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Hypoxia signaling in human health and diseases: implications and prospects for therapeutics. Signal Transduct Target Ther 2022; 7:218. [PMID: 35798726 PMCID: PMC9261907 DOI: 10.1038/s41392-022-01080-1] [Citation(s) in RCA: 90] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/17/2022] [Accepted: 06/23/2022] [Indexed: 02/07/2023] Open
Abstract
Molecular oxygen (O2) is essential for most biological reactions in mammalian cells. When the intracellular oxygen content decreases, it is called hypoxia. The process of hypoxia is linked to several biological processes, including pathogenic microbe infection, metabolic adaptation, cancer, acute and chronic diseases, and other stress responses. The mechanism underlying cells respond to oxygen changes to mediate subsequent signal response is the central question during hypoxia. Hypoxia-inducible factors (HIFs) sense hypoxia to regulate the expressions of a series of downstream genes expression, which participate in multiple processes including cell metabolism, cell growth/death, cell proliferation, glycolysis, immune response, microbe infection, tumorigenesis, and metastasis. Importantly, hypoxia signaling also interacts with other cellular pathways, such as phosphoinositide 3-kinase (PI3K)-mammalian target of rapamycin (mTOR) signaling, nuclear factor kappa-B (NF-κB) pathway, extracellular signal-regulated kinases (ERK) signaling, and endoplasmic reticulum (ER) stress. This paper systematically reviews the mechanisms of hypoxia signaling activation, the control of HIF signaling, and the function of HIF signaling in human health and diseases. In addition, the therapeutic targets involved in HIF signaling to balance health and diseases are summarized and highlighted, which would provide novel strategies for the design and development of therapeutic drugs.
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Qin Z, Kong B, Zheng J, Wang X, Li L. Alprostadil Injection Attenuates Coronary Microembolization-Induced Myocardial Injury Through GSK-3β/Nrf2/HO-1 Signaling-Mediated Apoptosis Inhibition. Drug Des Devel Ther 2020; 14:4407-4422. [PMID: 33122886 PMCID: PMC7588838 DOI: 10.2147/dddt.s272877] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/19/2020] [Indexed: 11/24/2022] Open
Abstract
Objective Coronary microembolization (CME) results in progressive contractile dysfunction associated with cardiomyocyte apoptosis. Alprostadil injection improves microcirculation, which is effective in treating various cardiovascular disorders. However, the therapeutic effects of alprostadil in CME-induced myocardia injury remain unknown. Therefore, we evaluated the effects of alprostadil injection on cardiac protection in a rat model of CME and explored the underlying mechanisms. Methods A rat model of CME was established by injecting polyethylene microspheres into the left ventricle. After injection of microspheres, rats in the alprostadil group received alprostadil via tail vein within 2 minutes. Cardiac function, histological alterations in myocardium, serum c-troponin I (cTnI) levels, myocardium adenosine triphosphate (ATP) concentrations, the activity of superoxide dismutase (SOD) and malondialdehyde (MDA) content in myocardium, and myocardial apoptosis-related proteins were detected 12 hours after CME modeling. Results Compared with the Sham group, ATP concentrations, SOD activity in the myocardium, and cardiac function were significantly decreased in a rat model of CME. In addition, serum cTnI levels, MDA content, expression levels of pro-apoptotic proteins, and the number of TUNEL-positive nuclei were remarkably higher in CME group than those in the Sham group. However, alprostadil treatment notably reduced serum cTnI levels and expression levels of pro-apoptotic proteins, while noticeably improved cardiac function, and accelerated SOD activity in the myocardium following CME. Additionally, it was unveiled that the protective effects of alprostadil injection inhibit CME-induced myocardial apoptosis in the myocardium potentially through regulation of the GSK-3β/Nrf2/HO-1 signaling pathway. Conclusion Alprostadil injection seems to significantly suppress oxidative stress, alleviate myocardial apoptosis in the myocardium, and improve cardiac systolic and diastolic functions following CME by regulating the GSK-3β/Nrf2/HO-1 signaling pathway.
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Affiliation(s)
- Zhenbai Qin
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Binghui Kong
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jing Zheng
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xiantao Wang
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Lang Li
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Prostaglandin E1 protects cardiomyocytes against hypoxia-reperfusion induced injury via the miR-21-5p/FASLG axis. Biosci Rep 2020; 39:221373. [PMID: 31782491 PMCID: PMC6923339 DOI: 10.1042/bsr20190597] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 11/12/2019] [Accepted: 11/25/2019] [Indexed: 12/21/2022] Open
Abstract
Background: Prostaglandin-E1 (PGE1) is a potent vasodilator with anti-inflammatory and antiplatelet effects. However, the mechanism by which PGE1 contributes to the amelioration of cardiac injury remains unclear. Methods: The present study was designed to investigate how PGE1 protects against hypoxia/reoxygenation (H/R)-induced injuries by regulating microRNA-21-5p (miR-21-5p) and fas ligand (FASLG). Rat H9C2 cells and isolated primary cardiomyocytes were cultured under hypoxic conditions for 6 h (6H, hypoxia for 6 h), and reoxygenated for periods of 6 (6R, reoxygenation for 6 h), 12, and 24 h, respectively. Cells from the 6H/6R group were treated with various doses of PGE1; after which, their levels of viability and apoptosis were detected. Results: The 6H/6R treatment regimen induced the maximum level of H9C2 cell apoptosis, which was accompanied by the highest levels of Bcl-2-associated X protein (Bax) and cleaved-caspase-3 expression and the lowest level of B-cell lymphoma 2 (Bcl-2) expression. Treatment with PGE1 significantly diminished the cell cytotoxicity and apoptosis induced by the 6H/6R regimen, and also decreased expression of IL-2, IL-6, P-p65, TNF-α, and cleaved-caspase-3. In addition, we proved that PGE1 up-regulated miR-21-5p expression in rat cardiomyocytes exposed to conditions that produce H/R injury. FASLG was a direct target of miR-21-5p, and PGE1 reduced the ability of H/R-injured rat cardiomyocytes to undergo apoptosis by affecting the miR-21-5p/FASLG axis. In addition, we proved that PGE1 could protect primary cardiomyocytes against H/R-induced injuries. Conclusions: These results indicate that PGE1 exerts cardioprotective effects in H9C2 cells during H/R by regulating the miR-21-5p/FASLG axis.
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Sayed KM, Mostafa EM, Mounir A, Abd Elhaliem NG, Alsmman AH. Analysis of Bimatoprost-Induced changes on Rabbits eyelash Follicle: Clinical and Electron microscopic study. Clin Ophthalmol 2019; 13:2421-2426. [PMID: 31824136 PMCID: PMC6901034 DOI: 10.2147/opth.s229335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/14/2019] [Indexed: 11/23/2022] Open
Abstract
Objective To analyze ultrastructural changes of rabbits' eyelash follicles treated with bimatoprost eye drops to increase our knowledge of how this drug works. Methods The study included 15 clinically healthy male rabbits. All rabbits were treated with bimatoprost 0.03% daily for 4 weeks with one drop of the topical eye drops applied to the conjunctival fornix of the right eyes; left eyes were used as controls. Eyelash lengths were measured before and after treatment. The eyelid of each animal was dissected for light and electron microscopic analysis. Results Both control and treated rabbit eyes matched regarding eyelash length before treatment (9.80±0.388mm vs 9.88±0.24mm) (P=0.108). There was a significant increase in eyelash length between control (9.75±0.33 mm) and treated rabbit eyes (11.60±0.46 mm) (P=0.369). Light and electron microscopy revealed, bimatoprost treated eyes had thick epidermis. The dermis contained two hairs growing out of the same hair follicle. Heavily keratinized Henle's layer, the cortical cells (Cx) have prominent nucleolus and cytoplasm is studded with melanin granules. Conclusion Bimatoprost-induced eyelash changes were not restricted to increased eyelash length, thickness, and pigmentation but also showed increased number of eyelashes within the same hair follicle which were stronger and could resist pulling from the skin without any evidence of inflammatory cells within the specimens. These changes occurred as early as 1 month of treatment, giving rise to thoughts about the possibility of using bimatoprost eye drops as a prophylaxis against madarosis associated with chemotherapy if it is started 1 month before chemotherapy and continued afterwards, making eyelashes stronger and resistant to falling out.
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Affiliation(s)
- Khulood Muhammad Sayed
- The Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Engy Mohammed Mostafa
- The Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Amr Mounir
- The Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
| | | | - Alahmady Hamad Alsmman
- The Department of Ophthalmology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
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Ling L, Zhang S, Ji Z, Huang H, Yao G, Wang M, He R, Deng W, Fang L. Therapeutic effects of lipo-prostaglandin E1 on angiogenesis and neurogenesis after ischemic stroke in rats. Int J Neurosci 2015; 126:469-77. [PMID: 26000823 DOI: 10.3109/00207454.2015.1031226] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Previous studies have demonstrated that prostaglandin E1 (PGE1) has a neuroprotective effect on cerebral ischemia. However, it remains unknown whether PGE1 promotes angiogenesis and neurogenesis after ischemic stroke. In this study, adult male Sprague-Dawley rats were subjected to permanently distal middle cerebral artery occlusion (MCAO). Rats were treated with lipo-prostaglandin E1(lipo-PGE1, 10 μg/kg/d) or the same volume of 0.9% saline starting 24 hours after MCAO daily for 6 consecutive days. All rats were injected 5'-bromo-2'-deoxyuridine (BrdU, 50 mg/kg) intraperitoneally every 12 hours for 3 consecutive days before being sacrificed. At 7 and 14 days after MCAO or sham-operation, rats were sacrificed. Post-stroke neurological outcome, infarction volume, angiogenesis and neurogenesis were evaluated. Treatment with lipo-PGE1 significantly increased the vascular density in the peri-infarct areas at 7 and 14 days after MCAO. The lipo-PGE1 treatment significantly enhanced the proliferation and migration of endogenous neural stem cells in the ipsilateral subventricular zone. The neural stem cells associated with blood vessels closely within a neurovascular niche in lipo-PGE1-treated rats after stroke. The lipo-PGE1 treatment also significantly improved the neurological recovery after MCAO. These results indicate that treatment with lipo-PGE1 promotes post-stroke angiogenesis, neurogenesis and their interaction, which would contribute to neurological recovery after cerebral infarction. Our study provides novel experimental evidences for the neuroprotective roles of PGE1 in ischemic stroke.
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Affiliation(s)
- Li Ling
- a 1 Department of Neurology, Guangzhou Red Cross Hospital, Medical College , Jinan University , Guangzhou , P.R. China
| | - Suping Zhang
- a 1 Department of Neurology, Guangzhou Red Cross Hospital, Medical College , Jinan University , Guangzhou , P.R. China
| | - Zhangge Ji
- a 1 Department of Neurology, Guangzhou Red Cross Hospital, Medical College , Jinan University , Guangzhou , P.R. China
| | - Huihong Huang
- a 1 Department of Neurology, Guangzhou Red Cross Hospital, Medical College , Jinan University , Guangzhou , P.R. China
| | - Gang Yao
- b 2 Department of Ophthalmology , The People's Hospital of Guangxi Zhuang Autonomous Region , Nanning , P.R. China
| | - Muzhen Wang
- a 1 Department of Neurology, Guangzhou Red Cross Hospital, Medical College , Jinan University , Guangzhou , P.R. China
| | - Rui He
- a 1 Department of Neurology, Guangzhou Red Cross Hospital, Medical College , Jinan University , Guangzhou , P.R. China
| | - Wanqing Deng
- a 1 Department of Neurology, Guangzhou Red Cross Hospital, Medical College , Jinan University , Guangzhou , P.R. China
| | - Li Fang
- c 3 Department of Pathology, Guangzhou Red Cross Hospital, Medical College , Jinan University , Guangzhou , P.R. China
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Eo S, Kwon C, Lee H, Cho S, Kim J, Baek G, Yeo J, Lim C. Quantification of the effect of Lipo-PGE1 on angiogenesis. J Plast Reconstr Aesthet Surg 2014; 68:104-12. [PMID: 25448364 DOI: 10.1016/j.bjps.2014.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 07/07/2014] [Accepted: 09/15/2014] [Indexed: 10/24/2022]
Abstract
Fifteen rabbits were used to assess the effect of Lipo-PGE1 on neovascularization. Merocel(®) and Alloderm(®) of the same size were implanted separately under the back skin to act as matrices for vessel growth. Lipo-PGE1 was injected intravenously for 2 weeks in an experimental group of eight rabbits, and they were compared with a control group of seven untreated animals. Blood flow was measured using the (99m)TcO4(-) clearance technique. The mean blood clearance halftime (T1/2) and washout radioactivity were measured. Newly formed vessels were counted by CD31. The mean clearance halftime was 4005 ± 2161.3 and 13840 ± 4644.6 s in the experimental and control group, respectively, in the 1 × 2 × 1.5-cm-sized implants (p = 0.0125), and 1560 ± 1174.7 and 3405 ± 807.03 s, respectively, in the 2 × 2 × 1.5-cm-sized implants (p = 0.0413). Histological examinations revealed that the mean numbers of newly formed vessels in the experimental and control groups were 11 ± 1.58 and 7.8 ± 1.71, respectively, in the 1 × 2 × 1.5-cm-sized implants (p = 0.0501), and 20.19 ± 12.47 and 12.33 ± 3.25, respectively, in the 2 × 2 × 1.5-cm-sized implants (p = 0.02679). Lipo-PGE1 was found to be effective in promoting angiogenesis in a rabbit matrix model.
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Affiliation(s)
- SuRak Eo
- Department of Plastic and Reconstructive Surgery, DongGuk University Graduate School of Medicine, Seoul, South Korea.
| | - Chan Kwon
- Department of Plastic and Reconstructive Surgery, DongGuk University Graduate School of Medicine, Seoul, South Korea
| | - HyunJic Lee
- Department of Plastic and Reconstructive Surgery, DongGuk University Graduate School of Medicine, Seoul, South Korea
| | - SangHun Cho
- Department of Plastic and Reconstructive Surgery, DongGuk University Graduate School of Medicine, Seoul, South Korea
| | - JinYoung Kim
- Department of Orthopaedic Surgery, DongGuk University Graduate School of Medicine, Seoul, South Korea
| | - GooHyun Baek
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea
| | - JeongSeok Yeo
- Department of Nuclear Medicine, DongGuk University Graduate School of Medicine, Seoul, South Korea
| | - ChiYeon Lim
- Department of Clinical Trial Test, DongGuk University Graduate School of Medicine, Seoul, South Korea
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Does PGE₁ vasodilator prevent orthopaedic implant-related infection in diabetes? Preliminary results in a mouse model. PLoS One 2014; 9:e94758. [PMID: 24718359 PMCID: PMC3981866 DOI: 10.1371/journal.pone.0094758] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 03/19/2014] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Implant-related infections are characterized by bacterial colonization and biofilm formation on the prosthesis. Diabetes represents one of the risk factors that increase the chances of prosthetic infections because of related severe peripheral vascular disease. Vasodilatation can be a therapeutic option to overcome diabetic vascular damages and increase the local blood supply. In this study, the effect of a PGE₁ vasodilator on the incidence of surgical infections in diabetic mice was investigated. METHODOLOGY A S. aureus implant-related infection was induced in femurs of diabetic mice, then differently treated with a third generation cephalosporin alone or associated with a PGE₁ vasodilator. Variations in mouse body weight were evaluated as index of animal welfare. The femurs were harvested after 28 days and underwent both qualitative and quantitative analysis as micro-CT, histological and microbiological analyses. RESULTS The analysis performed in this study demonstrated the increased host response to implant-related infection in diabetic mice treated with the combination of a PGE₁ and antibiotic. In this group, restrained signs of infections were identified by micro-CT and histological analysis. On the other hand, the diabetic mice treated with the antibiotic alone showed a severe infection and inability to successfully respond to the standard antimicrobial treatment. CONCLUSIONS The present study revealed interesting preliminary results in the use of a drug combination of antibiotic and vasodilator to prevent implant-related Staphylococcus aureus infections in a diabetic mouse model.
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Caliskan A, Yavuz C, Karahan O, Yazici S, Guclu O, Demirtas S, Mavitas B. Iloprost reduces myocardial edema in a rat model of myocardial ischemia reperfusion. Perfusion 2013; 29:260-4. [PMID: 24297774 DOI: 10.1177/0267659113514472] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Myocardial ischemia severely reduces myocyte longevity and function. Extensive interstitial edema and cell damage occur as a result of myocardial reperfusion injury. Current therapies are directed at prevention of ischemia-induced damage to cardiac tissue. Iloprost is a novel pharmaceutical agent for the treatment of ischemia. METHODS Twenty rats were segregated into four experimental groups. The procedure control group consisted of four rats undergoing a sham operation. The remaining 16 rats were divided into two equal groups. The first group (control group) received a continuous intravenous infusion of physiological serum immediately prior to the procedure. Iloprost was administered by a continuous intravenous infusion into the right jugular vein at an infusion rate of 100 ng/kg/min for 30 minutes prior to reperfusion in the experimental group (study group). Following the infusion treatments, ligation of the left coronary artery was conducted for 30 minutes to induce myocardial ischemia. The rats were euthanized 24 hours after reperfusion and cardiac tissue was harvested from all specimens for analysis. RESULTS Histological examination revealed three myocardial tissue specimens with grade II damage and five myocardial tissue specimens with grade III reperfusion injury in the control group. However, the study group consisted of two grade III myocardial tissue specimens, five grade II myocardial tissue specimens and one grade I myocardial tissue specimen. Moreover, a statistically significant reduction in myocardial edema was observed in the study group (p=0.022). CONCLUSION Our results support the hypothesis that iloprost enhances protection against cardiac ischemia reperfusion injury. This protective effect may be associated with vasodilation, antioxidant or anti-edema mechanisms.
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Affiliation(s)
- A Caliskan
- Medical School of Dicle University, Diyarbakir, Turkey
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Suzuki K, Nishi K, Takabuchi S, Kai S, Matsuyama T, Kurosawa S, Adachi T, Maruyama T, Fukuda K, Hirota K. Differential roles of prostaglandin E-type receptors in activation of hypoxia-inducible factor 1 by prostaglandin E1 in vascular-derived cells under non-hypoxic conditions. PeerJ 2013; 1:e220. [PMID: 24349900 PMCID: PMC3845874 DOI: 10.7717/peerj.220] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 11/11/2013] [Indexed: 11/24/2022] Open
Abstract
Prostaglandin E1 (PGE1), known pharmaceutically as alprostadil, has vasodilatory properties and is used widely in various clinical settings. In addition to acute vasodilatory properties, PGE1 may exert beneficial effects by altering protein expression of vascular cells. PGE1 is reported to be a potent stimulator of angiogenesis via upregulation of VEGF expression, which is under the control of the transcription factor hypoxia-inducible factor 1 (HIF-1). However, the molecular mechanisms behind the phenomenon are largely unknown. In the present study, we investigated the mechanism by which PGE1 induces HIF-1 activation and VEGF gene expression in human aortic smooth muscle cells (HASMCs) and human umbilical vein endothelial cells (HUVECs), both vascular-derived cells. HUVECs and HASMCs were treated with PGE1 at clinically relevant concentrations under 20% O2 conditions and HIF-1 protein expression was investigated. Expression of HIF- 1α protein and the HIF-1-downstream genes were low under 20% O2 conditions and increased in response to PGE1 treatment in both HUVECs and HASMCs in a dose- and time-dependent manner under 20% O2 conditions as comparable to exposure to 1% O2 conditions. Studies using EP-receptor-specific agonists and antagonists revealed that EP1 and EP3 are critical to PGE1-induced HIF-1 activation. In vitro vascular permeability assays using HUVECs indicated that PGE1 increased vascular permeability in HUVECs. Thus, we demonstrate that PGE1 induces HIF- 1α protein expression and HIF-1 activation under non-hypoxic conditions and also provide evidence that the activity of multiple signal transduction pathways downstream of EP1 and EP3 receptors is required for HIF-1 activation.
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Affiliation(s)
- Kengo Suzuki
- Department of Anesthesia, Kyoto University Hospital , Kyoto , Japan ; Department of Anesthesiology, Tohoku University Hospital , Sendai , Japan
| | - Kenichiro Nishi
- Department of Anesthesiology, Kansai Medical University , Hirakata, Osaka , Japan
| | - Satoshi Takabuchi
- Department of Anesthesiology, Kansai Medical University , Hirakata, Osaka , Japan
| | - Shinichi Kai
- Department of Anesthesia, Kyoto University Hospital , Kyoto , Japan
| | | | - Shin Kurosawa
- Department of Anesthesiology, Tohoku University Hospital , Sendai , Japan
| | - Takehiko Adachi
- Department of Anesthesia, Tazuke Kofukai Medical Research Institute Kitano Hospital , Osaka , Japan
| | - Takayuki Maruyama
- Minase Research Institutes, Research Headquarters, Ono Pharmaceutical , Osaka , Japan
| | - Kazuhiko Fukuda
- Department of Anesthesia, Kyoto University Hospital , Kyoto , Japan
| | - Kiichi Hirota
- Department of Anesthesiology, Kansai Medical University , Hirakata, Osaka , Japan
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Milio G, Novo G, Genova C, Luigi Almasio P, Novo S, Pinto A. Pharmacological treatment of patients with chronic critical limb ischemia: L-propionyl-carnitine enhances the short-term effects of PGE-1. Cardiovasc Drugs Ther 2009; 23:301-6. [PMID: 19548076 DOI: 10.1007/s10557-009-6178-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the therapeutic effects of L-propionyl-carnitine (LPC) in patients with critical limb ischemia (CLI), as defined by the TASC guidelines. METHODS The study, double-blinded, randomised, assessed intravenous infusion of LPC 1.2 g/day in combination with PGE-1, 60 mg/day (LPC group: 37 patients), or PGE-1 only (control group: 38 patients) in a total of 75 patients suffering from CLI. Treatment duration was 20 days. We evaluated rest pain, maximum walking distance (MWD) and skin ulcer size. RESULTS In both groups we observed a significant reduction in pain score and ulcer size and an increase in MWD. In the patients treated with the combination, the improvement was greater: median value for pain score decreased from 2.75 to 0.85 in the LPC group and from 2.51 to 1.71 in the control group; MWD increased from 55 M to 130 M in the LPC group, and from 55 M to 102 M in the control group; median decrease of ulcer size was significantly greater in patients treated with LPC + PGE1. CONCLUSIONS Our study shows that LPC, whose effectiveness on claudication is already known, has favourable effects in patients with CLI, since it reinforces the effects produced by PGE-1.
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Affiliation(s)
- Glauco Milio
- Department of Internal Medicine Cardiovascular and Nephro-Urological Diseases, University of Palermo, Via M. Rutelli, 9-90143, Palermo, Italy.
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Eo S, Hur G, Cho S, Azari KK. Successful composite graft for fingertip amputations using ice-cooling and lipo-prostaglandin E1. J Plast Reconstr Aesthet Surg 2009; 62:764-70. [DOI: 10.1016/j.bjps.2007.09.064] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2007] [Accepted: 09/05/2007] [Indexed: 10/22/2022]
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Esaki J, Sakaguchi H, Marui A, Bir SC, Arai Y, Huang Y, Tsubota H, Kanaji T, Ikeda T, Sakata R. Local Sustained Release of Prostaglandin E1 Induces Neovascularization in Murine Hindlimb Ischemia. Circ J 2009; 73:1330-6. [DOI: 10.1253/circj.cj-08-0999] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Jiro Esaki
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
| | - Hisashi Sakaguchi
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
| | - Akira Marui
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
| | - Shyamal Chandra Bir
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
| | - Yoshio Arai
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
| | - Yuhong Huang
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
| | - Hideki Tsubota
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
| | | | - Tadashi Ikeda
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
| | - Ryuzo Sakata
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
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Suzuki H, Fujimura T, Shiomori T, Ohbuchi T, Kitamura T, Hashida K, Udaka T. Prostaglandin E1 versus steroid in combination with hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss. Auris Nasus Larynx 2008; 35:192-7. [PMID: 17826927 DOI: 10.1016/j.anl.2007.06.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2007] [Revised: 04/29/2007] [Accepted: 06/04/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE We conducted a controlled retrospective analysis of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) in order to investigate the effect of prostaglandin E1 (PGE1) plus hyperbaric oxygen (HBO) therapy in comparison with that of steroid plus HBO therapy. METHODS One hundred and ninety-six consecutive patients with ISSNHL (hearing levels > or ==40dB; time from the onset of hearing loss to the start of treatment < or ==30 days) were enrolled. Ninety-five patients underwent PGE1 plus HBO therapy (PG group) and 101 underwent steroid administration plus HBO therapy (steroid group). Hearing recovery was evaluated by grade assessment and by the improvement in hearing compared to the unaffected contralateral ear. RESULTS The hearing levels after treatment were 52.2+/-3.0 and 47.5+/-2.8dB, the hearing gains were 31.3+/-2.2 and 27.2+/-2.3dB, the cure rates were 28.4% and 28.7%, the recovery rates were 54.7% and 53.5%, and the hearing improvement rates were 48.4+/-5.1% and 53.9+/-4.2% in the PG and steroid groups, respectively. There were no significant differences between the two groups. CONCLUSION We concluded that PGE1 and a steroid are equally effective in the treatment of ISSNHL when used together with HBO therapy. PGE1 plus HBO therapy can be one of the potential alternative treatments for ISSNHL, particularly in steroid-intolerant patients such as those with severe diabetes mellitus, an active peptic ulcer, or viral hepatitis.
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Affiliation(s)
- Hideaki Suzuki
- Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
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Moreschi D, Fagundes DJ, Hernandes L, Haapalainen EF. Effects of Prostaglandin E1 in the Genesis of Blood Capillaries in the Ischemic Skeletal Muscle of Rats: Ultrastructural Analysis. Ann Vasc Surg 2008; 22:121-6. [DOI: 10.1016/j.avsg.2007.07.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2007] [Revised: 06/11/2007] [Accepted: 07/16/2007] [Indexed: 10/21/2022]
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Huang Y, Marui A, Sakaguchi H, Esaki J, Arai Y, Hirose K, Bir SC, Horiuchi H, Maruyama T, Ikeda T, Tabata Y, Komeda M. Sustained Release of Prostaglandin E1 Potentiates the Impaired Therapeutic Angiogenesis by Basic Fibroblast Growth Factor in Diabetic Murine Hindlimb Ischemia. Circ J 2008; 72:1693-9. [DOI: 10.1253/circj.cj-07-0960] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yuhong Huang
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
| | - Akira Marui
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
| | - Hisashi Sakaguchi
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
| | - Jiro Esaki
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
| | - Yoshio Arai
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
| | - Keiichi Hirose
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
| | - Shyamal Chandra Bir
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
| | - Hisanori Horiuchi
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | | | - Tadashi Ikeda
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
| | - Yasuhiko Tabata
- Department of Biomaterials, Institute for Frontier Medical Sciences, Kyoto University
| | - Masashi Komeda
- Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine
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Moreschi Jr. D, Fagundes DJ, Amado LEB, Hernandes L, Moreschi HK. Efeitos da prostaglandina E1 (PGE1) na gênese de capilares sanguíneos em músculo esquelético isquêmico de ratos: estudo histológico. J Vasc Bras 2007. [DOI: 10.1590/s1677-54492007000400004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
CONTEXTO: A angiogênese terapêutica é uma modalidade de tratamento para pacientes com insuficiência arterial crônica que não têm indicação para revascularização direta ou angioplastia e que não tiveram uma resposta satisfatória ao tratamento clínico. Entre as drogas utilizadas para essa finalidade está a prostaglandina E1 (PGE1). OBJETIVO: Estudar os aspectos morfológicos na gênese de capilares sanguíneos em músculo esquelético do membro caudal de ratos submetidos à isquemia sob a ação da PGE1, administrada por via intramuscular (IM) ou endovenosa (EV). MÉTODOS: Foram utilizados 48 ratos, linhagem Wistar-UEM, distribuídos aleatoriamente em três grupos de 16, redistribuídos igualmente em dois subgrupos, observados no 7º e 14º dias, sendo um grupo controle onde apenas foi provocada a isquemia no membro, outro com a isquemia e a injeção da PGE1 via IM e outro com a isquemia e a injeção da PGE1 EV. Para análise dos resultados, foram realizadas a coloração com hematoxilina e eosina (HE) e coloração imuno-histoquímica. RESULTADOS: Constatou-se um aumento estatisticamente significativo no número de capilares nos subgrupos com o uso da PGE1 IM e EV, através da contagem nos cortes corados com HE. A imunomarcação não foi eficiente para a quantificação dos capilares. CONCLUSÕES: A PGE1, administrada por via IM ou EV, promoveu, após 14 dias de observação, um aumento no número de capilares no músculo esquelético de ratos submetido à isquemia, identificáveis histologicamente com a coloração em HE. A imunocoloração não permitiu estabelecer uma correlação com o aumento de vasos encontrados na coloração com HE.
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Adjunctive parenteral therapy with lipo-ecraprost, a prostaglandin E1 analog, in patients with critical limb ischemia undergoing distal revascularization does not improve 6-month outcomes. J Vasc Surg 2007; 45:953-60; discussion 960-1. [PMID: 17350216 DOI: 10.1016/j.jvs.2006.12.057] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2006] [Accepted: 12/19/2006] [Indexed: 11/21/2022]
Abstract
PURPOSE In patients with critical limb ischemia (CLI), distal revascularization remains the procedure of choice for preventing limb loss, but long-term outcomes for pain relief, wound healing, and prevention of amputation remain suboptimal. Prostaglandin drug therapy as an adjuvant to revascularization may improve these outcomes. The current trial was designed to test the hypothesis that the use of lipo-ecraprost, a lipid encapsulated prostaglandin E(1) prodrug, as an adjunctive therapy after distal revascularization would improve amputation-free survival in patients with CLI. METHODS The study was randomized, multicenter, double blind, and placebo controlled. Patients meeting clinical and hemodynamic criteria for CLI who were undergoing either bypass or endovascular revascularization of the below knee popliteal or more distal arteries were randomized to receive placebo or a 60-microg dose of lipo-ecraprost administered intravenously starting <or=72 hours of the index revascularization and then 5 days per week for 8 weeks. The study primary end point was the composite end point of death or amputation at or above the level of the ankle at 180 days. RESULTS The study randomized 322 patients, and 284 received at least one dose of study medication and were included in the intention-to-treat population. A total of 213 patients underwent surgical bypass, and 71 underwent endovascular revascularization before receiving study medication. The distribution of index revascularization procedures and location of distal target arteries were similar for both placebo and lipo-ecraprost groups. At 180 days, 21 patients (7.4%) were lost to follow-up before reaching the primary end point. Seventy-one percent of the patients taking the placebo completed at least half the doses of the study medication compared with 48% of those taking lipo-ecraprost. Index leg revascularization-assisted primary patency was 82% in the placebo group and 84% in the lipo-ecraprost group (P = .874). Changes in lower extremity hemodynamics as a result of the revascularization during the study period did not differ between the placebo and lipo-ecraprost treatment arms. For the primary event of amputation-free survival, there were no differences between groups: 19 major amputations occurred in the placebo group and 17 in the lipo-ecraprost group; 19 deaths occurred in the placebo group and 13 in the lipo-ecraprost group. CONCLUSION Eight weeks of parenteral therapy with lipo-ecraprost after distal revascularization in patients with CLI provided no additional benefit in the reduction of major amputation or death at 180 days.
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Brass EP, Anthony R, Dormandy J, Hiatt WR, Jiao J, Nakanishi A, McNamara T, Nehler M. Parenteral therapy with lipo-ecraprost, a lipid-based formulation of a PGE1 analog, does not alter six-month outcomes in patients with critical leg ischemia. J Vasc Surg 2006; 43:752-9. [PMID: 16616232 DOI: 10.1016/j.jvs.2005.11.041] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2005] [Accepted: 11/27/2005] [Indexed: 10/24/2022]
Abstract
PURPOSE Eicosanoids with vasodilating and angiogenic properties have been postulated to be effective therapies for critical leg ischemia (CLI) secondary to atherosclerotic peripheral arterial disease. The ability to deliver active drug to the site of action at adequate doses for sufficient duration has been a major limitation in the clinical development of such therapies. Lipo-ecraprost is a lipid-encapsulated prostaglandin E1 prodrug with the potential to deliver active prostaglandin to the site of critical arterial ischemia. The current trial was designed to test the hypothesis that lipo-ecraprost would improve amputation-free survival in patients with CLI who had no revascularization options. METHODS The study was randomized, multicenter, double blind, and placebo controlled. Patients who met clinical and hemodynamic criteria were randomized to receive placebo or lipo-ecraprost (60 microg) administered intravenously on each of 5 days per week, for a total of 8 weeks. The study's primary endpoint was the rate of a composite end point of death or amputation above the level of the ankle at 180 days (6 months). RESULTS The study was terminated on a recommendation from the Data and Safety Monitoring Board after the completion of a protocol-specified interim analysis for futility. At the time of termination, 383 of the planned 560 patients had been randomized, of which 379 received at least one dose of study medication and thus were included in the intention-to-treat population. Twenty-three patients were lost to follow-up and were not available for 6-month assessments. At 6 months of follow-up, there were 23 amputations in the 177 patients who received placebo, and 29 amputations in the 179 patients randomized to lipo-ecraprost. At 6 months, 10 deaths had occurred in the placebo group and 18 deaths had occurred in the lipo-ecraprost arm. Changes in lower-extremity hemodynamics over the 6-month study period did not differ between the placebo and lipo-ecraprost treatment arms. CONCLUSION Intensive treatment with lipo-ecraprost failed to modify the 6-month amputation rate in patients with CLI who were not candidates for revascularization.
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Affiliation(s)
- Eric P Brass
- Harbor-UCLA Medical Center for Clinical Pharmacology, Torrance, California 90502, USA.
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Wang B, Ansari R, Sun Y, Postlethwaite AE, Weber KT, Kiani MF. The scar neovasculature after myocardial infarction in rats. Am J Physiol Heart Circ Physiol 2005; 289:H108-13. [PMID: 15722410 DOI: 10.1152/ajpheart.00001.2005] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A series of novel techniques, adapted from the field of tumor biology, were developed to quantify vascular structure and function and to explore the role of ANG II receptor AT1 in cardiac remodeling after myocardial infarction (MI). We examined the scar neovasculature at 1-4 wk post-MI in Sprague-Dawley rats with a view toward its ability to deliver and exchange oxygen. CD31 and DiOC7(3) staining was used to visualize anatomical vessels vs. those perfused. EF5/Cy3 immunohistochemical staining was used to quantify tissue hypoxia. We compared untreated controls with rats treated with losartan, an AT1 receptor antagonist. Our findings indicated that, at the infarct site, there was not only a 42-75% (1-4 wk post-MI) decrease in the number of anatomical vessels compared with controls but also a decrease in the fraction of perfused vessels from 70% in normal coronary vasculature to 48% at the infarct site. These changes were accompanied by progressive increases in diffusion distance and tissue hypoxia (100% increase in EF5/Cy3 staining at 4 wk post-MI). Losartan-treated rats exhibited a significantly less marked reduction in vascular perfusion and a significantly lesser extent of tissue hypoxia. Over the course of 4 wk post-MI, there is a reduction in coronary vasculature at the infarct site, the extent of which is attenuated by losartan. These findings implicate AT1 receptor upregulation, and perhaps angiotensin-related peptides, as being antiangiogenic.
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Affiliation(s)
- Bin Wang
- Dept. of Mechanical Engineering, 1947 North 12th St., Philadelphia, PA 19122, USA
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