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Rothman A, Mann D, Nunez JA, Tarmidi R, Restrepo H, Sarukhanov V, Williams R, Evans WN. A Bioinformatic Algorithm based on Pulmonary Endoarterial Biopsy for Targeted Pulmonary Arterial Hypertension Therapy. Open Respir Med J 2023; 17:e187430642308160. [PMID: 38655076 PMCID: PMC11037516 DOI: 10.2174/18743064-v17-230927-2023-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 04/26/2024] Open
Abstract
Background Optimal pharmacological therapy for pulmonary arterial hypertension (PAH) remains unclear, as pathophysiological heterogeneity may affect therapeutic outcomes. A ranking methodology based on pulmonary vascular genetic expression analysis could assist in medication selection and potentially lead to improved prognosis. Objective To describe a bioinformatics approach for ranking currently approved pulmonary arterial antihypertensive agents based on gene expression data derived from percutaneous endoarterial biopsies in an animal model of pulmonary hypertension. Methods We created a chronic PAH model in Micro Yucatan female swine by surgical anastomosis of the left pulmonary artery to the descending aorta. A baseline catheterization, angiography and pulmonary endoarterial biopsy were performed. We obtained pulmonary vascular biopsy samples by passing a biopsy catheter through a long 8 French sheath, introduced via the carotid artery, into 2- to 3-mm peripheral pulmonary arteries. Serial procedures were performed on days 7, 21, 60, and 180 after surgical anastomosis. RNA microarray studies were performed on the biopsy samples. Results Utilizing the medical literature, we developed a list of PAH therapeutic agents, along with a tabulation of genes affected by these agents. The effect on gene expression from pharmacogenomic interactions was used to rank PAH medications at each time point. The ranking process allowed the identification of a theoretical optimum three-medication regimen. Conclusion We describe a new potential paradigm in the therapy for PAH, which would include endoarterial biopsy, molecular analysis and tailored pharmacological therapy for patients with PAH.
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Affiliation(s)
- Abraham Rothman
- Children’s Heart Center Nevada, 3131 La Canada, Suite 230, Las Vegas, NV 89169, USA
- Department of Pediatrics, Division of Pediatric Cardiology, Kirk Kerkorian School of Medicine at UNLV, 2040 W. Charleston Blvd Ste. 402, Las Vegas, NV 89109, USA
| | - David Mann
- Vascular Biosciences, 72 Santa Felicia Drive, Goleta, CA, 93117, USA
| | - Jose A. Nunez
- Vascular Biosciences, 72 Santa Felicia Drive, Goleta, CA, 93117, USA
- College of Engineering, University of California, Santa Barbara, Lagoon Rd, Santa Barbara, CA 93106, USA
| | - Reinhardt Tarmidi
- Vascular Biosciences, 72 Santa Felicia Drive, Goleta, CA, 93117, USA
- College of Engineering, University of California, Santa Barbara, Lagoon Rd, Santa Barbara, CA 93106, USA
| | - Humberto Restrepo
- Children’s Heart Center Nevada, 3131 La Canada, Suite 230, Las Vegas, NV 89169, USA
- Department of Pediatrics, Division of Pediatric Cardiology, Kirk Kerkorian School of Medicine at UNLV, 2040 W. Charleston Blvd Ste. 402, Las Vegas, NV 89109, USA
| | - Valeri Sarukhanov
- Children’s Heart Center Nevada, 3131 La Canada, Suite 230, Las Vegas, NV 89169, USA
| | - Roy Williams
- Vascular Biosciences, 72 Santa Felicia Drive, Goleta, CA, 93117, USA
- Institute of Genomic Medicine, University of California, San Diego, 9500 Gilman Drive #0761, La Jolla, CA 92093, USA
| | - William N. Evans
- Children’s Heart Center Nevada, 3131 La Canada, Suite 230, Las Vegas, NV 89169, USA
- Department of Pediatrics, Division of Pediatric Cardiology, Kirk Kerkorian School of Medicine at UNLV, 2040 W. Charleston Blvd Ste. 402, Las Vegas, NV 89109, USA
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Lampmann T, Borger V, Konczalla J, Gispert S, Auburger G, Vatter H, Güresir E. Experimental Induction of Intracranial Aneurysms in Rats: A New Model Utilizing a Genetic Modification within the EDNRA Gene. Brain Sci 2022; 12:brainsci12091239. [PMID: 36138975 PMCID: PMC9497172 DOI: 10.3390/brainsci12091239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/08/2022] [Accepted: 09/10/2022] [Indexed: 12/01/2022] Open
Abstract
The rupture of an intracranial aneurysm (IA) leads to life-threatening subarachnoid hemorrhage. Aside from well-established risk factors, recently published genome-wide association studies of IA revealed the strong association of a common variant near the endothelin receptor type A (EDNRA) gene with IA risk. However, the role of EDNRA in the pathogenesis of IA remains unclear. The aim of this study was to investigate the influence of a genetic modification within the EDNRA gene on IA pathogenesis in a novel in vivo model. Adult wild-type Sprague–Dawley rats (WT rats) and genetically modified rats (EDNRA rats) were used for the induction of IA using arterial hypertension (HT). Animals were stratified into four groups: WT rats without (WT_CTL) and with induction of HT (WT + HT), as well as EDNRA rats without (EDNRA_CTL) and with induction of HT (EDNRA + HT). Blood pressure (BP) was observed for 12 weeks. After the observation period, cerebral arteries were analyzed for morphological (i.e., aneurysmal) changes as well as histological and functional changes by immunofluorescence and functional investigation. In the groups of rats with induction of HT, BP was higher in EDNRA + HT compared with that in WT + HT. No IAs were observed in WT_CTL and EDNRA_CTL but were found in WT + HT and EDNRA + HT. There was no histological difference in the immunofluorescence of EDNRA between all groups. Contractility and potency of endothelin-1 differed between the groups in functional investigation. In summary, we created a new model that is suitable for further studies for better understanding of the role of EDNRA in IA pathogenesis.
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Affiliation(s)
- Tim Lampmann
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany
- Correspondence:
| | - Valeri Borger
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany
| | - Jürgen Konczalla
- Department of Neurosurgery, University Hospital Frankfurt, 60528 Frankfurt am Main, Germany
| | - Suzana Gispert
- Experimental Neurology, Medical Faculty, Goethe University, 60590 Frankfurt am Main, Germany
| | - Georg Auburger
- Experimental Neurology, Medical Faculty, Goethe University, 60590 Frankfurt am Main, Germany
| | - Hartmut Vatter
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany
| | - Erdem Güresir
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany
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3
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Derella CC, Blanks AM, Nguyen A, Looney J, Tucker MA, Jeong J, Rodriguez-Miguelez P, Thomas J, Lyon M, Pollock DM, Harris RA. Dual endothelin receptor antagonism increases resting energy expenditure in people with increased adiposity. Am J Physiol Endocrinol Metab 2022; 322:E508-E516. [PMID: 35373585 PMCID: PMC9126219 DOI: 10.1152/ajpendo.00349.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 03/22/2022] [Accepted: 03/29/2022] [Indexed: 01/18/2023]
Abstract
Increased adiposity is associated with dysregulation of the endothelin system, both of which increase the risk of cardiovascular disease (CVD). Preclinical data indicate that endothelin dysregulation also reduces resting energy expenditure (REE). The objective was to test the hypothesis that endothelin receptor antagonism will increase REE in people with obesity compared with healthy weight individuals. Using a double blind, placebo-controlled, crossover design, 32 participants [healthy weight (HW): n = 16, BMI: 21.3 ± 2.8 kg/m2, age: 26 ± 7 yr and overweight/obese (OB): n = 16, BMI: 33.5 ± 9.5 kg/m2, age: 31 ± 6 yr] were randomized to receive either 125 mg of bosentan (ETA/B antagonism) or placebo twice per day for 3 days. Breath-by-breath gas exchange data were collected and REE was assessed by indirect calorimetry. Venous blood samples were analyzed for concentrations of endothelin-1 (ET-1). Treatment with bosentan increased plasma ET-1 in both OB and HW groups. Within the OB group, the changes in absolute REE (PLA: -77.6 ± 127.6 vs. BOS: 72.2 ± 146.6 kcal/day; P = 0.046). The change in REE was not different following either treatment in the HW group. Overall, absolute plasma concentrations of ET-1 following treatment with bosentan were significantly associated with kcal/day of fat (r = 0.488, P = 0.005), percentage of fat utilization (r = 0.415, P = 0.020), and inversely associated with the percentage of carbohydrates (r = -0.419, P = 0.019), and respiratory exchange ratio (r = -0.407, P = 0.023). Taken together, these results suggest that modulation of the endothelin system may represent a novel therapeutic approach to increase both resting metabolism and caloric expenditure, and reduce CVD risk in people with increased adiposity.NEW & NOTEWORTHY Findings from our current translational investigation demonstrate that dual endothelin A/B receptor antagonism increases total REE in overweight/obese individuals. These results suggest that modulation of the endothelin system may represent a novel therapeutic target to increase both resting metabolism and caloric expenditure, enhance weight loss, and reduce CVD risk in seemingly healthy individuals with elevated adiposity.
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Affiliation(s)
- Cassandra C Derella
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Anson M Blanks
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Andy Nguyen
- Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Jacob Looney
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Matthew A Tucker
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Jinhee Jeong
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Paula Rodriguez-Miguelez
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Jeffrey Thomas
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Matthew Lyon
- Medical College of Georgia, Augusta University, Augusta, Georgia
| | - David M Pollock
- Cardio-Renal Physiology and Medicine Section, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ryan A Harris
- Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
- Sport and Exercise Science Research Institute, Ulster University, Jordanstown, United Kingdom
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4
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Derella CC, Blanks AM, Wang X, Tucker MA, Horsager C, Jeong JH, Rodriguez-Miguelez P, Looney J, Thomas J, Pollock DM, Harris RA. Endothelin receptor blockade blunts the pressor response to acute stress in men and women with obesity. J Appl Physiol (1985) 2022; 132:73-83. [PMID: 34762528 PMCID: PMC8742738 DOI: 10.1152/japplphysiol.00156.2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Obesity is associated with dysregulation of the endothelin system. In individuals with obesity, an exaggerated pressor response to acute stress is accompanied by increased circulating endothelin-1 (ET-1). The impact of combined endothelin A/B receptor (ETA/B) antagonism on the stress-induced pressor response in overweight/obese (OB) individuals is unknown. The objective of this study is to test the hypothesis that treatment with an ETA/B antagonist (bosentan) would reduce the stress-induced pressor response and arterial stiffness in overweight/obese compared with normal weight (NW) individuals. Forty participants [normal weight (NW): n = 20, body mass index (BMI): 21.7 ± 2.4 kg/m2 and overweight/obese (OB): n = 20, BMI: 33.8 ± 8.2 kg/m2] were randomized to placebo or 125 mg of bosentan twice a day (250 mg total) for 3 days. Hemodynamics were assessed before, during, and after a cold pressor test (CPT). Endothelin-1 was assessed at baseline and immediately after CPT. Following a washout period, the same protocol was repeated with the opposite treatment. The change from baseline in mean arterial pressure (MAP) during CPT following bosentan was significantly lower (P = 0.039) in the OB group than in the NW group (OB: 28 ± 12 vs. NW: 34 ± 15 mmHg). These results suggest that ETA/B antagonism favorably blunts the pressor response to acute stress in overweight/obese individuals.NEW & NOTEWORTHY Findings from our current translational investigation demonstrate that dual endothelin A/B receptor antagonism blunts the pressor response to acute stress in overweight/obese individuals. These results suggest that modulation of the endothelin system may represent a novel therapeutic target to reduce cardiovascular disease (CVD) risk by blunting the stress response in overweight/obese individuals.
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Affiliation(s)
- Cassandra C. Derella
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Anson M. Blanks
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Xiaoling Wang
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Matthew A. Tucker
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Chase Horsager
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Jin Hee Jeong
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Paula Rodriguez-Miguelez
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia,2Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
| | - Jacob Looney
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - Jeffrey Thomas
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia
| | - David M. Pollock
- 3Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ryan A. Harris
- 1Department of Medicine, Georgia Prevention Institute, Augusta University, Augusta, Georgia,4Sport and Exercise Science Research Institute, Ulster University, Jordanstown, United Kingdom
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5
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The role of immune cells in pulmonary hypertension: Focusing on macrophages. Hum Immunol 2021; 83:153-163. [PMID: 34844784 DOI: 10.1016/j.humimm.2021.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/14/2021] [Accepted: 11/15/2021] [Indexed: 01/06/2023]
Abstract
Pulmonary hypertension (PH) is a life-threatening pathological state with elevated pulmonary arterial pressure, resulting in right ventricular failure and heart functional failure. Analyses of human samples and rodent models of pH support the infiltration of various immune cells, including neutrophils, mast cells, dendritic cells, B-cells, T-cells, and natural killer cells, to the lungs and pulmonary perivascular regions and their involvement in the PH development. There is evidence that macrophages are presented in the pulmonary lesions of pH patients as first-line myeloid leucocytes. Macrophage accumulation and presence, both M1 and M2 phenotypes, is a distinctive hallmark of pH which plays a pivotal role in pulmonary artery remodeling through various cellular and molecular interactions and mechanisms, including CCL2 and CX3CL1 chemokines, adventitial fibroblasts, glucocorticoid-regulated kinase 1 (SGK1), crosstalk with other immune cells, leukotriene B4 (LTB4), bone morphogenetic protein receptor 2 (BMPR2), macrophage migration inhibitory factor (MIF), and thrombospondin-1 (TSP-1). In this paper, we reviewed the molecular mechanisms and the role of immune cells and responses are involved in PH development. We also summarized the polarization of macrophages in response to different stimuli and their pathological role and their infiltration in the lung of pH patients and animal models.
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6
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Ozen G, Benyahia C, Amgoud Y, Patel J, Abdelazeem H, Bouhadoun A, Yung S, Li F, Mahieddine Y, Silverstein AM, Castier Y, Cazes A, Longrois D, Clapp LH, Norel X. Interaction between PGI2 and ET-1 pathways in vascular smooth muscle from Group-III pulmonary hypertension patients. Prostaglandins Other Lipid Mediat 2020; 146:106388. [DOI: 10.1016/j.prostaglandins.2019.106388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 09/08/2019] [Accepted: 10/24/2019] [Indexed: 12/16/2022]
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7
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Veteskova J, Kmecova Z, Malikova E, Doka G, Radik M, Vavrinec P, Krenek P, Klimas J. Opposite alterations of endothelin-1 in lung and pulmonary artery mirror gene expression of bone morphogenetic protein receptor 2 in experimental pulmonary hypertension. Exp Lung Res 2019; 45:30-41. [PMID: 31012341 DOI: 10.1080/01902148.2019.1605426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Aim of the Study: Endothelin-1 (ET-1) overexpression was suggested to play a role in pulmonary hypertension (PH). However, the roles of ET-1 in early stages of PH remain unexplored. We examined the expression of ET-1 and relevant disease progression markers in the pulmonary artery and the lungs during the development of PH induced by monocrotaline (MCT). Material and Methods: Male 12-weeks-old Wistar rats were administered with MCT (60 mg/kg, s.c.) or saline (CON). We measured right ventricular pressure (RVP) by catheterization under tribromoethanol anesthesia; hemoglobin oxygen saturation, breathing rate were measured by pulse oximetry in conscious animals. Rats were sacrificed 1, 2 or 4 weeks after MCT. mRNA levels of ET-1, its receptors, inflammatory markers IL-1beta, TNFalpha, IL-6 and genes related to VSMC proliferation or lung damage (Bmpr2, nestin, Pim1, PAI-1, TGFbeta-1) were analyzed by RT-qPCR. Results: RVP and breathing rate increased and hemoglobin oxygen saturation decreased after MCT only at week 4. Lung weight was increased at all time points. ET-1 was upregulated in the pulmonary artery at weeks 1 and 4, while being clearly suppressed in the lungs at all times. Bone morphogenetic protein receptor 2 followed a similar pattern to ET-1. PAI-1 markedly increased in the MCT lungs (but not pulmonary artery) from week 1 to 4. Nestin peaked at week 2 in both tissues. TGFbeta-1 increased in both tissues at week 4. ET-1 expression did not correlate with other genes, however, Bmpr2 tightly negatively correlated with PAI-1 in the lungs, but not pulmonary artery of MCT groups. Conclusions: ET-1 overexpression in the pulmonary artery preceded development of PH, but it was clearly and unexpectedly downregulated in the lungs of monocrotaline-treated rats and showed no correlation to disease progression markers. We speculate that endothelin-1 may play opposing roles in the lungs vs pulmonary artery in monocrotaline-induced PH.
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Affiliation(s)
- Jana Veteskova
- a Department of Pharmacology and Toxicology, Faculty of Pharmacy , Comenius University in Bratislava , Bratislava , Slovakia
| | - Zuzana Kmecova
- a Department of Pharmacology and Toxicology, Faculty of Pharmacy , Comenius University in Bratislava , Bratislava , Slovakia
| | - Eva Malikova
- a Department of Pharmacology and Toxicology, Faculty of Pharmacy , Comenius University in Bratislava , Bratislava , Slovakia
| | - Gabriel Doka
- a Department of Pharmacology and Toxicology, Faculty of Pharmacy , Comenius University in Bratislava , Bratislava , Slovakia
| | - Michal Radik
- a Department of Pharmacology and Toxicology, Faculty of Pharmacy , Comenius University in Bratislava , Bratislava , Slovakia
| | - Peter Vavrinec
- a Department of Pharmacology and Toxicology, Faculty of Pharmacy , Comenius University in Bratislava , Bratislava , Slovakia
| | - Peter Krenek
- a Department of Pharmacology and Toxicology, Faculty of Pharmacy , Comenius University in Bratislava , Bratislava , Slovakia
| | - Jan Klimas
- a Department of Pharmacology and Toxicology, Faculty of Pharmacy , Comenius University in Bratislava , Bratislava , Slovakia
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8
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Angus JA, Hughes RJA, Wright CE. Distortion of K B estimates of endothelin-1 ET A and ET B receptor antagonists in pulmonary arteries: Possible role of an endothelin-1 clearance mechanism. Pharmacol Res Perspect 2018; 5. [PMID: 29226623 PMCID: PMC5723704 DOI: 10.1002/prp2.374] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 10/23/2017] [Indexed: 11/08/2022] Open
Abstract
Dual endothelin ETA and ETB receptor antagonists are approved therapy for pulmonary artery hypertension (PAH). We hypothesized that ETB receptor‐mediated clearance of endothelin‐1 at specific vascular sites may compromise this targeted therapy. Concentration‐response curves (CRC) to endothelin‐1 or the ETB agonist sarafotoxin S6c were constructed, with endothelin receptor antagonists, in various rat and mouse isolated arteries using wire myography or in rat isolated trachea. In rat small mesenteric arteries, bosentan displaced endothelin‐1 CRC competitively indicative of ETA receptor antagonism. In rat small pulmonary arteries, bosentan 10 μmol L−1 left‐shifted the endothelin‐1 CRC, demonstrating potentiation consistent with antagonism of an ETB receptor‐mediated endothelin‐1 clearance mechanism. Removal of endothelium or L‐NAME did not alter the EC50 or Emax of endothelin‐1 nor increase the antagonism by BQ788. In the presence of BQ788 and L‐NAME, bosentan displayed ETA receptor antagonism. In rat trachea (ETB), bosentan was a competitive ETB antagonist against endothelin‐1 or sarafotoxin S6c. Modeling showed the importance of dual receptor antagonism where the potency ratio of ETA to ETB antagonism is close to unity. In conclusion, the rat pulmonary artery is an example of a special vascular bed where the resistance to antagonism of endothelin‐1 constriction by ET dual antagonists, such as bosentan or the ETB antagonist BQ788, is possibly due to the competition of potentiation of endothelin‐1 by blockade of ETB‐mediated endothelin‐1 clearance located on smooth muscle and antagonism of ETA‐ and ETB‐mediated contraction. This conclusion may have direct application for the efficacy of endothelin‐1 antagonists for treating PAH.
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Affiliation(s)
- James A Angus
- Cardiovascular Therapeutics Unit, Department of Pharmacology and Therapeutics, University of Melbourne, Melbourne, Vic., Australia
| | - Richard J A Hughes
- Cardiovascular Therapeutics Unit, Department of Pharmacology and Therapeutics, University of Melbourne, Melbourne, Vic., Australia
| | - Christine E Wright
- Cardiovascular Therapeutics Unit, Department of Pharmacology and Therapeutics, University of Melbourne, Melbourne, Vic., Australia
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9
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van Duin RWB, Stam K, Cai Z, Uitterdijk A, Garcia-Alvarez A, Ibanez B, Danser AHJ, Reiss IKM, Duncker DJ, Merkus D. Transition from post-capillary pulmonary hypertension to combined pre- and post-capillary pulmonary hypertension in swine: a key role for endothelin. J Physiol 2018; 597:1157-1173. [PMID: 29799120 PMCID: PMC6375874 DOI: 10.1113/jp275987] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 05/11/2018] [Indexed: 12/31/2022] Open
Abstract
Key points Passive, isolated post‐capillary pulmonary hypertension (PH) secondary to left heart disease may progress to combined pre‐ and post‐capillary or ‘active’ PH This ‘activation’ of post‐capillary PH significantly increases morbidity and mortality, and is still incompletely understood. In this study, pulmonary vein banding gradually produced post‐capillary PH with structural and functional microvascular remodelling in swine. Ten weeks after banding, the pulmonary endothelin pathway was upregulated, likely contributing to pre‐capillary aspects in the initially isolated post‐capillary PH. Inhibition of the endothelin pathway could potentially stop the progression of early stage post‐capillary PH.
Abstract Passive, isolated post‐capillary pulmonary hypertension (IpcPH) secondary to left heart disease may progress to combined pre‐ and post‐capillary or ‘active’ PH (CpcPH) characterized by chronic pulmonary vascular constriction and remodelling. The mechanisms underlying this ‘activation’ of passive pulmonary hypertension (PH) remain incompletely understood. Here we investigated the role of the vasoconstrictor endothelin‐1 (ET) in the progression from IpcPH to CpcPH in a swine model for post‐capillary PH. Swine underwent pulmonary vein banding (PVB; n = 7) or sham‐surgery (Sham; n = 6) and were chronically instrumented 4 weeks later. Haemodynamics were assessed for 8 weeks, at rest and during exercise, before and after administration of the ET receptor antagonist tezosentan. After sacrifice, the pulmonary vasculature was investigated by histology, RT‐qPCR and myograph experiments. Pulmonary arterial pressure and resistance increased significantly over time. mRNA expression of prepro‐endothelin‐1 and endothelin converting enzyme‐1 in the lung was increased, while ETA expression was unchanged and ETB expression was downregulated. This was associated with increased plasma ET levels from week 10 onward and a more pronounced vasodilatation to in vivo administration of tezosentan at rest and during exercise. Myograph experiments showed decreased endothelium‐dependent vasodilatation to Substance P and increased vasoconstriction to KCl in PVB swine consistent with increased muscularization observed with histology. Moreover, maximal vasoconstriction to ET was increased whereas ET sensitivity was decreased. In conclusion, PVB swine gradually developed PH with structural and functional vascular remodelling. From week 10 onward, the pulmonary ET pathway was upregulated, likely contributing to pre‐capillary activation of the initially isolated post‐capillary PH. Inhibition of the ET pathway could thus potentially provide a pharmacotherapeutic target for early stage post‐capillary PH. Passive, isolated post‐capillary pulmonary hypertension (PH) secondary to left heart disease may progress to combined pre‐ and post‐capillary or ‘active’ PH This ‘activation’ of post‐capillary PH significantly increases morbidity and mortality, and is still incompletely understood. In this study, pulmonary vein banding gradually produced post‐capillary PH with structural and functional microvascular remodelling in swine. Ten weeks after banding, the pulmonary endothelin pathway was upregulated, likely contributing to pre‐capillary aspects in the initially isolated post‐capillary PH. Inhibition of the endothelin pathway could potentially stop the progression of early stage post‐capillary PH.
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Affiliation(s)
- Richard W B van Duin
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
| | - Kelly Stam
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
| | - Zongye Cai
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
| | - André Uitterdijk
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
| | - Ana Garcia-Alvarez
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.,Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - Borja Ibanez
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.,IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain.,CIBERCV, Madrid, Spain
| | - A H Jan Danser
- Department of Pharmacology, Erasmus MC, Rotterdam, The Netherlands
| | - Irwin K M Reiss
- Pediatrics / Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Dirk J Duncker
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
| | - Daphne Merkus
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
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10
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Bedan M, Grimm D, Wehland M, Simonsen U, Infanger M, Krüger M. A Focus on Macitentan in the Treatment of Pulmonary Arterial Hypertension. Basic Clin Pharmacol Toxicol 2018; 123:103-113. [PMID: 29719121 DOI: 10.1111/bcpt.13033] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 04/18/2018] [Indexed: 01/10/2023]
Abstract
The approval of macitentan has increased the number of pharmacological treatments of pulmonary arterial hypertension (PAH). Here, we review the effect on PAH of macitentan compared to other endothelin receptor antagonists. Drugs targeting the endothelin (ET) pathway include the selective ETA receptor antagonist ambrisentan, the ETA /ETB receptor antagonists, bosentan and macitentan, which were recently approved for PAH treatment. Macitentan exhibits higher antagonistic potency than bosentan and ambrisentan in pulmonary smooth muscle cells. Compared to ambrisentan and bosentan, macitentan has a longer duration of action, reflected by the longer half-life, as well as pharmacodynamics attributed to its active metabolite, ACT-132577. The efficacy of macitentan on PAH was investigated in the phase III SERAPHIN trial (NCT00660179). Macitentan significantly reduced morbidity and mortality. It improved the 6-min. walk distance (6MWD) among PAH patients. In the AMB-320/321-E (NCT00578786) study, ambrisentan improved exercise capacity. In the EARLY study (NCT00091715), bosentan showed improvements in 6MWD which were not statistically significant. Bosentan had an effect on PAH in patients with Eisenmenger syndrome (ES) in the BREATHE-5 study (NCT00367770), while macitentan did not improve 6MWD in these patients, but there are differences regarding study size and functional class, and that 30% of the patients treated with macitentan were already in treatment with a phosphodiesterase type 5 inhibitor. Macitentan revealed a lower risk of developing peripheral oedema and hepatotoxicity in the SERAPHIN study. In summary, macitentan has an efficiency comparable to bosentan and ambrisentan in the treatment of PAH. Patients treated with macitentan exhibited less adverse effects compared to bosentan and ambrisentan. In patients with PAH associated with ES, the trials with bosentan and macitentan do not seem comparable, and it needs to be clarified whether these drugs are effective when administered as part of a combination treatment in this condition.
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Affiliation(s)
- Martin Bedan
- Department of Biomedicine, Pharmacology, Aarhus University, Aarhus C, Denmark
| | - Daniela Grimm
- Department of Biomedicine, Pharmacology, Aarhus University, Aarhus C, Denmark.,Clinic for Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Markus Wehland
- Clinic for Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Ulf Simonsen
- Department of Biomedicine, Pharmacology, Aarhus University, Aarhus C, Denmark
| | - Manfred Infanger
- Clinic for Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Marcus Krüger
- Clinic for Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
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Angus JA, Soeding PF, Hughes RJA, Wright CE. Functional estimation of endothelin-1 receptor antagonism by bosentan, macitentan and ambrisentan in human pulmonary and radial arteries in vitro. Eur J Pharmacol 2017; 804:111-116. [PMID: 28300593 DOI: 10.1016/j.ejphar.2017.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 02/28/2017] [Accepted: 03/10/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Endothelin receptor antagonists are approved for pulmonary arterial hypertension. Development of selective ETA-receptor antagonists over mixed or dual receptor antagonists has depended on a range of receptor binding assays, second messenger assays and functional blood vessel assays. This study compared the 3 clinically-approved endothelin receptor antagonists in assays of human isolated pulmonary and radial arteries in vitro. METHODS Human isolated pulmonary (i.d. 5.5mm) and human radial (i.d. 3.23mm) artery ring segments were mounted in organ baths for isometric force measurement. Single concentration-contraction curves to endothelin-1 were constructed in the absence or presence of bosentan (1-10µM), macitentan (0.03-0.3µM) or ambrisentan (0.1-1µM). RESULTS All 3 endothelin antagonists caused competitive rightward shifts in the endothelin-1 concentration-response curves in both arteries. The Clark plot and analysis gave the following pKB values: bosentan, pulmonary artery 6.28±0.13 and radial artery 6.04±0.10; macitentan, pulmonary artery 8.02±0.13 and radial artery 7.49±0.08; and ambrisentan, pulmonary artery 7.38±0.13 and radial artery 6.96±0.10. CONCLUSIONS Noting the maximum plasma levels attained from recommended oral doses of each antagonist in volunteers, the pKB findings here show that there would be significant antagonism of endothelin-1 contraction in the pulmonary and radial arteries at therapeutic plasma levels. This functional assay confirms in human tissue that much higher plasma concentrations of endothelin-1 receptor antagonists are required to be effective than those predicted from binding or other biochemical assays.
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Affiliation(s)
- James A Angus
- Cardiovascular Therapeutics Unit, Department of Pharmacology and Therapeutics, University of Melbourne, Victoria 3010, Australia.
| | - Paul F Soeding
- Cardiovascular Therapeutics Unit, Department of Pharmacology and Therapeutics, University of Melbourne, Victoria 3010, Australia.
| | - Richard J A Hughes
- Cardiovascular Therapeutics Unit, Department of Pharmacology and Therapeutics, University of Melbourne, Victoria 3010, Australia.
| | - Christine E Wright
- Cardiovascular Therapeutics Unit, Department of Pharmacology and Therapeutics, University of Melbourne, Victoria 3010, Australia.
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Gao Y, Chen T, Raj JU. Endothelial and Smooth Muscle Cell Interactions in the Pathobiology of Pulmonary Hypertension. Am J Respir Cell Mol Biol 2016; 54:451-60. [PMID: 26744837 DOI: 10.1165/rcmb.2015-0323tr] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
In the pulmonary vasculature, the endothelial and smooth muscle cells are two key cell types that play a major role in the pathobiology of pulmonary vascular disease and pulmonary hypertension. The normal interactions between these two cell types are important for the homeostasis of the pulmonary circulation, and any aberrant interaction between them may lead to various disease states including pulmonary vascular remodeling and pulmonary hypertension. It is well recognized that the endothelial cell can regulate the function of the underlying smooth muscle cell by releasing various bioactive agents such as nitric oxide and endothelin-1. In addition to such paracrine regulation, other mechanisms exist by which there is cross-talk between these two cell types, including communication via the myoendothelial injunctions and information transfer via extracellular vesicles. Emerging evidence suggests that these nonparacrine mechanisms play an important role in the regulation of pulmonary vascular tone and the determination of cell phenotype and that they are critically involved in the pathobiology of pulmonary hypertension.
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Affiliation(s)
- Yuansheng Gao
- 1 Department of Physiology and Pathophysiology, Health Science Center, Peking University, Beijing, China; and
| | - Tianji Chen
- 2 Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - J Usha Raj
- 2 Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
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Mahdavi N, Joukar S, Najafipour H, Asadi-Shekaari M. The promising effect of barberry (Zereshk) extract against experimental pulmonary microvascular remodeling and hypertension: A comparison with sildenafil. PHARMACEUTICAL BIOLOGY 2015; 54:509-515. [PMID: 26023989 DOI: 10.3109/13880209.2015.1050676] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
CONTEXT Despite the beneficial effects of barberry (Berberis integerrima Berberidaceae) on decreasing systemic hypertension, its influence has not been investigated on pulmonary hypertension. OBJECTIVE The objective of this study is to examine the effect of barberry fruit, on monocrotaline-induced pulmonary hypertension. MATERIALS AND METHODS Nine groups were arranged as follows: the control group, the monocrotaline (M) group, the barberry groups with doses of 50, 100, and 200 (mg/kg), the M plus barberry groups, and the M plus sildenafil group. Two weeks after a single injection of monocrotaline (60 mg/kg, s.c.), barberry water extracts or sildenafil (30 mg/kg/d) were gavaged daily for 2 weeks. At the end of the 4th week, hemodynamic, biochemical, and histopathological parameters were assessed. RESULTS In comparison with the M group, barberry (200 mg/kg) or sildenafil significantly reduced the right ventricular systolic pressure (RVSP) (22.95 ± 1.78 mm Hg and 30.71 ± 1.64 mm Hg, versus 41.28 ± 1.5 mm Hg), right ventricular hypertrophy (RVH) (0.39 ± 0.03 and 0.42 ± 0.02, versus 0.57 ± 0.02), and the medial wall thickness (MWT) (4.56 ± 0.15 µm and 5.97 ± 0.19 µm, versus 7.02 ± 0.43 µm). Barberry or sildenafil had no significant effect on the plasma level of endothelin-1, glutathione peroxidase, and the malondialdehide of lung. CONCLUSION 200 mg/kg of barberry has an improving effect on the monocrotaline-induced pulmonary hypertension. This effect was stronger than that of the sildenafil's and may have been mediated through mechanisms other than the modulation of the endothelin-1 or redox system.
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Affiliation(s)
- Naser Mahdavi
- a Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences , Kerman , Iran
- b Department of Physiology and Pharmacology , School of Medicine, Kerman University of Medical Sciences , Kerman , Iran
| | - Siyavash Joukar
- a Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences , Kerman , Iran
- b Department of Physiology and Pharmacology , School of Medicine, Kerman University of Medical Sciences , Kerman , Iran
| | - Hamid Najafipour
- b Department of Physiology and Pharmacology , School of Medicine, Kerman University of Medical Sciences , Kerman , Iran
- c Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences , Kerman , Iran , and
| | - Majid Asadi-Shekaari
- d Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences , Kerman , Iran
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14
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Endothelin(A)-endothelin(B) receptor cross talk in endothelin-1-induced contraction of smooth muscle. J Cardiovasc Pharmacol 2013; 60:483-94. [PMID: 22987051 DOI: 10.1097/fjc.0b013e31826f32c1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The efficacy of selective endothelin (ET) receptor antagonists may be limited by a functional interaction between the ET(A) and ET(B) receptors. This interaction, also termed "cross talk", is characterized by the dependency of the inhibition of an ET-1 response due to antagonism of one ET receptor subtype upon concomitant antagonism of the other ET receptor subtype. Although a reduction in ET(A)-ET(B) receptor cross talk would presumably increase the efficacy of selective ET receptor antagonists, an approach that accomplishes this aim is largely absent due to a lack of mechanistic understanding. Toward this goal, we evaluated the characteristics and potential dependencies of cross talk in smooth muscle. Smooth muscle was adopted as an exemplar not only because cross talk is widely reported in this tissue type, thereby allowing numerous comparisons, but also significant controversy surrounds the use of selective versus nonselective ET receptor antagonists in ET-1-related pathophysiologies involving smooth muscle. Based on this evaluation, we suggest that ET(A)-ET(B) receptor cross talk is a dynamic process directed by either or both ET receptor subtypes and expressed to varying magnitudes depending on the ET-1 and selective ET receptor antagonist concentrations, tone due to intraluminal pressure/stretch, agonists acting at receptors other than the ET(A)/ET(B) receptors, and endothelial/epithelial function. It is speculated that ET(A)-ET(B) receptor cross talk occurs through signal transduction pathways along with changes at the receptor level. Pharmacologic intervention of the signaling pathways could increase the therapeutic efficacy of ET receptor antagonists.
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15
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Bolli MH, Boss C, Binkert C, Buchmann S, Bur D, Hess P, Iglarz M, Meyer S, Rein J, Rey M, Treiber A, Clozel M, Fischli W, Weller T. The Discovery of N-[5-(4-Bromophenyl)-6-[2-[(5-bromo-2-pyrimidinyl)oxy]ethoxy]-4-pyrimidinyl]-N′-propylsulfamide (Macitentan), an Orally Active, Potent Dual Endothelin Receptor Antagonist. J Med Chem 2012; 55:7849-61. [DOI: 10.1021/jm3009103] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Martin H. Bolli
- Drug Discovery Chemistry, Actelion Pharmaceuticals
Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Christoph Boss
- Drug Discovery Chemistry, Actelion Pharmaceuticals
Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Christoph Binkert
- Drug Discovery Chemistry, Actelion Pharmaceuticals
Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Stephan Buchmann
- Drug Discovery Chemistry, Actelion Pharmaceuticals
Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Daniel Bur
- Drug Discovery Chemistry, Actelion Pharmaceuticals
Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Patrick Hess
- Drug Discovery Chemistry, Actelion Pharmaceuticals
Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Marc Iglarz
- Drug Discovery Chemistry, Actelion Pharmaceuticals
Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Solange Meyer
- Drug Discovery Chemistry, Actelion Pharmaceuticals
Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Josiane Rein
- Drug Discovery Chemistry, Actelion Pharmaceuticals
Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Markus Rey
- Drug Discovery Chemistry, Actelion Pharmaceuticals
Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Alexander Treiber
- Drug Discovery Chemistry, Actelion Pharmaceuticals
Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Martine Clozel
- Drug Discovery Chemistry, Actelion Pharmaceuticals
Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Walter Fischli
- Drug Discovery Chemistry, Actelion Pharmaceuticals
Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Thomas Weller
- Drug Discovery Chemistry, Actelion Pharmaceuticals
Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
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16
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Ahnstedt H, Stenman E, Cao L, Henriksson M, Edvinsson L. Cytokines and growth factors modify the upregulation of contractile endothelin ET(A) and ET(B) receptors in rat cerebral arteries after organ culture. Acta Physiol (Oxf) 2012; 205:266-78. [PMID: 22145714 DOI: 10.1111/j.1748-1716.2011.02392.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 09/20/2011] [Accepted: 11/30/2011] [Indexed: 11/30/2022]
Abstract
AIM Experimental cerebral ischaemia and organ culture of cerebral arteries induce an increased endothelin ET(B) receptor-mediated contraction. The aim of this study was to examine whether cytokines and growth factors, known to be activated in ischaemia, can influence the expression and function of endothelin receptors after organ culture. METHODS Rat middle cerebral arteries were cultured for 24 h at 37 °C in humidified 5% CO(2) and air in culture medium alone, or with tumour necrosis factor-α (TNF-α), interleukin-1β (IL-1β), platelet-derived growth factor (PDGF), epidermal growth factor (EGF) or basic fibroblast growth factor (bFGF). Concentration-response curves were obtained for sarafotoxin 6c (ET(B) receptor agonist) and endothelin-1 (here ET(A) receptor agonist, because of ET(B) receptor desensitization). The receptor mRNA expression was examined by real-time PCR and the protein expression by immunohistochemistry and Western blot. RESULTS Tumour necrosis factor-α (100 ng mL(-1) ) and EGF (20 ng mL(-1) ) potentiated the ET(B) receptor-mediated contraction (increase in pEC(50) without change in E(max) ). bFGF (10 ng mL(-1) ) and IL-1β (10 ng mL(-1) ) induced an enhanced ET(A) receptor-mediated contraction. bFGF (10 ng mL(-1) ) significantly increased the ET(B) mRNA level, and EGF (20 ng mL(-1) ) increased the ET(A) receptor protein. Increased ET(B) receptor mRNA and protein level also were observed after treatment with IL-1β (10 ng mL(-1) ). CONCLUSION This study shows that TNF-α, IL-1β, EGF and bFGF can modify the expression and function of endothelin receptors during organ culture. Because there is similar receptor upregulation in experimental stroke, the effect of cytokines and growth factors on endothelin receptor upregulation is an interesting aspect to study in vivo.
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Affiliation(s)
- H. Ahnstedt
- Division of Experimental Vascular Research; Department of Clinical Sciences; Lund University; Lund; Sweden
| | - E. Stenman
- Division of Experimental Vascular Research; Department of Clinical Sciences; Lund University; Lund; Sweden
| | - L. Cao
- Division of Experimental Vascular Research; Department of Clinical Sciences; Lund University; Lund; Sweden
| | - M. Henriksson
- Division of Experimental Vascular Research; Department of Clinical Sciences; Lund University; Lund; Sweden
| | - L. Edvinsson
- Division of Experimental Vascular Research; Department of Clinical Sciences; Lund University; Lund; Sweden
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17
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Endothelin and endothelin receptors in the renal and cardiovascular systems. Life Sci 2012; 91:490-500. [PMID: 22480517 DOI: 10.1016/j.lfs.2012.03.026] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 03/12/2012] [Accepted: 03/16/2012] [Indexed: 01/08/2023]
Abstract
Endothelin-1 (ET-1) is a multifunctional hormone which regulates the physiology of the cardiovascular and renal systems. ET-1 modulates cardiac contractility, systemic and renal vascular resistance, salt and water renal reabsorption, and glomerular function. ET-1 is responsible for a variety of cellular events: contraction, proliferation, apoptosis, etc. These effects take place after the activation of the two endothelin receptors ET(A) and ET(B), which are present - among others - on cardiomyocytes, fibroblasts, smooth muscle and endothelial cells, glomerular and tubular cells of the kidney. The complex and numerous intracellular pathways, which can be contradictory in term of functional response depending on the receptor type, cell type and physiological situation, are described in this review. Many diseases share an enhanced ET-1 expression as part of the pathophysiology. However, the use of endothelin blockers is currently restricted to pulmonary arterial hypertension, and more recently to digital ulcer. The complexity of the endothelin system does not facilitate the translation of the molecular knowledge to clinical applications. Endothelin antagonists can prevent disease development but secondary undesirable effects limit their usage. Nevertheless, the increasing understanding of the effects of ET-1 on the cardiac and renal physiology maintains the endothelin system as a promising therapeutic target.
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18
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Yoon S, Zuccarello M, Rapoport RM. EndothelinA–endothelinB receptor cross-talk in rat basilar artery in situ. Naunyn Schmiedebergs Arch Pharmacol 2012; 385:437-41. [DOI: 10.1007/s00210-012-0725-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 01/03/2012] [Indexed: 11/29/2022]
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19
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Rodríguez-Pascual F, Busnadiego O, Lagares D, Lamas S. Role of endothelin in the cardiovascular system. Pharmacol Res 2011; 63:463-72. [DOI: 10.1016/j.phrs.2011.01.014] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 01/13/2011] [Accepted: 01/29/2011] [Indexed: 01/22/2023]
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20
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Billaud M, Dahan D, Marthan R, Savineau JP, Guibert C. Role of the gap junctions in the contractile response to agonists in pulmonary artery from two rat models of pulmonary hypertension. Respir Res 2011; 12:30. [PMID: 21414209 PMCID: PMC3068940 DOI: 10.1186/1465-9921-12-30] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Accepted: 03/17/2011] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Pulmonary hypertension (PH) is characterized by arterial vascular remodelling and alteration in vascular reactivity. Since gap junctions are formed with proteins named connexins (Cx) and contribute to vasoreactivity, we investigated both expression and role of Cx in the pulmonary arterial vasoreactivity in two rat models of PH. METHODS Intrapulmonary arteries (IPA) were isolated from normoxic rats (N), rats exposed to chronic hypoxia (CH) or treated with monocrotaline (MCT). RT-PCR, Western Blot and immunofluorescent labelling were used to study the Cx expression. The role of Cx in arterial reactivity was assessed by using isometric contraction and specific gap junction blockers. Contractile responses were induced by agonists already known to be involved in PH, namely serotonin, endothelin-1 and phenylephrine. RESULTS Cx 37, 40 and 43 were expressed in all rat models and Cx43 was increased in CH rats. In IPA from N rats only, the contraction to serotonin was decreased after treatment with 37-43Gap27, a specific Cx-mimetic peptide blocker of Cx 37 and 43. The contraction to endothelin-1 was unchanged after incubation with 40Gap27 (a specific blocker of Cx 40) or 37-43Gap27 in N, CH and MCT rats. In contrast, the contraction to phenylephrine was decreased by 40Gap27 or 37-43Gap27 in CH and MCT rats. Moreover, the contractile sensitivity to high potassium solutions was increased in CH rats and this hypersensitivity was reversed following 37-43Gap27 incubation. CONCLUSION Altogether, Cx 37, 40 and 43 are differently expressed and involved in the vasoreactivity to various stimuli in IPA from different rat models. These data may help to understand alterations of pulmonary arterial reactivity observed in PH and to improve the development of innovative therapies according to PH aetiology.
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MESH Headings
- Analysis of Variance
- Animals
- Blood Pressure/drug effects
- Blotting, Western
- Connexin 43/metabolism
- Connexins/genetics
- Connexins/metabolism
- Disease Models, Animal
- Dose-Response Relationship, Drug
- Endothelin-1/pharmacology
- Fluorescent Antibody Technique
- Gap Junctions/drug effects
- Gap Junctions/metabolism
- Hypertension, Pulmonary/etiology
- Hypertension, Pulmonary/metabolism
- Hypertension, Pulmonary/physiopathology
- Hypoxia/complications
- Hypoxia/metabolism
- Hypoxia/physiopathology
- Male
- Monocrotaline
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/physiopathology
- Phenylephrine/pharmacology
- Pulmonary Artery/drug effects
- Pulmonary Artery/metabolism
- Pulmonary Artery/physiopathology
- Rats
- Rats, Wistar
- Reverse Transcriptase Polymerase Chain Reaction
- Serotonin/metabolism
- Serotonin/pharmacology
- Vasoconstriction/drug effects
- Vasoconstrictor Agents/pharmacology
- Gap Junction alpha-5 Protein
- Gap Junction alpha-4 Protein
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Affiliation(s)
- Marie Billaud
- INSERM, U1045, 146 rue Léo Saignat, F-33076 Bordeaux, France
- Université Bordeaux Segalen, Centre de Recherche Cardio-Thoracique de Bordeaux, F-33076 Bordeaux, France
| | - Diana Dahan
- INSERM, U1045, 146 rue Léo Saignat, F-33076 Bordeaux, France
- Université Bordeaux Segalen, Centre de Recherche Cardio-Thoracique de Bordeaux, F-33076 Bordeaux, France
| | - Roger Marthan
- INSERM, U1045, 146 rue Léo Saignat, F-33076 Bordeaux, France
- Université Bordeaux Segalen, Centre de Recherche Cardio-Thoracique de Bordeaux, F-33076 Bordeaux, France
- CHU de Bordeaux, F 33076 Bordeaux, France
| | - Jean-Pierre Savineau
- INSERM, U1045, 146 rue Léo Saignat, F-33076 Bordeaux, France
- Université Bordeaux Segalen, Centre de Recherche Cardio-Thoracique de Bordeaux, F-33076 Bordeaux, France
| | - Christelle Guibert
- INSERM, U1045, 146 rue Léo Saignat, F-33076 Bordeaux, France
- Université Bordeaux Segalen, Centre de Recherche Cardio-Thoracique de Bordeaux, F-33076 Bordeaux, France
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Henno P, Boitiaux JF, Douvry B, Cazes A, Lévy M, Devillier P, Delclaux C, Israël-Biet D. Tobacco-associated pulmonary vascular dysfunction in smokers: role of the ET-1 pathway. Am J Physiol Lung Cell Mol Physiol 2011; 300:L831-9. [PMID: 21378026 DOI: 10.1152/ajplung.00251.2010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Pulmonary vascular remodeling and dysfunction associated to tobacco smoking might pave the way for the subsequent development of pulmonary hypertension. Its prognosis is dreadful and its underlying mechanisms are so far largely unknown in humans. To assess the potential role of endothelin-1 and its receptors in smokers' pulmonary artery vasoactive properties. Endothelium-dependent vasodilation to ACh was assessed in pulmonary vascular rings from 34 smokers and compared with that of 10 nonsmokers. The effects of ET-A (BQ 123) or ET-B (BQ 788) blockers and that of an ET-B activator (sarafotoxin) were evaluated. Endothelin-1 was quantitated by ELISA. Expression of its receptors was quantitated by Western blotting. Smokers exhibited an impaired pulmonary endothelium-dependent vasodilation compared with nonsmokers (P < 0.01). In the former group, 8 of 34 subjects exhibited a marked endothelial dysfunction (ED(+)) whereas 26 (ED(-)) (P < 10(-4)) displayed a vasorelaxation to ACh that was comparable to that of nonsmokers. In ED(+) subjects, ET-A was overexpressed (P < 0.05) and inversely correlated (P < 10(-2)) with the response to ACh. Sarafotoxin significantly improved vasodilation in all subjects (P < 10(-2)). In conclusion, tobacco smoking is associated to an impaired pulmonary vasorelaxation at least partly mediated by an ET-1/ET-A-dependent dysfunction.
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Affiliation(s)
- Priscilla Henno
- Unité Propre de Recherche de l’Enseignement Supérieur EA, UFR Biomédicale des Saints Pères, Paris, France
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Nguyen A, Thorin-Trescases N, Thorin E. Working under pressure: coronary arteries and the endothelin system. Am J Physiol Regul Integr Comp Physiol 2010; 298:R1188-94. [PMID: 20237301 DOI: 10.1152/ajpregu.00653.2009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Endogenous endothelin-1-dependent (ET-1) tone in coronary arteries depends on the balance between ET(A) and ET(B) receptor-mediated effects and on parameters such as receptor distribution and endothelial integrity. Numerous studies highlight the striking functional interactions that exist between nitric oxide (NO) and ET-1 in the regulation of vascular tone. Many of the cardiovascular complications associated with cardiovascular risk factors and aging are initially attributable, at least in part, to endothelial dysfunction characterized by a dysregulation between NO and ET-1. The contribution of the imbalance between smooth muscle ET(A/B) and endothelial ET(B) receptors to this process is poorly understood. An increased contribution of ET-1 that is associated with a proportional decrease in that of NO accompanies the development of coronary endothelial dysfunction, coronary vasospasm, and atherosclerosis. These data form the basis for the rationale of testing therapeutic approaches counteracting ET-1-induced cardiovascular dysfunction. It remains to be determined whether the beneficial role of endothelial ET(B) receptors declines with age and risk factors for cardiovascular diseases, revealing smooth muscle ET(B) receptors with proconstricting and proinflammatory activities.
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Affiliation(s)
- Albert Nguyen
- Institut de Cardiologie de Montréal, centre de recherche, 5000 rue Bélanger, Montréal, Québec, Canada
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Dhillon S, Keating GM. Bosentan: a review of its use in the management of mildly symptomatic pulmonary arterial hypertension. Am J Cardiovasc Drugs 2010; 9:331-50. [PMID: 19791841 DOI: 10.2165/11202270-000000000-00000] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Bosentan (Tracleer) is an orally administered dual endothelin-1 (ET-1) receptor antagonist approved for use in patients with WHO class II (mildly symptomatic) pulmonary arterial hypertension (PAH). Oral bosentan therapy was beneficial and generally well tolerated in patients with mildly symptomatic PAH. In a well designed, placebo-controlled trial in adolescents and adults with mildly symptomatic PAH, pulmonary vascular resistance was significantly reduced with bosentan relative to placebo, but the 6-minute walk distance did not increase significantly. Similarly, pediatric patients (most of whom had mildly symptomatic PAH) in a small uncontrolled trial experienced some improvement in hemodynamic variables with bosentan, but did not experience a significant increase in exercise capacity. Adverse events associated with bosentan were consistent with those seen in other indications, with major concerns being the potential for teratogenicity and hepatotoxicity, for which regular liver function monitoring is recommended. Overall, considering the progressive nature of PAH, bosentan extends the treatment options available to patients with mildly symptomatic PAH.
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Thorin E, Clozel M. The cardiovascular physiology and pharmacology of endothelin-1. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2010; 60:1-26. [PMID: 21081213 PMCID: PMC3693982 DOI: 10.1016/b978-0-12-385061-4.00001-5] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
One year after the discovery in 1980 that the endothelium was obligatory for acetylcholine to relax isolated arteries, it was clearly shown that the endothelium could also promote contraction. In 1988, Dr Yanagisawa's group identified endothelin-1 (ET-1) as the first endothelium-derived contracting factor. The circulating levels of this short (21 amino acids) peptide were quickly determined in humans and it was reported that in most cardiovascular diseases, circulating levels of ET-1 were increased and ET-1 was then recognized as a likely mediator of pathological vasoconstriction in human. The discovery of two receptor subtypes in 1990, ET(A) and ET(B), permitted optimization of bosentan, which entered clinical development in 1993, and was offered to patients with pulmonary arterial hypertension in 2001. In this report, we discuss the physiological and pathophysiological role of endothelium-derived ET-1, the pharmacology of its two receptors, focusing on the regulation of the vascular tone and as much as possible in humans. The coronary bed will be used as a running example, but references to the pulmonary, cerebral, and renal circulation will also be made. Many of the cardiovascular complications associated with aging and cardiovascular risk factors are initially attributable, at least in part, to endothelial dysfunction, particularly dysregulation of the vascular function associated with an imbalance in the close interdependence of NO and ET-1, in which the implication of the ET(B) receptor may be central.
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Affiliation(s)
- Eric Thorin
- Department of Surgery, Montreal Heart Institute, Research Center, Université de Montréal, Montreal, Quebec, Canada
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25
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Thorin E, Webb DJ. Endothelium-derived endothelin-1. Pflugers Arch 2009; 459:951-8. [PMID: 19967386 DOI: 10.1007/s00424-009-0763-y] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Revised: 11/10/2009] [Accepted: 11/12/2009] [Indexed: 12/20/2022]
Abstract
One year after the revelation by Dr. Furchgott in 1980 that the endothelium was obligatory for acetylcholine to relax isolated arteries, it was clearly shown that the endothelium could also promote contraction. In 1988, Dr. Yanagisawa's group identified endothelin-1 (ET-1) as the first endothelium-derived contracting factor. The circulating levels of this short (21-amino acid) peptide were quickly determined in humans, and it was reported that, in most cardiovascular diseases, circulating levels of ET-1 were increased, and ET-1 was then tagged as "a bad guy." The discovery of two receptor subtypes in 1990, ET(A) and ET(B), permitted optimization of the first dual ET-1 receptor antagonist in 1993 by Dr. Clozel's team, who entered clinical development with bosentan, which was offered to patients with pulmonary arterial hypertension in 2001. The revelation of Dr. Furchgott opened a Pandora's box with ET-1 as one of the actors. In this brief review, we will discuss the physiological and pathophysiological role of endothelium-derived ET-1 focusing on the regulation of the vascular tone, and as much as possible in humans. The coronary bed will be used as a running example in this review because it is the most susceptible to endothelial dysfunction, but references to the cerebral and renal circulation will also be made. Many of the cardiovascular complications associated with aging and cardiovascular risk factors are initially attributable, at least in part, to endothelial dysfunction, particularly dysregulation of the vascular function associated with an imbalance in the close interdependence of nitric oxide and ET-1.
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Affiliation(s)
- Eric Thorin
- Department of Surgery and Research Center, Institut de Cardiologie de Montréal, Université de Montréal, Montréal, QC, Canada.
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Dhillon S. Bosentan: a review of its use in the management of digital ulcers associated with systemic sclerosis. Drugs 2009; 69:2005-24. [PMID: 19747014 DOI: 10.2165/10489160-000000000-00000] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Bosentan (Tracleer) is an orally administered dual endothelin-1 (ET-1) receptor antagonist approved in the EU for reducing the number of new digital ulcers in patients with systemic sclerosis and ongoing digital ulcer disease. Oral bosentan therapy was beneficial and generally well tolerated in patients with digital ulcers associated with systemic sclerosis. In well designed, placebo-controlled trials, bosentan treatment significantly reduced the number of new ulcers, but had no effect on ulcer healing, in patients with digital ulcers. Adverse events associated with bosentan were consistent with those seen during treatment for other indications, with major concerns being the potential for teratogenicity and hepatotoxicity, for which regular liver function monitoring is recommended. Overall, considering the large unmet need for therapeutic options in patients with digital ulcers, bosentan extends the treatment options available to patients with systemic sclerosis-associated digital ulcers.
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