1
|
Markousis-Mavrogenis G, Baumhove L, Al-Mubarak AA, Aboumsallem JP, Bomer N, Voors AA, van der Meer P. Immunomodulation and immunopharmacology in heart failure. Nat Rev Cardiol 2024; 21:119-149. [PMID: 37709934 DOI: 10.1038/s41569-023-00919-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 09/16/2023]
Abstract
The immune system is intimately involved in the pathophysiology of heart failure. However, it is currently underused as a therapeutic target in the clinical setting. Moreover, the development of novel immunomodulatory therapies and their investigation for the treatment of patients with heart failure are hampered by the fact that currently used, evidence-based treatments for heart failure exert multiple immunomodulatory effects. In this Review, we discuss current knowledge on how evidence-based treatments for heart failure affect the immune system in addition to their primary mechanism of action, both to inform practising physicians about these pleiotropic actions and to create a framework for the development and application of future immunomodulatory therapies. We also delineate which subpopulations of patients with heart failure might benefit from immunomodulatory treatments. Furthermore, we summarize completed and ongoing clinical trials that assess immunomodulatory treatments in heart failure and present several therapeutic targets that could be investigated in the future. Lastly, we provide future directions to leverage the immunomodulatory potential of existing treatments and to foster the investigation of novel immunomodulatory therapeutics.
Collapse
Affiliation(s)
- George Markousis-Mavrogenis
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Lukas Baumhove
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ali A Al-Mubarak
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Joseph Pierre Aboumsallem
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Department of Cardiology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Nils Bomer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Adriaan A Voors
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Peter van der Meer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
| |
Collapse
|
2
|
Kilic A, Ustunova S, Bulut H, Meral I. Pre and postnatal exposure to 900 MHz electromagnetic fields induce inflammation and oxidative stress, and alter renin-angiotensin system components differently in male and female offsprings. Life Sci 2023; 321:121627. [PMID: 36997060 DOI: 10.1016/j.lfs.2023.121627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/23/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023]
Abstract
AIMS This study was designed to investigate inflammation, oxidative stress and renin-angiotensin system components in brain and kidney tissues of female and male rats prenatally and/or postnatally exposed to 900 MHz electromagnetic field (EMF). It is aimed to evaluate the biological effects of 900 MHz EMF exposure due to the increase in mobile phone use and especially the more widespread use of the GSM 900 system. MAIN METHODS Male and female Wistar albino offsprings were divided into four groups of control, prenatal, postnatal, and prenatal+postnatal exposed to 900 MHz EMF for 1 h/day (23 days during pregnancy for prenatal period, 40 days for postnatal period). The brain and kidney tissues were collected when they reached puberty. KEY FINDINGS It was found that the total oxidant status, IL-2, IL-6, and TNF-α levels increased (p < 0.001) and the total antioxidant status levels decreased (p < 0.001) in all three EMF groups comparing to controls in both male and female brain and kidney tissues. The renin- angiotensin system components such as angiotensinogen, renin, angiotensin type 1 and type 2 receptors, and MAS1-like G protein-coupled receptor expression were higher (p < 0.001) in all three EMF exposure groups comparing to controls in both male and female brain and kidney tissues. Although there are some differences of the levels of proinflammatory markers, ROS components and RAS components in brain and kidney tissues between males and females, the common result of all groups was increase in oxidative stress, inflammation markers and angiotensin system components with exposure to 900 MHz EMF. SIGNIFICANCE In conclusion, our study suggested that the 900 MHz EMF can activate brain and kidney renin-angiotensin system, and this activation is maybe related to inflammation and oxidative stress in both male and female offsprings.
Collapse
Affiliation(s)
- Aysu Kilic
- Department of Physiology, School of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Savas Ustunova
- Department of Physiology, School of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Huri Bulut
- Department of Medical Biochemistry, School of Medicine, Istinye University, Istanbul, Turkey
| | - Ismail Meral
- Department of Physiology, School of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
| |
Collapse
|
3
|
Liu Z, Wang Q, Li N, Xu C, Li Y, Zhou J, Liu L, Zhang H, Mo Y, Han F, Xu D. Cardiovascular benefits of air purifier in patients with stable coronary artery disease: A randomized single-blind crossover study. Front Public Health 2023; 10:1082327. [PMID: 36699920 PMCID: PMC9868303 DOI: 10.3389/fpubh.2022.1082327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/09/2022] [Indexed: 01/10/2023] Open
Abstract
Background Exposure to PM2.5 will accelerate the progression of cardiovascular diseases. Air purifier can reduce the PM2.5 exposure and theoretically alleviate the influence of PM2.5 on patients with stable coronary artery disease (SCAD). However, few studies of the protective effect showed significant results because the interferent effects of routine medication had not been taken into account. In order to explore the actual effect on patients with SCAD, we conducted a randomized single-blind crossover air purifier intervention trial. Method Levels of PM2.5 exposure during intervention and cardiovascular indicators (inflammation, coagulation, plaque stability, and blood lipids) after intervention were detected, meanwhile the information of drug use was obtained by questionnaire. The kinds of drug used by more than 20% of the subjects were sorted out. And the influence of these drugs on cardiovascular indicators was summarized through literature review. Based on that, the drug use was included as a variable in linear mixed effects models that used to analyze the associations between PM2.5 exposure reduction by air purifier and cardiovascular indicators. Results The result revealed that the interpretation contribution rate of drug use was more than that of PM2.5 exposure. The level of C-reactive protein significantly decreased by 20.93% (95%CI: 6.56%, 33.10%), 23.44% (95%CI: 2.77%, 39.39%) and 24.11% (95%CI: 4.21%, 39.69%) on lag1, lag01 and lag02 respectively, while the level of high-density lipoprotein cholesterol significantly increased by 5.10% (95%CI: 0.69%, 9.05%), 3.71% (95%CI: 0.92%, 6.60%) and 6.48% (95%CI: 2.58%, 10.24%) respectively on lag0, lag1 and lag01 associated with an interquartile range decrease of 22.51 μg/m3 in PM2.5 exposure. Conclusion The study shows positive effects of air purifier on SCAD, and also provides methodological reference for future related research.
Collapse
Affiliation(s)
- Zhe Liu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qin Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Na Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chunyu Xu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yunpu Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jun Zhou
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liu Liu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China,Chaoyang District Center for Disease Control and Prevention, Beijing, China
| | - Haijing Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yang Mo
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Feng Han
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China,National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dongqun Xu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China,*Correspondence: Dongqun Xu ✉
| |
Collapse
|
4
|
Dubé M, Chazara O, Lemaçon A, Asselin G, Provost S, Barhdadi A, Lemieux Perreault L, Mongrain I, Wang Q, Carss K, Paul DS, Cunningham JW, Rouleau J, Solomon SD, McMurray JJ, Yusuf S, Granger CB, Haefliger C, de Denus S, Tardif J. Pharmacogenomic study of heart failure and candesartan response from the CHARM programme. ESC Heart Fail 2022; 9:2997-3008. [PMID: 35736394 PMCID: PMC9715825 DOI: 10.1002/ehf2.14026] [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: 09/23/2021] [Revised: 03/21/2022] [Accepted: 06/03/2022] [Indexed: 11/07/2022] Open
Abstract
AIMS The Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity (CHARM) programme consisted of three parallel, randomized, double-blind clinical trials comparing candesartan with placebo in patients with heart failure (HF) categorized according to left ventricular ejection fraction and tolerability to an angiotensin-converting enzyme inhibitor. We conducted a pharmacogenomic study of the CHARM trials with the objective of identifying genetic predictors of HF progression and of the efficacy and safety of treatment with candesartan. METHODS We performed genome-wide association studies in 2727 patients of European ancestry from CHARM-Overall and stratified by CHARM study according to preserved and reduced ejection fraction and according to assignment to the interventional treatment with candesartan. We tested genetic association with the composite endpoint of cardiovascular death or hospitalization for heart failure for drug efficacy in candesartan-treated patients and for HF progression using patients from both candesartan and placebo arms. The safety endpoints for response to candesartan were hyperkalaemia, renal dysfunction, hypotension, and change in systolic blood pressure between baseline and 6 weeks of treatment. To support our observations, we conducted a genome-wide gene-level collapsing analysis from whole-exome sequencing data with the composite cardiovascular endpoint. RESULTS We found that the A allele (14% allele frequency) of the genetic variant rs66886237 at 8p21.3 near the gene GFRA2 was associated with the composite cardiovascular endpoint in 1029 HF patients with preserved ejection fraction from the CHARM-Preserved study (hazard ratio: 1.91, 95% confidence interval: 1.55-2.35; P = 1.7 × 10-9 ). The association was independent of candesartan treatment, and the genetic variant was not associated with the cardiovascular endpoint in patients with reduced ejection fraction. None of the genome-wide association studies for candesartan safety or efficacy conducted in patients treated with candesartan passed the significance threshold. We found no significant association from the gene-level collapsing analysis. CONCLUSIONS We have identified a candidate genetic variant potentially predictive of the progression of heart failure in patients with preserved ejection fraction. The findings require further replication, and we cannot exclude the possibility that the results may be chance findings.
Collapse
Affiliation(s)
- Marie‐Pierre Dubé
- Montreal Heart InstituteMontrealCanada
- Université de Montréal Beaulieu‐Saucier Pharmacogenomics CentreMontrealCanada
- Université de Montréal, Faculty of Medicine, Department of medicineUniversité de MontréalMontrealCanada
| | - Olympe Chazara
- Centre for Genomics Research (CGR), Discovery Sciences, BioPharmaceuticals R&D, AstraZenecaCambridgeUK
| | - Audrey Lemaçon
- Montreal Heart InstituteMontrealCanada
- Université de Montréal Beaulieu‐Saucier Pharmacogenomics CentreMontrealCanada
- Université de Montréal, Faculty of Medicine, Department of medicineUniversité de MontréalMontrealCanada
| | - Géraldine Asselin
- Montreal Heart InstituteMontrealCanada
- Université de Montréal Beaulieu‐Saucier Pharmacogenomics CentreMontrealCanada
| | - Sylvie Provost
- Montreal Heart InstituteMontrealCanada
- Université de Montréal Beaulieu‐Saucier Pharmacogenomics CentreMontrealCanada
| | - Amina Barhdadi
- Montreal Heart InstituteMontrealCanada
- Université de Montréal Beaulieu‐Saucier Pharmacogenomics CentreMontrealCanada
| | | | - Ian Mongrain
- Montreal Heart InstituteMontrealCanada
- Université de Montréal Beaulieu‐Saucier Pharmacogenomics CentreMontrealCanada
| | - Quanli Wang
- Centre for Genomics Research (CGR), Discovery Sciences, BioPharmaceuticals R&D, AstraZenecaCambridgeUK
| | - Keren Carss
- Centre for Genomics Research (CGR), Discovery Sciences, BioPharmaceuticals R&D, AstraZenecaCambridgeUK
| | - Dirk S. Paul
- Centre for Genomics Research (CGR), Discovery Sciences, BioPharmaceuticals R&D, AstraZenecaCambridgeUK
| | | | - Jean Rouleau
- Montreal Heart InstituteMontrealCanada
- Université de Montréal, Faculty of Medicine, Department of medicineUniversité de MontréalMontrealCanada
| | - Scott D. Solomon
- Cardiovascular Division, Brigham and Women's HospitalHarvard Medical SchoolBostonMAUSA
| | | | - Salim Yusuf
- The Population Health Research Institute, Hamilton Health Sciences and the School of Rehabilitation ScienceMcMaster UniversityHamiltonONCanada
| | - Chris B. Granger
- Duke Clinical Research InstituteDuke University School of MedicineDurhamNCUSA
| | - Carolina Haefliger
- Centre for Genomics Research (CGR), Discovery Sciences, BioPharmaceuticals R&D, AstraZenecaCambridgeUK
| | - Simon de Denus
- Montreal Heart InstituteMontrealCanada
- Université de Montréal Beaulieu‐Saucier Pharmacogenomics CentreMontrealCanada
- Faculty of PharmacyUniversité de MontréalMontrealCanada
| | - Jean‐Claude Tardif
- Montreal Heart InstituteMontrealCanada
- Université de Montréal, Faculty of Medicine, Department of medicineUniversité de MontréalMontrealCanada
| |
Collapse
|
5
|
Gopcevic KR, Gkaliagkousi E, Nemcsik J, Acet Ö, Bernal-Lopez MR, Bruno RM, Climie RE, Fountoulakis N, Fraenkel E, Lazaridis A, Navickas P, Rochfort KD, Šatrauskienė A, Zupkauskienė J, Terentes-Printzios D. Pathophysiology of Circulating Biomarkers and Relationship With Vascular Aging: A Review of the Literature From VascAgeNet Group on Circulating Biomarkers, European Cooperation in Science and Technology Action 18216. Front Physiol 2021; 12:789690. [PMID: 34970157 PMCID: PMC8712891 DOI: 10.3389/fphys.2021.789690] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/17/2021] [Indexed: 12/14/2022] Open
Abstract
Impairment of the arteries is a product of sustained exposure to various deleterious factors and progresses with time; a phenomenon inherent to vascular aging. Oxidative stress, inflammation, the accumulation of harmful agents in high cardiovascular risk conditions, changes to the extracellular matrix, and/or alterations of the epigenetic modification of molecules, are all vital pathophysiological processes proven to contribute to vascular aging, and also lead to changes in levels of associated circulating molecules. Many of these molecules are consequently recognized as markers of vascular impairment and accelerated vascular aging in clinical and research settings, however, for these molecules to be classified as biomarkers of vascular aging, further criteria must be met. In this paper, we conducted a scoping literature review identifying thirty of the most important, and eight less important, biomarkers of vascular aging. Herein, we overview a selection of the most important molecules connected with the above-mentioned pathological conditions and study their usefulness as circulating biomarkers of vascular aging.
Collapse
Affiliation(s)
- Kristina R. Gopcevic
- Laboratory for Analytics of Biomolecules, Department of Chemistry in Medicine, Faculty of Medicine, Belgrade, Serbia
| | - Eugenia Gkaliagkousi
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - János Nemcsik
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
- Health Service of ZUGLO, Department of Family Medicine, Budapest, Hungary
| | - Ömür Acet
- Vocational School of Health Science, Pharmacy Services Program, Tarsus University, Tarsus, Turkey
| | - M. Rosa Bernal-Lopez
- Internal Medicine Department, Regional University Hospital of Malaga, Instituto de Investigacion Biomedica de Malaga, University of Malaga, CIBER Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Málaga, Spain
| | - Rosa M. Bruno
- Unversite de Paris, INSERM, U970, Paris Cardiovascular Research Center, Paris, France
| | - Rachel E. Climie
- Unversite de Paris, INSERM, U970, Paris Cardiovascular Research Center, Paris, France
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
- Sports Cardiology Lab, Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Nikolaos Fountoulakis
- Faculty of Life Sciences and Medicine, King’s College London - Waterloo Campus, London, United Kingdom
| | - Emil Fraenkel
- 1st Department of Internal Medicine, University Hospital and Pavol Jozef Šafárik University in Košice, Košice, Slovakia
| | - Antonios Lazaridis
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Petras Navickas
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Keith D. Rochfort
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Agnė Šatrauskienė
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Jūratė Zupkauskienė
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Dimitrios Terentes-Printzios
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
6
|
Zhang L, Zhang B, Wu J, Zou Y, Jiang H, Ge J. AT1 receptor blocker inhibits HMGB1 expression in pressure overload-induced acute cardiac dysfunction by suppressing the MAPK/NF-κB signaling pathway. Clin Exp Hypertens 2021; 44:93-99. [PMID: 34704526 DOI: 10.1080/10641963.2021.1996588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND High-mobility group box 1 (HMGB1) expression not only peaks during the early phase of pressure overload (PO), but also serves a role in the pathogenesis of PO-induced cardiac remodeling. Meanwhile, angiotensin II type 1 (AT1) receptor blockers reverse PO-induced cardiac remodeling and repress the secretion of inflammatory factors. However, whether AT1 receptor inhibitors decrease HMGB1 expression in the early stages of PO remains unknown. MATERIALS AND METHODS PO mouse models were established using transverse aortic constriction (TAC), in which losartan was administrated. Transthoracic echocardiography was performed 3 days after the operation, and serum and cardiac HMGB1 expression, as well as the expression levels of related proteins were measured. RESULTS PO-induced acute cardiac dysfunction was observed 3 days after TAC, and was subsequently slightly, but not significantly relieved by losartan. The expression levels of HMGB1, tumor necrosis factor-α and interleukin-6 in both the serum and myocardium were upregulated in response to TAC, while they were significantly reduced by losartan. Moreover, the phosphorylation of extracellular signal-regulated kinases, p38 mitogen-activated protein kinase (MAPK) and nuclear factor-κB (NF-κB) in the myocardium were significantly increased under PO, and this was also prevented by losartan. CONCLUSION These data suggest that losartan may downregulate the expression of HMGB1 in acute cardiac dysfunction induced by PO by inhibiting the MAPKs/NF-κB signaling pathway, which indicates a novel beneficial role of AT1 receptor antagonists in ameliorating cardiac remodeling under PO.
Collapse
Affiliation(s)
- Lei Zhang
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Baoli Zhang
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Jian Wu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Yunzeng Zou
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Hong Jiang
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| |
Collapse
|
7
|
Abstract
Neurohormones and inflammatory mediators have effects in both the heart and the peripheral vasculature. In patients with heart failure (HF), neurohormonal activation and increased levels of inflammatory mediators promote ventricular remodeling and development of HF, as well as vascular dysfunction and arterial stiffness. These processes may lead to a vicious cycle, whereby arterial stiffness perpetuates further ventricular remodeling leading to exacerbation of symptoms. Although significant advances have been made in the treatment of HF, currently available treatment strategies slow, but do not halt, this cycle. The current treatment for HF patients involves the inhibition of neurohormonal activation, which can reduce morbidity and mortality related to this condition. Beyond benefits associated with neurohormonal blockade, other strategies have focused on inhibition of inflammatory pathways implicated in the pathogenesis of HF. Unfortunately, attempts to target inflammation have not yet been successful to improve prognosis of HF. Further work is required to interrupt key maladaptive mechanisms involved in disease progression.
Collapse
|
8
|
Baker JV, Wolfson J, Collins G, Morse C, Rhame F, Liappis AP, Rizza S, Temesgen Z, Mystakelis H, Deeks S, Neaton J, Schacker T, Sereti I, Tracy RP. Losartan to reduce inflammation and fibrosis endpoints in HIV disease. AIDS 2021; 35:575-583. [PMID: 33252490 PMCID: PMC8062089 DOI: 10.1097/qad.0000000000002773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Persistent inflammation and incomplete immune recovery among persons with HIV (PHIV) are associated with increased disease risk. We hypothesized that the angiotensin receptor blocker (ARB) losartan would reduce inflammation by mitigating nuclear factor (NF)κB responses and promote T-cell recovery via inhibition of transforming growth factor-beta (TGFβ)-mediated fibrosis. METHODS Losartan (100 mg) versus placebo over 12 months was investigated in a randomized (1 : 1) placebo-controlled trial, among PHIV age at least 50 years, receiving antiretroviral therapy (ART), with HIV RNA less than 200 copies/ml and CD4+ cell count 600 cells/μl or less. Inflammation, fibrosis and myocardial biomarkers were measured in blood using ELISA, electrochemiluminescence and immunoturbidimetric methods, and T-cell and monocyte phenotypes were assessed with flow cytometry among a subset of participants. Changes over follow-up in (log-2 transformed) biomarkers and cell phenotypes (untransformed) were compared between losartan and placebo arms using linear mixed models. RESULTS Among 108 PHIV (n = 52 to losartan; n = 56 to placebo), 97% had a month 12 visit. Median age was 57 years and baseline CD4+ cell count was 408 cells/μl. Losartan treatment was not associated with an improvement in interleukin-6 levels, or other blood measures of inflammation, immune activation, fibrosis activity or myocardial function. CD4+ and CD8+ T cells also did not differ by treatment group. Losartan reduced SBP and DBP by 6 and 5 mmHg, respectively. CONCLUSION Among older PHIV with viral suppression, losartan did not improve blood measures of inflammation nor T-cell immune recovery. Losartan treatment is unlikely to reduce inflammation associated comorbidities to a clinically meaningful degree, beyond the benefits from lowering blood pressure. CLINICALTRIALSGOV NCT02049307.
Collapse
Affiliation(s)
- Jason V. Baker
- Hennepin Healthcare Research Institute
- University of Minnesota, Minneapolis, Minnesota
| | | | | | - Caryn Morse
- Wake Forest Baptist Medical Center, Winston Salem, North Carolina
| | | | | | | | | | | | - Steven Deeks
- University of California San Francisco, San Francisco, California
| | | | | | | | | |
Collapse
|
9
|
Pająk-Łysek E, Polak M, Kopeć G, Podolec M, Desvarieux M, Pająk A, Zarzecka J. Associations between Pharmacotherapy for Cardiovascular Diseases and Periodontitis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E770. [PMID: 33477530 PMCID: PMC7831110 DOI: 10.3390/ijerph18020770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/03/2021] [Accepted: 01/08/2021] [Indexed: 02/04/2023]
Abstract
The goal of the study was to assess the relationship between cardioprotective medications, i.e., beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), angiotensin II receptor blockers (ARBs), statins, acetylsalicylic acid (ASA), and periodontitis (PD). BACKGROUND Xerostomia increases the risk of PD and is a side effect of some pharmacotherapies. Information about the effect of cardioprotective treatment of periodontal status is scarce. METHODS We studied 562 dentate residents of Krakow at the age of 50 to 70 years. Information about treatment was collected using a standardized questionnaire. The pocket depth and clinical attachment level (CAL) were used to ascertain PD. Multivariate logistic regression was applied to assess the relation between cardioprotective medications and PD. RESULTS PD was found in 74% of participants. The range of cardioprotective drug use among participants was 7% (ARBs) to 32% (beta-blockers). After adjusting for age, sex, number of teeth, smoking, and education, ASA's use was related to a lower prevalence of PD in all dentate participants (odds ratio (OR) = 0.63, 95% confidence interval (CI): 0.40-0.99). The use of ARBs and statins was found to be associated with a higher prevalence of PD in persons having ≥6 teeth (odds ratio (OR) = 3.57, 95% CI: 1.06-11.99 and OR = 1.81, 95% CI: 1.03-3.16, respectively). Further adjustment for CVD risk factors, history of coronary heart disease, and other chronic diseases did not attenuate the results. There was no significant relation between PD and the use of other cardioprotective drugs.
Collapse
Affiliation(s)
- Ewa Pająk-Łysek
- Department of Conservative Dentistry with Endodontics, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Kraków, Poland;
| | - Maciej Polak
- Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Kraków, Poland; (M.P.); (A.P.)
| | - Grzegorz Kopeć
- Pulmonary Circulation Centre, Department of Cardiac and Vascular Diseases, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Kraków, Poland;
- John Paul II Hospital, 31-202 Kraków, Poland;
| | - Mateusz Podolec
- John Paul II Hospital, 31-202 Kraków, Poland;
- Department of Coronary Artery Disease and Heart Failure, Faculty of Medicine, Jagiellonian University Medical College, John Paul II Hospital, 31-008 Kraków, Poland
| | - Moïse Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
- INSERM UMR 1153, Center de Recherche Epidemiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Core, 75004 Paris, France
| | - Andrzej Pająk
- Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Kraków, Poland; (M.P.); (A.P.)
| | - Joanna Zarzecka
- Department of Conservative Dentistry with Endodontics, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Kraków, Poland;
| |
Collapse
|
10
|
Risk of lung cancer and renin-angiotensin blockade: a concise review. J Cancer Res Clin Oncol 2020; 147:195-204. [PMID: 33231730 PMCID: PMC7684567 DOI: 10.1007/s00432-020-03445-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/28/2020] [Indexed: 02/06/2023]
Abstract
Purpose The blockade of the renin–angiotensin–aldosterone system (RAAS) by angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) is one of the most common treatments for hypertension, heart failure and renal diseases. However, concerns have been raised about a possible link between RAAS-blockers and an increased risk of cancer, particularly of lung cancer. This narrative review aims to give a critical appraisal of current evidence and to help physicians understand potential links between RAAS blockade and de novo lung cancer development. Methods Numerous pharmaco-epidemiologic studies, mostly retrospective cohort analyses, evaluated the association of RAAS blockade with lung cancer incidence and reported inconsistent findings. Meta-analyses could not further clarify a possible link between RAAS blockade and the risk of lung cancer. Results International regulatory agencies (FDA, EMA) have concluded that the use of RAAS blockers is not associated with an increased risk of developing lung cancer. Co-administration of RAAS blockers to systemic therapy of advanced non-small cell lung cancer seems to have positive effects on the outcome. Conclusion Until more comprehensive analyses have been completed, there is no need to change clinical practise. Additional prospective randomized trials with long-term follow-up are needed to investigate the effects of these drugs on the development and progression of lung cancer.
Collapse
|
11
|
Li J, Wang Q, Zhang Q, Wang Z, Wan X, Miao C, Zeng X. Higher Blood Vascular Cell Adhesion Molecule-1 is Related to the Increased Risk of Cardiovascular Events in Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2020; 15:2289-2295. [PMID: 33061346 PMCID: PMC7532039 DOI: 10.2147/copd.s264889] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/06/2020] [Indexed: 11/23/2022] Open
Abstract
Background Vascular cell adhesion molecule-1 (VCAM-1) is associated with vascular-related inflammation and atherosclerosis. This study aimed to evaluate whether VCAM-1 can be used for an indication of increased risk of CV events in patients with COPD. Methods Serum VCAM-1 levels were measured in 163 COPD patients. All COPD patients were prospectively followed up for a median period of 48 months (range=3-54). Cox proportional hazard analysis was performed to evaluate the prognostic value of serum VCAM-1 for predicting CV events. Results Serum VCAM-1 levels were higher in COPD patients with CV events than in those without CV events (1174.4±365.3 ng/mL vs 947.8±293.2 ng/mL; P<0.001). The logistic regression analysis revealed that serum VCAM-1 (OR=1.750; 95% CI, 1.324-2.428; Ptrend=0.0012) was independently associated with CVD (cardiovascular disease) history after adjusting for age, sex, BMI, current smoker, current drinker, admission systolic and diastolic BP, LVEF and laboratory measurements in patients with COPD at baseline. The Kaplan-Meier analysis demonstrated that the rate of CV events was higher in COPD patients with serum VCAM-1 levels above the median (517.3 ng/mL) than in those with VCAM-1 levels below the median. The Cox proportional hazard analysis revealed that serum VCAM-1 (HR=2.617; 95% CI, 1.673-5.328; Ptrend<0.001) may be an independent prognostic factor for CV events in the COPD patients. Conclusion Our results suggested that serum VCAM-1 was significantly and independently associated with CV events in COPD patients. The inflammatory marker may help clinicians predict CV complications early.
Collapse
Affiliation(s)
- Jinlin Li
- Department of Respiratory Medicine, Suizhou Hospital, Hubei University of Medicine, Suizhou, Hubei441300, People’s Republic of China
| | - Qi Wang
- Department of Respiratory Medicine, Suizhou Hospital, Hubei University of Medicine, Suizhou, Hubei441300, People’s Republic of China
| | - Qingping Zhang
- Department of Otolaryngology Head and Neck Surgery, Suizhou Hospital, Hubei University of Medicine, Suizhou, Hubei441300, People’s Republic of China
| | - Zhengyan Wang
- Department of Respiratory Medicine, Suizhou Hospital, Hubei University of Medicine, Suizhou, Hubei441300, People’s Republic of China
| | - Xin Wan
- Department of Critical Care Medicine, Mindong Hospital of Fujian Medical University, Fuan, Fujian355000, People’s Republic of China
| | - Chenfang Miao
- Department of Anesthesiology, Mindong Hospital of Fujian Medical University, Fuan, Fujian355000, People’s Republic of China
| | - Xi Zeng
- Department of Geriatrics, Mindong Hospital of Fujian Medical University, Fuan, Fujian355000, People’s Republic of China
| |
Collapse
|
12
|
Mohammed El Tabaa M, Mohammed El Tabaa M. Targeting Neprilysin (NEP) pathways: A potential new hope to defeat COVID-19 ghost. Biochem Pharmacol 2020; 178:114057. [PMID: 32470547 PMCID: PMC7250789 DOI: 10.1016/j.bcp.2020.114057] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 05/22/2020] [Indexed: 02/06/2023]
Abstract
COVID-19 is an ongoing viral pandemic disease that is caused by SARS-CoV2, inducing severe pneumonia in humans. However, several classes of repurposed drugs have been recommended, no specific vaccines or effective therapeutic interventions for COVID-19 are developed till now. Viral dependence on ACE-2, as entry receptors, drove the researchers into RAS impact on COVID-19 pathogenesis. Several evidences have pointed at Neprilysin (NEP) as one of pulmonary RAS components. Considering the protective effect of NEP against pulmonary inflammatory reactions and fibrosis, it is suggested to direct the future efforts towards its potential role in COVID-19 pathophysiology. Thus, the review aimed to shed light on the potential beneficial effects of NEP pathways as a novel target for COVID-19 therapy by summarizing its possible molecular mechanisms. Additional experimental and clinical studies explaining more the relationships between NEP and COVID-19 will greatly benefit in designing the future treatment approaches.
Collapse
Affiliation(s)
- Manar Mohammed El Tabaa
- Pharmacology & Environmental Toxicology, Environmental Studies & Research Institute, University of Sadat City, Egypt.
| | | |
Collapse
|
13
|
Bajaj NS, Gupta K, Gharpure N, Pate M, Chopra L, Kalra R, Prabhu SD. Effect of immunomodulation on cardiac remodelling and outcomes in heart failure: a quantitative synthesis of the literature. ESC Heart Fail 2020; 7:1319-1330. [PMID: 32198851 PMCID: PMC7261557 DOI: 10.1002/ehf2.12681] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 02/09/2020] [Accepted: 02/22/2020] [Indexed: 11/13/2022] Open
Abstract
AIMS Immunomodulation in heart failure (HF) has been studied in several randomized controlled trials (RCTs) with variable effects on cardiac structure, function, and outcomes. We sought to determine the effect of immunomodulation on left ventricular ejection fraction (LVEF), LV end-diastolic dimension (LVEDD), and all-cause mortality in patients with HF with reduced ejection fraction (HFrEF) through meta-analyses and trial sequential analyses (TSAs) of RCTs. METHODS AND RESULTS PubMed, Embase®, Cochrane CENTRAL, and ClinicalTrials.gov were systematically reviewed to identify RCTs that studied the effects of immunomodulation in patients with HFrEF. The primary endpoint in this analysis was change in LVEF. Secondary outcomes were changes in LVEDD and all-cause mortality. TSA was used to quantify the statistical reliability of data in the cumulative meta-analyses. Nineteen RCTs with 1341 HFrEF subjects were eligible for analyses. The aetiology of HF, specific immunomodulation strategy, and treatment duration were variable across trials. Immunomodulation led to a greater improvement in LVEF [mean difference: +5.7% 95% confidence interval (CI): 3.0-8.5%, P < 0.001] and reduction in LVEDD (mean difference: -3.7 mm, 95% CI: -7.0 to -0.4 mm, P = 0.028) than no immunomodulation in meta-analyses and TSAs. We observed a non-significant decrease in all-cause mortality among those on immumomodulation (risk ratio: 0.7, 95% CI: 0.4-1.3, P = 0.234), but the Z-curve for cumulative treatment effect of immunomodulation in the TSA did not cross the boundary of futility. CONCLUSIONS Immunomodulation led to improved cardiac structure and function in patients with HFrEF. While these benefits did not translate into a significant improvement in mortality, our analysis suggests that larger studies of targeted immunomodulation are needed to understand the true benefits.
Collapse
Affiliation(s)
- Navkaranbir S. Bajaj
- Division of Cardiovascular DiseaseUniversity of Alabama at Birmingham1900 University Boulevard, 311 THTBirminghamAL35294‐0006USA
- Cardiology Service, Birmingham Veterans Affair Medical CenterBirminghamALUSA
- Division of Molecular Imaging and Therapeutics, Department of RadiologyUniversity of Alabama at BirminghamBirminghamALUSA
| | - Kartik Gupta
- Division of Cardiovascular DiseaseUniversity of Alabama at Birmingham1900 University Boulevard, 311 THTBirminghamAL35294‐0006USA
| | - Nitin Gharpure
- Division of Cardiovascular DiseaseUniversity of Alabama at Birmingham1900 University Boulevard, 311 THTBirminghamAL35294‐0006USA
| | - Mike Pate
- Division of Cardiovascular DiseaseUniversity of Alabama at Birmingham1900 University Boulevard, 311 THTBirminghamAL35294‐0006USA
| | - Lakshay Chopra
- Division of Cardiovascular DiseaseUniversity of Alabama at Birmingham1900 University Boulevard, 311 THTBirminghamAL35294‐0006USA
| | - Rajat Kalra
- Cardiovascular DivisionUniversity of MinnesotaMinneapolisMNUSA
| | - Sumanth D. Prabhu
- Division of Cardiovascular DiseaseUniversity of Alabama at Birmingham1900 University Boulevard, 311 THTBirminghamAL35294‐0006USA
- Cardiology Service, Birmingham Veterans Affair Medical CenterBirminghamALUSA
| |
Collapse
|
14
|
Abstract
Cardiorenal syndrome is a complex interplay of dysregulated heart and kidney interaction that leads to multiorgan system dysfunction, which is not an uncommon occurrence in the setting of right heart failure. The traditional concept of impaired perfusion and forward flow recently has been modified to include the recognition of systemic venous congestion as a contributor, with direct and indirect mechanisms, including elevated renal venous pressure, reduced renal perfusion pressure, increased renal interstitial pressure, tubular dysfunction, splanchnic congestion, and neurohormonal and inflammatory activation. Treatment options beyond diuretics and vasoactive drugs remain limited and lack supportive evidence.
Collapse
Affiliation(s)
- Thida Tabucanon
- Kaufman Center for Heart Failure Treatment and Recovery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH 44195, USA
| | - Wai Hong Wilson Tang
- Kaufman Center for Heart Failure Treatment and Recovery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH 44195, USA; Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH 44195, USA.
| |
Collapse
|
15
|
Stenvinkel P, Chung SH, Heimbürger O, Lindholm B. Malnutrition, Inflammation, and Atherosclerosis in Peritoneal Dialysis Patients. Perit Dial Int 2020. [DOI: 10.1177/089686080102103s27] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Peter Stenvinkel
- Department of Nephrology and Baxter Novum, Huddinge University Hospital, Stockholm, Sweden
| | - Sung Hee Chung
- Department of Nephrology and Baxter Novum, Huddinge University Hospital, Stockholm, Sweden
| | - Olof Heimbürger
- Department of Nephrology and Baxter Novum, Huddinge University Hospital, Stockholm, Sweden
| | - Bengt Lindholm
- Department of Nephrology and Baxter Novum, Huddinge University Hospital, Stockholm, Sweden
| |
Collapse
|
16
|
Zhang L, Mao H. The Relationship Between Serum VCAM-1 and Alzheimer's Disease in Patients with Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2020; 13:4661-4667. [PMID: 33299334 PMCID: PMC7721106 DOI: 10.2147/dmso.s274232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/23/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Previous studies have reported that diabetes mellitus (DM) is a risk factor for Alzheimer's disease (AD). Vascular cell adhesion molecule-1 (VCAM-1) plays an important role in the pathological process of atherosclerosis. The aim was to elucidate the relationship between serum VCAM-1 and early AD in DM patients. METHODS Serum samples for VCAM-1 were tested in 208 DM patients. All included DM patients were followed up for a median of 36 months prospectively. The prognostic value of serum VCAM-1 for predicting AD events was analyzed by using Cox proportional hazard. RESULTS Serum VCAM-1 was independently associated with AD history after adjusting for related confounding factors in patients with DM at baseline by using the logistic regression analysis (OR=1.861; 95% CI, 1.435-2.539; P trend=0.020). The Cox proportional hazard model suggested that VCAM-1 was a prognostic factor for AD events in the DM patients (HR=2.728; 95% CI, 1.785-5.439; P trend<0.001). Stratified analysis showed that the significant association between AD event and serum VCAM-1 in DM patients was not affective by CVD history. CONCLUSION Our results showed that higher VCAM-1 levels were significantly related to a higher risk of AD events in DM patients. The serum biomarker might be beneficial to predict AD early. Serum VCAM-1 might be a good biochemical parameter for predicting AD in DM.
Collapse
Affiliation(s)
- Lingyun Zhang
- Department of Laboratory Medicine, Zutangshan Hospital, Nanjing211153, Jiangsu, People’s Republic of China
| | - Huawu Mao
- Department of Neurology, Taizhou Second People’s Hospital, Taizhou225500, Jiangsu, People’s Republic of China
- Correspondence: Huawu MaoDepartment of Neurology, Taizhou Second People’s Hospital, NO. 27 Jiankang Road, Jiangyan District, Taizhou City225500, Jiangsu, People’s Republic of ChinaTel +86 52388245686 Email
| |
Collapse
|
17
|
Kim HJ, Lee MH, Jo SH, Seo WW, Kim SE, Kim KJ, Choi JO, Ahn HS, Choi DJ, Ryu KH. Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin-Receptor Blockers in Heart Failure With Chronic Kidney Disease - Propensity Score Matching Analysis. Circ J 2019; 84:83-90. [PMID: 31776309 DOI: 10.1253/circj.cj-19-0782] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Whether angiotensin-converting enzyme inhibitor (ACEI) or angiotensin-receptor blocker (ARB) exert beneficial effects in patients with concomitant heart failure (HF) and chronic kidney disease (CKD) remains uncertain. In this study, the effects of ACEI and ARB on long-term clinical outcomes in such patients were investigated.Methods and Results:Study data were obtained from a multicenter cohort that included patients hospitalized for HF. A total of 1,601 patients with both HF and CKD were classified according to prescription of ACEI or ARB at discharge. The mortality rate was 19.0% in the ACEI/ARB treatment group (n=943) and 33.6% in the no ACEI/ARB treatment group (n=658) during follow-up. The ACEI/ARB treatment group had a significantly higher cumulative death-free survival rate than the no ACEI/ARB treatment group. Cox regression analysis showed that using ACEI or ARB was independently associated with reduced risk of all-cause death after adjusting for confounding factors. The beneficial effects of ACEI or ARB were retained after propensity score matching. CONCLUSIONS Prescription of an ACEI or ARB at discharge was associated with reduction in all-cause mortality in patients with acute HF and CKD. Clinicians need to be aware of the prognostic value and consider prescribing ACEI or ARB to high-risk patients.
Collapse
Affiliation(s)
- Hyun-Jin Kim
- Cardiovascular Center, Hanyang University Guri Hospital
| | - Min-Ho Lee
- Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital
| | - Sang-Ho Jo
- Cardiovascular Center, Hallym University Sacred Heart Hospital
| | - Won-Woo Seo
- Department of Internal Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine
| | - Sung Eun Kim
- Department of Internal Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine
| | - Kyung-Jin Kim
- Division of Cardiology, Department of Internal Medicine, Ewha Womans University School of Medicine
| | - Jin-Oh Choi
- Division of Cardiology, Cardiovascular and Stroke Imaging Center, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Hyo-Suk Ahn
- Cardiovascular Center, Uijeongbu St. Mary's Hospital
| | - Dong-Ju Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Bundang Hospital
| | - Kyu-Hyung Ryu
- Department of Cardiovascular Medicine, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University
| |
Collapse
|
18
|
Willeit K, Pechlaner R, Willeit P, Skroblin P, Paulweber B, Schernthaner C, Toell T, Egger G, Weger S, Oberhollenzer M, Kedenko L, Iglseder B, Bonora E, Schett G, Mayr M, Willeit J, Kiechl S. Association Between Vascular Cell Adhesion Molecule 1 and Atrial Fibrillation. JAMA Cardiol 2019; 2:516-523. [PMID: 28355442 DOI: 10.1001/jamacardio.2017.0064] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Importance Accumulating evidence links inflammation and atrial fibrillation (AF). Objective To assess whether markers of systemic and atrial inflammation are associated with incident AF in the general population. Design, Setting, and Participants The Bruneck Study is a prospective, population-based cohort study with a 20-year follow-up (n = 909). The population included a random sample of the general community aged 40 to 79 years. Levels of 13 inflammation markers were measured at baseline in 1990. Findings were replicated in a case-control sample nested within the prospective Salzburg Atherosclerosis Prevention Program in Subjects at High Individual Risk (SAPHIR) study (n = 1770). Data analysis was performed from February to May 2016. Exposures Levels of 13 inflammation markers. Main Outcomes and Measures Incident AF over a 20-year follow-up period in the Bruneck Study. Results Of the 909 participants included in the Bruneck Study, mean [SD] age was 58.8 (11.4) years and 448 (49.3%) were women. Among the 880 participants free of prevalent AF (n = 29) at baseline, 117 developed AF during the 20-year follow-up period (incidence rate, 8.2; 95% CI, 6.8-9.6 per 1000 person-years). The levels of soluble vascular cell adhesion molecule 1 (VCAM-1) and osteoprotegerin were significantly associated with incident AF (hazard ratio [HR], 1.49; 95% CI, 1.26-1.78; and 1.46; 95% CI, 1.25-1.69, respectively; P < .001 with Bonferroni correction for both), but osteoprotegerin lost significance after age and sex adjustment (HR, 1.05; 95% CI, 0.87-1.27; P > .99 with Bonferroni correction). Matrix metalloproteinase 9, metalloproteinase inhibitor 1, monocyte chemoattractant protein-1, P-selectin, fibrinogen, receptor activator of nuclear factor-κB ligand, high-sensitivity C-reactive protein, adiponectin, leptin, soluble intercellular adhesion molecule 1, and E-selectin all fell short of significance (after Bonferroni correction in unadjusted and age- and sex-adjusted analyses). The HR for a 1-SD higher soluble VCAM-1 level was 1.34 (95% CI, 1.11-1.62; Bonferroni-corrected P = .03) in a multivariable model. The association was of a dose-response type, at least as strong as that obtained for N-terminal pro-B-type natriuretic peptide (multivariable HR for a 1-SD higher N-terminal pro-B-type natriuretic peptide level, 1.15; 95% CI, 1.04-1.26), internally consistent in various subgroups, and successfully replicated in the SAPHIR Study (age- and sex-adjusted, and multivariable odds ratios for a 1-SD higher soluble VCAM-1 level, 1.91; 95% CI, 1.24-2.96, P = .003; and 2.59; 95% CI, 1.45-4.60; P = .001). Conclusions and Relevance Levels of soluble VCAM-1, but not other inflammation markers, are significantly associated with new-onset AF in the general community. Future studies should address whether soluble VCAM-1 is capable of improving AF risk classification beyond the information provided by standard risk scores.
Collapse
Affiliation(s)
- Karin Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Raimund Pechlaner
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Peter Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria2Department of Public Health and Primary Care, University of Cambridge, Cambridge, England3Cardiovascular Division, King's British Heart Foundation Centre, King's College London, London, England
| | - Philipp Skroblin
- Cardiovascular Division, King's British Heart Foundation Centre, King's College London, London, England
| | - Bernhard Paulweber
- First Department of Internal Medicine, Paracelsus Medical University/Salzburger Landeskliniken, Salzburg, Austria
| | - Christiana Schernthaner
- Department of Cardiology, Paracelsus Medical University/Salzburger Landeskliniken, Salzburg, Austria
| | - Thomas Toell
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Georg Egger
- Department of Internal Medicine, Bruneck Hospital, Bruneck, Italy
| | - Siegfried Weger
- Department of Internal Medicine, Bruneck Hospital, Bruneck, Italy
| | | | - Ludmilla Kedenko
- First Department of Internal Medicine, Paracelsus Medical University/Salzburger Landeskliniken, Salzburg, Austria
| | - Bernhard Iglseder
- Department of Geriatric Medicine, Paracelsus Medical University/Salzburger Landeskliniken, Salzburg, Austria
| | - Enzo Bonora
- Division of Endocrinology, Diabetes and Metabolic Diseases, University and Hospital Trust of Verona, Verona, Italy
| | - Georg Schett
- Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Manuel Mayr
- Cardiovascular Division, King's British Heart Foundation Centre, King's College London, London, England
| | - Johann Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Stefan Kiechl
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| |
Collapse
|
19
|
Mittal R, Jhaveri VM, Kay SIS, Greer A, Sutherland KJ, McMurry HS, Lin N, Mittal J, Malhotra AK, Patel AP. Recent Advances in Understanding the Pathogenesis of Cardiovascular Diseases and Development of Treatment Modalities. Cardiovasc Hematol Disord Drug Targets 2019; 19:19-32. [PMID: 29737266 DOI: 10.2174/1871529x18666180508111353] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 12/15/2017] [Accepted: 03/28/2018] [Indexed: 06/08/2023]
Abstract
Cardiovascular Diseases (CVDs) are a leading cause of morbidity and mortality worldwide. The underlying pathology for cardiovascular disease is largely atherosclerotic in nature and the steps include fatty streak formation, plaque progression and plaque rupture. While there is optimal drug therapy available for patients with CVD, there are also underlying drug delivery obstacles that must be addressed. Challenges in drug delivery warrant further studies for the development of novel and more efficacious medical therapies. An extensive understanding of the molecular mechanisms of disease in combination with current challenges in drug delivery serves as a platform for the development of novel drug therapeutic targets for CVD. The objective of this article is to review the pathogenesis of atherosclerosis, first-line medical treatment for CVD, and key obstacles in an efficient drug delivery.
Collapse
Affiliation(s)
- Rahul Mittal
- Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida FL, United States
| | - Vasanti M Jhaveri
- Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida FL, United States
| | - Sae-In Samantha Kay
- College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida FL, United States
| | - Aubrey Greer
- Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida FL, United States
| | - Kyle J Sutherland
- Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida FL, United States
| | - Hannah S McMurry
- Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida FL, United States
| | - Nicole Lin
- Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida FL, United States
| | - Jeenu Mittal
- Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida FL, United States
| | - Arul K Malhotra
- Department of Otolaryngology, University of Miami, Miller School of Medicine, Miami, Florida FL, United States
| | - Amit P Patel
- College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida FL, United States
| |
Collapse
|
20
|
Zhou P, Xie W, Luo Y, Lu S, Dai Z, Wang R, Sun G, Sun X. Protective Effects of Total Saponins of Aralia elata (Miq.) on Endothelial Cell Injury Induced by TNF-α via Modulation of the PI3K/Akt and NF-κB Signalling Pathways. Int J Mol Sci 2018; 20:ijms20010036. [PMID: 30577658 PMCID: PMC6337668 DOI: 10.3390/ijms20010036] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/11/2018] [Accepted: 12/18/2018] [Indexed: 12/19/2022] Open
Abstract
Atherosclerosis is an arterial disease associated with inflammation. Hence, the discovery of novel therapeutic agents for suppressing inflammatory responses is urgent and vital for the treatment of atherosclerosis in cardiovascular diseases. The total saponins of Aralia elata (Miq.) Seem. (TAS) are the main components extracted from the Chinese traditional herb Longya Aralia chinensis L., a folk medicine used in Asian countries for treating numerous diseases, enhancing energy and boosting immunity. However, the protective effects of TAS against inflammation-triggered vascular endothelial dysfunction, a critical early event during the course of atherosclerosis, and the potential mechanisms of this protection have been not demonstrated. Accordingly, the aim of this study was to investigate the anti-inflammatory and anti-apoptotic effects and the protective mechanisms of TAS, and show how TAS ameliorates human umbilical vein endothelial cell (HUVEC) damage caused by tumour necrosis factor-α (TNF-α). The results indicated that TAS exerted cytoprotective effects by inhibiting TNF-α-triggered HUVEC apoptosis, mitochondrial membrane potential depolarisation, and the regulation of inflammatory factors (IL-6, MCP-1, and VCAM-1) while suppressing NF-κB transcription. Furthermore, this phenomenon was related to activation of the phosphoinositide 3-kinase (PI3K)/Akt signalling pathway. Blocking the Akt pathway with LY294002, a PI3K inhibitor, reversed the cytoprotective effect of TAS against TNF-α-induced endothelial cell death. Moreover, LY294002 partially abolished the effects of TAS on the upregulation of the Bcl-2 family of proteins and the downregulation of Bax protein expression. In conclusion, the results of our study suggest that TAS suppresses the inflammation and apoptosis of HUVECs induced by TNF-α and that PI3K/Akt signalling plays a key role in promoting cell survival and anti-inflammatory reactions during this process.
Collapse
Affiliation(s)
- Ping Zhou
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100193, China.
- Key Laboratory of Bioactive Substances and Resource Utilization of Chinese Herbal Medicine, Ministry of Education, Beijing 100193, China.
- Key Laboratory of Efficacy Evaluation of Chinese Medicine against Glycolipid Metabolic Disorders, State Administration of Traditional Chinese Medicine, Beijing 100193, China.
- Zhongguancun Open Laboratory of the Research and Development of Natural Medicine and Health Products, Beijing 100193, China.
| | - Weijie Xie
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100193, China.
- Key Laboratory of Bioactive Substances and Resource Utilization of Chinese Herbal Medicine, Ministry of Education, Beijing 100193, China.
- Key Laboratory of Efficacy Evaluation of Chinese Medicine against Glycolipid Metabolic Disorders, State Administration of Traditional Chinese Medicine, Beijing 100193, China.
- Zhongguancun Open Laboratory of the Research and Development of Natural Medicine and Health Products, Beijing 100193, China.
| | - Yun Luo
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100193, China.
- Key Laboratory of Bioactive Substances and Resource Utilization of Chinese Herbal Medicine, Ministry of Education, Beijing 100193, China.
- Key Laboratory of Efficacy Evaluation of Chinese Medicine against Glycolipid Metabolic Disorders, State Administration of Traditional Chinese Medicine, Beijing 100193, China.
- Zhongguancun Open Laboratory of the Research and Development of Natural Medicine and Health Products, Beijing 100193, China.
| | - Shan Lu
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100193, China.
- Key Laboratory of Bioactive Substances and Resource Utilization of Chinese Herbal Medicine, Ministry of Education, Beijing 100193, China.
- Key Laboratory of Efficacy Evaluation of Chinese Medicine against Glycolipid Metabolic Disorders, State Administration of Traditional Chinese Medicine, Beijing 100193, China.
- Zhongguancun Open Laboratory of the Research and Development of Natural Medicine and Health Products, Beijing 100193, China.
| | - Ziru Dai
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100193, China.
- Key Laboratory of Bioactive Substances and Resource Utilization of Chinese Herbal Medicine, Ministry of Education, Beijing 100193, China.
- Key Laboratory of Efficacy Evaluation of Chinese Medicine against Glycolipid Metabolic Disorders, State Administration of Traditional Chinese Medicine, Beijing 100193, China.
- Zhongguancun Open Laboratory of the Research and Development of Natural Medicine and Health Products, Beijing 100193, China.
| | - Ruiying Wang
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100193, China.
- Key Laboratory of Bioactive Substances and Resource Utilization of Chinese Herbal Medicine, Ministry of Education, Beijing 100193, China.
- Key Laboratory of Efficacy Evaluation of Chinese Medicine against Glycolipid Metabolic Disorders, State Administration of Traditional Chinese Medicine, Beijing 100193, China.
- Zhongguancun Open Laboratory of the Research and Development of Natural Medicine and Health Products, Beijing 100193, China.
| | - Guibo Sun
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100193, China.
- Key Laboratory of Bioactive Substances and Resource Utilization of Chinese Herbal Medicine, Ministry of Education, Beijing 100193, China.
- Key Laboratory of Efficacy Evaluation of Chinese Medicine against Glycolipid Metabolic Disorders, State Administration of Traditional Chinese Medicine, Beijing 100193, China.
- Zhongguancun Open Laboratory of the Research and Development of Natural Medicine and Health Products, Beijing 100193, China.
| | - Xiaobo Sun
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100193, China.
- Key Laboratory of Bioactive Substances and Resource Utilization of Chinese Herbal Medicine, Ministry of Education, Beijing 100193, China.
- Key Laboratory of Efficacy Evaluation of Chinese Medicine against Glycolipid Metabolic Disorders, State Administration of Traditional Chinese Medicine, Beijing 100193, China.
- Zhongguancun Open Laboratory of the Research and Development of Natural Medicine and Health Products, Beijing 100193, China.
| |
Collapse
|
21
|
Leete J, Layton AT. Sex-specific long-term blood pressure regulation: Modeling and analysis. Comput Biol Med 2018; 104:139-148. [PMID: 30472496 DOI: 10.1016/j.compbiomed.2018.11.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 11/01/2018] [Accepted: 11/03/2018] [Indexed: 01/17/2023]
Abstract
Hypertension is a global health challenge: it affects one billion people worldwide and is estimated to account for >60% of all cases or types of cardiovascular disease. In part because sex differences in blood pressure regulation mechanisms are not sufficiently well understood, fewer hypertensive women achieve blood pressure control compared to men, even though compliance and treatment rates are generally higher in women. Thus, the objective of this study is to identify which factors contribute to the sexual dimorphism in response to anti-hypertensive therapies targeting the renin angiotensin system (RAS). To accomplish that goal, we develop sex-specific blood pressure regulation models. Sex differences in the RAS, baseline adosterone level, and the reactivity of renal sympathetic nervous activity (RSNA) are represented. A novel aspect of the model is the representation of sex-specific vasodilatory effect of the bound angiotensin II type two receptor (AT2R-bound Ang II) on renal vascular resistance. Model simulations suggest that sex differences in RSNA are the largest cause of female resistance to developing hypertension due to the direct influence of RSNA on afferent arteriole resistance. Furthermore, the model predicts that the sex-specific vasodilatory effects of AT2R-bound Ang II on renal vascular resistance may explain the higher effectiveness of angiotensin receptor blockers in treating hypertensive women (but not men), compared to angiotensin converting enzyme inhibitors.
Collapse
Affiliation(s)
- Jessica Leete
- Computational Biology & Bioinformatics Program, Duke University, Durham, NC, USA.
| | - Anita T Layton
- Departments of Mathematics, Biomedical Engineering, and Medicine, Duke University, Durham, NC, USA; Department of Applied Mathematics and School of Pharmacy, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| |
Collapse
|
22
|
Verschure DO, Baas F, van Eck-Smit BLF, Somsen GA, Verberne HJ. Polymorphism of SLC6A2 gene does not influence outcome of myocardial 123I-mIBG scintigraphy in patients with chronic heart failure. J Nucl Cardiol 2018; 25:900-906. [PMID: 27844334 PMCID: PMC5966480 DOI: 10.1007/s12350-016-0722-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 10/17/2016] [Indexed: 01/09/2023]
Abstract
AIM The NET, encoded by SLC6A2, is responsible for presynaptic NE-reuptake. 123I-mIBG is clinically used to evaluate cardiac sympathetic function. However, it is unknown if polymorphism of SLC6A2 influences cardiac sympathetic activity as assessed with 123I-mIBG. Therefore we studied the influence of SLC6A2 SNPs on myocardial 123I-mIBG parameters in CHF. MATERIALS AND METHODS Forty-nine adults with stable CHF (age 66.5 ± 8.1 years, LVEF 22.3 ± 6.4) were enrolled. Fifteen minutes (early) and 4 hours (late) after administration of 123I-mIBG planar images were acquired. The H/M ratio was calculated from the manually drawn ROI over the left ventricle and a fixed mediastinal ROI. Fourteen exons of the SLC6A2 gene were analyzed from whole blood samples. RESULTS We found 6 different SLC6A2 SNPs, although none were functional. LVEF was the only independent predictor for early (adjusted R 2 = 0.063, p = 0.045) and late H/M ratio (adjusted R 2 = 0.116, p = 0.010). NT-proBNP was the only independent predictor for 123I-mIBG WO (adjusted R 2 = 0.074, p = 0.032). SLC6A2 SNPs were not associated with any myocardial 123I-mIBG-derived parameter. CONCLUSION In this specific CHF population polymorphism of SLC6A2 gene was not associated with any 123I-mIBG derived parameters.
Collapse
Affiliation(s)
- Derk O Verschure
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands.
- Department of Cardiology, Zaans Medical Center, Zaandam, The Netherlands.
| | - F Baas
- Department of Genome Analysis, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Berthe L F van Eck-Smit
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands
| | - G Aernout Somsen
- Cardiology Centers of the Netherlands, Amsterdam, The Netherlands
| | - Hein J Verberne
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands
| |
Collapse
|
23
|
Azzam ZS, Kinaneh S, Bahouth F, Ismael-Badarneh R, Khoury E, Abassi Z. Involvement of Cytokines in the Pathogenesis of Salt and Water Imbalance in Congestive Heart Failure. Front Immunol 2017; 8:716. [PMID: 28674538 PMCID: PMC5474564 DOI: 10.3389/fimmu.2017.00716] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 06/02/2017] [Indexed: 12/28/2022] Open
Abstract
Congestive heart failure (CHF) has become a major medical problem in the western world with high morbidity and mortality rates. CHF adversely affects several systems, mainly the kidneys and the lungs. While the involvement of the renin-angiotensin-aldosterone system and the sympathetic nervous system in the progression of cardiovascular, pulmonary, and renal dysfunction in experimental and clinical CHF is well established, the importance of pro-inflammatory mediators in the pathogenesis of this clinical setting is still evolving. In this context, CHF is associated with overexpression of pro-inflammatory cytokines, such as tumor necrosis factor-α, interleukin (IL)-1, and IL-6, which are activated in response to environmental injury. This family of cytokines has been implicated in the deterioration of CHF, where it plays an important role in initiating and integrating homeostatic responses both at the myocardium and circulatory levels. We and others showed that angiotensin II decreased the ability of the lungs to clear edema and enhanced the fibrosis process via phosphorylation of the mitogen-activated protein kinases p38 and p42/44, which are generally involved in cellular responses to pro-inflammatory cytokines. Literature data also indicate the involvement of these effectors in modulating ion channel activity. It has been reported that in heart failure due to mitral stenosis; there were varying degrees of vascular and other associated parenchymal changes such as edema and fibrosis. In this review, we will discuss the effects of cytokines and other inflammatory mediators on the kidneys and the lungs in heart failure; especially their role in renal and alveolar ion channels activity and fluid balance.
Collapse
Affiliation(s)
- Zaher S. Azzam
- Department of Physiology and Biophysics, Technion, Israel Institute of Technology, Haifa, Israel
- Internal Medicine “B”, Rambam Health Care Campus, Haifa, Israel
| | - Safa Kinaneh
- Department of Physiology and Biophysics, Technion, Israel Institute of Technology, Haifa, Israel
| | - Fadel Bahouth
- Department of Physiology and Biophysics, Technion, Israel Institute of Technology, Haifa, Israel
| | - Reem Ismael-Badarneh
- Department of Physiology and Biophysics, Technion, Israel Institute of Technology, Haifa, Israel
| | - Emad Khoury
- Department of Physiology and Biophysics, Technion, Israel Institute of Technology, Haifa, Israel
| | - Zaid Abassi
- Department of Physiology and Biophysics, Technion, Israel Institute of Technology, Haifa, Israel
| |
Collapse
|
24
|
Kun J. Next step: functional studies on hypertension, lichen planus, and TRPA1 connections. Oral Dis 2017; 23:811-812. [PMID: 28130802 DOI: 10.1111/odi.12645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jozsef Kun
- Department of Pharmacology and Pharmacotherapy, University of Pecs Medical School, Pecs, Hungary.,MTA-PTE NAP-B Chronic Pain Research Group, University of Pecs Medical School, Pecs, Hungary.,Molecular Pharmacology Group, University of Pecs, Janos Szentagothai Research Center, Pecs, Hungary
| |
Collapse
|
25
|
Affiliation(s)
- Stefan D. Anker
- Clinical Cardiology, National Heart Lung Institute, Imperial College School of Medicine, London, UK
- Franz Volhard Klinik (Charité, Campus Berlin-Buch), Max Delbrück Centre for Molecular Medicine, Berlin, Germany
| |
Collapse
|
26
|
Kun J, Perkecz A, Knie L, Sétáló G, Tornóczki T, Pintér E, Bán Á. TRPA1 receptor is upregulated in human oral lichen planus. Oral Dis 2016; 23:189-198. [PMID: 27718297 DOI: 10.1111/odi.12593] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 09/14/2016] [Accepted: 10/04/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology with antigen-specific and non-specific mechanisms. Transient receptor potential ankyrin 1 (TRPA1) is a non-selective cation channel activated by noxious stimuli such as oxidative stress products evoking pain and release of proinflammatory mediators from sensory nerve endings culminating in neurogenic inflammation. Extraneuronal TRPA1s, for example, on immune cells possess yet unknown functions. SUBJECTS AND METHODS We studied the buccal mRNA expression (qPCR) and protein localization (immunohistochemistry) of TRPA1 receptors and key OLP mediator transcripts in oral mucosa samples of healthy volunteers (n = 9), OLP patients (n = 43), and OLP-like hyperkeratotic patients (n = 12). RESULTS We measured 27.7- and 25.5-fold TRPA1 mRNA increase in OLP and OLP-like hyperkeratotic patients compared to healthy controls. TRPA1 transcripts elevated 2.4-fold in hypertensive OLP but not in hyperkeratotic patients compared to counterparts, reduced by 1.6-fold by angiotensin-convertase inhibitor intake. TRPA1 messenger RNA was more coexpressed with transcripts of tumor necrosis factor α than with interferon γ. Keratinocytes, macrophages but not T cells expressed TRPA1. CONCLUSIONS We provided evidence for the extraneuronal presence and upregulation of the proinflammatory TRPA1 receptor in buccal samples of patients with OLP. This may implicate the ion channel in the pathomechanism of OLP.
Collapse
Affiliation(s)
- J Kun
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, Pécs, Hungary.,Molecular Pharmacology Group, Szentágothai Research Center, University of Pecs, Pécs, Hungary.,MTA-PTE NAP B Chronic Pain Research Group, University of Pécs, Pécs, Hungary
| | - A Perkecz
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, Pécs, Hungary
| | - L Knie
- Department of Dentistry, Oral and Maxillofacial Surgery, University of Pécs Medical School, Pécs, Hungary
| | - G Sétáló
- Department of Medical Biology, University of Pécs Medical School, Pécs, Hungary
| | - T Tornóczki
- Oral Pathology Unit, Department of Pathology, University of Pécs Medical School, Hungary
| | - E Pintér
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, Pécs, Hungary.,Molecular Pharmacology Group, Szentágothai Research Center, University of Pecs, Pécs, Hungary
| | - Á Bán
- Department of Dentistry, Oral and Maxillofacial Surgery, University of Pécs Medical School, Pécs, Hungary
| |
Collapse
|
27
|
New Agents in Treatment of Hyperkalemia: an Opportunity to Optimize Use of RAAS Inhibitors for Blood Pressure Control and Organ Protection in Patients with Chronic Kidney Disease. Curr Hypertens Rep 2016; 18:55. [DOI: 10.1007/s11906-016-0663-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
28
|
Angiotensin receptor blockers are not associated with reduced inflammatory markers in the general population. J Hypertens 2016; 33:2173-8. [PMID: 26237561 DOI: 10.1097/hjh.0000000000000683] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Angiotensin receptor blockers (ARBs) have been suggested to reduce inflammation in randomized controlled trials. We assessed the association between ARBs and inflammatory markers in a general population setting. METHODS This is a population-based prospective study conducted in Lausanne, Switzerland. Baseline data from 933 participants on antihypertensive drugs (424 on ARBs) was collected in 2003-2006. Follow-up data from 1120 participants (572 on ARBs) was collected in 2009-2012. C-reactive protein (CRP), interleukins 1β and 6 and tumor necrosis factor alpha (TNF-α) were assessed and categorized in quartiles. RESULTS At baseline, no differences were found between participants taking or not taking ARBs for all inflammatory markers studied, and this association persisted after multivariate adjustment: odds ratios (ORs) and (95% confidence interval) for being in the highest quartile of interleukin-1β, interleukin-6, TNF-α and CRP for participants on ARB compared to participants not on ARB were 1.23 (0.89-1.70), 1.26 (0.93-1.70), 1.14 (0.85-1.53) and 1.27 (0.96-1.69) respectively (P > 0.05). These findings were further replicated in the follow-up study: OR and (95% CI) of 1.10 (0.78-1.55), 0.87 (0.64-1.19), 0.83 (0.61-1.14) and 0.91 (0.68-1.22) for interleukin-1β, interleukin-6, TNF-α and CRP respectively (P > 0.05). Finally, no effect of ARBs was found when comparing participants who received ARBs throughout the 5.4-year follow-up with participants on other antihypertensive drugs: OR and (95% CI) of 0.93 (0.61-1.42), 0.80 (0.54-1.17), 0.86 (0.59-1.25) and 0.95 (0.67-1.35) for interleukin-1β, interleukin-6, TNF-α and CRP respectively (P > 0.05). CONCLUSION ARBs are not associated with reduced levels of inflammatory markers in the general population.
Collapse
|
29
|
Karnik SS, Unal H, Kemp JR, Tirupula KC, Eguchi S, Vanderheyden PML, Thomas WG. International Union of Basic and Clinical Pharmacology. XCIX. Angiotensin Receptors: Interpreters of Pathophysiological Angiotensinergic Stimuli [corrected]. Pharmacol Rev 2015; 67:754-819. [PMID: 26315714 PMCID: PMC4630565 DOI: 10.1124/pr.114.010454] [Citation(s) in RCA: 207] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The renin angiotensin system (RAS) produced hormone peptides regulate many vital body functions. Dysfunctional signaling by receptors for RAS peptides leads to pathologic states. Nearly half of humanity today would likely benefit from modern drugs targeting these receptors. The receptors for RAS peptides consist of three G-protein-coupled receptors—the angiotensin II type 1 receptor (AT1 receptor), the angiotensin II type 2 receptor (AT2 receptor), the MAS receptor—and a type II trans-membrane zinc protein—the candidate angiotensin IV receptor (AngIV binding site). The prorenin receptor is a relatively new contender for consideration, but is not included here because the role of prorenin receptor as an independent endocrine mediator is presently unclear. The full spectrum of biologic characteristics of these receptors is still evolving, but there is evidence establishing unique roles of each receptor in cardiovascular, hemodynamic, neurologic, renal, and endothelial functions, as well as in cell proliferation, survival, matrix-cell interaction, and inflammation. Therapeutic agents targeted to these receptors are either in active use in clinical intervention of major common diseases or under evaluation for repurposing in many other disorders. Broad-spectrum influence these receptors produce in complex pathophysiological context in our body highlights their role as precise interpreters of distinctive angiotensinergic peptide cues. This review article summarizes findings published in the last 15 years on the structure, pharmacology, signaling, physiology, and disease states related to angiotensin receptors. We also discuss the challenges the pharmacologist presently faces in formally accepting newer members as established angiotensin receptors and emphasize necessary future developments.
Collapse
Affiliation(s)
- Sadashiva S Karnik
- Department of Molecular Cardiology, Lerner Research Institute of Cleveland Clinic, Cleveland, Ohio (S.S.K., H.U., J.R.K., K.C.T.); Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, Pennsylvania (S.E.); Faculty of Sciences and Bioengineering Sciences, Vrije Universiteit Brussel, Brussels, Belgium (P.M.L.V.); and Department of General Physiology, School of Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia (W.G.T.)
| | - Hamiyet Unal
- Department of Molecular Cardiology, Lerner Research Institute of Cleveland Clinic, Cleveland, Ohio (S.S.K., H.U., J.R.K., K.C.T.); Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, Pennsylvania (S.E.); Faculty of Sciences and Bioengineering Sciences, Vrije Universiteit Brussel, Brussels, Belgium (P.M.L.V.); and Department of General Physiology, School of Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia (W.G.T.)
| | - Jacqueline R Kemp
- Department of Molecular Cardiology, Lerner Research Institute of Cleveland Clinic, Cleveland, Ohio (S.S.K., H.U., J.R.K., K.C.T.); Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, Pennsylvania (S.E.); Faculty of Sciences and Bioengineering Sciences, Vrije Universiteit Brussel, Brussels, Belgium (P.M.L.V.); and Department of General Physiology, School of Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia (W.G.T.)
| | - Kalyan C Tirupula
- Department of Molecular Cardiology, Lerner Research Institute of Cleveland Clinic, Cleveland, Ohio (S.S.K., H.U., J.R.K., K.C.T.); Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, Pennsylvania (S.E.); Faculty of Sciences and Bioengineering Sciences, Vrije Universiteit Brussel, Brussels, Belgium (P.M.L.V.); and Department of General Physiology, School of Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia (W.G.T.)
| | - Satoru Eguchi
- Department of Molecular Cardiology, Lerner Research Institute of Cleveland Clinic, Cleveland, Ohio (S.S.K., H.U., J.R.K., K.C.T.); Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, Pennsylvania (S.E.); Faculty of Sciences and Bioengineering Sciences, Vrije Universiteit Brussel, Brussels, Belgium (P.M.L.V.); and Department of General Physiology, School of Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia (W.G.T.)
| | - Patrick M L Vanderheyden
- Department of Molecular Cardiology, Lerner Research Institute of Cleveland Clinic, Cleveland, Ohio (S.S.K., H.U., J.R.K., K.C.T.); Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, Pennsylvania (S.E.); Faculty of Sciences and Bioengineering Sciences, Vrije Universiteit Brussel, Brussels, Belgium (P.M.L.V.); and Department of General Physiology, School of Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia (W.G.T.)
| | - Walter G Thomas
- Department of Molecular Cardiology, Lerner Research Institute of Cleveland Clinic, Cleveland, Ohio (S.S.K., H.U., J.R.K., K.C.T.); Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, Pennsylvania (S.E.); Faculty of Sciences and Bioengineering Sciences, Vrije Universiteit Brussel, Brussels, Belgium (P.M.L.V.); and Department of General Physiology, School of Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia (W.G.T.)
| |
Collapse
|
30
|
Kumar A, Singh B, Mishra J, Sah SP, Pottabathini R. Neuroprotective mechanism of losartan and its interaction with nimesulide against chronic fatigue stress. Inflammopharmacology 2015; 23:291-305. [PMID: 26122818 DOI: 10.1007/s10787-015-0238-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 06/13/2015] [Indexed: 01/04/2023]
Abstract
Potential role of angiotensin-II and cyclooxygenase have been suggested in the pathophysiology of chronic fatigue stress. The present study has been designed to evaluate the neuroprotective effect of losartan and its interaction with nimesulide against chronic fatigue stress and related complications in mice. In the present study, male Laca mice (20-30 g) were subjected to running wheel activity test session (RWATS) for 6 min daily for 21 days. Losartan, nimesulide and their combinations were administered daily for 21 days, 45 min before being subjected to RWATS. Various behavioral and biochemical and neuroinflammatory mediators were assessed subsequently. 21 days RWATS treatment significantly decreased number of wheel rotations/6 min indicating fatigue stress like behaviors as compared to naive group. 21 days treatment with losartan (10 and 20 mg/kg, ip), nimesulide (5 and 10 mg/kg, po) and their combinations significantly improved behavior [increased number of wheel rotations, reversal of post-exercise fatigue, locomotor activity, antianxiety-like behavior (number of entries, latency to enter and time spent in mirror chamber), and memory performance (transfer latency in plus-maze performance task)], biochemical parameters (reduced serum corticosterone, brain lipid peroxidation, nitrite concentration, acetylcholinesterase activity, restored reduced glutathione levels and catalase activity) as compared to RWATS control. Besides, TNF-α, CRP levels were significantly attenuated by these drugs and their combinations as compared to control. The present study highlights the role of cyclooxygenase modulation in the neuroprotective effect of losartan against chronic fatigue stress-induced behavioral, biochemical and cellular alterations in mice.
Collapse
Affiliation(s)
- Anil Kumar
- Pharmacology Division, University Institute of Pharmaceutical Sciences, UGC-Center of Advanced Study (UGC-CAS), Panjab University, Chandigarh, 160014, India.
| | - Barinder Singh
- Pharmacology Division, University Institute of Pharmaceutical Sciences, UGC-Center of Advanced Study (UGC-CAS), Panjab University, Chandigarh, 160014, India
| | - Jitendriya Mishra
- Pharmacology Division, University Institute of Pharmaceutical Sciences, UGC-Center of Advanced Study (UGC-CAS), Panjab University, Chandigarh, 160014, India
| | - Sangeeta Pilkhwal Sah
- Pharmacology Division, University Institute of Pharmaceutical Sciences, UGC-Center of Advanced Study (UGC-CAS), Panjab University, Chandigarh, 160014, India
| | - Raghavender Pottabathini
- Pharmacology Division, University Institute of Pharmaceutical Sciences, UGC-Center of Advanced Study (UGC-CAS), Panjab University, Chandigarh, 160014, India
| |
Collapse
|
31
|
Rajapakse NW, Nanayakkara S, Kaye DM. Pathogenesis and treatment of the cardiorenal syndrome: Implications of L-arginine-nitric oxide pathway impairment. Pharmacol Ther 2015; 154:1-12. [PMID: 25989232 DOI: 10.1016/j.pharmthera.2015.05.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 05/07/2015] [Indexed: 01/11/2023]
Abstract
A highly complex interplay exists between the heart and kidney in the setting of both normal and abnormal physiology. In the context of heart failure, a pathophysiological condition termed the cardiorenal syndrome (CRS) exists whereby dysfunction in the heart or kidney can accelerate pathology in the other organ. The mechanisms that underpin CRS are complex, and include neuro-hormonal activation, oxidative stress and endothelial dysfunction. The endothelium plays a central role in the regulation of both cardiac and renal function, and as such impairments in endothelial function can lead to dysfunction of both these organs. In particular, reduced bioavailability of nitric oxide (NO) is a key pathophysiologic component of endothelial dysfunction. The synthesis of NO by the endothelium is critically dependent on the plasmalemmal transport of its substrate, L-arginine, via the cationic amino acid transporter-1 (CAT1). Impaired L-arginine-NO pathway activity has been demonstrated individually in heart and renal failure. Recent findings suggest abnormalities of the L-arginine-NO pathway also play a role in the pathogenesis of CRS and thus this pathway may represent a potential new target for the treatment of heart and renal failure.
Collapse
Affiliation(s)
- Niwanthi W Rajapakse
- Heart Failure Research Group, Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Physiology, Monash University, Melbourne, Australia.
| | | | - David M Kaye
- Heart Failure Research Group, Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne Australia; Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Australia
| |
Collapse
|
32
|
Koulis C, Chow BSM, McKelvey M, Steckelings UM, Unger T, Thallas-Bonke V, Thomas MC, Cooper ME, Jandeleit-Dahm KA, Allen TJ. AT2R agonist, compound 21, is reno-protective against type 1 diabetic nephropathy. Hypertension 2015; 65:1073-81. [PMID: 25776077 DOI: 10.1161/hypertensionaha.115.05204] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 02/18/2015] [Indexed: 12/12/2022]
Abstract
The hemodynamic and nonhemodynamic effects of angiotensin II on diabetic complications are considered to be primarily mediated by the angiotensin II type 1 receptor subtype. However, its biological and functional effect mediated through the angiotensin II type 2 receptor subtype is still unclear. Activation of the angiotensin II type 2 receptors has been postulated to oppose angiotensin II type 1 receptor-mediated actions and thus attenuate fibrosis. This study aimed to elucidate the reno-protective role of the novel selective angiotensin II type 2 receptor agonist, Compound 21, in an experimental model of type 1 diabetic nephropathy. Compound 21 treatment significantly attenuated diabetes mellitus-induced elevated levels of cystatin C, albuminuria, mesangial expansion, and glomerulosclerosis in diabetic mice. Moreover, Compound 21 markedly inhibited the expression of various proteins implicated in oxidative stress, inflammation, and fibrosis, in association with decreased extracellular matrix production. These findings demonstrate that monotherapy of Compound 21 is protective against the progression of experimental diabetic nephropathy by inhibiting renal oxidative stress, inflammation, and fibrosis.
Collapse
Affiliation(s)
- Christine Koulis
- From the Diabetic Complications Division, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.K., B.S.M.C., M.M., V.T.-B., M.C.T., M.E.C., K.A.J.-D., T.J.A.); the Department of Medicine, Monash University, Monash, Australia (M.C.T., M.E.C., K.A.J.-D., T.J.A.); IMM-Department of Cardiovascular and Renal Research, University of Southern Denmark, Odense. Denmark (U.M.S.); and CARIM-School of Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands (T.U.)
| | - Bryna S M Chow
- From the Diabetic Complications Division, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.K., B.S.M.C., M.M., V.T.-B., M.C.T., M.E.C., K.A.J.-D., T.J.A.); the Department of Medicine, Monash University, Monash, Australia (M.C.T., M.E.C., K.A.J.-D., T.J.A.); IMM-Department of Cardiovascular and Renal Research, University of Southern Denmark, Odense. Denmark (U.M.S.); and CARIM-School of Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands (T.U.)
| | - Maria McKelvey
- From the Diabetic Complications Division, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.K., B.S.M.C., M.M., V.T.-B., M.C.T., M.E.C., K.A.J.-D., T.J.A.); the Department of Medicine, Monash University, Monash, Australia (M.C.T., M.E.C., K.A.J.-D., T.J.A.); IMM-Department of Cardiovascular and Renal Research, University of Southern Denmark, Odense. Denmark (U.M.S.); and CARIM-School of Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands (T.U.)
| | - Ulrike M Steckelings
- From the Diabetic Complications Division, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.K., B.S.M.C., M.M., V.T.-B., M.C.T., M.E.C., K.A.J.-D., T.J.A.); the Department of Medicine, Monash University, Monash, Australia (M.C.T., M.E.C., K.A.J.-D., T.J.A.); IMM-Department of Cardiovascular and Renal Research, University of Southern Denmark, Odense. Denmark (U.M.S.); and CARIM-School of Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands (T.U.)
| | - Thomas Unger
- From the Diabetic Complications Division, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.K., B.S.M.C., M.M., V.T.-B., M.C.T., M.E.C., K.A.J.-D., T.J.A.); the Department of Medicine, Monash University, Monash, Australia (M.C.T., M.E.C., K.A.J.-D., T.J.A.); IMM-Department of Cardiovascular and Renal Research, University of Southern Denmark, Odense. Denmark (U.M.S.); and CARIM-School of Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands (T.U.)
| | - Vicki Thallas-Bonke
- From the Diabetic Complications Division, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.K., B.S.M.C., M.M., V.T.-B., M.C.T., M.E.C., K.A.J.-D., T.J.A.); the Department of Medicine, Monash University, Monash, Australia (M.C.T., M.E.C., K.A.J.-D., T.J.A.); IMM-Department of Cardiovascular and Renal Research, University of Southern Denmark, Odense. Denmark (U.M.S.); and CARIM-School of Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands (T.U.)
| | - Merlin C Thomas
- From the Diabetic Complications Division, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.K., B.S.M.C., M.M., V.T.-B., M.C.T., M.E.C., K.A.J.-D., T.J.A.); the Department of Medicine, Monash University, Monash, Australia (M.C.T., M.E.C., K.A.J.-D., T.J.A.); IMM-Department of Cardiovascular and Renal Research, University of Southern Denmark, Odense. Denmark (U.M.S.); and CARIM-School of Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands (T.U.)
| | - Mark E Cooper
- From the Diabetic Complications Division, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.K., B.S.M.C., M.M., V.T.-B., M.C.T., M.E.C., K.A.J.-D., T.J.A.); the Department of Medicine, Monash University, Monash, Australia (M.C.T., M.E.C., K.A.J.-D., T.J.A.); IMM-Department of Cardiovascular and Renal Research, University of Southern Denmark, Odense. Denmark (U.M.S.); and CARIM-School of Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands (T.U.)
| | - Karin A Jandeleit-Dahm
- From the Diabetic Complications Division, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.K., B.S.M.C., M.M., V.T.-B., M.C.T., M.E.C., K.A.J.-D., T.J.A.); the Department of Medicine, Monash University, Monash, Australia (M.C.T., M.E.C., K.A.J.-D., T.J.A.); IMM-Department of Cardiovascular and Renal Research, University of Southern Denmark, Odense. Denmark (U.M.S.); and CARIM-School of Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands (T.U.)
| | - Terri J Allen
- From the Diabetic Complications Division, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (C.K., B.S.M.C., M.M., V.T.-B., M.C.T., M.E.C., K.A.J.-D., T.J.A.); the Department of Medicine, Monash University, Monash, Australia (M.C.T., M.E.C., K.A.J.-D., T.J.A.); IMM-Department of Cardiovascular and Renal Research, University of Southern Denmark, Odense. Denmark (U.M.S.); and CARIM-School of Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands (T.U.).
| |
Collapse
|
33
|
Oriowo MA. Perivascular adipose tissue, vascular reactivity and hypertension. Med Princ Pract 2015; 24 Suppl 1:29-37. [PMID: 24503717 PMCID: PMC6489082 DOI: 10.1159/000356380] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Accepted: 10/09/2013] [Indexed: 12/13/2022] Open
Abstract
Most blood vessels are surrounded by a variable amount of adventitial adipose tissue, perivascular adipose tissue (PVAT), which was originally thought to provide mechanical support for the vessel. It is now known that PVAT secretes a number of bioactive substances including vascular endothelial growth factor, tumor necrosis factor-alpha (TNF-α), leptin, adiponectin, insulin-like growth factor, interleukin-6, plasminogen activator substance, resistin and angiotensinogen. Several studies have shown that PVAT significantly modulated vascular smooth muscle contractions induced by a variety of agonists and electrical stimulation by releasing adipocyte-derived relaxing (ADRF) and contracting factors. The identity of ADRF is not yet known. However, several vasodilators have been suggested including adiponectin, angiotensin 1-7, hydrogen sulfide and methyl palmitate. The anticontractile effect of PVAT is mediated through the activation of potassium channels since it is abrogated by inhibiting potassium channels. Hypertension is characterized by a reduction in the size and amount of PVAT and this is associated with the attenuated anticontractile effect of PVAT in hypertension. However, since a reduction in size and amount of PVAT and the attenuated anticontractile effect of PVAT were already evident in prehypertensive rats with no evidence of impaired release of ADRF, there is the possibility that the anticontractile effect of PVAT was not directly related to an altered function of the adipocytes per se. Hypertension is characterized by low-grade inflammation and infiltration of macrophages. One of the adipokines secreted by macrophages is TNF-α. It has been shown that exogenously administered TNF-α enhanced agonist-induced contraction of a variety of vascular smooth muscle preparations and reduced endothelium-dependent relaxation. Other procontractile factors released by the PVAT include angiotensin II and superoxide. It is therefore possible that the loss could be due to an increased amount of these proinflammatory and procontractile factors. More studies are definitely required to confirm this.
Collapse
Affiliation(s)
- Mabayoje A Oriowo
- Department of Pharmacology and Toxicology, Faculty of Medicine, Health Sciences Centre, Kuwait University, Jabriya, Kuwait
| |
Collapse
|
34
|
Angiotensin receptor 1 blockade reduces secretion of inflammation associated cytokines from cultured human carotid atheroma and vascular cells in association with reduced extracellular signal regulated kinase expression and activation. Atherosclerosis 2014; 236:108-15. [DOI: 10.1016/j.atherosclerosis.2014.06.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Revised: 05/21/2014] [Accepted: 06/11/2014] [Indexed: 11/21/2022]
|
35
|
Weymann A, Sabashnikov A, Patil NP, Konertz W, Modersohn D, Dohmen PM. Eprosartan improves cardiac function in swine working heart model of ischemia-reperfusion injury. Med Sci Monit Basic Res 2014; 20:55-62. [PMID: 24762635 PMCID: PMC4010602 DOI: 10.12659/msmbr.890444] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 03/31/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Eprosartan is an angiotensin II receptor antagonist used as an antihypertensive. We sought to evaluate the regional effect of Eprosartan on postinfarct ventricular remodeling and myocardial function in an isolated swine working heart model of ischemia-reperfusion injury. MATERIAL AND METHODS 22 swine hearts were perfused with the Langendorff perfusion apparatus under standard experimental conditions. Myocardial ischemia was induced by a 10-min left anterior descending artery ligation. Hearts were reperfused with either saline (control group, n=11), or Eprosartan (treatment group, n=11). Left ventricular pressure (LVP) and regional heart parameters such as intramyocardial pressure (IMP), wall thickening rate (WTh), and pressure-length-loops (PLL) were measured at baseline and after 30 min of reperfusion. RESULTS Measured parameters were statistically similar between the 2 groups at baseline. The administration of Eprosartan led to a significantly better recovery of IMP and WTh: 44.4±2.5 mmHg vs. 51.2±3.3 mmHg, p<0.001 and 3.8±0.4 µm vs. 4.4±0.3 µm, p=0.001, respectively. PLL were also significantly higher in the treatment group following reperfusion (21694±3259 units vs. 31267±3429 units, p<0.01). There was no difference in the LVP response to Eprosartan versus controls (63.6±3.0 mmHg vs. 62.5±3.1 mmHg, p=0.400). CONCLUSIONS Pre-treatment with Eprosartan is associated with a significant improvement in regional cardiac function under ischemic conditions. Pharmacological treatment with eprosartan may exert a direct cardioprotective effect on ischemic myocardium.
Collapse
Affiliation(s)
- Alexander Weymann
- Department of Cardiac Surgery, Heart Center – University of Heidelberg, Heidelberg, Germany
- Department of Cardiothoracic Transplantation & Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust, Harefield, Middlesex, London, U.K
| | - Anton Sabashnikov
- Department of Cardiothoracic Transplantation & Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust, Harefield, Middlesex, London, U.K
| | - Nikhil P. Patil
- Department of Cardiothoracic Transplantation & Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust, Harefield, Middlesex, London, U.K
| | - Wolfgang Konertz
- Department of Cardiovascular Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Diethelm Modersohn
- Department of Cardiovascular Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Pascal M. Dohmen
- Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Leipzig, Germany
- Department of Cardiothoracic Surgery, University of the Free State, Bloemfontain, South Africa
| |
Collapse
|
36
|
Ogino K, Kinugasa Y, Kato M, Yamamoto K, Hisatome I, Anker SD, Doehner W. Spironolactone, not furosemide, improved insulin resistance in patients with chronic heart failure. Int J Cardiol 2014; 171:398-403. [DOI: 10.1016/j.ijcard.2013.12.039] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 12/17/2013] [Indexed: 11/26/2022]
|
37
|
Guo X, Saini HK, Wang J, Gupta SK, Goyal RK, Dhalla NS. Prevention of remodeling in congestive heart failure due to myocardial infarction by blockade of the renin–angiotensin system. Expert Rev Cardiovasc Ther 2014; 3:717-32. [PMID: 16076281 DOI: 10.1586/14779072.3.4.717] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Ventricular remodeling subsequent to myocardial infarction (MI) is a complex process and is considered to be a major determinant of the clinical course of congestive heart failure (CHF). Emerging evidence suggests that activation of the renin-angiotensin system (RAS) plays an important role in post-MI ventricular remodeling; however, it is becoming clear that this is one of several neurohumoral systems that are activated in CHF. Blockade of RAS by angiotensin-converting enzyme inhibitors or angiotensin II type 1 receptor antagonists attenuates the ventricular dysfunction, but the effects of individual drugs in reducing the morbidity and mortality in CHF patients are variable. Furthermore, there is a difference of opinion as to the time of initiation of therapy with RAS blockers after the onset of MI. Since blockade of RAS partially improves cardiac function, it is suggested that a combination therapy involving RAS blockers (angiotensin-converting enzyme inhibitors or angiotensin II type 1 receptor antagonists) and agents that affect other neurohumoral systems may prove useful for improved treatment of CHF. Although activation of RAS has been shown to promote oxidative stress in experimental studies, the use of antioxidant therapy in CHF patients is controversial. Recent experimental studies have shown that ventricular remodeling in CHF is associated with remodeling of subcellular organelles such as sarcolemma, sarcoplasmic reticulum, myofibrils and extracellular matrix in terms of their molecular structure and composition. Since attenuation of remodeling in one and/or more subcellular organelles by different agents may prevent the progression of CHF, it is a challenge to develop specific drugs affecting molecular mechanisms associated with subcellular remodeling for the improved therapy of CHF.
Collapse
Affiliation(s)
- Xiaobing Guo
- University of Manitoba, Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre and Department of Physiology, Faculty of Medicine, Winnipeg, Canada
| | | | | | | | | | | |
Collapse
|
38
|
Duan YF, Li XD, Zhu F, Zhang F. Expression and clinical significance of angiotensin II type 1 receptor in human hepatocellular carcinoma. Exp Ther Med 2013; 7:323-328. [PMID: 24396398 PMCID: PMC3881037 DOI: 10.3892/etm.2013.1411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Accepted: 11/07/2013] [Indexed: 02/07/2023] Open
Abstract
This study aimed to investigate the expression of angiotensin II type 1 receptor (AT-1R) mRNA and the AT-1R protein in human primary hepatocellular carcinoma (PHC), and to attempt to elucidate their association with pathological and clinical characteristics. Fresh tumor and normal liver tissues were obtained from 44 patients with PHC following hepatectomies. AT-1R mRNA levels were quantitatively analyzed by quantitative polymerase chain reaction (qPCR) while the protein levels were assessed by immunohistochemistry. The expression levels of AT-1R were observed in hepatocellular carcinoma tissues and normal liver tissues. The level of AT-1R protein expression in normal liver tissues was higher compared with that in PHC tissues (P=0.0033). The AT-1R mRNA levels were higher in patients with negative hepatitis B virus surface antigen (HBsAg), normal α-fetoprotein (AFP) levels and high tumor differentiation, compared with those in patients with positive HBsAg (P=0.0005), upregulated AFP levels (P=0.0008) and poor tumor differentiation (P=0.0290). No significant correlation was identified between the expression levels of AT-1R mRNA and general characteristics such as gender, age, cirrhotic nodules, tumor size, tumor encapsulation, tumor number, carcinoma embolus, tumor metastasis or tumor recurrence. Downregulated levels of AT-1R mRNA and AT-1R protein may indicate a poor prognosis for patients with PHC.
Collapse
Affiliation(s)
- Yun-Fei Duan
- Department of Liver Transplantation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Xiao-Dong Li
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213003, P.R. China
| | - Feng Zhu
- Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213003, P.R. China
| | - Feng Zhang
- Department of Liver Transplantation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| |
Collapse
|
39
|
Zhang N, Chen T, Liu C, Tang B, Nie L, An H, Zhao D, Pan L, Yu M. Inhibition of ubiquitin protein expression and 20S proteasome activity by irbesartan prevents post-infarction ventricular remodeling and decreases TNF-α generation. Biomed Rep 2013; 1:935-939. [PMID: 24649056 DOI: 10.3892/br.2013.165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 08/30/2013] [Indexed: 01/12/2023] Open
Abstract
Myocardial infarction (MI) may induce severe alterations of the cardiac contractile function that may, in turn, lead to heart failure (HF). The ubiquitin-proteasome system (UPS) plays a critical role in cardiac remodeling following MI. Angiotensin II type 1 receptor (AT1R) blockers effectively prevent left ventricular (LV) remodeling. However, it has not been elucidated whether the preventive effect of AT1R-blockers on LV remodeling is mediated through the UPS pathway. In the present study, with the use of cardiac morphometric parameters, haemodynamic measurements and enzyme-linked immunosorbent assay, we demonstrated that post-ischemic HF rats exhibited a significant increase in ventricular remodeling and irbesartan was effective in reversing cardiac remodeling. The expression of TNF-α, ubiquitin protein and 20S proteasome were significantly increased in the MI control group and irbesartan was shown to dose-dependently inhibit the expression of TNF-α, ubiquitin protein and 20S proteasome. In conclusion, it was hypothesized that UPS signaling is involved in ventricular remodeling following MI and the mechanism underlying the effect of irbesartan on ventricular remodeling may be associated with the downregulation of the expression of TNF-α, ubiquitin protein and 20S proteasome.
Collapse
Affiliation(s)
- Naiju Zhang
- Department of Pharmacy, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Tianping Chen
- Department of Cardiovasology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Chunfang Liu
- Department of Cardiovasology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Bi Tang
- Department of Cardiovasology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| | - Ling Nie
- Department of Pharmacy, Bengbu Second People's Hospital, Bengbu, Anhui 233000, P.R. China
| | - Huiling An
- Department of Pharmacy, Bengbu Second People's Hospital, Bengbu, Anhui 233000, P.R. China
| | - Duilan Zhao
- Department of Pharmacy, Bengbu Second People's Hospital, Bengbu, Anhui 233000, P.R. China
| | - Li Pan
- Department of Pharmacy, Bengbu Second People's Hospital, Bengbu, Anhui 233000, P.R. China
| | - Meiling Yu
- Department of Pharmacy, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
| |
Collapse
|
40
|
Ryu S, Shin JS, Cho YW, Kim HK, Paik SH, Lee JH, Chi YH, Kim JH, Kim JH, Lee KT. Fimasartan, anti-hypertension drug, suppressed inducible nitric oxide synthase expressions via nuclear factor-kappa B and activator protein-1 inactivation. Biol Pharm Bull 2013; 36:467-74. [PMID: 23449332 DOI: 10.1248/bpb.b12-00859] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Since inhibition of angiotensin II type 1 (AT1) receptor reduces chronic inflammation associated with hypertension, we evaluated the anti-inflammatory potential and the underlying mechanism of fimasartan, a Korean Food and Drug Administration approved anti-hypertension drug, in lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages. Fimasartan suppressed the expressions of inducible nitric oxide synthase (iNOS) by down-regulating its transcription, and subsequently inhibited the productions of nitric oxide (NO). In addition, fimasartan attenuated LPS-induced transcriptional and DNA-binding activities of nuclear factor-kappa B (NF-κB) and activator protein-1 (AP-1). These reductions were accompanied by parallel reductions in the nuclear translocation of NF-κB and AP-1. Taken together, our data suggest that fimasartan down-regulates the expression of the iNOS in macrophages via NF-κB and AP-1 inactivation.
Collapse
Affiliation(s)
- Suran Ryu
- Department of Pharmaceutical Biochemistry, College of Pharmacy, Kyung Hee University, Seoul 130–701, Republic of Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Dessein PH, Woodiwiss AJ, Norton GR, Solomon A. Rheumatoid arthritis is associated with reduced adiposity but not with unfavorable major cardiovascular risk factor profiles and enhanced carotid atherosclerosis in black Africans from a developing population: a cross-sectional study. Arthritis Res Ther 2013; 15:R96. [PMID: 23968456 PMCID: PMC3979152 DOI: 10.1186/ar4276] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 08/22/2013] [Indexed: 01/05/2023] Open
Abstract
Introduction Rheumatoid arthritis (RA) is characterized by inflamed joint-derived cytokine-mediated high-grade systemic inflammation that enhances cardiovascular metabolic risk and disease in developed populations. We investigated the potential impact of RA on cardiovascular risk factors including systemic inflammation and atherosclerosis, and their relationships in black Africans from a developing population. Methods We evaluated demographic features, adiposity indices, major traditional cardiovascular risk factors, circulating C-reactive protein and interleukin-6 concentrations and ultrasound determined carotid intima-media thickness (cIMT) in 274 black Africans; 115 had established RA. Data were analyzed in confounder-adjusted mixed regression models. Results The body mass index and waist-height ratio were lower in RA compared to non-RA subjects (29.2 (6.6) versus 33.7 (8.0), P < 0.0001 and 0.58 (0.09) versus 0.62 (0.1), P = 0.0003, respectively). Dyslipidemia was less prevalent in patients with RA (odds ratio (OR) (95% confidence interval (CI) = 0.54 (0.30 to1.00)); this disparity was no longer significant after further adjustment for reduced adiposity and chloroquine use. RA was also not associated with hypertension, current smoking and diabetes. The number of major traditional risk factors did not differ by RA status (1.1 (0.8) versus 1.2 (0.9), P = 0.7). Circulating C-reactive protein concentrations were similar and serum interleukin-6 concentrations reduced in RA (7.2 (3.1) versus 6.7 (3.1) mg/l, P = 0.7 and 3.9 (1.9) versus 6.3 (1.9) pg/ml, P < 0.0001, respectively). The cIMT was 0.700 (0.085) and 0.701 (0.111) mm in RA and non-RA subjects, respectively (P = 0.7). RA disease activity and severity parameters were consistently unrelated to systemic inflammation, despite the presence of clinically active disease in 82.6% of patients. In all participants, adiposity indices, smoking and converting angiotensin inhibitor non-use were associated with increased systemic inflammation, which related to more atherogenic lipid profiles, and circulating low density lipoprotein concentrations were associated with cIMT (partial R = 0.153, P = 0.032); RA did not impact on these relationships (interaction P ≥0.1). Conclusions Among black Africans, patients with established RA experience reduced overall and abdominal adiposity but no enhanced major traditional risk factor and atherosclerosis burden. This study further suggests that an absent interleukin-6 release by inflamed RA joints into the circulation may account for this unaltered cardiovascular disease risk.
Collapse
|
42
|
|
43
|
Ziegelstein RC. Improving depression and reducing cardiac events: which is the chicken and which is the egg? J Psychosom Res 2013; 74:454-7. [PMID: 23597336 DOI: 10.1016/j.jpsychores.2013.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 02/02/2013] [Accepted: 02/05/2013] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To examine the assumption that depression leads to recurrent cardiac events and death in those with heart disease. METHODS Consideration of alternative perspectives and discussion of the literature. RESULTS It is not clear from studies like MIND-IT, ENRICHD or SADHART whether depression treatment improves cardiac outcomes. In these studies, recurrent cardiac events and death were recorded 6months or more after study entry, but shorter-term cardiac outcomes (e.g., stabilization of plaque prone to rupture and thrombosis or changes in areas of myocardium prone to life-threatening arrhythmia) were not assessed. Although the prevailing view is that shorter-term improvement in depression is necessary to improve cardiovascular outcomes, the possibility that shorter-term improvement in cardiac status might result in reduced symptoms of depression has not been examined. If correct, this possibility might explain why studies have shown that patients whose depression improves also exhibit improved cardiovascular outcomes and lower mortality, even though randomization to the depression intervention in these studies had no effect. CONCLUSION It is not clear whether improving depression comes first and reduced cardiac events follows or whether patients whose cardiac status improves also exhibit improvement in depression. Which is the chicken and which the egg is more than just a philosophical question, since it may affect the direction of future research in this field, and even how we approach the care of patients with heart disease and depression.
Collapse
Affiliation(s)
- Roy C Ziegelstein
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
| |
Collapse
|
44
|
Colombo PC, Ganda A, Lin J, Onat D, Harxhi A, Iyasere JE, Uriel N, Cotter G. Inflammatory activation: cardiac, renal, and cardio-renal interactions in patients with the cardiorenal syndrome. Heart Fail Rev 2013; 17:177-90. [PMID: 21688186 DOI: 10.1007/s10741-011-9261-3] [Citation(s) in RCA: 146] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although inflammation is a physiologic response designed to protect us from infection, when unchecked and ongoing it may cause substantial harm. Both chronic heart failure (CHF) and chronic kidney disease (CKD) are known to cause elaboration of several pro-inflammatory mediators that can be detected at high concentrations in the tissues and blood stream. The biologic sources driving this chronic inflammatory state in CHF and CKD are not fully established. Traditional sources of inflammation include the heart and the kidneys which produce a wide range of pro-inflammatory cytokines in response to neurohormones and sympathetic activation. However, growing evidence suggests that non-traditional biomechanical mechanisms such as venous and tissue congestion due to volume overload are also important as they stimulate endotoxin absorption from the bowel and peripheral synthesis and release of pro-inflammatory mediators. Both during the chronic phase and, more rapidly, during acute exacerbations of CHF and CKD, inflammation and congestion appear to amplify each other resulting in a downward spiral of worsening cardiac, vascular, and renal functions that may negatively impact patients' outcome. Anti-inflammatory treatment strategies aimed at attenuating end organ damage and improving clinical prognosis in the cardiorenal syndrome have been disappointing to date. A new therapeutic paradigm may be needed, which involves different anti-inflammatory strategies for individual etiologies and stages of CHF and CKD. It may also include specific (short-term) anti-inflammatory treatments that counteract inflammation during the unsettled phases of clinical decompensation. Finally, it will require greater focus on volume overload as an increasingly significant source of systemic inflammation in the cardiorenal syndrome.
Collapse
Affiliation(s)
- Paolo C Colombo
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, College of Physicians and Surgeons, New York, NY, USA.
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Dhindsa S, Garg R, Bandyopadhyay A, Dandona P. Angiotensin II and Inflammation: The Effect of ACE Inhibition and Angiotensin II Receptor Blockade. Metab Syndr Relat Disord 2012; 1:255-9. [PMID: 18370649 DOI: 10.1089/1540419031361408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
|
46
|
Dandona P, Dhindsa S, Aljada A, Chaudhuri A. Classical Anti-oxidants (Scavengers) versus Biological Anti-oxidants (Suppressors of ROS Generation): ANovel Way to Explain the Anti-oxidant Paradox. Metab Syndr Relat Disord 2012; 2:155-9. [PMID: 18370680 DOI: 10.1089/met.2004.2.155] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Paresh Dandona
- Division of Endocrinology, Diabetes and Metabolism, State University of New York, and Kaleida Health, Buffalo, New York
| | | | | | | |
Collapse
|
47
|
Stein GY, Yosef N, Reichman H, Horev J, Laser-Azogui A, Berens A, Resau J, Ruppin E, Sharan R, Tsarfaty I. Met kinetic signature derived from the response to HGF/SF in a cellular model predicts breast cancer patient survival. PLoS One 2012; 7:e45969. [PMID: 23049908 PMCID: PMC3457970 DOI: 10.1371/journal.pone.0045969] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 08/23/2012] [Indexed: 11/19/2022] Open
Abstract
To determine the signaling pathways leading from Met activation to metastasis and poor prognosis, we measured the kinetic gene alterations in breast cancer cell lines in response to HGF/SF. Using a network inference tool we analyzed the putative protein-protein interaction pathways leading from Met to these genes and studied their specificity to Met and prognostic potential. We identified a Met kinetic signature consisting of 131 genes. The signature correlates with Met activation and with response to anti-Met therapy (p<0.005) in in-vitro models. It also identifies breast cancer patients who are at high risk to develop an aggressive disease in six large published breast cancer patient cohorts (p<0.01, N>1000). Moreover, we have identified novel putative Met pathways, which correlate with Met activity and patient prognosis. This signature may facilitate personalized therapy by identifying patients who will respond to anti-Met therapy. Moreover, this novel approach may be applied for other tyrosine kinases and other malignancies.
Collapse
Affiliation(s)
- Gideon Y. Stein
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Internal Medicine “B”, Beilinson Hospital, Rabin Medical Center, Petah-Tikva, Israel
| | - Nir Yosef
- Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel
| | - Hadar Reichman
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Judith Horev
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adi Laser-Azogui
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Angelique Berens
- Van Andel Research Institute, Grand Rapids, Michigan, United States of America
| | - James Resau
- Van Andel Research Institute, Grand Rapids, Michigan, United States of America
| | - Eytan Ruppin
- Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel
| | - Roded Sharan
- Blavatnik School of Computer Science, Tel Aviv University, Tel Aviv, Israel
| | - Ilan Tsarfaty
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- * E-mail:
| |
Collapse
|
48
|
Abstract
BACKGROUND Chronic heart failure (HF) is a prevalent world-wide. Angiotensin receptor blockers (ARBs) are widely prescribed for chronic HF although their role is controversial. OBJECTIVES To assess the benefit and harm of ARBs compared with ACE inhibitors (ACEIs) or placebo on mortality, morbidity and withdrawals due to adverse effects in patients with symptomatic HF and left ventricular systolic dysfunction or preserved systolic function. SEARCH METHODS Clinical trials were identified by searching CENTRAL, HTA, and DARE , (The Cochrane Library 2010 Issue 3), as well as MEDLINE (2002 to July 2010), and EMBASE (2002 to July 2010). Reference lists of retrieved articles and systematic reviews were checked for additional studies not identified by the electronic searches. SELECTION CRITERIA Double blind randomised controlled trials in men and women of all ages who have symptomatic (NYHA Class II to IV) HF and: 1) left ventricular systolic dysfunction, defined as left ventricular ejection fraction (LVEF) ≤40%; or 2) preserved ejection fraction, defined as LVEF >40%. DATA COLLECTION AND ANALYSIS Two authors independently assessed risk of bias and extracted data from included studies. MAIN RESULTS Twenty two studies evaluated the effects of ARBs in 17,900 patients with a LVEF ≤40% (mean 2.2 years). ARBs did not reduce total mortality (RR 0.87 [95% CI 0.76, 1.00]) or total morbidity as measured by total hospitalisations (RR 0.94 [95% CI 0.88, 1.01]) compared with placebo.Total mortality (RR 1.05 [95% CI 0.91, 1.22]), total hospitalisations (RR 1.00 [95% CI 0.92, 1.08]), MI (RR 1.00 [95% CI 0.62, 1.63]), and stroke (RR 1.63 [0.77, 3.44]) did not differ between ARBs and ACEIs but withdrawals due to adverse effects were lower with ARBs (RR 0.63 [95% CI 0.52, 0.76]). Combinations of ARBs plus ACEIs increased the risk of withdrawals due to adverse effects (RR 1.34 [95% CI 1.19, 1.51]) but did not reduce total mortality or total hospital admissions versus ACEI alone.Two placebo-controlled studies evaluated ARBs in 7151 patients with a LVEF >40% (mean 3.7 years). ARBs did not reduce total mortality (RR 1.02 [95% CI 0.93, 1.12]) or total morbidity as measured by total hospitalisations (RR 1.00 [95% CI 0.97, 1.05]) compared with placebo. Withdrawals due to adverse effects were higher with ARBs versus placebo when all patients were pooled irrespective of LVEF (RR 1.06 [95% CI 1.01, 1.12]). AUTHORS' CONCLUSIONS In patients with symptomatic HF and systolic dysfunction or with preserved ejection fraction, ARBs compared to placebo or ACEIs do not reduce total mortality or morbidity. ARBs are better tolerated than ACEIs but do not appear to be as safe and well tolerated as placebo in terms of withdrawals due to adverse effects. Adding an ARB in combination with an ACEI does not reduce total mortality or total hospital admission but increases withdrawals due to adverse effects compared with ACEI alone.
Collapse
Affiliation(s)
- Balraj S Heran
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada.
| | | | | | | | | |
Collapse
|
49
|
Iwashita M, Sakoda H, Kushiyama A, Fujishiro M, Ohno H, Nakatsu Y, Fukushima T, Kumamoto S, Tsuchiya Y, Kikuchi T, Kurihara H, Akazawa H, Komuro I, Kamata H, Nishimura F, Asano T. Valsartan, independently of AT1 receptor or PPARγ, suppresses LPS-induced macrophage activation and improves insulin resistance in cocultured adipocytes. Am J Physiol Endocrinol Metab 2012; 302:E286-96. [PMID: 22045314 DOI: 10.1152/ajpendo.00324.2011] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Macrophages are integrated into adipose tissues and interact with adipocytes in obese subjects, thereby exacerbating adipose insulin resistance. This study aimed to elucidate the molecular mechanism underlying the insulin-sensitizing effect of the angiotensin II receptor blocker (ARB) valsartan, as demonstrated in clinical studies. Insulin signaling, i.e., insulin receptor substrate-1 and Akt phosphorylations, in 3T3-L1 adipocytes was impaired markedly by treatment with tumor necrosis factor-α (TNFα) or in the culture medium of lipopolysaccharide (LPS)-stimulated RAW 264.7 murine macrophages, and valsartan had no effects on these impairments. However, in contrast, when cocultured with RAW 264.7 cells using a transwell system, the LPS-induced insulin signaling impairment in 3T3-L1 adipocytes showed almost complete normalization with coaddition of valsartan. Furthermore, valsartan strongly suppressed LPS-induced productions of cytokines such as interleukin (IL)-1β, IL-6, and TNFα with nuclear factor-κB activation and c-Jun NH(2)-terminal kinase phosphorylation in RAW 264.7 and primary murine macrophages. Very interestingly, this effect of valsartan was also observed in THP-1 cells treated with angiotensin II type 1 (AT1) siRNA or a peroxisome proliferator-activated receptor-γ (PPARγ) antagonist as well as macrophages from AT1a receptor-knockout mice. We conclude that valsartan suppresses the inflammatory response of macrophages, albeit not via PPARγ or the AT1a receptor. This suppression appears to secondarily improve adipose insulin resistance.
Collapse
MESH Headings
- 3T3-L1 Cells
- Adipocytes, White/drug effects
- Adipocytes, White/immunology
- Adipocytes, White/metabolism
- Angiotensin II Type 1 Receptor Blockers/pharmacology
- Animals
- Anti-Inflammatory Agents, Non-Steroidal/pharmacology
- Cell Line
- Cells, Cultured
- Coculture Techniques
- Humans
- Insulin Resistance
- Macrophage Activation/drug effects
- Macrophages/drug effects
- Macrophages/immunology
- Macrophages/metabolism
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- PPAR gamma/antagonists & inhibitors
- PPAR gamma/metabolism
- RNA Interference
- RNA, Small Interfering
- Receptor, Angiotensin, Type 1/chemistry
- Receptor, Angiotensin, Type 1/genetics
- Receptor, Angiotensin, Type 1/metabolism
- Tetrazoles/pharmacology
- Valine/analogs & derivatives
- Valine/pharmacology
- Valsartan
Collapse
Affiliation(s)
- Misaki Iwashita
- Department of Biomedical Chemistry, Division of Molecular Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Weber J, Tiriveedhi V, Takenaka M, Lu W, Hachem R, Trulock E, Patterson GA, Mohanakumar T. Inhibition of renin angiotensin aldosterone system causes abrogation of obliterative airways disease through inhibition of tumor necrosis factor-α-dependant interleukin-17. J Heart Lung Transplant 2012; 31:419-26. [PMID: 22289485 DOI: 10.1016/j.healun.2011.12.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Revised: 10/25/2011] [Accepted: 12/14/2011] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Alloimmune-induced immune responses to self-antigens are involved in the development of chronic lung allograft rejection. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) have been shown to modulate autoimmune diseases. This study investigated the effect of modulation of the renin angiotensin aldosterone system (RAAS) a murine model of obliterative airways disease (OAD). METHODS Major histocompatibility complex (MHC) class I antibodies were administered intrabronchially to C57Bl/6 mice on Days 1, 2, 3, and 6, and weekly thereafter. ACEI/ARB (10 mg/kg/day) were administered in water 5 days before antibody administration. Antibodies were analyzed by enzyme-linked immunosorbent assay, cytokines by Luminex, Th-frequency by enzyme-linked immunosorbent spot, and transcription factors by Western blotting and real-time polymerase chain reaction. RESULTS Significant decreases (50%-70%) in airway lesions and fibrous deposition were noted in lungs at Day 30 in the animals administered ACEI and ARB vs controls. Antibody concentrations to self-antigens also decreased from 14 ± 21 to 62 ± 18 μg/ml for collagen V and from 263 ± 43 to 84 ± 28 μg/ml for K-α1 tubulin. Th-precursor frequency and cytokine analysis showed increased interleukin (IL)-10 (3-fold increase) and decreased levels of IL-6 (3.4-fold) and IL-17 (4-fold decrease; p < 0.05) in ACEI and ARB groups. There was also messenger RNA level downregulation of tumor necrosis factor-α (8.6-fold) and p38/mitogen-activated protein (MAP)kinase (3.1-fold) in the treatment groups. CONCLUSIONS Our results demonstrate that modulation of RAAS leads to downregulation of IL-17 through tumor necrosis factor-α-dependant IL-6 through p38/MAPKinase pathway and thus abrogation of anti-MHC-induced OAD.
Collapse
Affiliation(s)
- Joseph Weber
- Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | | | | | | | | | | | | | | |
Collapse
|