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Iyer DR, Venkatraman J, Tanguy E, Vitale N, Mahapatra NR. Chromogranin A and its derived peptides: potential regulators of cholesterol homeostasis. Cell Mol Life Sci 2023; 80:271. [PMID: 37642733 PMCID: PMC11072126 DOI: 10.1007/s00018-023-04908-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/31/2023]
Abstract
Chromogranin A (CHGA), a member of the granin family of proteins, has been an attractive therapeutic target and candidate biomarker for several cardiovascular, neurological, and inflammatory disorders. The prominence of CHGA stems from the pleiotropic roles of several bioactive peptides (e.g., catestatin, pancreastatin, vasostatins) generated by its proteolytic cleavage and by their wide anatomical distribution. These peptides are emerging as novel modulators of cardiometabolic diseases that are often linked to high blood cholesterol levels. However, their impact on cholesterol homeostasis is poorly understood. The dynamic nature of cholesterol and its multitudinous roles in almost every aspect of normal body function makes it an integral component of metabolic physiology. A tightly regulated coordination of cholesterol homeostasis is imperative for proper functioning of cellular and metabolic processes. The deregulation of cholesterol levels can result in several pathophysiological states. Although studies till date suggest regulatory roles for CHGA and its derived peptides on cholesterol levels, the mechanisms by which this is achieved still remain unclear. This review aims to aggregate and consolidate the available evidence linking CHGA with cholesterol homeostasis in health and disease. In addition, we also look at common molecular regulatory factors (viz., transcription factors and microRNAs) which could govern the expression of CHGA and genes involved in cholesterol homeostasis under basal and pathological conditions. In order to gain further insights into the pathways mediating cholesterol regulation by CHGA/its derived peptides, a few prospective signaling pathways are explored, which could act as primers for future studies.
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Affiliation(s)
- Dhanya R Iyer
- Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai, 600036, India
| | - Janani Venkatraman
- Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai, 600036, India
| | - Emeline Tanguy
- Institut des Neurosciences Cellulaires et Intégratives, CNRS UPR 3212 and Université de Strasbourg, 5 Rue Blaise Pascal, 67000, Strasbourg, France
| | - Nicolas Vitale
- Institut des Neurosciences Cellulaires et Intégratives, CNRS UPR 3212 and Université de Strasbourg, 5 Rue Blaise Pascal, 67000, Strasbourg, France.
| | - Nitish R Mahapatra
- Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai, 600036, India.
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Ioannidis M, Mahata SK, van den Bogaart G. The immunomodulatory functions of chromogranin A-derived peptide pancreastatin. Peptides 2022; 158:170893. [PMID: 36244579 PMCID: PMC10760928 DOI: 10.1016/j.peptides.2022.170893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/08/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
Chromogranin A (CgA) is a 439 amino acid protein secreted by neuroendocrine cells. Proteolytic processing of CgA results in the production of different bioactive peptides. These peptides have been associated with inflammatory bowel disease, diabetes, and cancer. One of the chromogranin A-derived peptides is ∼52 amino acid long Pancreastatin (PST: human (h)CgA250-301, murine (m)CgA263-314). PST is a glycogenolytic peptide that inhibits glucose-induced insulin secretion from pancreatic islet β-cells. In addition to this metabolic role, evidence is emerging that PST also has inflammatory properties. This review will discuss the immunomodulatory properties of PST and its possible mechanisms of action and regulation. Moreover, this review will discuss the potential translation to humans and how PST may be an interesting therapeutic target for treating inflammatory diseases.
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Affiliation(s)
- Melina Ioannidis
- Department of Molecular Immunology, Groningen Biomolecular Sciences and Biotechnology Institute, University of Groningen, Groningen, the Netherlands
| | - Sushil K Mahata
- VA San Diego Healthcare System, San Diego, CA, USA; Department of Medicine, University of California San Diego, La Jolla, CA, USA.
| | - Geert van den Bogaart
- Department of Molecular Immunology, Groningen Biomolecular Sciences and Biotechnology Institute, University of Groningen, Groningen, the Netherlands; Department of Medical Biology and Pathology, University Medical Center Groningen, Groningen, the Netherlands.
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Wei J, Wang Y, Yang S, Hao Z, Pan X, Ma A. Plasma chromogranin A levels are associated with acute ischemic stroke with anterior circulation large vessel occlusion. Nutr Metab Cardiovasc Dis 2022; 32:195-202. [PMID: 34893409 DOI: 10.1016/j.numecd.2021.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 08/17/2021] [Accepted: 09/21/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS To investigate the relationship between chromogranin A (CgA) levels and acute ischemic stroke (AIS), especially anterior circulation large vessel occlusion (LVO). METHODS AND RESULTS 587 subjects were included in this study, including 205 AIS patients with anterior circulation LVO and 205 nonocclusive patients, as well as 177 healthy controls. On admission, plasma CgA levels were measured and neurological deficits were assessed by the NIH Stroke Scale. Outcomes were assessed by the modified Rankin Scale at 3 months. The predictive properties of CgA were evaluated by receiver operating characteristic (ROC) curve analysis. Binary logistic analysis assessed the association of CgA levels and AIS or anterior circulation LVO. AIS patients had lower CgA levels than health controls (p < 0.001). Anterior circulation LVO patients had lower CgA levels than nonocclusive patients (p < 0.001). The area under the ROC curve of plasma CgA levels in predicting anterior circulation LVO from AIS was 0.744 and the optimal cutoff value was 15.49 ng/mL with a Youden value of 0.332. Logistic analysis showed that CgA ≤15.49 ng/mL remained an independent risk factor for anterior circulation LVO after adjusting for related factors (OR = 6.519, 95% CI: 3.790-11.214, p < 0.001). CgA was an independent protective factor for mild stroke and good prognosis (p = 0.009, p = 0.005); however, the association disappeared after adjusting for occlusion (p = 0.768, p = 0.335). CONCLUSION CgA levels were lower in AIS patients, especially in anterior circulation LVO patients. Lower CgA levels are potential biomarker for anterior circulation LVO, and they may indicate good prognosis at 3 months in AIS.
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Affiliation(s)
- Jin Wei
- Department of Neurology, The Affiliated Hospital of Qingdao University, 59 Haier Road, Qingdao, 266100, Shandong, China
| | - Yuan Wang
- Department of Neurology, The Affiliated Hospital of Qingdao University, 59 Haier Road, Qingdao, 266100, Shandong, China
| | - Shaonan Yang
- Department of Neurology, The Affiliated Hospital of Qingdao University, 59 Haier Road, Qingdao, 266100, Shandong, China
| | - Zhongnan Hao
- Department of Neurology, The Affiliated Hospital of Qingdao University, 59 Haier Road, Qingdao, 266100, Shandong, China
| | - Xudong Pan
- Department of Neurology, The Affiliated Hospital of Qingdao University, 59 Haier Road, Qingdao, 266100, Shandong, China.
| | - Aijun Ma
- Department of Neurology, The Affiliated Hospital of Qingdao University, 59 Haier Road, Qingdao, 266100, Shandong, China.
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Catestatin as a Biomarker of Cardiovascular Diseases: A Clinical Perspective. Biomedicines 2021; 9:biomedicines9121757. [PMID: 34944578 PMCID: PMC8698910 DOI: 10.3390/biomedicines9121757] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 02/07/2023] Open
Abstract
Accounting for almost one-third of the global mortality, cardiovascular diseases (CVDs) represent a major global health issue. Emerging data suggest that most of the well-established mechanistic explanations regarding the cardiovascular pathophysiology are flawed, and cannot fully explain the progression and long-term effects of these diseases. On the other hand, dysregulation of the sympathetic nervous system (SNS) has emerged as an important player in the pathophysiology of CVDs. Even though upregulated SNS activity is an essential compensatory response to various stress conditions, in the long term, it becomes a major contributor to both cardiac dysfunction and vascular damage. Despite the fact that the importance of SNS hyperactivity in the setting of CVDs has been well-appreciated, its exact quantification and clinical application in either diagnostics or therapy of CVDs is still out of reach. Nevertheless, in recent years a number of novel laboratory biomarkers implicated in the pathophysiology of SNS activation have been explored. Specifically, in this review, we aimed to discuss the role of catestatin, a potent physiological inhibitor of catecholamine spillover that offers cardioprotective effects. Limited data indicate that catestatin could also be a reliable indirect marker of SNS activity and it is likely that high CST levels reflect advanced CV disease burden. Consequently, large-scale studies are required to validate these observations in the upcoming future.
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The Emerging Roles of Chromogranins and Derived Polypeptides in Atherosclerosis, Diabetes, and Coronary Heart Disease. Int J Mol Sci 2021; 22:ijms22116118. [PMID: 34204153 PMCID: PMC8201018 DOI: 10.3390/ijms22116118] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 02/07/2023] Open
Abstract
Chromogranin A (CgA), B (CgB), and C (CgC), the family members of the granin glycoproteins, are associated with diabetes. These proteins are abundantly expressed in neurons, endocrine, and neuroendocrine cells. They are also present in other areas of the body. Patients with diabetic retinopathy have higher levels of CgA, CgB, and CgC in the vitreous humor. In addition, type 1 diabetic patients have high CgA and low CgB levels in the circulating blood. Plasma CgA levels are increased in patients with hypertension, coronary heart disease, and heart failure. CgA is the precursor to several functional peptides, including catestatin, vasostatin-1, vasostatin-2, pancreastatin, chromofungin, and many others. Catestatin, vasostain-1, and vasostatin-2 suppress the expression of vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 in human vascular endothelial cells. Catestatin and vasostatin-1 suppress oxidized low-density lipoprotein-induced foam cell formation in human macrophages. Catestatin and vasostatin-2, but not vasostatin-1, suppress the proliferation and these three peptides suppress the migration in human vascular smooth muscles. Chronic infusion of catestatin, vasostatin-1, or vasostatin-2 suppresses the development of atherosclerosis of the aorta in apolipoprotein E-deficient mice. Catestatin, vasostatin-1, vasostatin-2, and chromofungin protect ischemia/reperfusion-induced myocardial dysfunction in rats. Since pancreastatin inhibits insulin secretion from pancreatic β-cells, and regulates glucose metabolism in liver and adipose tissues, pancreastatin inhibitor peptide-8 (PSTi8) improves insulin resistance and glucose homeostasis. Catestatin stimulates therapeutic angiogenesis in the mouse hind limb ischemia model. Gene therapy with secretoneurin, a CgC-derived peptide, stimulates postischemic neovascularization in apolipoprotein E-deficient mice and streptozotocin-induced diabetic mice, and improves diabetic neuropathy in db/db mice. Therefore, CgA is a biomarker for atherosclerosis, diabetes, hypertension, and coronary heart disease. CgA- and CgC--derived polypeptides provide the therapeutic target for atherosclerosis and ischemia-induced tissue damages. PSTi8 is useful in the treatment of diabetes.
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Borovac JA, D'Amario D, Bozic J, Glavas D. Sympathetic nervous system activation and heart failure: Current state of evidence and the pathophysiology in the light of novel biomarkers. World J Cardiol 2020; 12:373-408. [PMID: 32879702 PMCID: PMC7439452 DOI: 10.4330/wjc.v12.i8.373] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 05/19/2020] [Accepted: 07/19/2020] [Indexed: 02/06/2023] Open
Abstract
Heart failure (HF) is a complex clinical syndrome characterized by the activation of at least several neurohumoral pathways that have a common role in maintaining cardiac output and adequate perfusion pressure of target organs and tissues. The sympathetic nervous system (SNS) is upregulated in HF as evident in dysfunctional baroreceptor and chemoreceptor reflexes, circulating and neuronal catecholamine spillover, attenuated parasympathetic response, and augmented sympathetic outflow to the heart, kidneys and skeletal muscles. When these sympathoexcitatory effects on the cardiovascular system are sustained chronically they initiate the vicious circle of HF progression and become associated with cardiomyocyte apoptosis, maladaptive ventricular and vascular remodeling, arrhythmogenesis, and poor prognosis in patients with HF. These detrimental effects of SNS activity on outcomes in HF warrant adequate diagnostic and treatment modalities. Therefore, this review summarizes basic physiological concepts about the interaction of SNS with the cardiovascular system and highlights key pathophysiological mechanisms of SNS derangement in HF. Finally, special emphasis in this review is placed on the integrative and up-to-date overview of diagnostic modalities such as SNS imaging methods and novel laboratory biomarkers that could aid in the assessment of the degree of SNS activation and provide reliable prognostic information among patients with HF.
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Affiliation(s)
- Josip Anđelo Borovac
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
- Working Group on Heart Failure of Croatian Cardiac Society, Zagreb 10000, Croatia
| | - Domenico D'Amario
- Department of Cardiovascular and Thoracic Sciences, IRCCS Fondazione Policlinico A. Gemelli, Universita Cattolica Sacro Cuore, Rome 00168, Italy
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Duska Glavas
- Working Group on Heart Failure of Croatian Cardiac Society, Zagreb 10000, Croatia
- Clinic for Cardiovascular Diseases, University Hospital of Split, Split 21000, Croatia
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Tarantino N, Santoro F, Di Biase L, Di Terlizzi V, Vitale E, Barone R, Della Rocca DG, De Leon De La Cruz NS, Di Biase M, Brunetti ND. Chromogranin-A serum levels in patients with takotsubo syndrome and ST elevation acute myocardial infarction. Int J Cardiol 2020; 320:12-17. [PMID: 32739447 DOI: 10.1016/j.ijcard.2020.07.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/20/2020] [Accepted: 07/28/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Sympathergic hyperactivity is considered one of the main trigger precipitating takotsubo syndrome (TTS). Chromogranin-A (CgA), a prognostic biomarker of sympatho-adrenal activation, is markedly high in acute coronary syndrome (ACS) and heart failure (HF), but its role in TTS is unknown. METHODS CgA serum levels from patients with TTS and symptoms onset <24 hours were consecutively evaluated and compared with anterior ST-elevation myocardial infarction (STEMI) patients from November 2016 to December 2019. Short and long-term follow-up data were recorded. RESULTS Eleven women with TTS and 10 subjects with anterior STEMI were analyzed and compared; differences were not significant in terms of age, gender and cardiovascular risk factors. NT-pro-BNP levels were similar (9,887 ± 12,170 vs 8,969 ± 15,053 pg/ml, p = .88), while troponin-I levels were higher in patients with STEMI (4 ± 3.2 vs 13.3 ± 10 ng/dl, p = .03). CgA admission levels were significantly lower in TTS patients (2.2 ± 1.5 vs 7.3 ± 6.2 nMol/l, p = .017), even after multivariable correction for principal bias. CgA levels correlated with NTproBNP levels (p = .02) and were higher in subjects with in-hospital events (3.7 ± 1.1 vs 1.6 ± 1.2 nMol/l, p = .03), even after multivariable forward stepwise analysis (p < .01). CgA levels <3.25 nMol/l (AUC 0.754, 95% C.I. 0.54-0.968) were able to discriminate TTS from anterior STEMI (negative predictive power of 99%). CONCLUSIONS Systemic CgA levels in the acute phase of TTS are lower than in anterior STEMI, possibly indicating a greater myocardial catecholamine release rather than adrenal.
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Affiliation(s)
- Nicola Tarantino
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy; Arrhythmia Service, Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Francesco Santoro
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
| | - Luigi Di Biase
- Arrhythmia Service, Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA; Texas Cardiac Arrhyhtmia Institute (TCAI) at St. David's Hospital, Austin, TX, USA; Department of Biomedical Engineering, Cockrell School of Engineering, University of Texas, Austin, TX, USA; Department of Internal Medicine, Dell Medical School, University of Texas, Austin, TX, USA
| | - Vito Di Terlizzi
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Enrica Vitale
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Roberta Barone
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | | | - Matteo Di Biase
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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Mahata SK, Corti A. Chromogranin A and its fragments in cardiovascular, immunometabolic, and cancer regulation. Ann N Y Acad Sci 2019; 1455:34-58. [PMID: 31588572 PMCID: PMC6899468 DOI: 10.1111/nyas.14249] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 09/09/2019] [Accepted: 09/13/2019] [Indexed: 12/11/2022]
Abstract
Chromogranin A (CgA)-the index member of the chromogranin/secretogranin secretory protein family-is ubiquitously distributed in endocrine, neuroendocrine, and immune cells. Elevated levels of CgA-related polypeptides, consisting of full-length molecules and fragments, are detected in the blood of patients suffering from neuroendocrine tumors, heart failure, renal failure, hypertension, rheumatoid arthritis, and inflammatory bowel disease. Full-length CgA and various CgA-derived peptides, including vasostatin-1, pancreastatin, catestatin, and serpinin, are expressed at different relative levels in normal and pathological conditions and exert diverse, and sometime opposite, biological functions. For example, CgA is overexpressed in genetic hypertension, whereas catestatin is diminished. In rodents, the administration of catestatin decreases hypertension, cardiac contractility, obesity, atherosclerosis, and inflammation, and it improves insulin sensitivity. By contrast, pancreastatin is elevated in diabetic patients, and the administration of this peptide to obese mice decreases insulin sensitivity and increases inflammation. CgA and the N-terminal fragment of vasostatin-1 can enhance the endothelial barrier function, exert antiangiogenic effects, and inhibit tumor growth in animal models, whereas CgA fragments lacking the CgA C-terminal region promote angiogenesis and tumor growth. Overall, the CgA system, consisting of full-length CgA and its fragments, is emerging as an important and complex player in cardiovascular, immunometabolic, and cancer regulation.
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Affiliation(s)
- Sushil K Mahata
- VA San Diego Healthcare System, San Diego, California.,Metabolic Physiology & Ultrastructural Biology Laboratory, Department of Medicine, University of California, San Diego, La Jolla, California
| | - Angelo Corti
- IRCCS San Raffaele Scientific Institute, San Raffaele Vita-Salute University, Milan, Italy
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Editorial commentary: Pathophysiological effects of proton pump inhibitors in cardiac patients: Time for a critical reappraisal. Trends Cardiovasc Med 2019; 29:361-362. [DOI: 10.1016/j.tcm.2018.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 11/03/2018] [Indexed: 02/07/2023]
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Corti A, Marcucci F, Bachetti T. Circulating chromogranin A and its fragments as diagnostic and prognostic disease markers. Pflugers Arch 2017; 470:199-210. [PMID: 29018988 DOI: 10.1007/s00424-017-2030-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 07/04/2017] [Accepted: 07/06/2017] [Indexed: 12/19/2022]
Abstract
Chromogranin A (CgA), a secretory protein released in the blood by neuroendocrine cells and neurons, is the precursor of various bioactive fragments involved in the regulation of the cardiovascular system, metabolism, innate immunity, angiogenesis, and tissue repair. After the original demonstration that circulating CgA can serve as a biomarker for a wide range of neuroendocrine tumors, several studies have shown that increased levels of CgA can be present also in the blood of patients with cardiovascular, gastrointestinal, and inflammatory diseases with, in certain cases, important diagnostic and prognostic implications. Considering the high structural and functional heterogeneity of the CgA system, comprising precursor and fragments, it is not surprising that the different immunoassays used in these studies led, in some cases, to discrepant results. Here, we review these notions and we discuss the importance of measuring total-CgA, full-length CgA, specific fragments, and their relative levels for a more thorough assessment of the pathophysiological function and diagnostic/prognostic value of the CgA system.
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Affiliation(s)
- Angelo Corti
- Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy. .,Vita-Salute San Raffaele University, Milan, Italy.
| | - Fabrizio Marcucci
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Tiziana Bachetti
- Clinical Trials Centre, Istituti Clinici Scientifici Maugeri, IRCCS Pavia, Pavia, Italy
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Ottesen AH, Carlson CR, Louch WE, Dahl MB, Sandbu RA, Johansen RF, Jarstadmarken H, Bjørås M, Høiseth AD, Brynildsen J, Sjaastad I, Stridsberg M, Omland T, Christensen G, Røsjø H. Glycosylated Chromogranin A in Heart Failure: Implications for Processing and Cardiomyocyte Calcium Homeostasis. Circ Heart Fail 2017; 10:CIRCHEARTFAILURE.116.003675. [PMID: 28209766 DOI: 10.1161/circheartfailure.116.003675] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 01/11/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND Chromogranin A (CgA) levels have previously been found to predict mortality in heart failure (HF), but currently no information is available regarding CgA processing in HF and whether the CgA fragment catestatin (CST) may directly influence cardiomyocyte function. METHODS AND RESULTS CgA processing was characterized in postinfarction HF mice and in patients with acute HF, and the functional role of CST was explored in experimental models. Myocardial biopsies from HF, but not sham-operated mice, demonstrated high molecular weight CgA bands. Deglycosylation treatment attenuated high molecular weight bands, induced a mobility shift, and increased shorter CgA fragments. Adjusting for established risk indices and biomarkers, circulating CgA levels were found to be associated with mortality in patients with acute HF, but not in patients with acute exacerbation of chronic obstructive pulmonary disease. Low CgA-to-CST conversion was also associated with increased mortality in acute HF, thus, supporting functional relevance of impaired CgA processing in cardiovascular disease. CST was identified as a direct inhibitor of CaMKIIδ (Ca2+/calmodulin-dependent protein kinase IIδ) activity, and CST reduced CaMKIIδ-dependent phosphorylation of phospholamban and the ryanodine receptor 2. In line with CaMKIIδ inhibition, CST reduced Ca2+ spark and wave frequency, reduced Ca2+ spark dimensions, increased sarcoplasmic reticulum Ca2+ content, and augmented the magnitude and kinetics of cardiomyocyte Ca2+ transients and contractions. CONCLUSIONS CgA-to-CST conversion in HF is impaired because of hyperglycosylation, which is associated with clinical outcomes in acute HF. The mechanism for increased mortality may be dysregulated cardiomyocyte Ca2+ handling because of reduced CaMKIIδ inhibition.
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Affiliation(s)
- Anett Hellebø Ottesen
- From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.)
| | - Cathrine R Carlson
- From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.)
| | - William E Louch
- From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.)
| | - Mai Britt Dahl
- From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.)
| | - Ragnhild A Sandbu
- From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.)
| | - Rune Forstrøm Johansen
- From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.)
| | - Hilde Jarstadmarken
- From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.)
| | - Magnar Bjørås
- From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.)
| | - Arne Didrik Høiseth
- From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.)
| | - Jon Brynildsen
- From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.)
| | - Ivar Sjaastad
- From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.)
| | - Mats Stridsberg
- From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.)
| | - Torbjørn Omland
- From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.)
| | - Geir Christensen
- From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.)
| | - Helge Røsjø
- From the Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., M.B.D., R.A.S., A.D.H., J.B., T.O., H.R.); Institute for Experimental Medical Research, Oslo University Hospital and Center for Heart Failure Research, University of Oslo, Norway (A.H.O., C.R.C., W.E.L., R.A.S., H.J., I.S., G.C.); Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway and Institute for Clinical Medicine, University of Oslo, Norway (M.B.D., R.A.S.); Department of Microbiology, Oslo University Hospital, Rikshospitalet, Norway, and University of Oslo, Norway (R.F.J., M.B.); Department of Medical Sciences, Uppsala University, Sweden (M.S.).
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13
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Clauss S, Scherr J, Hanley A, Schneider J, Klier I, Lackermair K, Hoster E, Vogeser M, Nieman DC, Halle M, Nickel T. Impact of polyphenols on physiological stress and cardiac burden in marathon runners – results from a substudy of the BeMaGIC study. Appl Physiol Nutr Metab 2017; 42:523-528. [DOI: 10.1139/apnm-2016-0457] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Both physiologic stress and chronic heart disease are associated with increased systemic levels of chromogranin A (CGA) and NT-proBNP. Marathon running causes physiological stress and imposes a significant cardiac burden. Polyphenol-rich Mediterranean and Asian diets have been demonstrated to exert beneficial effects on the cardiovascular system. In this study we investigated whether pretreatment with a polyphenol beverage could attenuate the physiological and cardiac stress associated with a marathon. In the BeMaGIC trial, 277 athletes were randomized into 2 groups in a double-blinded fashion, receiving 1–1.5 L/day of the same beverages either with (study beverage) or without (placebo) polyphenol enrichment (approximately 400 mg of gallic acid equivalents per day of a complex mixture of polyphenols). Blood samples were taken 3 weeks and 1 day before, and immediately, 24 h, and 72 h after running a marathon. In our current substudy, CGA and NT-proBNP levels were analyzed by ELISA in the fastest 18 and the slowest 22 runners. CGA and NT-proBNP levels increased significantly immediately after the marathon and returned to baseline at 72 h after the marathon. Neither CGA nor NT-proBNP differed significantly between athletes receiving study beverage versus placebo. Separating our cohort into fast and slow runners did not reveal any significant difference regarding CGA or NT-proBNP levels between groups. Our study provides no evidence that polyphenol supplementation attenuates marathon running-induced physiological stress and cardiac burden in fast or slow runners.
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Affiliation(s)
- Sebastian Clauss
- Medizinische Klinik und Poliklinik I, University Hospital of Munich, Campus Grosshadern, Ludwig-Maximilians-Universität München (LMU), DE-81377 Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner site Munich, Munich Heart Alliance, DE-80802 Munich, Germany
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Johannes Scherr
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar (MRI), Technische Universität München, DE-80992 Munich, Germany
| | - Alan Hanley
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Jens Schneider
- Department of Cardiology and Angiology II, Universitäts Herz-Zentrum Freiburg−Bad Krozingen, Südring.15, DE-79189 Bad Krozingen, Germany
| | - Ina Klier
- Medizinische Klinik und Poliklinik I, University Hospital of Munich, Campus Grosshadern, Ludwig-Maximilians-Universität München (LMU), DE-81377 Munich, Germany
| | - Korbinian Lackermair
- Medizinische Klinik und Poliklinik I, University Hospital of Munich, Campus Grosshadern, Ludwig-Maximilians-Universität München (LMU), DE-81377 Munich, Germany
| | - Eva Hoster
- Institute for Medical Informatics Biometry and Epidemiology, Ludwig-Maximilians-University Munich, DE-81377 Munich, Germany
| | - Michael Vogeser
- Institute for Laboratory Medicine, University Hospital of Munich, Campus Grosshadern, LMU, DE-81377 Munich, Germany
| | - David C. Nieman
- Human Performance Laboratory, Appalachian State University and North Carolina Research Campus, Kannapolis, NC 28081, USA
| | - Martin Halle
- DZHK (German Centre for Cardiovascular Research), Partner site Munich, Munich Heart Alliance, DE-80802 Munich, Germany
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar (MRI), Technische Universität München, DE-80992 Munich, Germany
| | - Thomas Nickel
- Medizinische Klinik und Poliklinik I, University Hospital of Munich, Campus Grosshadern, Ludwig-Maximilians-Universität München (LMU), DE-81377 Munich, Germany
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14
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Myhre PL, Stridsberg M, Linko R, Okkonen M, Nygård S, Christensen G, Pettilä V, Omland T, Røsjø H. Circulating chromogranin B levels in patients with acute respiratory failure: data from the FINNALI Study. Biomarkers 2017; 22:775-781. [PMID: 28049363 DOI: 10.1080/1354750x.2016.1269200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Circulating chromogranin B (CgB) levels are increased in situations characterized by systemic and myocardial stress, but whether CgB provides prognostic information in patients with acute respiratory failure (ARF) is unknown. METHODS We included 584 patients with ARF, defined as ventilatory support >6 h, and with blood samples available on Intensive Care Unit (ICU) admission and day 3 (n = 479). CgB levels were measured by radioimmunoassay and follow-up was 90 days. RESULTS One-hundred-sixty-nine patients (29%) died during follow-up. Admission CgB levels separated non-survivors from survivors: median 1234 (Q1-3 989-1742) vs. 917 (753-1224) pmol/L, respectively, p < 0.001. CgB levels on ICU admission (logarithmically transformed) were associated with time to death after adjustment for established risk indices available on ICU admission, including N-terminal pro-B-type natriuretic levels: HR 2.62 (95%C.I. 1.82-3.77), p < 0.001. Admission CgB levels also improved prognostication on top of SOFA and SAPS II scores as assessed by Cox regression analyses and the category-free net reclassification index. The area under the curve (AUC) for admission CgB levels to separate survivors and non-survivors was 0.72 (95%CI 0.67-0.76), while the AUC on day 3 was 0.60 (0.54-0.66). CONCLUSIONS CgB levels measured on ICU admission provided additional prognostic information to established risk indices in ARF patients.
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Affiliation(s)
- Peder Langeland Myhre
- a Division of Medicine , Akershus University Hospital , Lørenskog , Norway.,b Center for Heart Failure Research, University of Oslo , Oslo , Norway.,c Center for Clinical Heart Research, Oslo University Hospital , Oslo , Norway
| | - Mats Stridsberg
- d Department of Medical Sciences , Uppsala University , Uppsala , Sweden
| | - Rita Linko
- e Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| | - Marjatta Okkonen
- e Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| | - Ståle Nygård
- f Bioinformatics core facility , Oslo University Hospital and the University of Oslo , Oslo , Norway
| | - Geir Christensen
- b Center for Heart Failure Research, University of Oslo , Oslo , Norway.,g Institute for Experimental Medical Research, Oslo University Hospital , Oslo , Norway
| | - Ville Pettilä
- e Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.,h Department of Intensive Care Medicine , Bern University Hospital, University of Bern , Bern , Switzerland
| | - Torbjørn Omland
- a Division of Medicine , Akershus University Hospital , Lørenskog , Norway.,b Center for Heart Failure Research, University of Oslo , Oslo , Norway
| | - Helge Røsjø
- a Division of Medicine , Akershus University Hospital , Lørenskog , Norway.,b Center for Heart Failure Research, University of Oslo , Oslo , Norway
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15
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Myhre PL, Ottesen AH, Okkonen M, Linko R, Stridsberg M, Nygård S, Christensen G, Pettilä V, Omland T, Røsjø H. Prognostic Value of Secretoneurin in Patients with Acute Respiratory Failure: Data from the FINNALI Study. Clin Chem 2016; 62:1380-9. [DOI: 10.1373/clinchem.2016.258764] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 06/23/2016] [Indexed: 12/16/2022]
Abstract
Abstract
BACKGROUND
We examined whether secretoneurin (SN), a biomarker associated with cardiomyocyte Ca2+ handling, provides prognostic information in patients with acute respiratory failure (ARF).
METHODS
We included 490 patients with ARF, defined as ventilatory support >6 h, with blood samples available on admission to the intensive care unit (ICU). SN concentrations were measured by RIA.
RESULTS
A total of 209 patients (43%) were hospitalized with cardiovascular (CV)-related ARF, and 90-day mortality rates were comparable between CV- and non–CV-related ARF (n = 281): 31% vs 24%, P = 0.11. Admission SN concentrations were higher in nonsurvivors than in survivors in both CV-related (median 148 [quartile 1–3, 117–203] vs 108 [87–143] pmol/L, P < 0.001) and non–CV-related ARF (139 [115–184] vs 113 [91–139] pmol/L, P < 0.001). In patients with CV-related ARF, SN concentrations on ICU admission were associated with 90-day mortality [odds ratio (OR) 1.97 (95% CI, 1.04–3.73, P = 0.04)] after adjusting for established risk indices, including N-terminal-pro-B-type natriuretic peptide (NT-proBNP) concentrations. SN also improved patient classification in CV-related ARF as assessed by the net reclassification index: 0.32 (95% CI, 0.04–0.59), P = 0.03. The area under the curve (AUC) of SN to predict mortality in patients with CV-related ARF was 0.72 (95% CI, 0.65–0.79), and the AUC of NT-proBNP was 0.64 (0.56–0.73). In contrast, SN concentrations on ICU admission did not provide incremental prognostic value to established risk indices in patients with non–CV-related ARF, and the AUC was 0.67 (0.60–0.75).
CONCLUSIONS
SN concentrations measured on ICU admission provided incremental prognostic information to established risk indices in patients with CV-related ARF, but not in patients with non–CV-related ARF.
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Affiliation(s)
- Peder L Myhre
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Oslo, Norway
- Center for Clinical Heart Research, Oslo University Hospital Ullevål, Oslo, Norway
| | - Anett H Ottesen
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Marjatta Okkonen
- Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Rita Linko
- Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mats Stridsberg
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Ståle Nygård
- Bioinformatics Core Facility, Oslo University Hospital and the University of Oslo, Oslo, Norway
| | - Geir Christensen
- Institute for Experimental Medical Research, Oslo University Hospital, Ullevål, Oslo, Norway and Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Ville Pettilä
- Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Intensive Care Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Torbjørn Omland
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Helge Røsjø
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Oslo, Norway
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16
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Serfőző G, Horváth T, Földesi I, Rafael B, von Känel R, Keresztes M. The Monocyte-to-Lymphocyte Ratio Correlates with Psycho-Neuro-Inflammatory Factors in Patients with Stable Coronary Artery Disease. Neuroimmunomodulation 2016; 23:67-74. [PMID: 26926300 DOI: 10.1159/000443835] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 01/06/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Psychosocial stress and depression have been recognized as major risk factors of coronary artery disease (CAD). Although monocytes are known to be key players in atherosclerosis, monocyte-based associations with psychoneuroendocrino-immuno-inflammatory (PNI) markers have not been widely investigated in stable CAD. OBJECTIVE We examined associations between the monocyte-to-lymphocyte ratio (MLR) and key PNI markers in stable CAD. METHODS We studied 23 patients with stable CAD who completed the Beck Depression Inventory (BDI) and Rahe's Brief Stress and Coping Inventory. A white blood cell differential was performed, and levels of cortisol, chromogranin A (CgA), LL-37, interleukin-6 (IL-6) and C-reactive protein (CRP) were assayed in plasma. RESULTS Monocyte fraction, MLR and plasma CgA levels exceeded reference values, the social support score was low, and 7 patients had elevated BDI scores. In the multivariate-adjusted analysis, a higher MLR was associated with greater depressive symptom severity (r = 0.624, p < 0.01) as well as with higher concentrations of CgA (r = 0.660, p < 0.01), LL-37 (r = 0.643, p < 0.01), IL-6 (r = 0.532, p < 0.05) and CRP (r = 0.470, p < 0.05). BDI scores associated with CgA concentration (r = 0.618, p < 0.01) and CgA level correlated negatively with the social support score (r = -0.511, p < 0.05). CONCLUSIONS Our findings suggest that, in patients with stable CAD, elevated MLR may be associated with depressive symptoms, with increased neuroendocrine-sympathetic activity (marked by CgA) and inflammatory markers that are pertinent to atherosclerosis initiation and progression. The increased neuroendocrine-sympathetic activity correlated with low social support and depressive symptom severity. The MLR might serve as an easy-to-obtain and inexpensive proxy measure of an activated PNI network in stable CAD.
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Affiliation(s)
- Gyöngyi Serfőző
- Department of Biochemistry, Medical Faculty, University of Szeged, Szeged, Hungary
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17
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Correlation of plasma catestatin level and the prognosis of patients with acute myocardial infarction. PLoS One 2015; 10:e0122993. [PMID: 25848973 PMCID: PMC4388679 DOI: 10.1371/journal.pone.0122993] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 02/26/2015] [Indexed: 01/29/2023] Open
Abstract
Catestatin is a peptide which is a potent inhibitor of catecholamine secretion and played essential functions in the cardiovascular system. Previous research found that dramatic changes of catestatin were associated with hemodynamics in acute myocardial infarction (AMI) during the first week after the AMI symptoms onset, but whether catestatin is also involved in the pathophysiological progression after AMI and then a predictor for outcomes is not clear. The aim of this study is to determine the correlation of plasma catestatin levels at different time points and the prognosis of AMI. 100 participants recruited were all patients with AMI, all of who received successful primary percutaneous coronary intervention (PCI) within 12h from the AMI symptom onset in our center; the concentrations of plasma catestatin were evaluated from blood samples of those 100 participants. Subsequent 65 months' follow-up was performed after discharging to evaluate cardiac adverse events and the association between catestatin levels and prognosis of AMI was examined. We confirmed the dramatic change of catestatin concentrations in the first week of AMI, and the levels of catestatin on D3 were much higher in adverse events group than those in non-adverse events group (p<0.0001), but the ratio of D7/D3 was significantly lower. In addition, the Kaplan-Meier analysis showed that the groups in which the levels on D3 were higher (p<0.0001) and the ratios of D7/D3 were lower (p<0.0001), patients trended to be more susceptive to adverse events after AMI. Furthermore, according to the analysis, we surmised catestatin level on D3 as an appropriate predictor for outcomes in patients with AMI with good specificity as well as sensitivity. All of the evidence confirmed that catestatin plays an important role in the progress of AMI, and may act as a promising target for prognostic prediction.
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18
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Herold Z, Nagy P, Patócs A, Somogyi A. [The role of chromogranin-A and its derived peptide, WE-14 in the development of type 1 diabetes mellitus]. Orv Hetil 2015; 156:163-70. [PMID: 25618857 DOI: 10.1556/oh.2015.30087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Chromogranin-A is a member of the granine protein family. It is produced in neuroendocrine cells via secretory granules. Many cleavage proteins are formed from chromogranin-A, from which some have well known biological activity, while the function of others is not yet fully known. Serum chromogranin-A levels are used in neuroendocrine tumour diagnostics. Recent studies showed that one of its cleavage protein, WE-14 may also play a role in the development of type 1 diabetes. WE-14 may function as an autoantigen for T-cells involved in the destruction of β-cells. This mechanism was previously observed only in non-obese diabetic mice. Novel results show that WE-14 also serves as a target for autoreactive cells in newly diagnosed type 1 diabetic patients as well, which reaction can be increased with transglutaminase. In this paper the authors summarize the recent knowledge about chromogranin-A and its potential role in the pathomechanism of type 1 diabetes mellitus.
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Affiliation(s)
- Zoltán Herold
- Szent István Egyetem Állatorvos-tudományi Kar Budapest Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest Szentkirályi utca 46. 1088
| | - Péter Nagy
- Semmelweis Egyetem, Általános Orvostudományi Kar I. Patológiai és Kísérleti Rákkutató Intézet Budapest
| | - Attila Patócs
- Semmelweis Egyetem, Általános Orvostudományi Kar Laboratóriumi Medicina Intézet Budapest MTA-SE "Lendület" Örökletes Endokrin Daganatok Kutatócsoport Budapest
| | - Anikó Somogyi
- Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest Szentkirályi utca 46. 1088
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19
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Tota B, Angelone T, Cerra MC. The surging role of Chromogranin A in cardiovascular homeostasis. Front Chem 2014; 2:64. [PMID: 25177680 PMCID: PMC4132265 DOI: 10.3389/fchem.2014.00064] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 07/25/2014] [Indexed: 02/06/2023] Open
Abstract
Together with Chromogranin B and Secretogranins, Chromogranin A (CGA) is stored in secretory (chromaffin) granules of the diffuse neuroendocrine system and released with noradrenalin and adrenalin. Co-stored within the granule together with neuropeptideY, cardiac natriuretic peptide hormones, several prohormones and their proteolytic enzymes, CGA is a multifunctional protein and a major marker of the sympatho-adrenal neuroendocrine activity. Due to its partial processing to several biologically active peptides, CGA appears an important pro-hormone implicated in relevant modulatory actions on endocrine, cardiovascular, metabolic, and immune systems through both direct and indirect sympatho-adrenergic interactions. As a part of this scenario, we here illustrate the emerging role exerted by the full-length CGA and its three derived fragments, i.e., Vasostatin 1, catestatin and serpinin, in the control of circulatory homeostasis with particular emphasis on their cardio-vascular actions under both physiological and physio-pathological conditions. The Vasostatin 1- and catestatin-induced cardiodepressive influences are achieved through anti-beta-adrenergic-NO-cGMP signaling, while serpinin acts like beta1-adrenergic agonist through AD-cAMP-independent NO signaling. On the whole, these actions contribute to widen our knowledge regarding the sympatho-chromaffin control of the cardiovascular system and its highly integrated “whip-brake” networks.
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Affiliation(s)
- Bruno Tota
- Department of Biology, Ecology and Earth Sciences, University of Calabria Arcavacata di Rende (CS), Italy
| | - Tommaso Angelone
- Department of Biology, Ecology and Earth Sciences, University of Calabria Arcavacata di Rende (CS), Italy
| | - Maria C Cerra
- Department of Biology, Ecology and Earth Sciences, University of Calabria Arcavacata di Rende (CS), Italy
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Dev NB, Mir SA, Gayen JR, Siddiqui JA, Mustapic M, Vaingankar SM. Cardiac electrical activity in a genomically "humanized" chromogranin a monogenic mouse model with hyperadrenergic hypertension. J Cardiovasc Transl Res 2014; 7:483-493. [PMID: 24821335 DOI: 10.1007/s12265-014-9563-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 04/06/2014] [Indexed: 12/16/2022]
Abstract
The prohormone chromogranin A (CHGA) is ubiquitously found in vesicles of adrenal chromaffin cells and adrenergic neurons, and it is processed to the hypotensive hormone peptide catestatin (CST). Both CHGA and CST regulate blood pressure and cardiac function. This study addresses their role in cardiac electrical activity. We have generated two genomically "humanized" transgenic mouse strains (Tg31CHGA+/+; Chga-/- (HumCHGA31) and Tg19CHGA+/+; Chga-/- (HumCHGA19)) with varied CHGA expression and the ability to rescue the Chga-/- phenotype (hypertensive, hyperadrenergic with dilated cardiomyopathy). The normotensive HumCHGA31 mice express CHGA at levels comparable to wild-type. In contrast, the hypertensive HumCHGA19 mice have low levels of CHGA. EKG recordings revealed that the QT interval, R-amplitude, and QRS time-voltage integral are markedly longer in HumCHGA19 compared to wild-type and HumCHGA31 mice. These differences are accompanied by increased heart rate and QT variability, indicating that ventricular assault happens in a status of low levels of circulating CST.
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Affiliation(s)
- Nagendu B Dev
- Department of Medicine, University of California at San Diego, USA
| | - Saiful A Mir
- Department of Medicine, University of California at San Diego, USA
| | | | - Jawed A Siddiqui
- Department of Medicine, University of California at San Diego, USA
| | - Maja Mustapic
- Department of Medicine, University of California at San Diego, USA
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Goetze JP, Alehagen U, Flyvbjerg A, Rehfeld JF. Chromogranin A as a biomarker in cardiovascular disease. Biomark Med 2014; 8:133-40. [DOI: 10.2217/bmm.13.102] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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22
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Goetze JP, Hilsted LM, Rehfeld JF, Alehagen U. Plasma chromogranin A is a marker of death in elderly patients presenting with symptoms of heart failure. Endocr Connect 2014; 3:47-56. [PMID: 24532383 PMCID: PMC3959729 DOI: 10.1530/ec-14-0017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Cardiovascular risk assessment remains difficult in elderly patients. We examined whether chromogranin A (CgA) measurement in plasma may be valuable in assessing risk of death in elderly patients with symptoms of heart failure in a primary care setting. A total of 470 patients (mean age 73 years) were followed for 10 years. For CgA plasma measurement, we used a two-step method including a screening test and a confirmative test with plasma pre-treatment with trypsin. Cox multivariable proportional regression and receiver-operating curve (ROC) analyses were used to assess mortality risk. Assessment of cardiovascular mortality during the first 3 years of observation showed that CgA measurement contained useful information with a hazard ratio (HR) of 5.4 (95% CI 1.7-16.4) (CgA confirm). In a multivariate setting, the corresponding HR was 5.9 (95% CI 1.8-19.1). WHEN ADDING N-TERMINAL PROBNP (NT-PROBNP) TO THE MODEL, CGA CONFIRM STILL POSSESSED PROGNOSTIC INFORMATION (HR: 6.1; 95% CI 1.8-20.7). The result for predicting all-cause mortality displayed the same pattern. ROC analyses in comparison to NT-proBNP to identify patients on top of clinical variables at risk of cardiovascular death within 5 years of follow-up showed significant additive value of CgA confirm measurements compared with NT-proBNP and clinical variables. CgA measurement in the plasma of elderly patients with symptoms of heart failure can identify those at increased risk of short- and long-term mortality.
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Affiliation(s)
| | | | | | - Urban Alehagen
- Division of Cardiovascular Medicine, Department of Medicine and Health Sciences, Faculty of Health Sciences, Department of Cardiology UHL, County Council of ÖstergötlandLinköping UniversityLinköpingSweden
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Frydland M, Kousholt B, Larsen JR, Burnettr JC, Hilsted L, Hasenkam JM, Goetze JP. Increased N-terminal CgA in circulation associated with cardiac reperfusion in pigs. Biomark Med 2013; 7:959-67. [DOI: 10.2217/bmm.13.92] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Acute myocardial infarction causes neurohumoral activation characterized by increased sympathetic activity. CgA is a protein released during sympathoadrenal stress from neuroendocrine tissue. Recently, increased CgA concentrations in circulation have been reported and suggested to be an independent predictor of mortality after acute myocardial infarction. Materials & methods: Eighteen pigs underwent 1 h of regional myocardial ischemia followed by 3 h of reperfusion. Blood samples were collected every hour and plasma CgA was measured with two radioimmunoassays. Results: We found a 30% increase in plasma N-terminal CgA 1 h after re-establishment of coronary blood supply. On the other hand, plasma pancreastatin did not change in response to ischemia or reperfusion but decreased during the entire experiment. Conclusion: Our results suggest a differentiated CgA response in myocardial reperfusion after local cardiac anoxia that may reflect tissue-specific post-translational processing and release.
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Affiliation(s)
- Martin Frydland
- Department of Cardiothoracic & Vascular Surgery, Aarhus University Hospital, Skejby, Denmark
| | - Birgitte Kousholt
- Department of Cardiothoracic & Vascular Surgery, Aarhus University Hospital, Skejby, Denmark
| | - Jens Rolighed Larsen
- Department of Cardiothoracic & Vascular Surgery, Anesthesia, Aarhus University Hospital, Skejby, Denmark
| | | | - Linda Hilsted
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - J Michael Hasenkam
- Department of Cardiothoracic & Vascular Surgery, Aarhus University Hospital, Skejby, Denmark
| | - Jens Peter Goetze
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Denmark
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Pasqua T, Corti A, Gentile S, Pochini L, Bianco M, Metz-Boutigue MH, Cerra MC, Tota B, Angelone T. Full-length human chromogranin-A cardioactivity: myocardial, coronary, and stimulus-induced processing evidence in normotensive and hypertensive male rat hearts. Endocrinology 2013; 154:3353-65. [PMID: 23751870 DOI: 10.1210/en.2012-2210] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Plasma chromogranin-A (CgA) concentrations correlate with severe cardiovascular diseases, whereas CgA-derived vasostatin-I and catestatin elicit cardiosuppression via an antiadrenergic/nitric oxide-cGMP mediated mechanism. Whether these phenomena are related is unknown. We here investigated whether and to what extent full-length CgA directly influences heart performance and may be subjected to stimulus-elicited intracardiac processing. Using normotensive and hypertensive rats, we evaluated the following: 1) direct myocardial and coronary effects of full-length CgA; 2) the signal-transduction pathway involved in its action mechanism; and 3) CgA intracardiac processing after β-adrenergic [isoproterenol (Iso)]- and endothelin-1(ET-1)-dependent stimulation. The study was performed by using a Langendorff perfusion apparatus, Western blotting, affinity chromatography, and ELISA. We found that CgA (1-4 nM) dilated coronaries and induced negative inotropism and lusitropism, which disappeared at higher concentrations (10-16 nM). In spontaneously hypertensive rats (SHRs), negative inotropism and lusitropism were more potent than in young normotensive rats. We found that perfusion itself, Iso-, and endothelin-1 stimulation induced intracardiac CgA processing in low-molecular-weight fragments in young, Wistar Kyoto, and SHR rats. In young normotensive and adult hypertensive rats, CgA increased endothelial nitric oxide synthase phosphorylation and cGMP levels. Analysis of the perfusate from both Wistar rats and SHRs of untreated and treated (Iso) hearts revealed CgA absence. In conclusion, in normotensive and hypertensive rats, we evidenced the following: 1) full-length CgA directly affects myocardial and coronary function by AkT/nitric oxide synthase/nitric oxide/cGMP/protein kinase G pathway; and 2) the heart generates intracardiac CgA fragments in response to hemodynamic and excitatory challenges. For the first time at the cardiovascular level, our data provide a conceptual link between systemic and intracardiac actions of full-length CgA and its fragments, expanding the knowledge on the sympathochromaffin/CgA axis under normal and physiopathological conditions.
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Affiliation(s)
- Teresa Pasqua
- Department of Biology, Ecology, and Earth Sciences, University of Calabria, 87036 Arcavacata di Rende (CS), Italy
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Affiliation(s)
- Jens P Goetze
- Department of Clinical Biochemistry, University of Copenhagen, DK-2100 Copenhagen, Denmark.
| | - Urban Alehagen
- Division of Cardiovascular Medicine, Linköping University, Sweden
| | - Allan Flyvbjerg
- Medical Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Jens F Rehfeld
- Department of Clinical Biochemistry, University of Copenhagen, DK-2100 Copenhagen, Denmark
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Bech PR, Martin NM, Ramachandran R, Bloom SR. The biochemical utility of chromogranin A, chromogranin B and cocaine- and amphetamine-regulated transcript for neuroendocrine neoplasia. Ann Clin Biochem 2013; 51:8-21. [DOI: 10.1177/0004563213489670] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Neuroendocrine neoplasia (NEN) is a heterogeneous group of tumours and often represents a therapeutic challenge to clinicians. The peptides chromogranin A (CgA), chromogranin B (CgB) and cocaine- and amphetamine-regulated transcript (CART) are widely distributed throughout the neuroendocrine system. CgA and CgB have been used as general NEN biomarkers for many years, while CART has only recently been identified. Of these biomarkers, CgA is the most commonly used. However, circulating CgA concentrations exhibit considerable intra-individual biological variation, are altered by proton pump inhibitors (PPIs) and somatostatin analogues and are elevated in non-NEN malignancies. Therefore, interpretation of CgA results must be in the context of these confounding factors. The effects of treatment and non-NEN conditions on circulating CgB and CART concentrations are less well understood. CgB is less affected by impaired renal function and PPIs than CgA; while, circulating CART concentrations lack a diurnal variation in humans and are more reliable markers of pancreatic NEN malignancy than CgA. The utility of circulating CgA measurements in NEN prognosis, surveillance and disease recurrence has been widely investigated. However, the utility of CgB and CART in NEN management is yet to be elucidated. Further studies are needed to establish whether CgB and CART are useful alternatives to CgA.
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Affiliation(s)
- PR Bech
- Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
| | - NM Martin
- Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
| | - R Ramachandran
- Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
| | - SR Bloom
- Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
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Effect of short- and long-term physical activities on circulating granin protein levels. ACTA ACUST UNITED AC 2013; 185:14-9. [DOI: 10.1016/j.regpep.2013.06.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 03/07/2013] [Accepted: 06/19/2013] [Indexed: 11/23/2022]
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Liu L, Ding W, Zhao F, Shi L, Pang Y, Tang C. Plasma levels and potential roles of catestatin in patients with coronary heart disease. SCAND CARDIOVASC J 2013; 47:217-24. [DOI: 10.3109/14017431.2013.794951] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Ferraro S, Ardoino I, Bassani N, Santagostino M, Rossi L, Biganzoli E, Bongo AS, Panteghini M. Multi-marker network in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention: when and what to measure. Clin Chim Acta 2013; 417:1-7. [PMID: 23246517 DOI: 10.1016/j.cca.2012.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2012] [Revised: 11/29/2012] [Accepted: 12/01/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Data on the correlations between biomarkers to suggest cost-effective multi-marker (MM) panels predictive for ST-elevation myocardial infarction (STEMI) patients are lacking. We sought to explore the relationship between cardiac troponin I (cTnI), C-reactive protein (CRP), B-type natriuretic peptide (BNP), and chromogranin A (CgA) accounting for biomarkers' profiles detected within 48h from successful primary percutaneous coronary intervention (PPCI). METHODS In 73 STEMI patients cTnI, CRP, BNP, and CgA were measured before PPCI and 6, 24, and 48h later. STATIS methods generalizing Principal Component Analysis on three-way data sets were employed to extract information about: 1) similarities between patients, 2) contribution of each time of sampling and 3) correlations between biomarkers' profiles. RESULTS STEMI patients who underwent successful PPCI emerged to have a homogeneous profile tailored on biomarkers' evaluation within 48h. Their measurements at 24h contributed the most variability and information both to patients' and to biomarkers' profiles. BNP and cTnI were highly correlated and explained the 40.1% of the total variance, whereas CgA resulted independent and explained the 26.3% of the total variance. CONCLUSIONS Markers' measurements at 24h after PPCI contributed most information to the definition of patients' profile. BNP and cTnI resulted interchangeable in a MM panel for reporting about the extent of necrosis.
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Affiliation(s)
- Simona Ferraro
- Cattedra di Biochimica Clinica e Biologia Molecolare Clinica, Dipartimento di Scienze Biomediche e Cliniche Luigi Sacco, Università degli Studi, Milano, Italy.
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Røsjø H, Stridsberg M, Florholmen G, Stensløkken KO, Ottesen AH, Sjaastad I, Husberg C, Dahl MB, Øie E, Louch WE, Omland T, Christensen G. Secretogranin II; a protein increased in the myocardium and circulation in heart failure with cardioprotective properties. PLoS One 2012; 7:e37401. [PMID: 22655045 PMCID: PMC3360055 DOI: 10.1371/journal.pone.0037401] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Accepted: 04/19/2012] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Several beneficial effects have been demonstrated for secretogranin II (SgII) in non-cardiac tissue. As cardiac production of chromogranin A and B, two related proteins, is increased in heart failure (HF), we hypothesized that SgII could play a role in cardiovascular pathophysiology. METHODOLOGY/PRINCIPAL FINDINGS SgII production was characterized in a post-myocardial infarction heart failure (HF) mouse model, functional properties explored in experimental models, and circulating levels measured in mice and patients with stable HF of moderate severity. SgII mRNA levels were 10.5 fold upregulated in the left ventricle (LV) of animals with myocardial infarction and HF (p<0.001 vs. sham-operated animals). SgII protein levels were also increased in the LV, but not in other organs investigated. SgII was produced in several cell types in the myocardium and cardiomyocyte synthesis of SgII was potently induced by transforming growth factor-β and norepinephrine stimulation in vitro. Processing of SgII to shorter peptides was enhanced in the failing myocardium due to increased levels of the proteases PC1/3 and PC2 and circulating SgII levels were increased in mice with HF. Examining a pathophysiological role of SgII in the initial phase of post-infarction HF, the SgII fragment secretoneurin reduced myocardial ischemia-reperfusion injury and cardiomyocyte apoptosis by 30% and rapidly increased cardiomyocyte Erk1/2 and Stat3 phosphorylation. SgII levels were also higher in patients with stable, chronic HF compared to age- and gender-matched control subjects: median 0.16 (Q1-3 0.14-0.18) vs. 0.12 (0.10-0.14) nmol/L, p<0.001. CONCLUSIONS We demonstrate increased myocardial SgII production and processing in the LV in animals with myocardial infarction and HF, which could be beneficial as the SgII fragment secretoneurin protects from ischemia-reperfusion injury and cardiomyocyte apoptosis. Circulating SgII levels are also increased in patients with chronic, stable HF and may represent a new cardiac biomarker.
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Affiliation(s)
- Helge Røsjø
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway.
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Prognostic value of chromogranin A in severe sepsis: data from the FINNSEPSIS study. Intensive Care Med 2012; 38:820-9. [PMID: 22491939 DOI: 10.1007/s00134-012-2546-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Accepted: 01/05/2012] [Indexed: 12/16/2022]
Abstract
PURPOSE To assess the prognostic information of chromogranin A (CgA), a marker associated with adrenergic tone and myocardial function, in patients with severe sepsis. METHODS CgA levels were measured at the time of study inclusion and 72 h later in 232 patients with severe sepsis recruited from 24 ICUs in Finland (FINNSEPSIS study). RESULTS Sixty-five patients (28%) died during the index hospitalization. CgA levels at inclusion and after 72 h correlated with several established indices of risk in sepsis. Patients who died during the hospitalization had higher baseline CgA levels than hospital survivors: 14.0 (Q1-3, 7.4-27.4) versus 9.1 (5.9-15.8) nmol/l, P = 0.002, and after 72 h: 16.2 (9.0-31.1) versus 9.8 (6.0-18.0) nmol/l, P = 0.001. Prior cardiovascular disease (P = 0.04) and cardiovascular SOFA levels on day 3 (P = 0.03) were associated with higher CgA levels after 72 h by linear regression. CgA levels on study inclusion and after 72 h were independently associated with hospital mortality by logistic regression: OR (logarithmically transformed CgA levels) 1.95 (95% CI 1.01-3.77), P = 0.046 and OR 2.03 (95% CI 1.18-3.49), P = 0.01, respectively. The prognostic accuracy was comparable for CgA measurements and SAPS II score, and the addition of CgA measurements to the SAPS II score improved risk stratification of the patients as assessed by the category-free net reclassification index. A CgA level >6.6 nmol/l on study inclusion was associated with septic shock during the hospitalization. CONCLUSION CgA levels measured during hospitalization for severe sepsis are associated with cardiovascular dysfunction and may provide additional prognostic information in patients with severe sepsis.
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Ferraro S, Ardoino I, Boracchi P, Santagostino M, Ciardi L, Antonini G, Braga F, Biganzoli E, Panteghini M, Bongo AS. Inside ST-elevation myocardial infarction by monitoring concentrations of cardiovascular risk biomarkers in blood. Clin Chim Acta 2012; 413:888-93. [PMID: 22333672 DOI: 10.1016/j.cca.2012.01.034] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 01/30/2012] [Accepted: 01/30/2012] [Indexed: 12/20/2022]
Abstract
BACKGROUND No information is available on the optimal sampling time to catch the highest increase for biomarkers whose elevation after ST-elevation myocardial infarction (STEMI) is prognostic for adverse events. This study aimed to investigate release kinetics and peak times of cardiac troponin I (cTnI), C-reactive protein (CRP), B-type natriuretic peptide (BNP), chromogranin A (CgA) and cystatin C (CyC) in STEMI patients undergoing primary percutaneous coronary intervention (PPCI). METHODS Blood concentrations of cTnI, CRP, BNP, CgA and CyC were measured before and 6 h, 24 h, and 48 h after PPCI in 84 STEMI patients. The averaged trajectory of marker kinetics was estimated by multivariable regression models adjusted for patient characteristics and orthogonal polynomials were used to describe related releases. RESULTS From the estimated kinetics cTnI peaked at 10 h from symptoms, BNP at 28 h and CRP within 30 h. CyC concentrations did not change, whereas CgA concentrations increased from 6 to 48 h after PPCI. The amount of BNP release was found to be affected by the interaction between gender and age: females<75 years had BNP concentrations fourfold higher than males. CONCLUSIONS According to different release kinetics a single blood sampling for measuring all biomarkers is not recommended.
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Bartolomucci A, Possenti R, Mahata SK, Fischer-Colbrie R, Loh YP, Salton SRJ. The extended granin family: structure, function, and biomedical implications. Endocr Rev 2011; 32:755-97. [PMID: 21862681 PMCID: PMC3591675 DOI: 10.1210/er.2010-0027] [Citation(s) in RCA: 228] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The chromogranins (chromogranin A and chromogranin B), secretogranins (secretogranin II and secretogranin III), and additional related proteins (7B2, NESP55, proSAAS, and VGF) that together comprise the granin family subserve essential roles in the regulated secretory pathway that is responsible for controlled delivery of peptides, hormones, neurotransmitters, and growth factors. Here we review the structure and function of granins and granin-derived peptides and expansive new genetic evidence, including recent single-nucleotide polymorphism mapping, genomic sequence comparisons, and analysis of transgenic and knockout mice, which together support an important and evolutionarily conserved role for these proteins in large dense-core vesicle biogenesis and regulated secretion. Recent data further indicate that their processed peptides function prominently in metabolic and glucose homeostasis, emotional behavior, pain pathways, and blood pressure modulation, suggesting future utility of granins and granin-derived peptides as novel disease biomarkers.
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Affiliation(s)
- Alessandro Bartolomucci
- Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, Minnesota 55455, USA
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Bassino E, Fornero S, Gallo MP, Ramella R, Mahata SK, Tota B, Levi R, Alloatti G. A novel catestatin-induced antiadrenergic mechanism triggered by the endothelial PI3K-eNOS pathway in the myocardium. Cardiovasc Res 2011; 91:617-24. [PMID: 21543385 DOI: 10.1093/cvr/cvr129] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIMS Catestatin (CST) is a chromogranin A (CgA)-derived peptide (hCgA352-372) with three identified human variants (G364S/P370L/R374Q-CST) that show differential potencies towards the inhibition of catecholamine release. Although CST affects several cardiovascular parameters, the mechanisms underlying CST action in the heart have remained elusive. Therefore, we sought to determine the mechanism of action of CST and its variants on ventricular myocardium and endothelial cells. METHODS AND RESULTS Contractile force and Ca(2+) transients were measured, respectively, on rat papillary muscles and isolated cardiomyocytes (CC) under basal conditions and after β-adrenergic stimulation. Nitric oxide (NO) production and endothelial nitric oxide synthase (eNOS) phosphorylation (P(Ser1179)eNOS) were studied in bovine aortic endothelial (BAE-1) cells. Under basal conditions, wild-type CST (WT-CST, 10-50 nM) transiently enhanced myocardial contractility. CST variants (G364S and P370L) exerted a comparable positive inotropic effect. The H(1) histamine receptor antagonist mepyramine abolished the increase of contractile force induced by WT-CST. Moreover, WT-CST dose-dependently (5-50 nM) reduced the effect of β-adrenergic stimulation. This anti-adrenergic effect was not mediated by a direct action on CC, but involved a PI3K-dependent NO release from endocardial endothelial cells. Indeed, CST induced a wortmannin-sensitive, Ca(2+)-independent increase in NO production and eNOS phosphorylation on BAE-1 cells. While the anti-adrenergic and NO release effects of P370L-CST were comparable with those of WT-CST, the G364S variant was ineffective on the same parameters. CONCLUSION Our results suggest that the anti-adrenergic action of CST depends on the endothelial PI3K-Akt-eNOS pathway and that its structural alterations entail functional features that correlate with the different anti-hypertensive potential described in humans.
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Affiliation(s)
- Eleonora Bassino
- Department of Animal and Human Biology, University of Turin, via Accademia Albertina, 13, 10123 Turin, Italy
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Mahata SK, Mahata M, Fung MM, O'Connor DT. Reprint of: Catestatin: a multifunctional peptide from chromogranin A. REGULATORY PEPTIDES 2010; 165:52-62. [PMID: 20965217 PMCID: PMC10838673 DOI: 10.1016/j.regpep.2010.09.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
In 1997, we identified a novel peptide, catestatin (CST: bovine chromogranin A [CHGA]₃₄₄₋₃₆₄: RSMRLSFRARGYGFRGPGLQL; human CHGA₃₅₂₋₃₇₂: SSMKLSFRARGYGFRGPGPQL), which is a potent inhibitor of nicotinic-cholinergic-stimulated catecholamine secretion. CST shows characteristic inhibitory effects on nicotinic cationic (Na+, Ca²+) signal transduction, which are specific to the neuronal nicotinic receptor. Utilizing systematic polymorphism discovery at the human CHGA locus we discovered three human variants of CST: G³⁶⁴S, P³⁷⁰L, and R³⁷⁴Q that showed differential potencies towards the inhibition of catecholamine secretion. In humans, CHGA is elevated and its processing to CST is diminished in hypertension. Diminished CST is observed not only in hypertensive individuals but also in the early-normotensive offspring of patients with hypertension, suggesting that an early deficiency of CST might play a pathogenic role in the subsequent development of the disease. Consistent with human findings, prevention of endogenous CST expression by targeted ablation (knockout) of the mouse Chga locus (Chga-KO) resulted in severe hypertension that can be "rescued" specifically by replacement of the CST peptide. CST acts directly on the heart to inhibit the inotropic and lusitropic properties of the rodent heart and also acts as a potent vasodilator in rats and humans. While the G³⁶⁴S CST variant caused profound changes in human autonomic activity and seemed to reduce the risk of developing hypertension, CST replacement rescued Chga-KO mice from dampened baroreflex sensitivity. In addition, CST has been shown to induce chemotaxis and acts as an antimicrobial as well as an antimalarial peptide. The present review summarizes these multiple actions of CST.
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Affiliation(s)
- Sushil K Mahata
- Department of Medicine (0838), University of California at San Diego, and Veterans Affairs San Diego Healthcare System, 9500 Gilman Drive, La Jolla, CA 92093-0838, USA.
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Catestatin improves post-ischemic left ventricular function and decreases ischemia/reperfusion injury in heart. Cell Mol Neurobiol 2010; 30:1171-9. [PMID: 21104119 PMCID: PMC3008938 DOI: 10.1007/s10571-010-9598-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Accepted: 09/02/2010] [Indexed: 02/02/2023]
Abstract
The Chromogranin A (CgA)-derived anti-hypertensive peptide catestatin (CST) antagonizes catecholamine secretion, and is a negative myocardial inotrope acting via a nitric oxide-dependent mechanism. It is not known whether CST contributes to ischemia/reperfusion injury or is a component of a cardioprotective response to limit injury. Here, we tested whether CST by virtue of its negative inotropic activity improves post-ischemic cardiac function and cardiomyocyte survival. Three groups of isolated perfused hearts from adult Wistar rats underwent 30-min ischemia and 120-min reperfusion (I/R, Group 1), or were post-conditioned by brief ischemic episodes (PostC, 5-cycles of 10-s I/R at the beginning of 120-min reperfusion, Group 2), or with exogenous CST (75 nM for 20 min, CST-Post, Group-3) at the onset of reperfusion. Perfusion pressure and left ventricular pressure (LVP) were monitored. Infarct size was evaluated with nitroblue-tetrazolium staining. The CST (5 nM) effects were also tested in simulated ischemia/reperfusion experiments on cardiomyocytes isolated from young-adult rats, evaluating cell survival with propidium iodide labeling. Infarct size was 61 ± 6% of risk area in hearts subjected to I/R only. PostC reduced infarct size to 34 ± 5%. Infarct size in CST-Post was 36 ± 3% of risk area (P < 0.05 respect to I/R). CST-Post reduced post-ischemic rise of diastolic LVP, an index of contracture, and significantly improved post-ischemic recovery of developed LVP. In isolated cardiomyocytes, CST increased the cell viability rate by about 65% after simulated ischemia/reperfusion. These results suggest a novel cardioprotective role for CST, which appears mainly due to a direct reduction of post-ischemic myocardial damages and dysfunction, rather than to an involvement of adrenergic terminals and/or endothelium.
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Biswas N, Curello E, O’Connor DT, Mahata SK. Chromogranin/secretogranin proteins in murine heart: myocardial production of chromogranin A fragment catestatin (Chga(364-384)). Cell Tissue Res 2010; 342:353-61. [PMID: 21052719 PMCID: PMC2996542 DOI: 10.1007/s00441-010-1059-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Accepted: 09/10/2010] [Indexed: 02/06/2023]
Abstract
In the heart, the secretory granules containing the atrial natriuretic peptides (ANP) and B-type myocardial natriuretic peptide (BNP) provide the basis for the endocrine function of this organ. We sought to determine whether atrial and myocardial secretory granules contain chromogranin/secretogranin proteins including chromogranin A (CHGA/Chga), chromogranin B (CHGB/Chgb) and secretogranin II (SCG2/Scg2). Deconvolution microscopy on immunolabeled proteins revealed the presence of Chga, Chgb, and Scg2 in murine cardiac secretory granules. The presence of low plasma catestatin (CST: mChga364–384) in older mice indicates diminished processing of Chga to CST with advancement of age, which is comparable to that found in humans. We have previously shown that CST (hCHGA352–372) exerts potent cardio-suppressive effects on frog and rat heart, but the source of CST for such action has remained elusive. In the present study, we found CST-related peptides in cardiomyocytes and in heart, which establishes an autocrine/paracrine function of CST in cardiac tissue. We conclude that cardiac secretory granules contain Chga, Chgb and Scg2 and that Chga is processed to CST in murine heart.
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Affiliation(s)
- Nilima Biswas
- Department of Medicine (0838), UCSD School of Medicine and VASDHS, 9500 Gilman Drive, La Jolla, CA 92093-0838 USA
| | - Erica Curello
- Department of Medicine (0838), UCSD School of Medicine and VASDHS, 9500 Gilman Drive, La Jolla, CA 92093-0838 USA
- Molecular Genetics, University of California, San Diego, CA USA
- VA San Diego Healthcare System, 9500 Gilman Drive, La Jolla, CA 92093-0838 USA
| | - Daniel T. O’Connor
- Department of Medicine (0838), UCSD School of Medicine and VASDHS, 9500 Gilman Drive, La Jolla, CA 92093-0838 USA
- Molecular Genetics, University of California, San Diego, CA USA
- VA San Diego Healthcare System, 9500 Gilman Drive, La Jolla, CA 92093-0838 USA
| | - Sushil K. Mahata
- Department of Medicine (0838), UCSD School of Medicine and VASDHS, 9500 Gilman Drive, La Jolla, CA 92093-0838 USA
- VA San Diego Healthcare System, 9500 Gilman Drive, La Jolla, CA 92093-0838 USA
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Brar BK, Helgeland E, Mahata SK, Zhang K, O'Connor DT, Helle KB, Jonassen AK. Human catestatin peptides differentially regulate infarct size in the ischemic-reperfused rat heart. ACTA ACUST UNITED AC 2010; 165:63-70. [PMID: 20655339 DOI: 10.1016/j.regpep.2010.07.153] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Revised: 06/29/2010] [Accepted: 07/08/2010] [Indexed: 01/06/2023]
Abstract
In acute myocardial infarction increased plasma levels of chromogranin A are correlated with decreased survival. At the human chromogranin A gene locus there are two naturally occurring amino acid substitution variants within the catestatin region, i.e. Gly³⁶⁴Ser and Pro³⁷⁰Leu, displaying differential potencies towards inhibition of nicotinic cholinergic agonist-evoked catecholamine secretion from sympathochromaffin cells and different degrees of processing from the prohormone. Here, we examine whether two of the variants and the wild type catestatin may affect the development of infarct size during ischemic reperfusion in the Langendorff rat heart model. The hearts were subjected to regional ischemia followed by reperfusion in the presence or absence of synthetic variants of human catestatin. Compared to the Gly³⁶⁴Ser variant both the wild type and Pro³⁷⁰Leu variants increased infarct size while decreasing the cardiac levels of phosphorylated Akt and two of its downstream targets, FoxO1 and BAD. In conclusion, these findings suggest that, in contrast to the Gly³⁶⁴Ser variant, wild type catestatin and the Pro³⁷⁰Leu variant (allele frequency ~0.3%) increased myocardial infarct size via a mechanism involving dephosphorylation of Akt and the two downstream targets during ischemic reperfusion in the isolated rat heart.
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Røsjø H, Husberg C, Dahl MB, Stridsberg M, Sjaastad I, Finsen AV, Carlson CR, Oie E, Omland T, Christensen G. Chromogranin B in heart failure: a putative cardiac biomarker expressed in the failing myocardium. Circ Heart Fail 2010; 3:503-11. [PMID: 20519641 DOI: 10.1161/circheartfailure.109.867747] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Chromogranin B (CgB) is a member of the granin protein family. Because CgB is often colocalized with chromogranin A (CgA), a recently discovered cardiac biomarker, we hypothesized that CgB is regulated during heart failure (HF) development. METHODS AND RESULTS CgB regulation was investigated in patients with chronic HF and in a post-myocardial infarction HF mouse model. Animals were phenotypically characterized by echocardiography and euthanized 1 week after myocardial infarction. CgB mRNA levels were 5.2-fold increased in the noninfarcted part of the left ventricle of HF animals compared with sham-operated animals (P<0.001). CgB mRNA level in HF animals correlated closely with animal lung weight (r=0.74, P=0.04) but not with CgA mRNA levels (r=0.20, P=0.61). CgB protein levels were markedly increased in both the noninfarcted (110%) and the infarcted part of the left ventricle (70%) but unaltered in other tissues investigated. Myocardial CgB immunoreactivity was confined to cardiomyocytes. Norepinephrine, angiotensin II, and transforming growth factor-beta increased CgB gene expression in cardiomyocytes. Circulating CgB levels were increased in HF animals (median levels in HF animals versus sham, 1.23 [interquartile range, 1.03 to 1.93] versus 0.98 [0.90 to 1.04] nmol/L; P=0.003) and in HF patients (HF patients versus control, 1.66 [1.48 to 1.85] versus 1.47 [1.39 to 1.58] nmol/L; P=0.007), with levels increasing in proportion to New York Heart Association functional class (P=0.03 for trend). Circulating CgB levels were only modestly correlated with CgA (r=0.31, P=0.009) and B-type natriuretic peptide levels (r=0.27, P=0.014). CONCLUSIONS CgB production is increased and regulated in proportion to disease severity in the left ventricle and circulation during HF development.
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Affiliation(s)
- Helge Røsjø
- Medical Division and EpiGen, Institute of Clinical Epidemiology and Molecular Biology, Akershus University Hospital, Lørenskog, Norway.
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Røsjø H, Masson S, Latini R, Flyvbjerg A, Milani V, La Rovere MT, Revera M, Mezzani A, Tognoni G, Tavazzi L, Omland T. Prognostic value of chromogranin A in chronic heart failure: data from the GISSI-Heart Failure trial. Eur J Heart Fail 2010; 12:549-56. [PMID: 20388648 DOI: 10.1093/eurjhf/hfq055] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS To assess the association between circulating levels of chromogranin A (CgA) and outcome in a large population of patients with chronic heart failure (HF). METHODS AND RESULTS Plasma CgA levels were measured at randomization and after 3 months in 1233 patients (median age 68 years, 80% male) with chronic, stable HF from the GISSI-HF trial. Circulating CgA levels were associated with several established risk markers in HF, including increased age, diabetes, reduced renal function, and heart rate variability. During a median follow-up of 3.9 years, 333 patients (27%) died. By univariable analysis, plasma CgA levels at baseline were strongly associated with all-cause mortality during follow-up; 2nd vs. 1st tertile: HR 1.58 (1.17-2.11), P = 0.002; and 3rd vs. 1st tertile: HR 2.35 (1.78-3.10), P < 0.0001. After adjustment for established risk factors of mortality, this association was attenuated and no longer significant. Randomized treatments with n-3 polyunsaturated fatty acid or rosuvastatin did not significantly change plasma CgA concentration over 3 months. CONCLUSION Measurement of circulating CgA levels in patients with chronic, stable HF does not provide incremental prognostic information to that obtained from physical examination, routine biochemical analysis, and contemporary HF biomarkers.
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Affiliation(s)
- Helge Røsjø
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway
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41
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Modlin IM, Gustafsson BI, Moss SF, Pavel M, Tsolakis AV, Kidd M. Chromogranin A--biological function and clinical utility in neuro endocrine tumor disease. Ann Surg Oncol 2010; 17:2427-43. [PMID: 20217257 DOI: 10.1245/s10434-010-1006-3] [Citation(s) in RCA: 244] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Indexed: 02/06/2023]
Abstract
BACKGROUND Neuroendocrine tumors (NETs) are a form of cancer that differ from other neoplasia in that they synthesize, store, and secrete peptides, e.g., chromogranin A (CgA) and amines. A critical issue is late diagnosis due to failure to identify symptoms or to establish the biochemical diagnosis. We review here the utility of CgA measurement in NETs and describe its biological role and the clinical value of its measurement. METHODS Literature review and analysis of the utility of plasma/serum CgA measurements in NETs and other diseases. RESULTS CgA is a member of the chromogranin family; its transcription and peptide processing are well characterized, but its precise function remains unknown. Levels are detectable in the circulation but vary substantially (approximately 25%) depending on which assay is used. Serum and plasma measurements are concordant. CgA is elevated in approximately 90% of gut NETs and correlates with tumor burden and recurrence. Highest values are noted in ileal NETs and gastrointestinal NETs associated with multiple endocrine neoplasia type 1. Both functioning and nonfunctioning pancreatic NETs have elevated values. CgA is more frequently elevated in well-differentiated tumors compared to poorly differentiated NETs. Effective treatment is often associated with decrease in CgA levels. Proton pump inhibitors falsely increase CgA, but levels normalize with therapy cessation. CONCLUSIONS CgA is currently the best available biomarker for the diagnosis of NETs. It is critical to establish diagnosis and has some utility in predicting disease recurrence, outcome, and efficacy of therapy. Measurement of plasma CgA is mandatory for the effective diagnosis and management of NET disease.
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Affiliation(s)
- Irvin M Modlin
- Gastrointestinal Pathobiology Research Group, Yale University School of Medicine, New Haven, CT, USA.
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Mahata SK, Mahata M, Fung MM, O'Connor DT. Catestatin: a multifunctional peptide from chromogranin A. ACTA ACUST UNITED AC 2010; 162:33-43. [PMID: 20116404 DOI: 10.1016/j.regpep.2010.01.006] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2009] [Revised: 01/11/2010] [Accepted: 01/21/2010] [Indexed: 12/16/2022]
Abstract
In 1997, we identified a novel peptide, catestatin (CST: bovine chromogranin A [CHGA](344-364): RSMRLSFRARGYGFRGPGLQL; human CHGA(352-372): SSMKLSFRARGYGFRGPGPQL), which is a potent inhibitor of nicotinic-cholinergic-stimulated catecholamine secretion. CST shows characteristic inhibitory effects on nicotinic cationic (Na(+), Ca(2+)) signal transduction, which are specific to the neuronal nicotinic receptor. Utilizing systematic polymorphism discovery at the human CHGA locus we discovered three human variants of CST: G(364)S, P(370)L, and R(374)Q that showed differential potencies towards the inhibition of catecholamine secretion. In humans, CHGA is elevated and its processing to CST is diminished in hypertension. Diminished CST is observed not only in hypertensive individuals but also in the early-normotensive offspring of patients with hypertension, suggesting that an early deficiency of CST might play a pathogenic role in the subsequent development of the disease. Consistent with human findings, prevention of endogenous CST expression by targeted ablation (knockout) of the mouse Chga locus (Chga-KO) resulted in severe hypertension that can be "rescued" specifically by replacement of the CST peptide. CST acts directly on the heart to inhibit the inotropic and lusitropic properties of the rodent heart and also acts as a potent vasodilator in rats and humans. While the G(364)S CST variant caused profound changes in human autonomic activity and seemed to reduce the risk of developing hypertension, CST replacement rescued Chga-KO mice from dampened baroreflex sensitivity. In addition, CST has been shown to induce chemotaxis and acts as an antimicrobial as well as an antimalarial peptide. The present review summarizes these multiple actions of CST.
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Affiliation(s)
- Sushil K Mahata
- Department of Medicine (0838), University of California at San Diego, and Veterans Affairs San Diego Healthcare System, 9500 Gilman Drive, La Jolla, CA 92093-0838, USA.
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Jeske W, Glinicki P. Prognostic value of circulating chromogranin A levels in acute coronary syndrome: reply. Eur Heart J 2010. [PMID: 19906689 PMCID: PMC2800921 DOI: 10.1093/eurheartj/ehp469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
The pathophysiology of heart failure is complex, and the list of biomarkers representing distinct pathophysiologic pathways is growing rapidly. This article focuses on some promising newer biomarkers that have contributed to a better understanding of pathophysiologic mechanisms involved in heart failure but for which less data are currently available: osteoprotegerin, galectin-3, cystatin C, chromogranin A, and the adipokines adiponectin, leptin, and resistin. Despite the intriguing early information from these newer markers, none is ready for routine clinical use. Much additional study is needed to determine how these biomarkers will fit into diagnostic and treatment algorithms for patients who have heart failure.
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Affiliation(s)
- Sachin Gupta
- The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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45
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Malaguarnera M, Cristaldi E, Cammalleri L, Colonna V, Lipari H, Capici A, Cavallaro A, Beretta M, Alessandria I, Luca S, Motta M. Elevated chromogranin A (CgA) serum levels in the patients with advanced pancreatic cancer. Arch Gerontol Geriatr 2009; 48:213-7. [PMID: 18329114 DOI: 10.1016/j.archger.2008.01.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2007] [Revised: 01/10/2008] [Accepted: 01/14/2008] [Indexed: 11/30/2022]
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46
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Impact of calibration fitting models on the clinical value of chromogranin A. Clin Chem Lab Med 2009; 47:1297-303. [DOI: 10.1515/cclm.2009.278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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47
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Jansson AM, Røsjø H, Omland T, Karlsson T, Hartford M, Flyvbjerg A, Caidahl K. Prognostic value of circulating chromogranin A levels in acute coronary syndromes. Eur Heart J 2008; 30:25-32. [PMID: 19028779 PMCID: PMC2639087 DOI: 10.1093/eurheartj/ehn513] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS To determine whether circulating levels of chromogranin A (CgA) provide prognostic information independently of conventional risk markers in acute coronary syndromes (ACSs). METHODS AND RESULTS We measured circulating CgA levels on day 1 in 1268 patients (median age 67 years, 70% male) with ACS admitted to a single coronary care unit of a Scandinavian teaching hospital. The merit of CgA as a biomarker was evaluated after adjusting for conventional cardiovascular risk factors. During a median follow-up of 92 months, 389 patients (31%) died. The baseline CgA concentration was strongly associated with increased long-term mortality [hazard ratio per 1 standard deviation increase in logarithmically transformed CgA level: 1.57 (1.44-1.70), P < 0.001], heart failure hospitalizations [1.54 (1.35-1.76), P < 0.001], and recurrent myocardial infarction (MI) [1.27 (1.10-1.47), P < 0.001], but not stroke. After adjustment for conventional cardiovascular risk markers, the association remained significant for mortality [hazard ratio 1.28 (1.15-1.42), P < 0.001] and heart failure hospitalization [hazard ratio 1.24 (1.04-1.47), P = 0.02], but not recurrent MI. CONCLUSION CgA is an independent predictor of long-term mortality and heart failure hospitalizations across the spectrum of ACSs and provides incremental prognostic information to conventional cardiovascular risk markers.
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Affiliation(s)
- Anna M Jansson
- Department of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
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48
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Cerra MC, Gallo MP, Angelone T, Quintieri AM, Pulerà E, Filice E, Guérold B, Shooshtarizadeh P, Levi R, Ramella R, Brero A, Boero O, Metz-Boutigue MH, Tota B, Alloatti G. The homologous rat chromogranin A1-64 (rCGA1-64) modulates myocardial and coronary function in rat heart to counteract adrenergic stimulation indirectly via endothelium-derived nitric oxide. FASEB J 2008; 22:3992-4004. [PMID: 18697842 DOI: 10.1096/fj.08-110239] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Chromogranin A (CGA), produced by human and rat myocardium, generates several biologically active peptides processed at specific proteolytic cleavage sites. A highly conserved cleavage N-terminal site is the bond 64-65 that reproduces the native rat CGA sequence (rCGA1-64), corresponding to human N-terminal CGA-derived vasostatin-1. rCGA1-64 cardiotropic activity has been explored in rat cardiac preparations. In Langendorff perfused rat heart, rCGA1-64 (from 33 nM) induced negative inotropism and lusitropism as well as coronary dilation, counteracting isoproterenol (Iso) - and endothelin-1 (ET-1) -induced positive inotropic effects and ET-1-dependent coronary constriction. rCGA1-64 also depressed basal and Iso-induced contractility on rat papillary muscles, without affecting calcium transients on isolated ventricular cells. Structure-function analysis using three modified peptides on both rat heart and papillary muscles revealed the disulfide bridge requirement for the cardiotropic action. A decline in Iso intrinsic activity in the presence of the peptides indicates a noncompetitive antagonistic action. Experiments on rat isolated cardiomyocytes and bovine aortic endothelial cells indicate that the negative inotropism observed in rat papillary muscle is probably due to an endothelial phosphatidylinositol 3-kinase-dependent nitric oxide release, rather than to a direct action on cardiomyocytes. Taken together, our data strongly suggest that in the rat heart the homologous rCGA1-64 fragment exerts an autocrine/paracrine modulation of myocardial and coronary performance acting as stabilizer against intense excitatory stimuli.
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Affiliation(s)
- M C Cerra
- B.T., Department of Cell Biology, University of Calabria, 87030 Arcavacata di Rende (CS), Calabria, Italy
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Zhang D, Lavaux T, Voegeli AC, Lavigne T, Castelain V, Meyer N, Sapin R, Aunis D, Metz-Boutigue MH, Schneider F. Prognostic value of chromogranin A at admission in critically ill patients: a cohort study in a medical intensive care unit. Clin Chem 2008; 54:1497-503. [PMID: 18635750 DOI: 10.1373/clinchem.2007.102442] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Risk assessments of patients should be based on objective variables, such as biological markers that can be measured routinely. The acute response to stress causes the release of catecholamines from the adrenal medulla accompanied by chromogranin A (CGA). To date, no study has evaluated the prognostic value of CGA in critically ill intensive care unit patients. METHODS We conducted a prospective study of intensive care unit patients by measuring serum procalcitonin (PCT), C-reactive protein (CRP), and CGA at the time of admission. Univariate and multivariate analyses were performed to evaluate the ability of these biomarkers to predict mortality. RESULTS In 120 consecutive patients, we found positive correlations between CGA and the following: CRP (r(2) = 0.216; P = 0.02), PCT (r(2) = 0.396; P < 0.001), Simplified Acute Physiologic Score II (SAPS II) (r(2) = 0.438; P < 0.001), and the Logistic Organ Dysfunction System (LODS) score (r(2) = 0.374; P < 0.001). Nonsurvivors had significantly higher CGA and PCT concentrations than survivors [median (interquartile range): 293.0 microg/L (163.5-699.5 microg/L) vs 86.0 microg/L (53.8-175.3 microg/L) for CGA, and 6.78 microg/L (2.39-22.92 microg/L) vs 0.54 microg/L (0.16-6.28 microg/L) for PCT; P < 0.001 for both comparisons]. In a multivariable linear regression analysis, creatinine (P < 0.001), age (P < 0.001), and SAPS II (P = 0.002) were the only significant independent variables predicting CGA concentration (r(2) = 0.352). A multivariate Cox regression analysis identified 3 independent factors predicting death: log-normalized CGA concentration [hazard ratio (HR), 7.248; 95% confidence interval (CI), 3.004-17.487], SAPS II (HR, 1.046; 95% CI, 1.026-1.067), and cardiogenic shock (HR, 3.920; 95% CI, 1.731-8.880). CONCLUSIONS CGA is a strong and independent indicator of prognosis in critically ill nonsurgical patients.
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Affiliation(s)
- Dan Zhang
- Service de Réanimation Médicale, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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Larsen AI, Helle KB, Christensen M, Kvaløy JT, Aarsland T, Dickstein K. Effect of exercise training on chromogranin A and relationship to N-ANP and inflammatory cytokines in patients with chronic heart failure. Int J Cardiol 2007; 127:117-20. [PMID: 17586073 DOI: 10.1016/j.ijcard.2007.04.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2007] [Accepted: 04/01/2007] [Indexed: 11/24/2022]
Abstract
Exercise training improves functional parameters in patients with congestive heart failure (CHF). The aim of this study was to establish whether exercise training influence the elevated CgA levels in CHF patients. Plasma CgA was determined at baseline and at peak exercise before and after 12 weeks of training in 25 men (mean age 67+/-8 years) with CHF (NYHA functional class II and III). Plasma Chromogranin A (CgA) was significantly elevated in CHF, however without change after the 12 week exercise period. A positive correlation was obtained for CgA versus N-ANP and CgA versus TNFalpha for the patients with poor survival, indicating that in these patients the elevated plasma CgA was more closely connected to the myocardial release of natriuretic peptides and the inflammatory response than to activation of the sympathoadrenergic system.
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