Viral infections are frequent causes of myocarditis and there is evidence that persistent viral infection is associated with poor prognosis in different subtypes of cardiomyopathy. OBJECTIVE To review methods for diagnosis of viral myocarditis and present the use of polymerase chain reaction (PCR)-based protocols for evaluating viral infection in myocarditis/cardiomyopathies. METHODS A review of published literature. RESULTS/CONCLUSION There is increasing evidence that PCR-based protocols can provide reliable molecular evidence for the presence of viral infection in myocardium. Thus application of molecular techniques will allow collection and analysis of more information on the epidemiology of viral cardiomyopathies, patient risk stratification and appropriate medical treatment.
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Affiliation(s)
- A Halapas
- University of Athens, Department of Experimental Physiology, Medical School, 75 Micras Asias, Goudi-Athens, 115 27, Greece
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45
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Chung AWY, Yang HHC, Radomski MW, van Breemen C. Long-term doxycycline is more effective than atenolol to prevent thoracic aortic aneurysm in marfan syndrome through the inhibition of matrix metalloproteinase-2 and -9. Circ Res 2008; 102:e73-85. [PMID: 18388324 DOI: 10.1161/circresaha.108.174367] [Citation(s) in RCA: 157] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Beta-blockers, eg, atenolol, are the cornerstone therapy for thoracic aortic aneurysm (TAA) in patients with Marfan syndrome; however, continued aortic dilatation has been reported. We have demonstrated that matrix metalloproteinase (MMP)-2 and -9 were upregulated during progression of TAA in Marfan syndrome, accompanied with degenerated elastic fibers and vasomotor dysfunction. We hypothesized that doxycycline, a nonspecific inhibitor of MMPs, would ameliorate TAA by attenuating elastic fiber degeneration and improving vasomotor function. A well-characterized mouse model of Marfan syndrome (Fbn1(C1039G/+)) was used. Mice were untreated (n=40), given doxycycline (0.24 g/L, n=30), or given atenolol (0.5 g/L, n=30) in drinking water at 6 weeks of age. The Fbn1(+/+) mice served as control (n=40). At 3, 6, and 9 months, aortic segments from the ascending, arch, and descending portions were used to obtain the "average" value of the whole thoracic aorta. TAA was prevented in the doxycycline group, whereas mild aneurysm was evident in the atenolol group. Doxycycline improved elastic fiber integrity, normalized aortic stiffness, and prevented vessel weakening. The impairment of vasocontraction and endothelium-dependent relaxation in the untreated and atenolol groups were improved by doxycycline. The upregulation of transforming growth factor-beta in the Marfan aorta was suppressed by doxycycline. Doxycycline augmented expression ratios of tissue inhibitors of MMP to MMPs. Intraperitoneally injected neutralizing antibodies against MMP-2 and -9 yielded similar effects to doxycycline. We concluded that long-term treatment with doxycycline, through the inhibition of MMP-2 and -9, is more effective than atenolol in preventing TAA in Marfan syndrome by preserving elastic fiber integrity, normalizing vasomotor function, and reducing transforming growth factor-beta activation.
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Affiliation(s)
- Ada W Y Chung
- Child and Family Research Institute, Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada.
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46
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Cheung C, Marchant D, Walker EKY, Luo Z, Zhang J, Yanagawa B, Rahmani M, Cox J, Overall C, Senior RM, Luo H, McManus BM. Ablation of Matrix Metalloproteinase-9 Increases Severity of Viral Myocarditis in Mice. Circulation 2008; 117:1574-82. [DOI: 10.1161/circulationaha.107.733238] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Coxsackievirus B3 (CVB3) causes human myocarditis, which can result in cardiac damage, maladaptive remodeling, and heart failure. Matrix metalloproteinases (MMP)-8 and -9 have been identified in virus-infected myocardium, but their particular roles and underlying mechanisms of effect are unknown. For the first time, we examine the severity of CVB3-induced myocarditis in MMP-8–and MMP-9–deficient mice.
Methods and Results—
CVB3-infected MMP-8 and MMP-9 knockout (KO) mice and corresponding wild-type (WT) mice were euthanized and harvested at 9 days after infection. Expression of MMP-2, -8, -12, and -13 and tissue inhibitors of MMPs was assessed by zymography or immunoblotting on harvested hearts, and in situ hybridization was performed to detect active infection. Infected MMP-9 KO mice had greater myocardial injury and foci of infection than WT mice despite similar pancreatic infection. Increased fibrosis (10.6±2.7% versus 7.1±2.6%,
P
=0.04), viral titer, as well as decreased cardiac output, were evident in MMP-9 KO compared with WT mice as assessed by picrosirius red staining, plaque assay, and echocardiography, respectively. Immune infiltration was also greatly increased in MMP-9 KO compared with WT mice (15.2±12.6% versus 2.0±3.0%,
P
<0.002). Myocardial interferon-β1, interferon-γ, interleukin-6, interleukin-10, and macrophage inflammatory protein-1α expression was elevated in MMP-9 KO mice as measured by quantitative real-time polymerase chain reaction and ELISA. In contrast, MMP-8 KO mice had the same degree of cardiac injury, fibrosis, and viral infection as their WT counterparts.
Conclusions—
During acute CVB3 infection, MMP-9 appears necessary to halt virus propagation in the heart, promote proper immune infiltration and remodeling, and preserve cardiac output.
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Affiliation(s)
- Caroline Cheung
- From the Department of Pathology and Laboratory Medicine (C.C., D.M., E.K.-Y.W., Z.L., J.Z., B.Y., M.R., H.L., B.M.M.), The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, St. Paul’s Hospital/Providence Health Care, and the Department of Oral Biological & Medical Sciences (J.C., C.O.), Centre for Blood Research, Life Sciences Centre, University of British Columbia, Vancouver, British Columbia, Canada; and the Division of Pulmonary and Critical Care Medicine (R.M.S.),
| | - David Marchant
- From the Department of Pathology and Laboratory Medicine (C.C., D.M., E.K.-Y.W., Z.L., J.Z., B.Y., M.R., H.L., B.M.M.), The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, St. Paul’s Hospital/Providence Health Care, and the Department of Oral Biological & Medical Sciences (J.C., C.O.), Centre for Blood Research, Life Sciences Centre, University of British Columbia, Vancouver, British Columbia, Canada; and the Division of Pulmonary and Critical Care Medicine (R.M.S.),
| | - Elizabeth K.-Y. Walker
- From the Department of Pathology and Laboratory Medicine (C.C., D.M., E.K.-Y.W., Z.L., J.Z., B.Y., M.R., H.L., B.M.M.), The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, St. Paul’s Hospital/Providence Health Care, and the Department of Oral Biological & Medical Sciences (J.C., C.O.), Centre for Blood Research, Life Sciences Centre, University of British Columbia, Vancouver, British Columbia, Canada; and the Division of Pulmonary and Critical Care Medicine (R.M.S.),
| | - Zongshu Luo
- From the Department of Pathology and Laboratory Medicine (C.C., D.M., E.K.-Y.W., Z.L., J.Z., B.Y., M.R., H.L., B.M.M.), The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, St. Paul’s Hospital/Providence Health Care, and the Department of Oral Biological & Medical Sciences (J.C., C.O.), Centre for Blood Research, Life Sciences Centre, University of British Columbia, Vancouver, British Columbia, Canada; and the Division of Pulmonary and Critical Care Medicine (R.M.S.),
| | - Jingchun Zhang
- From the Department of Pathology and Laboratory Medicine (C.C., D.M., E.K.-Y.W., Z.L., J.Z., B.Y., M.R., H.L., B.M.M.), The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, St. Paul’s Hospital/Providence Health Care, and the Department of Oral Biological & Medical Sciences (J.C., C.O.), Centre for Blood Research, Life Sciences Centre, University of British Columbia, Vancouver, British Columbia, Canada; and the Division of Pulmonary and Critical Care Medicine (R.M.S.),
| | - Bobby Yanagawa
- From the Department of Pathology and Laboratory Medicine (C.C., D.M., E.K.-Y.W., Z.L., J.Z., B.Y., M.R., H.L., B.M.M.), The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, St. Paul’s Hospital/Providence Health Care, and the Department of Oral Biological & Medical Sciences (J.C., C.O.), Centre for Blood Research, Life Sciences Centre, University of British Columbia, Vancouver, British Columbia, Canada; and the Division of Pulmonary and Critical Care Medicine (R.M.S.),
| | - Maziar Rahmani
- From the Department of Pathology and Laboratory Medicine (C.C., D.M., E.K.-Y.W., Z.L., J.Z., B.Y., M.R., H.L., B.M.M.), The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, St. Paul’s Hospital/Providence Health Care, and the Department of Oral Biological & Medical Sciences (J.C., C.O.), Centre for Blood Research, Life Sciences Centre, University of British Columbia, Vancouver, British Columbia, Canada; and the Division of Pulmonary and Critical Care Medicine (R.M.S.),
| | - Jennifer Cox
- From the Department of Pathology and Laboratory Medicine (C.C., D.M., E.K.-Y.W., Z.L., J.Z., B.Y., M.R., H.L., B.M.M.), The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, St. Paul’s Hospital/Providence Health Care, and the Department of Oral Biological & Medical Sciences (J.C., C.O.), Centre for Blood Research, Life Sciences Centre, University of British Columbia, Vancouver, British Columbia, Canada; and the Division of Pulmonary and Critical Care Medicine (R.M.S.),
| | - Christopher Overall
- From the Department of Pathology and Laboratory Medicine (C.C., D.M., E.K.-Y.W., Z.L., J.Z., B.Y., M.R., H.L., B.M.M.), The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, St. Paul’s Hospital/Providence Health Care, and the Department of Oral Biological & Medical Sciences (J.C., C.O.), Centre for Blood Research, Life Sciences Centre, University of British Columbia, Vancouver, British Columbia, Canada; and the Division of Pulmonary and Critical Care Medicine (R.M.S.),
| | - Robert M. Senior
- From the Department of Pathology and Laboratory Medicine (C.C., D.M., E.K.-Y.W., Z.L., J.Z., B.Y., M.R., H.L., B.M.M.), The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, St. Paul’s Hospital/Providence Health Care, and the Department of Oral Biological & Medical Sciences (J.C., C.O.), Centre for Blood Research, Life Sciences Centre, University of British Columbia, Vancouver, British Columbia, Canada; and the Division of Pulmonary and Critical Care Medicine (R.M.S.),
| | - Honglin Luo
- From the Department of Pathology and Laboratory Medicine (C.C., D.M., E.K.-Y.W., Z.L., J.Z., B.Y., M.R., H.L., B.M.M.), The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, St. Paul’s Hospital/Providence Health Care, and the Department of Oral Biological & Medical Sciences (J.C., C.O.), Centre for Blood Research, Life Sciences Centre, University of British Columbia, Vancouver, British Columbia, Canada; and the Division of Pulmonary and Critical Care Medicine (R.M.S.),
| | - Bruce M. McManus
- From the Department of Pathology and Laboratory Medicine (C.C., D.M., E.K.-Y.W., Z.L., J.Z., B.Y., M.R., H.L., B.M.M.), The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, St. Paul’s Hospital/Providence Health Care, and the Department of Oral Biological & Medical Sciences (J.C., C.O.), Centre for Blood Research, Life Sciences Centre, University of British Columbia, Vancouver, British Columbia, Canada; and the Division of Pulmonary and Critical Care Medicine (R.M.S.),
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Protective Effects of Carvedilol in Murine Model With the Coxsackievirus B3-Induced Viral Myocarditis. J Cardiovasc Pharmacol 2008; 51:92-8. [DOI: 10.1097/fjc.0b013e31815c6624] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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48
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Abstract
Myocarditis represents a heterogeneous final common pathway for myocardial inflammation of diverse etiologies and accounts for up to one-third of cases of dilated cardiomyopathy. The pathophysiology of viral myocarditis can be disaggregated into the effects of direct viral mediated injury, triggered acute and chronic autoimmune responses, and subsequent adverse remodeling. Recent research highlights the pathogenic role of persistent viral genome expression, Fas-ligand, tumor necrosis factor-alpha receptor 1, and antimyosin autoantibodies in the evolution of chronic systolic and diastolic heart failure. Recent refinements in endomyocardial biopsy evaluation, cardiac magnetic resonance imaging, and cytokine assays augment existing diagnostic modalities. Novel specific immunosuppressive targets aimed at interrupting myocyte injury and apoptosis, including interferon-beta seem promising to date in small clinical studies performed on selected patients.
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Affiliation(s)
- Christopher R Ellis
- From the Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, Tennessee 37232-8802, USA
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49
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Abstract
Peripartum cardiomyopathy (PPCM) is a disorder in which initial left ventricular systolic dysfunction and symptoms of heart failure occur between the late stages of pregnancy and the early postpartum period. It is common in some countries and rare in others. The causes and pathogenesis are poorly understood. Molecular markers of an inflammatory process are found in most patients. Clinical presentation includes usual signs and symptoms of heart failure, and unusual presentations relating to thromboembolism. Clinicians should consider PPCM in any peripartum patient with unexplained disease. Conventional heart failure treatment includes use of diuretics, beta blockers, and angiotensin-converting enzyme inhibitors. Effective treatment reduces mortality rates and increases the number of women who fully recover left ventricular systolic function. Outcomes for subsequent pregnancy after PPCM are better in women who have first fully recovered heart function. Areas for future research include immune system dysfunction, the role of viruses, non-conventional treatments such as immunosuppression, immunoadsorption, apheresis, antiviral treatment, suppression of proinflammatory cytokines, and strategies for control and prevention.
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Affiliation(s)
- Karen Sliwa
- Soweto Cardiovascular Research Unit, Department of Cardiology, Chris-Hani-Baragwanath Hospital, University of the Witwatersrand, P O Bertsham 2013, Johannesburg, South Africa.
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50
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Pauschinger M, Noutsias M, Lassner D, Schultheiss HP, Kuehl U. Inflammation, ECG changes and pericardial effusion: whom to biopsy in suspected myocarditis? Clin Res Cardiol 2006; 95:569-83. [PMID: 16897143 PMCID: PMC2780695 DOI: 10.1007/s00392-006-0427-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2006] [Accepted: 06/27/2006] [Indexed: 02/01/2023]
Abstract
The role of endomyocardial biopsies in patients with clinically suspected acute myocarditis, myocarditis in the past, and dilated cardiomyopathy is discussed controversially. In fact, it is still under discussion whether information obtained from endomyocardial biopsies is relevant for further clinical decisions. Therefore this Critical Perspective will deal with the question, which patient should undergo endomyocardial biopsy investigations for an etiopathogenic differentiation of the disease and for the possible choice of immunomodulatory treatment strategies.
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Affiliation(s)
- M Pauschinger
- Medizinische Klinik II, Department of Cardiology and Pneumonology, Charité - Universitätsmedizin Berlin Campus Benjamin Franklin, 12200, Berlin, Germany.
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