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Avagimyan A, Kajaia N, Gabunia L, Trofimenko A, Sulashvili N, Sanikidze T, Gorgaslidze N, Challa A, Sheibani M. The place of beta-adrenergic receptor blockers in the treatment of arterial hypertension: From bench-to-bedside. Curr Probl Cardiol 2024; 49:102734. [PMID: 38944226 DOI: 10.1016/j.cpcardiol.2024.102734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/01/2024]
Abstract
Arterial hypertension is a multifaceted condition influenced by numerous pathophysiological factors. The key contributors to its pathogenesis encompass an unhealthy lifestyle, dysregulation of the sympathetic nervous system, alterations in the activity of adrenergic receptors, disruptions in sodium metabolism, structural and functional abnormalities in the vascular bed, as well as endothelial dysfunction, low-grade inflammation, oxidative stress etc. Despite extensive research into the mechanisms of arterial hypertension development over the centuries, its pathogenesis remains incompletely understood, and the selection of an effective treatment strategy continues to pose a significant challenge. Arterial hypertension is characterized by a diminished sensitivity of the β-adrenergic system, leading to the utilization of β-adrenergic blockers and other antihypertensive drugs in its treatment. This review delves into the mechanisms of action of beta-adrenergic receptor blockers in the treatment of hypertension and their respective effects.
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Affiliation(s)
- Ashot Avagimyan
- Yerevan State Medical University after M. Heratsi, Yerevan, Armenia.
| | - Nana Kajaia
- Tbilisi State Medical University, Tbilisi, Georgia
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Zhang S, Wu Y, Lv C, Liu H, Wang Y, Dong L, Liu Y, Wang S, Jia J, Yin T. β1-blockers in the reduction of bleeding risk in patients prescribed with potent dual antiplatelet therapy after acute coronary syndrome or percutaneous coronary intervention. Hellenic J Cardiol 2024; 79:15-24. [PMID: 37783287 DOI: 10.1016/j.hjc.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/14/2023] [Accepted: 09/26/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND β1-blockers could improve clinical outcomes in patients with coronary artery disease by lowering the heart rate, blood pressure, and myocardial contractility. Moreover, recent studies have suggested that β1-blockers may also have the potential to reduce bleeding risk. OBJECTIVES This study aimed to evaluate the association between β1-blockers and bleeding risk in the patients prescribed with potent dual antiplatelet therapy (DAPT) after acute coronary syndrome (ACS) or percutaneous coronary intervention (PCI). METHODS Patients with ACS or undergoing PCI treated by DAPT of ticagrelor and aspirin were consecutively recruited. Follow-up for all eligible patients was conducted for 1 year. Major bleeding outcomes were defined as events that were type ≥2 based on the Bleeding Academic Research Consortium (BARC) criteria. RESULTS A total of 1,113 eligible ticagrelor-treated patients were recruited. During the 1-year follow-up interval, 142 (12.6%) patients experienced BARC ≥2 bleedings including 23 patients (2.1%) suffering BARC ≥3 bleedings, with the most common site of bleeding located in the gastrointestinal tract. β1-blockers treatment was associated with a lower risk of BARC ≥2 bleedings (11.2% vs. 23.3%, adjusted HR: 0.42, 95% CI: 0.28-0.62, P < 0.01). Moreover, metoprolol (11.1% vs. 23.3%, adjusted HR: 0.56, 95% CI: 0.37-0.83, P < 0.01) and bisoprolol (11.3% vs. 23.3%, adjusted HR: 0.56, 95% CI: 0.33-0.96, P = 0.04) had similar effects on the reduction of bleeding risk. CONCLUSION β1-blockers might be beneficial for the reduction of bleeding risk in potent dual antiplatelet therapy patients with ACS or undergoing PCI.
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Affiliation(s)
- Shizhao Zhang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, No.28 Fu Xing Road, Beijing 100853, China; Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China
| | - Yangxun Wu
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, No.28 Fu Xing Road, Beijing 100853, China; Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China
| | - Chao Lv
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, No.28 Fu Xing Road, Beijing 100853, China; Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China
| | - Haiping Liu
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, No.28 Fu Xing Road, Beijing 100853, China; Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China
| | - Yuyan Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, No.28 Fu Xing Road, Beijing 100853, China; Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China
| | - Lisha Dong
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, No.28 Fu Xing Road, Beijing 100853, China; Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China
| | - Yuqi Liu
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, No.28 Fu Xing Road, Beijing 100853, China; Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China
| | - Shengshu Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, No.28 Fu Xing Road, Beijing 100853, China; Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China
| | - Jianjun Jia
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, No.28 Fu Xing Road, Beijing 100853, China; Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China.
| | - Tong Yin
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, No.28 Fu Xing Road, Beijing 100853, China; Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China.
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Belenichev I, Goncharov O, Bukhtiyarova N, Kuchkovskyi O, Ryzhenko V, Makyeyeva L, Oksenych V, Kamyshnyi O. Beta-Blockers of Different Generations: Features of Influence on the Disturbances of Myocardial Energy Metabolism in Doxorubicin-Induced Chronic Heart Failure in Rats. Biomedicines 2024; 12:1957. [PMID: 39335471 PMCID: PMC11428500 DOI: 10.3390/biomedicines12091957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/17/2024] [Accepted: 08/23/2024] [Indexed: 09/30/2024] Open
Abstract
Beta-blockers are first-line drugs in the treatment of chronic heart failure (CHF). However, there is no consensus on the specific effects of the beta-blockers of the I-III generation on energy metabolism in CHF. The aim of this study is to conduct a study of beta-blockers of different generations on myocardial energy metabolism in experimental CHF. CHF was modeled in white outbred rats by administering doxorubicin. The study drugs were administered intragastrically-new drug Hypertril (1-(β-phenylethyl)-4-amino-1,2,4-triazolium bromide)-3.5 mg/kg, Metoprolol-15 mg/kg, Nebivolol -10 mg/kg, Carvedilol 50 mg/kg, and Bisoprolol, 10 mg/kg. In the myocardium, the main indices of energy metabolism were determined-ATP, ADP, AMP, malate, lactate, pyruvate, succinate dehydrogenase (SDH) activity, and NAD-dependent malate dehydrogenase (NAD-MDH) activity. Traditional second-generation beta-blockers (Metoprolol and Bisoprolol) did not affect the studied indices of energy metabolism, and third-generation beta-blockers with additional properties-Carvedilol and, especially, Nebivalol and Hypertril-improved myocardial energy metabolism. The obtained results will help to expand our understanding of the effect of beta-blockers of various generations used to treat cardiovascular diseases on energy metabolism, and are also an experimental justification for the practical choice of these drugs in the complex therapy of CHF.
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Affiliation(s)
- Igor Belenichev
- Department of Pharmacology and Medical Formulation with Course of Normal Physiology, Zaporizhzhia State Medical and Pharmaceutical University, 69035 Zaporizhzhia, Ukraine
| | - Olexiy Goncharov
- Department of Pharmacology and Medical Formulation with Course of Normal Physiology, Zaporizhzhia State Medical and Pharmaceutical University, 69035 Zaporizhzhia, Ukraine
| | - Nina Bukhtiyarova
- Department of Clinical Laboratory Diagnostics, Zaporizhzhia State Medical and Pharmaceutical University, 69035 Zaporizhzhia, Ukraine
| | - Oleh Kuchkovskyi
- Department of Pharmacology and Medical Formulation with Course of Normal Physiology, Zaporizhzhia State Medical and Pharmaceutical University, 69035 Zaporizhzhia, Ukraine
| | - Victor Ryzhenko
- Department of Medical and Pharmaceutical Informatics and Advanced Technologies, Zaporizhzhia State Medical and Pharmaceutical University, 69035 Zaporizhzhia, Ukraine
| | - Lyudmyla Makyeyeva
- Department of Histology, Cytology and Embryology, Zaporizhzhia State Medical and Pharmaceutical University, 69035 Zaporizhzhia, Ukraine
| | - Valentyn Oksenych
- Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway
| | - Oleksandr Kamyshnyi
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, 46001 Ternopil, Ukraine
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Lee J, Chun P. Real world prescription of beta-blockers in patients with asthma. Pharmacoepidemiol Drug Saf 2024; 33:e5806. [PMID: 39090769 DOI: 10.1002/pds.5806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 03/11/2024] [Accepted: 04/20/2024] [Indexed: 08/04/2024]
Abstract
PURPOSE This study aimed to investigate the prescription of beta-blockers (β-blockers) for patients with asthma. METHODS In this retrospective cross-sectional study using the National Patient Sample (NPS) of the Health Insurance Review and Assessment Service (HIRA) of South Korea, β-blockers and asthma medications were investigated using generic name codes provided by HIRA. Concomitant administration was identified when a β-blocker and an asthma medication were co-prescribed in one billing statement or when separate β-blocker and asthma prescriptions had overlapping dates of use. RESULTS In the 1027 patients with asthma who were prescribed non-selective β-blockers (non-SBs), 3087 non-SB prescriptions were identified, of which 62.3% and 37.3% were for carvedilol and propranolol, respectively. Of the 906 patients with asthma prescribed selective β-blockers (SBs), 2942 SB prescriptions were identified, of which 48.5%, 28.3%, and 20.3% were for bisoprolol, atenolol, and nebivolol, respectively. Overall, 2149 non-SB and 2124 SB prescriptions with overlapping use dates with asthma medications were identified, which were prescribed to 726 and 657 patients, accounting for 70.7% and 72.5% of the patients receiving non-SBs and SBs, respectively. β2-agonists accounted for 39.9% of the concomitant asthma medications with overlapping dates of use with non-SBs. Co-prescribing of bronchodilators occurred at a rate of 38.7% and 45.1% for the 3087 non-SB prescriptions and 2942 SB prescriptions, respectively. CONCLUSIONS Carvedilol and propranolol accounted for half of all β-blockers prescribed to asthma patients. Prescribing β-blockers to patients with asthma requires caution to prevent exacerbation of asthma and drug interactions between β-blockers and co-prescribed asthma medications.
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Affiliation(s)
- Jihyun Lee
- College of Pharmacy and Inje Institute of Pharmaceutical Sciences and Research, Inje University, Gimhae, Republic of Korea
| | - Pusoon Chun
- College of Pharmacy and Inje Institute of Pharmaceutical Sciences and Research, Inje University, Gimhae, Republic of Korea
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Katsukunya JN, Jones E, Soko ND, Blom D, Sinxadi P, Rayner B, Dandara C. Genetic Variation in ABCB1, ADRB1, CYP3A4, CYP3A5, NEDD4L and NR3C2 Confers Differential Susceptibility to Resistant Hypertension among South Africans. J Pers Med 2024; 14:664. [PMID: 39063918 PMCID: PMC11277774 DOI: 10.3390/jpm14070664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/13/2024] [Accepted: 06/17/2024] [Indexed: 07/28/2024] Open
Abstract
Resistant hypertension (RHTN) prevalence ranges from 4 to 19% in Africa. There is a paucity of data on the role of genetic variation on RHTN among Africans. We set out to investigate the role of polymorphisms in ABCB1, ADRB1, CYP3A4, CYP3A5, NEDD4L, and NR3C2, on RHTN susceptibility among South Africans. Using a retrospective matched case-control study, 190 RHTN patients (cases: blood pressure (BP) ≥ 140/90 mmHg on ≥3 anti-hypertensives or BP < 140/90 mmHg on >3 anti-hypertensives) and 189 non-RHTN patients (controls: <3 anti-hypertensives, BP < 140/90 or ≥140/90 mmHg), 12 single nucleotide polymorphisms were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), quantitative PCR and Sanger sequencing. Genetic association analyses were conducted using the additive model and multivariable logistic regression. Homozygosity for CYP3A5 rs776746C/C genotype (p = 0.02; OR: 0.44; CI: 0.22-0.89) was associated with reduced risk for RHTN. Homozygous ADRB1 rs1801252G/G (p = 0.02; OR: 3.30; CI: 1.17-10.03) and NEDD4L rs4149601A/A genotypes (p = 0.001; OR: 3.82; CI: 1.67-9.07) were associated with increased risk for RHTN. Carriers of the of ADRB1 rs1801252-rs1801253 G-C haplotype had 2.83-fold odds of presenting with RHTN (p = 0.04; OR: 2.83; CI: 1.05-8.20). These variants that are associated with RHTN may have clinical utility in the selection of antihypertensive drugs in our population.
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Affiliation(s)
- Jonathan N. Katsukunya
- Division of Human Genetics, Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; (J.N.K.); (N.D.S.)
- SAMRC/UCT Platform for Pharmacogenomics Research and Translation, South African Medical Research Council, Cape Town 7501, South Africa; (E.J.); (D.B.); (P.S.); (B.R.)
| | - Erika Jones
- SAMRC/UCT Platform for Pharmacogenomics Research and Translation, South African Medical Research Council, Cape Town 7501, South Africa; (E.J.); (D.B.); (P.S.); (B.R.)
- Department of Medicine, Division of Nephrology and Hypertension, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Nyarai D. Soko
- Division of Human Genetics, Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; (J.N.K.); (N.D.S.)
- SAMRC/UCT Platform for Pharmacogenomics Research and Translation, South African Medical Research Council, Cape Town 7501, South Africa; (E.J.); (D.B.); (P.S.); (B.R.)
- Department of Pharmaceutical Technology, School of Allied Health Sciences, Harare Institute of Technology, Harare P.O. Box BE 277, Zimbabwe
| | - Dirk Blom
- SAMRC/UCT Platform for Pharmacogenomics Research and Translation, South African Medical Research Council, Cape Town 7501, South Africa; (E.J.); (D.B.); (P.S.); (B.R.)
- Department of Medicine, Division of Lipidology and Cape Heart Institute, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Phumla Sinxadi
- SAMRC/UCT Platform for Pharmacogenomics Research and Translation, South African Medical Research Council, Cape Town 7501, South Africa; (E.J.); (D.B.); (P.S.); (B.R.)
- Department of Medicine, Division of Clinical Pharmacology, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Brian Rayner
- SAMRC/UCT Platform for Pharmacogenomics Research and Translation, South African Medical Research Council, Cape Town 7501, South Africa; (E.J.); (D.B.); (P.S.); (B.R.)
- Department of Medicine, Division of Nephrology and Hypertension, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Collet Dandara
- Division of Human Genetics, Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; (J.N.K.); (N.D.S.)
- SAMRC/UCT Platform for Pharmacogenomics Research and Translation, South African Medical Research Council, Cape Town 7501, South Africa; (E.J.); (D.B.); (P.S.); (B.R.)
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Duraisamy K, Kumar M, Nawabjan A, Lo EKK, Hui Lin M, Lefranc B, Bonnafé E, Treilhou M, El-Nezami H, Leprince J, Chow BKC. MRGPRB2/X2 and the analogous effects of its agonist and antagonist in DSS-induced colitis in mice. Biomed Pharmacother 2024; 174:116471. [PMID: 38547764 DOI: 10.1016/j.biopha.2024.116471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/08/2024] [Accepted: 03/18/2024] [Indexed: 05/01/2024] Open
Abstract
The mast cell receptor Mrgprb2, a mouse orthologue of human Mrgprx2, is known as an inflammatory receptor and its elevated expression is associated with various diseases such as ulcerative colitis. We aimed to elucidate the role of Mrgprb2/x2 and the effect of its ligands on a chemically induced murine colitis model. We showed that in Mrgprb2-/- mice, there is a differential regulation of cytokine releases in the blood plasma and severe colonic damages after DSS treatment. Unexpectedly, we demonstrated that known Mrgprb2/x2 agonists (peptide P17, P17 analogues and CST-14) and antagonist (GE1111) similarly increased the survival rate of WT mice subjected to 4% DSS-induced colitis, ameliorated the colonic damages of 2.5% DSS-induced colitis, restored major protein mRNA expression involved in colon integrity, reduced CD68+ and F4/80+ immune cell infiltration and restored cytokine levels. Collectively, our findings highlight the eminent role of Mrpgrb2/x2 in conferring a beneficial effect in the colitis model, and this significance is demonstrated by the heightened severity of colitis with altered cytokine releases and inflammatory immune cell infiltration observed in the Mrgprb2 knockout mice. Elevated expression of Mrgprb2 in WT colitis murine models may represent the organism's adaptive protective mechanism since Mrgprb2 knockout results in severe colitis. On the other hand, both agonist and antagonist of Mrgprb2 analogously mitigated the severity of colitis in DSS-induced colitis model by altering Mrgprb2 expression, immune cell infiltration and inflammatory cytokine releases.
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Affiliation(s)
- Karthi Duraisamy
- School of Biological Sciences, The University of Hong Kong, Hong Kong, China; INSERM U1239 NorDiC, PRIMACEN, Université Rouen Normandie, Rouen, France
| | - Mukesh Kumar
- School of Biological Sciences, The University of Hong Kong, Hong Kong, China
| | - Abdullah Nawabjan
- School of Biological Sciences, The University of Hong Kong, Hong Kong, China
| | - Emily Kwun Kwan Lo
- School of Biological Sciences, The University of Hong Kong, Hong Kong, China
| | - Ming Hui Lin
- School of Biological Sciences, The University of Hong Kong, Hong Kong, China
| | - Benjamin Lefranc
- INSERM U1239 NorDiC, PRIMACEN, Université Rouen Normandie, Rouen, France
| | - Elsa Bonnafé
- EA7417 BTSB, Université Fédérale Toulouse Midi-Pyrénées, INU Champollion, Albi, France
| | - Michel Treilhou
- EA7417 BTSB, Université Fédérale Toulouse Midi-Pyrénées, INU Champollion, Albi, France
| | - Hani El-Nezami
- School of Biological Sciences, The University of Hong Kong, Hong Kong, China; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jérôme Leprince
- INSERM U1239 NorDiC, PRIMACEN, Université Rouen Normandie, Rouen, France.
| | - Billy K C Chow
- School of Biological Sciences, The University of Hong Kong, Hong Kong, China.
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Ceasovschih A, Șorodoc V, Covantsev S, Balta A, Uzokov J, Kaiser SE, Almaghraby A, Lionte C, Stătescu C, Sascău RA, Onofrei V, Haliga RE, Stoica A, Bologa C, Ailoaei Ș, Şener YZ, Kounis NG, Șorodoc L. Electrocardiogram Features in Non-Cardiac Diseases: From Mechanisms to Practical Aspects. J Multidiscip Healthc 2024; 17:1695-1719. [PMID: 38659633 PMCID: PMC11041971 DOI: 10.2147/jmdh.s445549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/10/2024] [Indexed: 04/26/2024] Open
Abstract
Despite the noteworthy advancements and the introduction of new technologies in diagnostic tools for cardiovascular disorders, the electrocardiogram (ECG) remains a reliable, easily accessible, and affordable tool to use. In addition to its crucial role in cardiac emergencies, ECG can be considered a very useful ancillary tool for the diagnosis of many non-cardiac diseases as well. In this narrative review, we aimed to explore the potential contributions of ECG for the diagnosis of non-cardiac diseases such as stroke, migraine, pancreatitis, Kounis syndrome, hypothermia, esophageal disorders, pulmonary embolism, pulmonary diseases, electrolyte disturbances, anemia, coronavirus disease 2019, different intoxications and pregnancy.
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Affiliation(s)
- Alexandr Ceasovschih
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2nd Internal Medicine Department, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
| | - Victorița Șorodoc
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2nd Internal Medicine Department, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
| | - Serghei Covantsev
- Department of Research and Clinical Development, Botkin Hospital, Moscow, Russia
| | - Anastasia Balta
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2nd Internal Medicine Department, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
| | - Jamol Uzokov
- Department of Cardiology, Republican Specialized Scientific Practical Medical Center of Therapy and Medical Rehabilitation, Tashkent, Uzbekistan
| | - Sergio E Kaiser
- Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Abdallah Almaghraby
- Department of Cardiology, Ibrahim Bin Hamad Obaidallah Hospital, Ras Al Khaimah, United Arab Emirates
| | - Cătălina Lionte
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2nd Internal Medicine Department, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
| | - Cristian Stătescu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- Department of Cardiology, “Prof. Dr. George I.M. Georgescu” Cardiovascular Diseases Institute, Iasi, Romania
| | - Radu A Sascău
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- Department of Cardiology, “Prof. Dr. George I.M. Georgescu” Cardiovascular Diseases Institute, Iasi, Romania
| | - Viviana Onofrei
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- Department of Cardiology, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
| | - Raluca Ecaterina Haliga
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2nd Internal Medicine Department, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
| | - Alexandra Stoica
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2nd Internal Medicine Department, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
| | - Cristina Bologa
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2nd Internal Medicine Department, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
| | - Ștefan Ailoaei
- Department of Cardiology, “Prof. Dr. George I.M. Georgescu” Cardiovascular Diseases Institute, Iasi, Romania
| | - Yusuf Ziya Şener
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkiye
| | - Nicholas G Kounis
- Department of Internal Medicine, Division of Cardiology, University of Patras Medical School, Patras, Greece
| | - Laurențiu Șorodoc
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2nd Internal Medicine Department, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
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Floria M, Oancea AF, Morariu PC, Burlacu A, Iov DE, Chiriac CP, Baroi GL, Stafie CS, Cuciureanu M, Scripcariu V, Tanase DM. An Overview of the Pharmacokinetics and Pharmacodynamics of Landiolol (an Ultra-Short Acting β1 Selective Antagonist) in Atrial Fibrillation. Pharmaceutics 2024; 16:517. [PMID: 38675178 PMCID: PMC11054558 DOI: 10.3390/pharmaceutics16040517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Landiolol is an ultra-short-acting, selective β1-adrenergic receptor blocker that was originally approved in Japan for the treatment of intraoperative tachyarrhythmias. It has gained attention for its use in the management of tachyarrhythmias and perioperative tachycardia, especially atrial fibrillation for both cardiac and non-cardiac surgeries. It can be the ideal agent for heart rate control due to its high β1-selectivity, potent negative chronotropic effect, a limited negative inotropic potential, and an ultrashort elimination half-life (around 4 min); moreover, it may have a potential therapeutic effects for sepsis and pediatric patients. Landiolol seems to be superior to other short-acting and selective beta-blockers such as esmolol. This review aims to provide a comprehensive overview of landiolol, a new ultra-short-acting β1 selective antagonist, including its pharmacology, clinical applications, efficacy, safety profile, and future directions in research and clinical data.
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Affiliation(s)
- Mariana Floria
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.F.); (A.B.); (D.E.I.); (D.M.T.)
- Saint Spiridon Emergency Hospital, 700115 Iasi, Romania; (C.P.C.); (G.L.B.)
| | - Alexandru Florinel Oancea
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.F.); (A.B.); (D.E.I.); (D.M.T.)
- Saint Spiridon Emergency Hospital, 700115 Iasi, Romania; (C.P.C.); (G.L.B.)
| | - Paula Cristina Morariu
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.F.); (A.B.); (D.E.I.); (D.M.T.)
- Saint Spiridon Emergency Hospital, 700115 Iasi, Romania; (C.P.C.); (G.L.B.)
| | - Alexandru Burlacu
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.F.); (A.B.); (D.E.I.); (D.M.T.)
- Cardiovascular Disease Institute, 700503 Iasi, Romania
| | - Diana Elena Iov
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.F.); (A.B.); (D.E.I.); (D.M.T.)
- Saint Spiridon Emergency Hospital, 700115 Iasi, Romania; (C.P.C.); (G.L.B.)
| | | | - Genoveva Livia Baroi
- Saint Spiridon Emergency Hospital, 700115 Iasi, Romania; (C.P.C.); (G.L.B.)
- Department of Surgery, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Celina Silvia Stafie
- Department of Preventive Medicine and Interdisciplinarity, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Magdalena Cuciureanu
- Department of Pharmacology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Viorel Scripcariu
- Department of Surgery, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Regional Institute of Oncology, 700483 Iasi, Romania
| | - Daniela Maria Tanase
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.F.); (A.B.); (D.E.I.); (D.M.T.)
- Saint Spiridon Emergency Hospital, 700115 Iasi, Romania; (C.P.C.); (G.L.B.)
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9
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Xu X, Wang SY, Wang R, Wu LY, Yan M, Sun ZL, Sun QH. Association of antihypertensive drugs with psoriasis: A trans-ancestry and drug-target Mendelian randomization study. Vascul Pharmacol 2024; 154:107284. [PMID: 38360195 DOI: 10.1016/j.vph.2024.107284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/02/2024] [Accepted: 02/11/2024] [Indexed: 02/17/2024]
Affiliation(s)
- Xiao Xu
- Department of Nursing, Nantong Health College of Jiangsu Province, Nantong, China.
| | - Shu-Yun Wang
- Academic Affair Office, Nantong Vocational University, Nantong, China; Department of Postgraduate, St. Paul University Philippines, Tuggegarau, Philippines.
| | - Rongyun Wang
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China.
| | - Lin-Yun Wu
- College of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China.
| | - Min Yan
- Department of Epidemiology, School of Public Health, Changzhou University, Changzhou, China; Faculty of Health and Welfare, Satakunta University of Applied Sciences, Pori, Finland.
| | - Zhi-Ling Sun
- Department of Rheumatology, School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
| | - Qiu-Hua Sun
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China.
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10
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Tsabedze N, Naicker RD, Mrabeti S. Efficacy of beta-blockers on blood pressure control and morbidity and mortality endpoints in hypertensives of African ancestry: an individual patient data meta-analysis. Front Cardiovasc Med 2024; 10:1280953. [PMID: 38322274 PMCID: PMC10844441 DOI: 10.3389/fcvm.2023.1280953] [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: 08/21/2023] [Accepted: 12/11/2023] [Indexed: 02/08/2024] Open
Abstract
Introduction Compared with first-line antihypertensives, beta-blockers (BB) have been reported to lower the central aortic blood pressure suboptimally and are associated with increased stroke risk. This observation has not been investigated in hypertensives of African ancestry. We hypothesised that an individual patient data meta-analysis (IPD-MA) on the efficacy of second- or third-generation beta-blockers (STGBBs) in hypertensives of African descent may provide new insights. Methods A single-stage IPD-MA analysed the efficacy of STGBB in lowering the mean arterial blood pressure and reducing the composite outcomes: cardiovascular death, stroke, and myocardial infarction. Results A total of 11,860 participants from four randomised control trials were included in the analysis. Second- or third-generation beta-blockers reduced the mean arterial pressure by 1.75 mmHg [95% confidence interval (CI):1.16-2.33; P < 0.001] in all participants included in the analysis, and by 1.93 mmHg (95% CI: 0.86-3.00; P < 0.001) in hypertensive Africans. In patients with established cardiovascular disease, where the benefits of BB therapy are well established, STGBBs were associated with an adjusted odds ratio of 1.33 (95% CI: 1.06-1.65; P = 0.015) of the composite outcome, most likely due to confounding. Similarly, the risk of total myocardial infarction was 1.76 times higher (95% CI: 1.15-2.68; P = 0.008) in hypertensives of African ancestry on STGBBs. Conclusion The STGBBs reduced the mean arterial pressure comparably to other antihypertensives, and they were not associated with an increased risk of stroke.
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Affiliation(s)
- Nqoba Tsabedze
- Division of Cardiology, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - R. Darshni Naicker
- Medical Department, Healthcare Division, Merck Pty Ltd, Modderfontein, South Africa
| | - Sanaa Mrabeti
- Medical Affairs EMEA, Merck Serono Middle East FZ-LLC, Dubai, United Arab Emirates
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11
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Kupka JR, Sagheb K, Al-Nawas B, Schiegnitz E. The Sympathetic Nervous System in Dental Implantology. J Clin Med 2023; 12:jcm12082907. [PMID: 37109243 PMCID: PMC10143978 DOI: 10.3390/jcm12082907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/07/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
The sympathetic nervous system plays a vital role in various regulatory mechanisms. These include the well-known fight-or-flight response but also, for example, the processing of external stressors. In addition to many other tissues, the sympathetic nervous system influences bone metabolism. This effect could be highly relevant concerning osseointegration, which is responsible for the long-term success of dental implants. Accordingly, this review aims to summarize the current literature on this topic and to reveal future research perspectives. One in vitro study showed differences in mRNA expression of adrenoceptors cultured on implant surfaces. In vivo, sympathectomy impaired osseointegration in mice, while electrical stimulation of the sympathetic nerves promoted it. As expected, the beta-blocker propranolol improves histological implant parameters and micro-CT measurements. Overall, the present data are considered heterogeneous. However, the available publications reveal the potential for future research and development in dental implantology, which helps to introduce new therapeutic strategies and identify risk factors for dental implant failure.
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Affiliation(s)
- Johannes Raphael Kupka
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany
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12
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Farhoumand LS, Liu H, Tsimpaki T, Hendgen-Cotta UB, Rassaf T, Bechrakis NE, Fiorentzis M, Berchner-Pfannschmidt U. Blockade of ß-Adrenergic Receptors by Nebivolol Enables Tumor Control Potential for Uveal Melanoma in 3D Tumor Spheroids and 2D Cultures. Int J Mol Sci 2023; 24:ijms24065894. [PMID: 36982966 PMCID: PMC10054088 DOI: 10.3390/ijms24065894] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/07/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Uveal melanoma (UM) is the most common primary cancer of the eye in adults. A new systemic therapy is needed to reduce the high metastasis and mortality rate. As β-blockers are known to have anti-tumor effects on various cancer entities, this study focuses on investigating the effect of β1-selective blockers atenolol, celiprolol, bisoprolol, metoprolol, esmolol, betaxolol, and in particular, nebivolol on UM. The study was performed on 3D tumor spheroids as well as 2D cell cultures, testing tumor viability, morphological changes, long-term survival, and apoptosis. Flow cytometry revealed the presence of all three β-adrenoceptors with a dominance of β2-receptors on cell surfaces. Among the blockers tested, solely nebivolol concentration-dependently decreased viability and altered 3D tumor spheroid structure. Nebivolol blocked the repopulation of cells spreading from 3D tumor spheroids, indicating a tumor control potential at a concentration of ≥20 µM. Mechanistically, nebivolol induced ATP depletion and caspase-3/7 activity, indicating that mitochondria-dependent signaling is involved. D-nebivolol or nebivolol combined with the β2-antagonist ICI 118.551 displayed the highest anti-tumor effects, suggesting a contribution of both β1- and β2-receptors. Thus, the present study reveals the tumor control potential of nebivolol in UM, which may offer a perspective for co-adjuvant therapy to reduce recurrence or metastasis.
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Affiliation(s)
- Lina S Farhoumand
- Eye Research Lab, Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Hongtao Liu
- Eye Research Lab, Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Theodora Tsimpaki
- Eye Research Lab, Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Ulrike B Hendgen-Cotta
- CardioScience Labs, Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Tienush Rassaf
- CardioScience Labs, Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Nikolaos E Bechrakis
- Eye Research Lab, Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Miltiadis Fiorentzis
- Eye Research Lab, Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Utta Berchner-Pfannschmidt
- Eye Research Lab, Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
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13
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Brenneis M, Jenei-Lanzl Z, Kupka J, Braun S, Junker M, Zaucke F, Rickert M, Meurer A. Correlation between Adrenoceptor Expression and Clinical Parameters in Degenerated Lumbar Intervertebral Discs. Int J Mol Sci 2022; 23:ijms232315358. [PMID: 36499685 PMCID: PMC9739018 DOI: 10.3390/ijms232315358] [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: 09/01/2022] [Revised: 11/22/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Despite advanced knowledge of the cellular and biomechanical processes of intervertebral disc degeneration (IVDD), the trigger and underlying mechanisms remain unclear. Since the sympathetic nervous system (SNS) has been shown to exhibit catabolic effects in osteoarthritis pathogenesis, it is attractive to speculate that it also influences IVDD. Therefore, we explored the adrenoceptor (AR) expression profile in human IVDs and correlated it with clinical parameters of patients. IVD samples were collected from n = 43 patients undergoing lumbar spinal fusion surgery. AR gene expression was analyzed by semi-quantitative polymerase chain reaction. Clinical parameters as well as radiological Pfirrmann and Modic classification were collected and correlated with AR expression levels. In total human IVD homogenates α1A-, α1B-, α2A-, α2B-, α2C-, β1- and β2-AR genes were expressed. Expression of α1A- (r = 0.439), α2A- (r = 0.346) and β2-AR (r = 0.409) showed a positive and significant correlation with Pfirrmann grade. α1A-AR expression was significantly decreased in IVD tissue of patients with adjacent segment disease (p = 0.041). The results of this study indicate that a relationship between IVDD and AR expression exists. Thus, the SNS and its neurotransmitters might play a role in IVDD pathogenesis. The knowledge of differential AR expression in different etiologies could contribute to the development of new therapeutic approaches for IVDD.
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Affiliation(s)
- Marco Brenneis
- Department of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany
- Correspondence: or
| | - Zsuzsa Jenei-Lanzl
- Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Department of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany
| | - Johannes Kupka
- Department of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany
| | - Sebastian Braun
- Department of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany
| | - Marius Junker
- Department of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany
| | - Frank Zaucke
- Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Department of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany
| | - Marcus Rickert
- Department of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany
| | - Andrea Meurer
- Department of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany
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14
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Hijazzi S, Moon K, Larkins NG. Oral agents for acute severe hypertension in children with minimal or no symptoms. J Paediatr Child Health 2022; 58:1935-1941. [PMID: 36129141 DOI: 10.1111/jpc.16210] [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] [Received: 04/22/2022] [Revised: 08/14/2022] [Accepted: 08/23/2022] [Indexed: 12/01/2022]
Abstract
Acute hypertension is common among children admitted to hospital, and large or rapid increases in blood pressure place children at risk of complications such as posterior reversible encephalopathy syndrome. Guidelines in the United States and Europe now include definitions guiding the identification of acute severe hypertension (otherwise known as hypertensive crisis) and its management. This review discusses these recommendations and the appropriate use of oral antihypertensive agents for children with minimal or no symptoms. We focus on the role of oral calcium channel blockers, including isradipine (a second-generation dihydropyridine), given recent changes to regulatory approvals in Australia. The differing pharmacokinetic and pharmacodynamic properties of agents are compared, with the aim of facilitating directed drug selection and dosing.
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Affiliation(s)
- Sally Hijazzi
- Department of Pharmacy, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Kwi Moon
- Department of Pharmacy, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Nicholas G Larkins
- Department of Nephrology and Hypertension, Perth Children's Hospital, Perth, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia
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15
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Embaby A, van Merendonk L, Steeghs N, Beijnen J, Huitema A. Beta-adrenergic receptor blockade in angiosarcoma: Which beta-blocker to choose? Front Oncol 2022; 12:940582. [PMID: 36185303 PMCID: PMC9520289 DOI: 10.3389/fonc.2022.940582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/30/2022] [Indexed: 11/28/2022] Open
Abstract
Beta-blockers are currently studied to improve therapeutic options for patients with angiosarcoma. However, most of these patients have no cardiovascular co-morbidity and it is therefore crucial to discuss the most optimal pharmacological properties of beta-blockers for this population. To maximize the possible effectiveness in angiosarcoma, the use of a non-selective beta-blocker is preferred based on in vitro data. To minimize the risk of cardiovascular adverse events a beta-blocker should ideally have intrinsic sympathomimetic activity or vasodilator effects, e.g. labetalol, pindolol or carvedilol. However, except for one case of carvedilol, only efficacy data of propranolol is available. In potential follow-up studies labetalol, pindolol or carvedilol can be considered to reduce the risk of cardiovascular adverse events.
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Affiliation(s)
- Alaa Embaby
- Department of Medical Oncology and Clinical Pharmacology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, Netherlands
- *Correspondence: Alaa Embaby,
| | - Lisanne van Merendonk
- Department of Pharmacy and Pharmacology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, Netherlands
| | - Neeltje Steeghs
- Department of Medical Oncology and Clinical Pharmacology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, Netherlands
| | - Jos Beijnen
- Department of Pharmacy and Pharmacology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, Netherlands
| | - Alwin Huitema
- Department of Pharmacy and Pharmacology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, Netherlands
- Department of Pharmacology, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
- Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
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16
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Allen LB, Mirnics K. Metoprolol Inhibits Developmental Brain Sterol Biosynthesis in Mice. Biomolecules 2022; 12:1211. [PMID: 36139049 PMCID: PMC9496459 DOI: 10.3390/biom12091211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/26/2022] [Accepted: 08/28/2022] [Indexed: 12/29/2022] Open
Abstract
De novo sterol synthesis is a critical homeostatic mechanism in the brain that begins during early embryonic development and continues throughout life. Multiple medications have sterol-biosynthesis-inhibiting side effects, with potentially detrimental effects on brain health. Using LC-MS/MS, we investigated the effects of six commonly used beta-blockers on brain sterol biosynthesis in vitro using cell lines. Two beta-blockers, metoprolol (MTP) and nebivolol, showed extreme elevations of the highly oxidizable cholesterol precursor 7-dehydrocholesterol (7-DHC) in vitro across multiple cell lines. We followed up on the MTP findings using a maternal exposure model in mice. We found that 7-DHC was significantly elevated in all maternal brain regions analyzed as well as in the heart, liver and brain of the maternally exposed offspring. Since DHCR7-inhibiting/7-DHC elevating compounds can be considered teratogens, these findings suggest that MTP utilization during pregnancy might be detrimental for the development of offspring, and alternative beta-blockers should be considered.
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Affiliation(s)
- Luke B. Allen
- Munroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha, NE 68105, USA
- Department of Biochemistry and Molecular Biology, College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Károly Mirnics
- Munroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha, NE 68105, USA
- Department of Biochemistry and Molecular Biology, College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Department of Psychiatry, College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
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17
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Li W, Wan J, Chen C, Zhou C, Liao P, Hu Q, Hu J, Wang Y, Zhang Y, Peng C, Huang Y, Huang W, Zhang W, Mcleod HL, He Y. Dissecting the role of cell signaling versus CD8 + T cell modulation in propranolol antitumor activity. J Mol Med (Berl) 2022; 100:1299-1306. [PMID: 35895125 DOI: 10.1007/s00109-022-02238-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/24/2022] [Accepted: 07/13/2022] [Indexed: 11/26/2022]
Abstract
Preclinical and early clinical mechanistic studies of antitumor activity from the beta-adrenergic receptor (β-AR) blocker propranolol have revealed both cell signaling and immune function pathway effects. Intertumoral studies were performed using propranolol, a β1-AR selective agent (atenolol), and a β2-AR selective agent (ICI 118,551) in a preclinical in vivo model, as a step to dissect the contribution of cell signaling and CD8+ immunological effects on anticancer activity. We found that repression of β2-AR but not β1-AR signaling selectively suppressed cell viability and inhibited xenograft growth in vivo. Moreover, western blot analysis indicated that the phosphorylation levels of AKT/MEK/ERK were significantly decreased following the inhibition of β2-AR. Furthermore, propranolol was found to activate the tumor microenvironment by inducing an increased intratumoral frequency of CD8+ T cells, whereas neither selective β1 nor β2-AR blockers had a significant effect on the tumor immune microenvironment. Thus, the results of this mechanistic dissection support a predominant role of tumor cell signaling, rather than the accumulation of CD8+ T cells, as the basis for propranolol antitumor activity. KEY MESSAGES : Molecular signaling of AKT/MAPK pathway contributes to propranolol caused cancer control. CD8+ T cells in tumor microenvironment were activated upon propranolol exposure. The basis for propranolol antitumor activity was predominantly dependent on cell signaling, rather than the activation of CD8+ T cells.
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Affiliation(s)
- Wei Li
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, People's Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, 110 Xiangya Road, Changsha, 410078, People's Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha, 410078, People's Republic of China
| | - Jielin Wan
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, People's Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, 110 Xiangya Road, Changsha, 410078, People's Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha, 410078, People's Republic of China
| | - Cuiyu Chen
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, People's Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, 110 Xiangya Road, Changsha, 410078, People's Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha, 410078, People's Republic of China
| | - Chengfang Zhou
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, People's Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, 110 Xiangya Road, Changsha, 410078, People's Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha, 410078, People's Republic of China
| | - Ping Liao
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, People's Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, 110 Xiangya Road, Changsha, 410078, People's Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha, 410078, People's Republic of China
| | - Qian Hu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, People's Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, 110 Xiangya Road, Changsha, 410078, People's Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha, 410078, People's Republic of China
| | - Jiali Hu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, People's Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, 110 Xiangya Road, Changsha, 410078, People's Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha, 410078, People's Republic of China
| | - Yang Wang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, People's Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, 110 Xiangya Road, Changsha, 410078, People's Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha, 410078, People's Republic of China
| | - Yu Zhang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, People's Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, 110 Xiangya Road, Changsha, 410078, People's Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha, 410078, People's Republic of China
| | - Cong Peng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, 410000, China
| | - Yuanfei Huang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, People's Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, 110 Xiangya Road, Changsha, 410078, People's Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha, 410078, People's Republic of China
- National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Weihua Huang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, People's Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, 110 Xiangya Road, Changsha, 410078, People's Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha, 410078, People's Republic of China
- National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Wei Zhang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, People's Republic of China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, 110 Xiangya Road, Changsha, 410078, People's Republic of China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha, 410078, People's Republic of China
- National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Howard L Mcleod
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, People's Republic of China.
- Intermountain Precision Genomics, Intermountain Healthcare, St. George, UT, 84770, USA.
| | - Yijing He
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, People's Republic of China.
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, 110 Xiangya Road, Changsha, 410078, People's Republic of China.
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha, 410078, People's Republic of China.
- National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha, Hunan, 410008, People's Republic of China.
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18
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Duran‐Corbera A, Faria M, Ma Y, Prats E, Dias A, Catena J, Martinez KL, Raldua D, Llebaria A, Rovira X. A Photoswitchable Ligand Targeting the β
1
‐Adrenoceptor Enables Light‐Control of the Cardiac Rhythm**. Angew Chem Int Ed Engl 2022; 61:e202203449. [PMID: 35608051 PMCID: PMC9401038 DOI: 10.1002/anie.202203449] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Indexed: 11/06/2022]
Abstract
Catecholamine‐triggered β‐adrenoceptor (β‐AR) signaling is essential for the correct functioning of the heart. Although both β1‐ and β2‐AR subtypes are expressed in cardiomyocytes, drugs selectively targeting β1‐AR have proven this receptor as the main target for the therapeutic effects of beta blockers in the heart. Here, we report a new strategy for the light‐control of β1‐AR activation by means of photoswitchable drugs with a high level of β1‐/β2‐AR selectivity. All reported molecules allow for an efficient real‐time optical control of receptor function in vitro. Moreover, using confocal microscopy we demonstrate that the binding of our best hit, pAzo‐2, can be reversibly photocontrolled. Strikingly, pAzo‐2 also enables a dynamic cardiac rhythm management on living zebrafish larvae using light, thus highlighting the therapeutic and research potential of the developed photoswitches. Overall, this work provides the first proof of precise control of the therapeutic target β1‐AR in native environments using light.
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Affiliation(s)
- Anna Duran‐Corbera
- MCS, Laboratory of Medicinal Chemistry Institute for Advanced Chemistry of Catalonia (IQAC), CSIC Jordi Girona, 18 08034 Barcelona Spain
| | - Melissa Faria
- Institute for Environmental Assessment and Water Research (IDAEA), CSIC Jordi Girona, 18 08034 Barcelona Spain
| | - Yuanyuan Ma
- Department of Chemistry & Nanoscience Center University of Copenhagen Thorvaldsensvej 40 1871 Frederiksberg Denmark
| | - Eva Prats
- Research and Development Center (CID), CSIC Jordi Girona 18 08034 Barcelona Spain
| | - André Dias
- Department of Chemistry & Nanoscience Center University of Copenhagen Thorvaldsensvej 40 1871 Frederiksberg Denmark
| | - Juanlo Catena
- SIMchem, Service of Synthesis of High Added Value Molecules Institute for Advanced Chemistry of Catalonia (IQAC), CSIC Jordi Girona, 18 Barcelona Spain
| | - Karen L. Martinez
- Department of Chemistry & Nanoscience Center University of Copenhagen Thorvaldsensvej 40 1871 Frederiksberg Denmark
| | - Demetrio Raldua
- Institute for Environmental Assessment and Water Research (IDAEA), CSIC Jordi Girona, 18 08034 Barcelona Spain
| | - Amadeu Llebaria
- MCS, Laboratory of Medicinal Chemistry Institute for Advanced Chemistry of Catalonia (IQAC), CSIC Jordi Girona, 18 08034 Barcelona Spain
| | - Xavier Rovira
- MCS, Laboratory of Medicinal Chemistry Institute for Advanced Chemistry of Catalonia (IQAC), CSIC Jordi Girona, 18 08034 Barcelona Spain
- Previous address: Molecular Photopharmacology Research Group The Tissue Repair and Regeneration Laboratory (TR2Lab) Faculty of Sciences and Technology University of Vic, Central University of Catalonia 08500 Vic Spain
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19
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Sex/Gender- and Age-Related Differences in β-Adrenergic Receptor Signaling in Cardiovascular Diseases. J Clin Med 2022; 11:jcm11154280. [PMID: 35893368 PMCID: PMC9330499 DOI: 10.3390/jcm11154280] [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: 06/10/2022] [Revised: 07/15/2022] [Accepted: 07/22/2022] [Indexed: 11/17/2022] Open
Abstract
Sex differences in cardiovascular disease (CVD) are often recognized from experimental and clinical studies examining the prevalence, manifestations, and response to therapies. Compared to age-matched men, women tend to have reduced CV risk and a better prognosis in the premenopausal period. However, with menopause, this risk increases exponentially, surpassing that of men. Although several mechanisms have been provided, including sex hormones, an emerging role in these sex differences has been suggested for β-adrenergic receptor (β-AR) signaling. Importantly, β-ARs are the most important G protein-coupled receptors (GPCRs), expressed in almost all the cell types of the CV system, and involved in physiological and pathophysiological processes. Consistent with their role, for decades, βARs have been considered the first targets for rational drug design to fight CVDs. Of note, β-ARs are seemingly associated with different CV outcomes in females compared with males. In addition, even if there is a critical inverse correlation between β-AR responsiveness and aging, it has been reported that gender is crucially involved in this age-related effect. This review will discuss how β-ARs impact the CV risk and response to anti-CVD therapies, also concerning sex and age. Further, we will explore how estrogens impact β-AR signaling in women.
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20
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Varela-Chinchilla CD, Sánchez-Mejía DE, Trinidad-Calderón PA. Congenital Heart Disease: The State-of-the-Art on Its Pharmacological Therapeutics. J Cardiovasc Dev Dis 2022; 9:201. [PMID: 35877563 PMCID: PMC9316572 DOI: 10.3390/jcdd9070201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/17/2022] Open
Abstract
Congenital heart disease is one of the most common causes of death derived from malformations. Historically, its treatment has depended on timely diagnosis and early pharmacological and surgical interventions. Survival rates for patients with this disease have increased, primarily due to advancements in therapeutic choices, but mortality remains high. Since this disease is a time-sensitive pathology, pharmacological interventions are needed to improve clinical outcomes. Therefore, we analyzed the applications, dosage, and side effects of drugs currently used for treating congenital heart disease. Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, and potassium-sparing diuretics have shown a mortality benefit in most patients. Other therapies, such as endothelin receptor antagonists, phosphodiesterase-5 inhibitors, prostaglandins, and soluble guanylyl cyclase stimulators, have benefited patients with pulmonary artery hypertension. Likewise, the adjunctive symptomatic treatment of these patients has further improved the outcomes, since antiarrhythmics, digoxin, and non-steroidal anti-inflammatory drugs have shown their benefits in these cases. Conclusively, these drugs also carry the risk of troublesome adverse effects, such as electrolyte imbalances and hemodynamic compromise. However, their benefits for survival, symptom improvement, and stabilization outweigh the possible complications from their use. Thus, cases must be assessed individually to accurately identify interventions that would be most beneficial for patients.
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Affiliation(s)
- Carlos Daniel Varela-Chinchilla
- Tecnológico de Monterrey, School of Medicine and Health Sciences, Ave. Ignacio Morones Prieto 3000 Pte., Col. Los Doctores, Monterrey 64710, N.L., Mexico; (C.D.V.-C.); (D.E.S.-M.)
| | - Daniela Edith Sánchez-Mejía
- Tecnológico de Monterrey, School of Medicine and Health Sciences, Ave. Ignacio Morones Prieto 3000 Pte., Col. Los Doctores, Monterrey 64710, N.L., Mexico; (C.D.V.-C.); (D.E.S.-M.)
| | - Plinio A. Trinidad-Calderón
- Tecnológico de Monterrey, Escuela de Ingeniería y Ciencias, Ave. Eugenio Garza Sada 2501, Monterrey 64849, N.L., Mexico
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21
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Duran‐Corbera A, Faria M, Ma Y, Prats E, Dias A, Catena J, Martinez KL, Raldua D, Llebaria A, Rovira X. A Photoswitchable Ligand Targeting the β
1
‐Adrenoceptor Enables Light‐Control of the Cardiac Rhythm**. Angew Chem Int Ed Engl 2022. [DOI: 10.1002/ange.202203449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Anna Duran‐Corbera
- MCS, Laboratory of Medicinal Chemistry Institute for Advanced Chemistry of Catalonia (IQAC), CSIC Jordi Girona, 18 08034 Barcelona Spain
| | - Melissa Faria
- Institute for Environmental Assessment and Water Research (IDAEA), CSIC Jordi Girona, 18 08034 Barcelona Spain
| | - Yuanyuan Ma
- Department of Chemistry & Nanoscience Center University of Copenhagen Thorvaldsensvej 40 1871 Frederiksberg Denmark
| | - Eva Prats
- Research and Development Center (CID), CSIC Jordi Girona 18 08034 Barcelona Spain
| | - André Dias
- Department of Chemistry & Nanoscience Center University of Copenhagen Thorvaldsensvej 40 1871 Frederiksberg Denmark
| | - Juanlo Catena
- SIMchem, Service of Synthesis of High Added Value Molecules Institute for Advanced Chemistry of Catalonia (IQAC), CSIC Jordi Girona, 18 Barcelona Spain
| | - Karen L. Martinez
- Department of Chemistry & Nanoscience Center University of Copenhagen Thorvaldsensvej 40 1871 Frederiksberg Denmark
| | - Demetrio Raldua
- Institute for Environmental Assessment and Water Research (IDAEA), CSIC Jordi Girona, 18 08034 Barcelona Spain
| | - Amadeu Llebaria
- MCS, Laboratory of Medicinal Chemistry Institute for Advanced Chemistry of Catalonia (IQAC), CSIC Jordi Girona, 18 08034 Barcelona Spain
| | - Xavier Rovira
- MCS, Laboratory of Medicinal Chemistry Institute for Advanced Chemistry of Catalonia (IQAC), CSIC Jordi Girona, 18 08034 Barcelona Spain
- Molecular Photopharmacology Research Group The Tissue Repair and Regeneration Laboratory (TR2Lab) Faculty of Sciences and Technology University of Vic, Central University of Catalonia 08500 Vic Spain
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22
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Buda V, Prelipcean A, Cozma D, Man DE, Negres S, Scurtu A, Suciu M, Andor M, Danciu C, Crisan S, Dehelean CA, Petrescu L, Rachieru C. An Up-to-Date Article Regarding Particularities of Drug Treatment in Patients with Chronic Heart Failure. J Clin Med 2022; 11:2020. [PMID: 35407628 PMCID: PMC8999552 DOI: 10.3390/jcm11072020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/24/2022] [Accepted: 04/01/2022] [Indexed: 11/17/2022] Open
Abstract
Since the prevalence of heart failure (HF) increases with age, HF is now one of the most common reasons for the hospitalization of elderly people. Although the treatment strategies and overall outcomes of HF patients have improved over time, hospitalization and mortality rates remain elevated, especially in developed countries where populations are aging. Therefore, this paper is intended to be a valuable multidisciplinary source of information for both doctors (cardiologists and general physicians) and pharmacists in order to decrease the morbidity and mortality of heart failure patients. We address several aspects regarding pharmacological treatment (including new approaches in HF treatment strategies [sacubitril/valsartan combination and sodium glucose co-transporter-2 inhibitors]), as well as the particularities of patients (age-induced changes and sex differences) and treatment (pharmacokinetic and pharmacodynamic changes in drugs; cardiorenal syndrome). The article also highlights several drugs and food supplements that may worsen the prognosis of HF patients and discusses some potential drug-drug interactions, their consequences and recommendations for health care providers, as well as the risks of adverse drug reactions and treatment discontinuation, as an interdisciplinary approach to treatment is essential for HF patients.
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Affiliation(s)
- Valentina Buda
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (V.B.); (A.P.); (A.S.); (M.S.); (C.D.); (C.A.D.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Andreea Prelipcean
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (V.B.); (A.P.); (A.S.); (M.S.); (C.D.); (C.A.D.)
| | - Dragos Cozma
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (D.E.M.); (M.A.); (S.C.); (L.P.); (C.R.)
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Dana Emilia Man
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (D.E.M.); (M.A.); (S.C.); (L.P.); (C.R.)
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Simona Negres
- Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Traian Vuia 6, 020956 Bucharest, Romania;
| | - Alexandra Scurtu
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (V.B.); (A.P.); (A.S.); (M.S.); (C.D.); (C.A.D.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Maria Suciu
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (V.B.); (A.P.); (A.S.); (M.S.); (C.D.); (C.A.D.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Minodora Andor
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (D.E.M.); (M.A.); (S.C.); (L.P.); (C.R.)
| | - Corina Danciu
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (V.B.); (A.P.); (A.S.); (M.S.); (C.D.); (C.A.D.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Simina Crisan
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (D.E.M.); (M.A.); (S.C.); (L.P.); (C.R.)
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Cristina Adriana Dehelean
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (V.B.); (A.P.); (A.S.); (M.S.); (C.D.); (C.A.D.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Lucian Petrescu
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (D.E.M.); (M.A.); (S.C.); (L.P.); (C.R.)
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Ciprian Rachieru
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (D.E.M.); (M.A.); (S.C.); (L.P.); (C.R.)
- Center for Advanced Research in Cardiovascular Pathology and Hemostasis, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
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23
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Paczkowska-Walendowska M, Sip S, Staszewski R, Cielecka-Piontek J. Single-Pill Combination to Improve Hypertension Treatment: Pharmaceutical Industry Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4156. [PMID: 35409840 PMCID: PMC8999086 DOI: 10.3390/ijerph19074156] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 12/10/2022]
Abstract
Multiple illness is an increasingly common phenomenon. Its consequence is the need for polytherapy, which is particularly common among people suffering from arterial hypertension. The development of combined preparations (containing at least two API-active pharmaceutical ingredients) dedicated to the treatment of hypertension is a response to increased compliance, especially in elderly patients. In our work, we describe in particular the possibilities of using β-adrenergic receptors blockers and angiotensin-converting enzyme inhibitors in combinations. The combinations of APIs are used as single pills in patients with arterial hypertension with concomitant diseases such as hyperlipidemia; blood coagulation problems and diabetes mellitus were also discussed successively. Pharmacoeconomic analysis for the API combinations shown is also presented. As a final conclusion, numerous benefits of using the combined preparations should be indicated, especially by the elderly and/or in patients with coexistence of other diseases.
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Affiliation(s)
| | - Szymon Sip
- Department of Pharmacognosy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (M.P.-W.); (S.S.)
| | - Rafał Staszewski
- Department of Hypertension, Angiology and Internal Medicine, Poznan University of Medical Sciences, Długa 1/2, 61-848 Poznań, Poland;
| | - Judyta Cielecka-Piontek
- Department of Pharmacognosy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland; (M.P.-W.); (S.S.)
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24
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Azzouz B, De Guizelin A, Lambert A, Fresse A, Morel A, Trenque T. Psoriasis risk after betablocker exposure: description of a pharmacovigilance signal. Br J Clin Pharmacol 2022; 88:3813-3818. [PMID: 35352377 DOI: 10.1111/bcp.15330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 11/29/2022] Open
Abstract
AIM We aimed to investigate French pharmacovigilance data. The objective was to characterize psoriatic conditions occurred after BB exposure and bright to light a possible pharmacovigilance signal. METHODS Spontaneous reports of psoriatic conditions recorded in the French national Pharmacovigilance database (FPVD) between 1985 and 2019 were extracted. We performed a retrospective, descriptive analysis of reports linked to BB exposure. Association between psoriasis risk and BB exposure was assessed using a case/non-case study. RESULTS Two hundred and twenty-five reports of psoriatic conditions after BB exposure were recorded in the FPVD during the study period. Both, cardioselective and non-cardioselective, topical and systemic, BBs are involved. Therapeutic indication of BB was mainly hypertension Mean time to onset was 5 months and outcome was favorable in 68% after BB discontinuation. These features were concordant with those of literature reports. The reporting odds ratio (ROR) was 8.95 (95%CI 7.75 - 10.33). CONCLUSION We highlighted a statistically significant disproportionality which constitutes a pharmacovigilance signal. Psoriasis risk with BBs is a class effect. Increasing surveillance during the 1st year of BB exposure is needed.
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Affiliation(s)
- Brahim Azzouz
- Regional Centre of Pharmacovigilance and Pharmacoepidemiology, Reims University Hospital, Reims, France.,EA 3797 Vieillissement, Fragilité (VieFra), Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France
| | - Apolline De Guizelin
- Regional Centre of Pharmacovigilance and Pharmacoepidemiology, Reims University Hospital, Reims, France
| | - Aude Lambert
- Regional Pharmacovigilance Centre, Strasbourg University Hospital, Strasbourg, France
| | - Audrey Fresse
- Regional Pharmacovigilance Centre, Nancy University Hospital, Nancy, France
| | - Aurore Morel
- Regional Centre of Pharmacovigilance and Pharmacoepidemiology, Reims University Hospital, Reims, France
| | - Thierry Trenque
- Regional Centre of Pharmacovigilance and Pharmacoepidemiology, Reims University Hospital, Reims, France.,EA 3797 Vieillissement, Fragilité (VieFra), Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France
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25
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Nuevo equipo editorial, nuevas perspectivas. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2022.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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26
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Bhushan R. 'Ab Ovo' Chiral Phases and Chiral Reagents for Liquid Chromatographic Separation and Isolation of Enantiomers. CHEM REC 2022; 22:e202100295. [PMID: 35005840 DOI: 10.1002/tcr.202100295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/20/2021] [Indexed: 11/07/2022]
Abstract
The de-novo approach of mixing chirally pure reagents or Cu(II)-L-amino acid complexes in the slurry of silica gel for preparing TLC plates was reported from author's laboratory and was successful for separation and isolation of enantiomers. Using high molar absorptivity molecules, e. g., 1,5-difluoro-2,4-dinitrobenzene and cyanuric chloride, more than 38 new chiral derivatizing reagents were synthesized in our laboratory by straightforward nucleophilic substitution with simple chiral auxiliaries. Besides, (S)-naproxen, (S)-ketoprofen, and (S)-levofloxacin were used as chiral platforms. A conceptual approach using both achiral phases in chromatography for enantioseparation was also adopted. 1 H NMR and DFT based software were used to explain structures of non-covalent and covalent diastereomeric pairs and determination of configuration and separation mechanism. The methods can be easily used to determine and control enantiomeric purity with advantages over a variety of commercial chiral phases.
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Affiliation(s)
- Ravi Bhushan
- Department of Chemistry, Indian Institute of Technology Roorkee, 247667, Roorkee, India
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27
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Ok SH, Ahn SH, Lee SH, Kim HJ, Sim G, Park JK, Sohn JT. Lipid emulsion attenuates propranolol-induced early apoptosis in rat cardiomyoblasts. Hum Exp Toxicol 2022; 41:9603271221110852. [PMID: 35738838 DOI: 10.1177/09603271221110852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Propranolol is used to treat several cardiovascular diseases; however, toxic doses of propranolol cause severe myocardial depression and cardiac arrest. The aim of this study was to examine the effects of lipid emulsion (LE) on cardiotoxicity induced by toxic doses of propranolol in H9C2 rat cardiomyoblast cell line and to elucidate the underlying mechanism. METHODS The experimental groups comprised control, propranolol alone, esmolol alone, or LE followed by propranolol or esmolol treatment, and reactive oxygen species (ROS) inhibitor N-acetyl-L-cysteine (NAC) followed by propranolol treatment. The effects of propranolol, esmolol, NAC, and LE, alone or in combination, on cell viability, apoptosis, and ROS production were examined. Additionally, we investigated the effect of LE on propranolol concentration. RESULTS LE and NAC reversed the inhibition of cell viability induced by propranolol (p < .001). However, LE had no effect on the inhibition of cell viability caused by esmolol. The LE inhibited propranolol-induced expressions of cleaved caspase-3 (p < .001), caspase-9 (p < .001), and Bax (p < .01), but not caspase-8. NAC inhibited the propranolol-induced expression of cleaved caspase-3. LE inhibited propranolol-induced early apoptosis, but had no effect on late apoptosis. Additionally, LE inhibited the number of terminal deoxynucleotidyl transferase dUTP nick end labeling-positive cells generated by propranolol. It attenuated propranolol-induced ROS production. However, it had no effect on propranolol concentration. CONCLUSION LE inhibits early apoptosis caused by a toxic dose of propranolol by suppressing the intrinsic apoptotic pathway, via direct inhibition of ROS production.
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Affiliation(s)
- Seong-Ho Ok
- Department of Anesthesiology and Pain Medicine, 90162Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.,Department of Anesthesiology and Pain Medicine, 26720Gyeongsang National University College of Medicine, Jinju, Republic of Korea.,Institute of Health Sciences, 26720Gyeongsang National University, Jinju, Republic of Korea
| | - Seung Hyun Ahn
- Department of Anesthesiology and Pain Medicine, 90162Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Soo Hee Lee
- Department of Anesthesiology and Pain Medicine, 90162Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.,Department of Anesthesiology and Pain Medicine, 26720Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Hyun-Jin Kim
- Division of Applied Life Sciences (BK21 four), 26720Gyeongsang National University, Jinju, Republic of Korea.,Department of Food Science and Technology, 26720Institute of Agriculture and Life Science, Gyeongsang National University, Jinju, Republic of Korea
| | - Gyujin Sim
- Department of Anesthesiology and Pain Medicine, 90162Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Jin Kyeong Park
- Department of Anesthesiology and Pain Medicine, 90162Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Ju-Tae Sohn
- Institute of Health Sciences, 26720Gyeongsang National University, Jinju, Republic of Korea.,Department of Anesthesiology and Pain Medicine, Gyeongsang National University College of Medicine, 90162Gyeongsang National University Hospital, Jinju, Republic of Korea
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28
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Soltani Hekmat A, Farjam M, Javanmardi K, Behrouz S, Zarenezhad E, Soltani Rad MN. Design, Synthesis and In Vivo Cardiovascular Evaluation of Some Novel Aryloxy Propanol Amino Acid Derivatives. ChemistrySelect 2021. [DOI: 10.1002/slct.202101920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Ava Soltani Hekmat
- Department of Physiology School of Medicine Fasa University of Medical Sciences Fasa Iran
| | - Mojtaba Farjam
- Noncommunicable Diseases Research Center Fasa University of Medical Sciences Fasa Iran
- Department of Medical Pharmacology School of Medicine Fasa University of Medical Sciences Fasa Iran
| | - Kazem Javanmardi
- Department of Physiology School of Medicine Fasa University of Medical Sciences Fasa Iran
| | - Somayeh Behrouz
- Medicinal Chemistry Research Laboratory Department of Chemistry Shiraz University of Technology 71555–313 Shiraz Iran
| | - Elham Zarenezhad
- Noncommunicable Diseases Research Center Fasa University of Medical Sciences Fasa Iran
| | - Mohammad Navid Soltani Rad
- Medicinal Chemistry Research Laboratory Department of Chemistry Shiraz University of Technology 71555–313 Shiraz Iran
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Dos Santos RB, de C Oliveira LV, Sena EP, de Sousa DP, Maia Filho ALM, Soriano RN, da S Lopes L, Branco LGS, de Oliveira AP, Salgado HC, Sabino JPJ. Acute autonomic effects of rose oxide on cardiovascular parameters of Wistar and spontaneously hypertensive rats. Life Sci 2021; 287:120107. [PMID: 34717911 DOI: 10.1016/j.lfs.2021.120107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 11/24/2022]
Abstract
AIMS Anti-inflammatory molecules, such as rose oxide (RO), are likely to exert therapeutic effects in systemic arterial hypertension (SAH), a disease associated with abnormal immune responses. We aimed to investigate acute autonomic effects of RO on hemodynamic parameters of Wistar and spontaneously hypertensive rats (SHR). METHODS Rats were anesthetized and femoral artery and veins were cannulated. Next day, blood pressure (BP) and heart rate (HR) were recorded. Acute effects of RO (1.25, 2.5, or 5.0 mg/kg; iv) on BP, HR, and variability of systolic arterial pressure (SAP) and pulse interval (PI) were assessed. The effects of RO were also investigated in SHR, which received atropine (2 mg/kg), propranolol (4 mg/kg), or hexamethonium (20 mg/kg) 15 min before receiving RO. Vasorelaxant effects of RO (10-10 to 10-4 M) on aortic rings of rats were also assessed. KEY FINDINGS In Wistar rats, none of the RO doses evoked significant changes in BP, HR, and variability of SAP and PI. On the other hand, in SHR, RO elicited reduction in mean arterial pressure (MAP), and prevented the increase in the low frequency power (LF) of the SAP spectra. Pretreatment with atropine or propranolol did not alter hypotension, but attenuated RO-induced bradycardia. Hexamethonium prevented RO-induced hypotension and bradycardia. RO exerted vasorelaxant effects on aortic rings with (Wistar and SHR) or without functional endothelium (SHR only). SIGNIFICANCE Rose oxide, a monoterpene with anti-inflammatory properties, acts as an antihypertensive molecule due to its ability to acutely promote hypotension and bradycardia in spontaneously hypertensive rats.
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Affiliation(s)
- Rômulo B Dos Santos
- Department of Biophysics and Physiology, Federal University of Piauí, Teresina, PI, Brazil
| | - Lucas V de C Oliveira
- Department of Biophysics and Physiology, Federal University of Piauí, Teresina, PI, Brazil
| | - Emerson P Sena
- Research Center for Medicinal Plants, Federal University of Piauí, Teresina, PI, Brazil
| | - Damião P de Sousa
- Department of Pharmaceutical Sciences, Federal University of Paraíba, João Pessoa, PB, Brazil
| | | | - Renato Nery Soriano
- Division of Physiology and Biophysics, Department of Basic Life Sciences, Federal University of Juiz de Fora, Governador Valadares, MG, Brazil
| | - Luciano da S Lopes
- Department of Biophysics and Physiology, Federal University of Piauí, Teresina, PI, Brazil
| | - Luiz G S Branco
- Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Helio C Salgado
- Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - João Paulo J Sabino
- Department of Biophysics and Physiology, Federal University of Piauí, Teresina, PI, Brazil.
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Frimpong EK, Asong JA, Aremu AO. A Review on Medicinal Plants Used in the Management of Headache in Africa. PLANTS 2021; 10:plants10102038. [PMID: 34685845 PMCID: PMC8539318 DOI: 10.3390/plants10102038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/28/2021] [Accepted: 09/04/2021] [Indexed: 01/29/2023]
Abstract
The use of medicinal plants in the management of diverse ailments is entrenched in the culture of indigenous people in African communities. This review provides a critical appraisal of the ethnobotanical uses of medicinal plants for the management of headache in Africa. Research articles published from 2010 (Jan) to 2021 (July) with keywords such as Africa, ethnobotany, headache, medicinal plant and traditional medicine were assessed for eligibility based on sets of pre-defined criteria. A total of 117 plants, representing 56 families, were documented from the 87 eligible studies. Asteraceae (10%), Fabaceae (10%), Lamiaceae (9%) and Mimosaceae (5%) were the most represented plant families. The most popular plant species used in the management of headache were Ocimum gratissimum L. (n = 7), Allium sativum L. (n = 3), Ricinus communis L. (n = 3) and Artemisia afra Jack. ex. Wild (n = 2). The leaves (49%), roots (20%) and bark (12%) were the most common plant parts used. Decoction (40%) and infusion (16%) were the preferred methods of preparation, whereas the oral route (52%) was the most preferred route of administration. The data revealed that medicinal plants continue to play vital roles in the management of headache in African communities. In an attempt to fully explore the benefits from the therapeutic potential of indigenous flora for common ailments, further studies are essential to generate empirical evidence on their efficacies, using appropriate test systems/models. This approach may assist with the ongoing drive towards the integration of African traditional medicine within mainstream healthcare systems.
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Affiliation(s)
- Ebenezer Kwabena Frimpong
- Indigenous Knowledge Systems Centre, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2790, South Africa;
- Correspondence: (E.K.F.); (A.O.A.); Tel.: +27-18-389-2573 (A.O.A.)
| | - John Awungnjia Asong
- Indigenous Knowledge Systems Centre, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2790, South Africa;
| | - Adeyemi Oladapo Aremu
- Indigenous Knowledge Systems Centre, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2790, South Africa;
- Food Security and Safety Niche Area, Faculty of Natural and Agricultural Sciences, North-West University, Private Bag X2046, Mmabatho 2790, South Africa
- Correspondence: (E.K.F.); (A.O.A.); Tel.: +27-18-389-2573 (A.O.A.)
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Clemente-Moragón A, Martínez-Milla J, Oliver E, Santos A, Flandes J, Fernández I, Rodríguez-González L, Serrano Del Castillo C, Ioan AM, López-Álvarez M, Gómez-Talavera S, Galán-Arriola C, Fuster V, Pérez-Calvo C, Ibáñez B. Metoprolol in Critically Ill Patients With COVID-19. J Am Coll Cardiol 2021; 78:1001-1011. [PMID: 34474731 PMCID: PMC8404624 DOI: 10.1016/j.jacc.2021.07.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/17/2021] [Accepted: 07/01/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Severe coronavirus disease-2019 (COVID-19) can progress to an acute respiratory distress syndrome (ARDS), which involves alveolar infiltration by activated neutrophils. The beta-blocker metoprolol has been shown to ameliorate exacerbated inflammation in the myocardial infarction setting. OBJECTIVES The purpose of this study was to evaluate the effects of metoprolol on alveolar inflammation and on respiratory function in patients with COVID-19-associated ARDS. METHODS A total of 20 COVID-19 patients with ARDS on invasive mechanical ventilation were randomized to metoprolol (15 mg daily for 3 days) or control (no treatment). All patients underwent bronchoalveolar lavage (BAL) before and after metoprolol/control. The safety of metoprolol administration was evaluated by invasive hemodynamic and electrocardiogram monitoring and echocardiography. RESULTS Metoprolol administration was without side effects. At baseline, neutrophil content in BAL did not differ between groups. Conversely, patients randomized to metoprolol had significantly fewer neutrophils in BAL on day 4 (median: 14.3 neutrophils/µl [Q1, Q3: 4.63, 265 neutrophils/µl] vs median: 397 neutrophils/µl [Q1, Q3: 222, 1,346 neutrophils/µl] in the metoprolol and control groups, respectively; P = 0.016). Metoprolol also reduced neutrophil extracellular traps content and other markers of lung inflammation. Oxygenation (PaO2:FiO2) significantly improved after 3 days of metoprolol treatment (median: 130 [Q1, Q3: 110, 162] vs median: 267 [Q1, Q3: 199, 298] at baseline and day 4, respectively; P = 0.003), whereas it remained unchanged in control subjects. Metoprolol-treated patients spent fewer days on invasive mechanical ventilation than those in the control group (15.5 ± 7.6 vs 21.9 ± 12.6 days; P = 0.17). CONCLUSIONS In this pilot trial, intravenous metoprolol administration to patients with COVID-19-associated ARDS was safe, reduced exacerbated lung inflammation, and improved oxygenation. Repurposing metoprolol for COVID-19-associated ARDS appears to be a safe and inexpensive strategy that can alleviate the burden of the COVID-19 pandemic.
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Affiliation(s)
| | - Juan Martínez-Milla
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Cardiology Department, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Eduardo Oliver
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBER de Enfermedades Cardiovasculares, Madrid, Spain
| | - Arnoldo Santos
- Intensive Care Unit, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Javier Flandes
- Department of Pulmonary Medicine, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Iker Fernández
- Department of Pulmonary Medicine, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Lorena Rodríguez-González
- Pathology Department, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain; Biobank Patform-PT20/00141, IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain
| | | | - Ana-María Ioan
- Intensive Care Unit, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - María López-Álvarez
- Cardiology Department, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain; CIBER de Enfermedades Cardiovasculares, Madrid, Spain
| | - Sandra Gómez-Talavera
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Cardiology Department, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain; CIBER de Enfermedades Cardiovasculares, Madrid, Spain
| | - Carlos Galán-Arriola
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBER de Enfermedades Cardiovasculares, Madrid, Spain
| | - Valentín Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - César Pérez-Calvo
- Intensive Care Unit, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Borja Ibáñez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Cardiology Department, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain; CIBER de Enfermedades Cardiovasculares, Madrid, Spain.
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Sip S, Paczkowska-Walendowska M, Rosiak N, Miklaszewski A, Grabańska-Martyńska K, Samarzewska K, Cielecka-Piontek J. Chitosan as Valuable Excipient for Oral and Topical Carvedilol Delivery Systems. Pharmaceuticals (Basel) 2021; 14:ph14080712. [PMID: 34451809 PMCID: PMC8401298 DOI: 10.3390/ph14080712] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/20/2021] [Accepted: 07/20/2021] [Indexed: 01/28/2023] Open
Abstract
Chitosan is a valued excipient due to its biocompatibility properties and increasing solubility of poorly water-soluble drugs. The research presented in this paper concerns the preparation of binary combinations of chitosan (deacetylated chitin) with carvedilol (beta-blocker) to develop a formulation with a modified carvedilol release profile. As part of the research, six physical mixtures of chitosan with carvedilol were obtained and identified by spectral (PXRD, FT-IR, and Raman), thermal (DSC), and microscopic (SEM) methods. The next stage of the research estimated the profile changes and the dissolution rate for carvedilol in the obtained drug delivery systems; the reference sample was pure carvedilol. The studies were conducted at pH = 1.2 and 6.8, simulating the gastrointestinal tract conditions. Quantitative changes of carvedilol were determined using the developed isocratic UHPLC-DAD method. Established apparent permeability coefficients proved the changes in carvedilol's permeability after introducing a drug delivery system through membranes simulating the gastrointestinal tract and skin walls. A bioadhesive potential of carvedilol-chitosan systems was confirmed using the in vitro model. The conducted research and the obtained results indicate a significant potential of using chitosan as an excipient in modern oral or epidermal drug delivery systems of carvedilol.
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Affiliation(s)
- Szymon Sip
- Department of Pharmacognosy, Poznan University of Medical Sciences, 4 Swiecickiego Street, 60-781 Poznan, Poland; (S.S.); (M.P.-W.); (N.R.)
| | - Magdalena Paczkowska-Walendowska
- Department of Pharmacognosy, Poznan University of Medical Sciences, 4 Swiecickiego Street, 60-781 Poznan, Poland; (S.S.); (M.P.-W.); (N.R.)
| | - Natalia Rosiak
- Department of Pharmacognosy, Poznan University of Medical Sciences, 4 Swiecickiego Street, 60-781 Poznan, Poland; (S.S.); (M.P.-W.); (N.R.)
| | - Andrzej Miklaszewski
- Institute of Materials Science and Engineering, Poznan University of Technology, Jana Pawła II 24, 61-138 Poznan, Poland;
| | | | - Karolina Samarzewska
- Department of Clinical Auxiology and Pediatric Nursing, Poznan University of Medical Sciences, Szpitalna 27/33 Street, 60-572 Poznan, Poland;
| | - Judyta Cielecka-Piontek
- Department of Pharmacognosy, Poznan University of Medical Sciences, 4 Swiecickiego Street, 60-781 Poznan, Poland; (S.S.); (M.P.-W.); (N.R.)
- Correspondence:
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AlHabeeb W, Mrabeti S, Abdelsalam AAI. Therapeutic Properties of Highly Selective β-blockers With or Without Additional Vasodilator Properties: Focus on Bisoprolol and Nebivolol in Patients With Cardiovascular Disease. Cardiovasc Drugs Ther 2021; 36:959-971. [PMID: 34106365 PMCID: PMC9519665 DOI: 10.1007/s10557-021-07205-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/20/2021] [Indexed: 02/07/2023]
Abstract
Bisoprolol and nebivolol are highly selective β1-adrenoceptor antagonists, with clinical indications in many countries within the management of heart failure with reduced left ventricular ejection fraction (HFrEF), ischaemic heart disease (IHD), and hypertension. Nebivolol has additional vasodilator actions, related to enhanced release of NO in the vascular wall. In principle, this additional mechanism compared with bisoprolol might lead to more potent vasodilatation, which in turn might influence the effectiveness of nebivolol in the management of HFrEF, IHD and hypertension. In this article, we review the therapeutic properties of bisoprolol and nebivolol, as representatives of “second generation” and “third generation” β-blockers, respectively. Although head-to-head trials are largely lacking, there is no clear indication from published studies of an additional effect of nebivolol on clinical outcomes in patients with HFrEF or the magnitude of reductions of BP in patients with hypertension.
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Affiliation(s)
- Waleed AlHabeeb
- Cardiac Sciences Department, King Saud University, Riyadh, 12372, Saudi Arabia.
| | - Sanaa Mrabeti
- General Medicine and Endocrinology, Medical Affairs EMEA, Merck Serono Middle East FZ-LLC, Dubai, United Arab Emirates
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Clemente-Moragón A, Gómez M, Villena-Gutiérrez R, Lalama DV, García-Prieto J, Martínez F, Sánchez-Cabo F, Fuster V, Oliver E, Ibáñez B. Metoprolol exerts a non-class effect against ischaemia-reperfusion injury by abrogating exacerbated inflammation. Eur Heart J 2021; 41:4425-4440. [PMID: 33026079 PMCID: PMC7752252 DOI: 10.1093/eurheartj/ehaa733] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/11/2020] [Accepted: 08/25/2020] [Indexed: 02/06/2023] Open
Abstract
Aims Clinical guidelines recommend early intravenous β-blockers during ongoing myocardial infarction; however, it is unknown whether all β-blockers exert a similar cardioprotective effect. We experimentally compared three clinically approved intravenous β-blockers. Methods and results Mice undergoing 45 min/24 h ischaemia–reperfusion (I/R) received vehicle, metoprolol, atenolol, or propranolol at min 35. The effect on neutrophil infiltration was tested in three models of exacerbated inflammation. Neutrophil migration was evaluated in vitro and in vivo by intravital microscopy. The effect of β-blockers on the conformation of the β1 adrenergic receptor was studied in silico. Of the tested β-blockers, only metoprolol ameliorated I/R injury [infarct size (IS) = 18.0% ± 0.03% for metoprolol vs. 35.9% ± 0.03% for vehicle; P < 0.01]. Atenolol and propranolol had no effect on IS. In the three exacerbated inflammation models, neutrophil infiltration was significantly attenuated only in the presence of metoprolol (60%, 50%, and 70% reductions vs. vehicle in myocardial I/R injury, thioglycolate-induced peritonitis, and lipopolysaccharide-induced acute lung injury, respectively). Migration studies confirmed the particular ability of metoprolol to disrupt neutrophil dynamics. In silico analysis indicated different intracellular β1 adrenergic receptor conformational changes when bound to metoprolol than to the other two β-blockers. Conclusions Metoprolol exerts a disruptive action on neutrophil dynamics during exacerbated inflammation, resulting in an infarct-limiting effect not observed with atenolol or propranolol. The differential effect of β-blockers may be related to distinct conformational changes in the β1 adrenergic receptor upon metoprolol binding. If these data are confirmed in a clinical trial, metoprolol should become the intravenous β-blocker of choice for patients with ongoing infarction. ![]()
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Affiliation(s)
- Agustín Clemente-Moragón
- Myocardial Pathophysiology Area, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), c/Melchor Fernandez Almagro, 3. 28029 Madrid, Spain
| | - Mónica Gómez
- Myocardial Pathophysiology Area, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), c/Melchor Fernandez Almagro, 3. 28029 Madrid, Spain
| | - Rocío Villena-Gutiérrez
- Myocardial Pathophysiology Area, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), c/Melchor Fernandez Almagro, 3. 28029 Madrid, Spain
| | - Doménica V Lalama
- Myocardial Pathophysiology Area, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), c/Melchor Fernandez Almagro, 3. 28029 Madrid, Spain
| | - Jaime García-Prieto
- Myocardial Pathophysiology Area, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), c/Melchor Fernandez Almagro, 3. 28029 Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - Fernando Martínez
- Myocardial Pathophysiology Area, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), c/Melchor Fernandez Almagro, 3. 28029 Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - Fátima Sánchez-Cabo
- Myocardial Pathophysiology Area, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), c/Melchor Fernandez Almagro, 3. 28029 Madrid, Spain
| | - Valentín Fuster
- Myocardial Pathophysiology Area, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), c/Melchor Fernandez Almagro, 3. 28029 Madrid, Spain.,Division of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicina at Mount Sinai School, 1 Gustave L. Levy Place. 10029-5674 New York, NY, USA
| | - Eduardo Oliver
- Myocardial Pathophysiology Area, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), c/Melchor Fernandez Almagro, 3. 28029 Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
| | - Borja Ibáñez
- Myocardial Pathophysiology Area, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), c/Melchor Fernandez Almagro, 3. 28029 Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain.,Department of Cardiology, Instituto de Investigación Sanitaria (IIS)-Fundación Jiménez Díaz, Calle Isaac Peral, 42. 28015 Madrid, Spain
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Del Mauro JS, Prince PD, Santander Plantamura Y, Allo MA, Parola L, Fernandez Machulsky N, Morettón MA, Bin EP, González GE, Bertera FM, Carranza A, Berg G, Taira CA, Donato M, Chiappetta DA, Polizio AH, Höcht C. Nebivolol is more effective than atenolol for blood pressure variability attenuation and target organ damage prevention in L-NAME hypertensive rats. Hypertens Res 2021; 44:791-802. [PMID: 33612826 DOI: 10.1038/s41440-021-00630-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 12/06/2020] [Accepted: 12/27/2020] [Indexed: 02/07/2023]
Abstract
β-Adrenergic blockers are no longer recommended as first-line therapy due to the reduced cardioprotection of traditional β-blockers compared with other antihypertensive drugs. It is unknown whether third-generation β-blockers share the limitations of traditional β-blockers. The aim of the present study was to compare the effects of nebivolol or atenolol on central and peripheral systolic blood pressure (SBP) and its variability and target organ damage (TOD) in N-nitro-L-arginine methyl ester (L-NAME) hypertensive rats. Male Wistar rats were treated with L-NAME for 8 weeks together with oral administration of nebivolol 30 mg/kg (n = 8), atenolol 90 mg/kg (n = 8), or vehicle (n = 8). The control group was composed of vehicle-treated Wistar rats. SBP and its variability, as well as echocardiographic parameters, were assessed during the last 2 weeks of treatment. Tissue levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and transforming growth factor β (TGF-β), and histopathological parameters were evaluated in the left ventricle and aorta. Nebivolol had a greater ability than atenolol to decrease central SBP and mid-term and short-term blood pressure variability (BPV) in L-NAME rats. Echocardiographic analysis showed that nebivolol was more effective than atenolol on E/A wave ratio normalization. Compared with atenolol treatment, nebivolol had a greater protective effect on different TOD markers, inducing a decrease in collagen deposition and a reduction in the proinflammatory cytokines IL-6 and TNF-α in the left ventricle and aorta. Our findings suggest that the adverse hemodynamic profile and the reduced cardiovascular protection reported with traditional β-blockers must not be carried forward to third-generation β-blockers.
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Affiliation(s)
- Julieta S Del Mauro
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Farmacología, Buenos Aires, Argentina.
| | - Paula D Prince
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Físicoquímica, Instituto de Bioquímica y Medicina Molecular (IBIMOL), Buenos Aires, Argentina
| | - Yanina Santander Plantamura
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Farmacología, Buenos Aires, Argentina
| | - Miguel A Allo
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Farmacología, Buenos Aires, Argentina
| | - Luciano Parola
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Farmacología, Buenos Aires, Argentina
| | - Nahuel Fernandez Machulsky
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Laboratorio de Lípidos y Aterosclerosis, Buenos Aires, Argentina.,Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Buenos Aires, Argentina
| | - Marcela A Morettón
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Tecnología Farmacéutica, Buenos Aires, Argentina
| | - Eliana P Bin
- Universidad de Buenos Aires, Facultad de Medicina, Instituto de Fisiopatología Cardiovascular (INFICA), Departamento de Patología, Buenos Aires, Argentina
| | - Germán E González
- Instituto de Investigaciones Biomédicas (BIOMED UCA-CONICET), Laboratorio de Patología Cardiovascular Experimental e Hipertensión Arterial, Buenos Aires, Argentina
| | - Facundo M Bertera
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Farmacología, Buenos Aires, Argentina.,Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Buenos Aires, Argentina
| | - Andrea Carranza
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Farmacología, Buenos Aires, Argentina
| | - Gabriela Berg
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Laboratorio de Lípidos y Aterosclerosis, Buenos Aires, Argentina.,Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Buenos Aires, Argentina
| | - Carlos A Taira
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Farmacología, Buenos Aires, Argentina.,Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Buenos Aires, Argentina
| | - Martín Donato
- Universidad de Buenos Aires, Facultad de Medicina, Instituto de Fisiopatología Cardiovascular (INFICA), Departamento de Patología, Buenos Aires, Argentina
| | - Diego A Chiappetta
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Tecnología Farmacéutica, Buenos Aires, Argentina
| | - Ariel H Polizio
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Farmacología, Buenos Aires, Argentina
| | - Christian Höcht
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Farmacología, Buenos Aires, Argentina.,Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Buenos Aires, Argentina
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Yang Y, Wang Y, Bao Z, Yang Q, Zhang Z, Ren Q. Progress in the Enantioseparation of β-Blockers by Chromatographic Methods. Molecules 2021; 26:molecules26020468. [PMID: 33477385 PMCID: PMC7830546 DOI: 10.3390/molecules26020468] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 12/31/2022] Open
Abstract
β-adrenergic antagonists (β-blockers) with at least one chiral center are an exceedingly important class of drugs used mostly to treat cardiovascular diseases. At least 70 β-blockers have been investigated in history. However, only a few β-blockers, e.g., timolol, are clinically marketed as an optically pure enantiomer. Therefore, the separation of racemates of β-blockers is essential both in the laboratory and industry. Many approaches have been explored to obtain the single enantiomeric β-blocker, including high performance liquid chromatography, supercritical fluid chromatography and simulated moving bed chromatography. In this article, a review is presented on different chromatographic methods applied for the enantioseparation of β-blockers, covering high performance liquid chromatography (HPLC), supercritical fluid chromatography (SFC) and simulated moving bed chromatography (SMB).
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Affiliation(s)
- Yiwen Yang
- Institute of Pharmaceutical Engineering, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou 310027, China; (Y.W.); (Z.B.); (Q.Y.); (Z.Z.); (Q.R.)
- Institute of Zhejiang University-Quzhou, Quzhou 324000, China
- Correspondence:
| | - Yehui Wang
- Institute of Pharmaceutical Engineering, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou 310027, China; (Y.W.); (Z.B.); (Q.Y.); (Z.Z.); (Q.R.)
| | - Zongbi Bao
- Institute of Pharmaceutical Engineering, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou 310027, China; (Y.W.); (Z.B.); (Q.Y.); (Z.Z.); (Q.R.)
- Institute of Zhejiang University-Quzhou, Quzhou 324000, China
| | - Qiwei Yang
- Institute of Pharmaceutical Engineering, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou 310027, China; (Y.W.); (Z.B.); (Q.Y.); (Z.Z.); (Q.R.)
- Institute of Zhejiang University-Quzhou, Quzhou 324000, China
| | - Zhiguo Zhang
- Institute of Pharmaceutical Engineering, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou 310027, China; (Y.W.); (Z.B.); (Q.Y.); (Z.Z.); (Q.R.)
- Institute of Zhejiang University-Quzhou, Quzhou 324000, China
| | - Qilong Ren
- Institute of Pharmaceutical Engineering, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou 310027, China; (Y.W.); (Z.B.); (Q.Y.); (Z.Z.); (Q.R.)
- Institute of Zhejiang University-Quzhou, Quzhou 324000, China
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Spaczyńska M, Rocha SF, Oliver E. Pharmacology of Pulmonary Arterial Hypertension: An Overview of Current and Emerging Therapies. ACS Pharmacol Transl Sci 2020; 3:598-612. [PMID: 32832865 DOI: 10.1021/acsptsci.0c00048] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Indexed: 12/21/2022]
Abstract
Pulmonary arterial hypertension is a rare and devastating disease characterized by an abnormal chronic increase in pulmonary arterial pressure above 20 mmHg at rest, with a poor prognosis if not treated. Currently, there is not a single fully effective therapy, even though a dozen of drugs have been developed in the last decades. Pulmonary arterial hypertension is a multifactorial disease, meaning that several molecular mechanisms are implicated in its pathology. The main molecular pathways regulating the pulmonary vasomotor tone-endothelin, nitric oxide, and prostacyclin-are the most biologically and therapeutically explored to date. However, drugs targeting these pathways have already found their limitations. In the last years, translational research and clinical trials have made a strong effort in suggesting and testing novel therapeutic strategies for this disease. These approaches involve targeting the main molecular pathways with novel drugs, drug repurposing for novel targets, and also using combinatorial therapies. In this review, we summarize current strategies and drugs targeting the endothelin, nitric oxide, and prostacyclin pathways, as well as, the emerging new drugs proposed to cope with vascular remodelling, metabolic switch, perivascular inflammation, epigenetic modifications, estrogen deregulation, serotonin, and other neurohumoral mechanisms characteristic of this disease. Nowadays, pulmonary arterial hypertension remains an incurable disease; however, the incoming new knowledge makes us believe that new promising therapies are coming to the clinical arena soon.
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Affiliation(s)
- Monika Spaczyńska
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, 28029, Spain
| | - Susana F Rocha
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, 28029, Spain
| | - Eduardo Oliver
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, 28029, Spain.,Centro de Investigaciones Biomédicas en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, 28029, Spain
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Beta-Blockers and Cancer: Where Are We? Pharmaceuticals (Basel) 2020; 13:ph13060105. [PMID: 32466499 PMCID: PMC7345088 DOI: 10.3390/ph13060105] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 02/06/2023] Open
Abstract
Cancer is one of the leading causes of death worldwide. After diagnosis, cancer treatment may involve radiotherapy, chemotherapy, and surgery. Several of the approaches used to treat cancer also attack normal cells and, thus, there is the need for more effective treatments that decrease the toxicity to normal cells and increase the success rates of treatment. The use of beta-blockers in cancer has been studied for their antagonist action on the adrenergic system through inhibition of beta-adrenergic receptors. Besides regulating processes such as blood pressure, heart rate, and airway strength or reactivity, beta-blockers block mechanisms that trigger tumorigenesis, angiogenesis, and tumor metastasis. This study presents a literature review of the available studies addressing cancer treatments and beta-blockers. Overall, data suggest that propranolol may be used as a complement for the treatment of several types of cancer due to its ability to improve cancer outcomes by decreasing cancer cell proliferation rates. Nonetheless, additional in vitro studies should be performed to fully understand the protective role of BBs in cancer patients.
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Ferreira-González I, Sánchez-Recalde Á, Abu-Assi E, Arias MÁ, Gallego P, Del Río I. Revista Española de Cardiología: annual report 2019. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2020; 73:410-417. [PMID: 32291243 DOI: 10.1016/j.rec.2020.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
| | | | | | | | | | - Iria Del Río
- Editorial Director, Revista Española de Cardiología
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Ferreira-González I, Sánchez-Recalde Á, Abu-Assi E, Arias MÁ, Gallego P, del Río I. Revista Española de Cardiología: anuario de 2019. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2020.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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