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Chiu L, Agrawal V, Armstrong D, Brittain E, Collins S, Hemnes AR, Hill JA, Lindenfeld J, Shah SJ, Stevenson LW, Wang TJ, Gupta DK. Correlates of Plasma NT-proBNP/Cyclic GMP Ratio in Heart Failure With Preserved Ejection Fraction: An Analysis of the RELAX Trial. J Am Heart Assoc 2024; 13:e031796. [PMID: 38533961 PMCID: PMC11179778 DOI: 10.1161/jaha.123.031796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/28/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Phosphodiesterases degrade cyclic GMP (cGMP), the second messenger that mediates the cardioprotective effects of natriuretic peptides. High natriuretic peptide/cGMP ratio may reflect, in part, phosphodiesterase activity. Correlates of natriuretic peptide/cGMP in patients with heart failure with preserved ejection fraction are not well understood. Among patients with heart failure with preserved ejection fraction in the RELAX (Phosphodiesterase-5 Inhibition to Improve Clinical Status and Exercise Capacity in Heart Failure With Preserved Ejection Fraction) trial, we examined (1) cross-sectional correlates of circulating NT-proBNP (N-terminal pro-B-type natriuretic peptide)/cGMP ratio, (2) whether selective phosphodiesterase-5 inhibition by sildenafil changed the ratio, and (3) whether the effect of sildenafil on 24-week outcomes varied by baseline ratio. METHODS AND RESULTS In 212 subjects, NT-proBNP/cGMP ratio was calculated at randomization and 24 weeks. Correlates of the ratio and its change were examined in multivariable proportional odds models. Whether baseline ratio modified the sildenafil effect on outcomes was examined by interaction terms. Higher NT-proBNP/cGMP ratio was associated with greater left ventricular mass and troponin, the presence of atrial fibrillation, and lower estimated glomerular filtration rate and peak oxygen consumption. Compared with placebo, sildenafil did not alter the ratio from baseline to 24 weeks (P=0.17). The effect of sildenafil on 24-week change in peak oxygen consumption, left ventricular mass, or clinical composite outcome was not modified by baseline NT-proBNP/cGMP ratio (P-interaction >0.30 for all). CONCLUSIONS Among patients with heart failure with preserved ejection fraction, higher NT-proBNP/cGMP ratio associated with an adverse cardiorenal phenotype, which was not improved by selective phosphodiesterase-5 inhibition. Other phosphodiesterases may be greater contributors than phosphodiesterase-5 to the adverse phenotype associated with a high natriuretic peptide/cGMP ratio in HFpEF. REGISTRATION INFORMATION clinicaltrials.gov. Identifier: NCT00763867.
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Affiliation(s)
- Leonard Chiu
- Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Vineet Agrawal
- Division of Cardiovascular Medicine and Vanderbilt Translational and Clinical Cardiovascular Research CenterVanderbilt University Medical CenterNashvilleTNUSA
| | - David Armstrong
- Division of Cardiovascular Medicine and Vanderbilt Translational and Clinical Cardiovascular Research CenterVanderbilt University Medical CenterNashvilleTNUSA
| | - Evan Brittain
- Division of Cardiovascular Medicine and Vanderbilt Translational and Clinical Cardiovascular Research CenterVanderbilt University Medical CenterNashvilleTNUSA
| | - Sheila Collins
- Division of Cardiovascular Medicine and Vanderbilt Translational and Clinical Cardiovascular Research CenterVanderbilt University Medical CenterNashvilleTNUSA
| | - Anna R. Hemnes
- Division of Pulmonary MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Joseph A. Hill
- Department of Internal Medicine (Cardiology)University of Texas Southwestern Medical CenterDallasTXUSA
- Department of Molecular BiologyUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - JoAnn Lindenfeld
- Division of Cardiovascular Medicine and Vanderbilt Translational and Clinical Cardiovascular Research CenterVanderbilt University Medical CenterNashvilleTNUSA
| | - Sanjiv J. Shah
- Division of Cardiology, Department of Medicine and Bluhm Cardiovascular InstituteNorthwestern University Feinberg School of MedicineChicagoILUSA
| | - Lynne W. Stevenson
- Division of Cardiovascular Medicine and Vanderbilt Translational and Clinical Cardiovascular Research CenterVanderbilt University Medical CenterNashvilleTNUSA
| | - Thomas J. Wang
- Department of Internal Medicine (Cardiology)University of Texas Southwestern Medical CenterDallasTXUSA
| | - Deepak K. Gupta
- Division of Cardiovascular Medicine and Vanderbilt Translational and Clinical Cardiovascular Research CenterVanderbilt University Medical CenterNashvilleTNUSA
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Ang WF, Liao D, Koh CY, Kini RM. Unveiling the potential role of natriuretic peptide receptor a isoforms in fine-tuning the cGMP production and tissue-specific function. Sci Rep 2023; 13:20439. [PMID: 37993528 PMCID: PMC10665444 DOI: 10.1038/s41598-023-47710-8] [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: 10/10/2023] [Accepted: 11/17/2023] [Indexed: 11/24/2023] Open
Abstract
Atrial natriuretic peptide (ANP) is a peptide hormone that regulates blood pressure and volume. ANP interacts with natriuretic peptide receptor-A (NPR-A) to lower the blood pressure through vasodilation, diuresis and natriuresis. Previously, we designed two human ANP analogues, one with exclusively diuretic function (DGD-ANP) and the other with exclusively vasodilatory function (DRD-ANP). Although both ANP analogues interact with NPR-A, their ability to produce cGMP was different. Three alternatively spliced isoforms of NPR-A were previously identified in rodents. Here, we evaluated the putative human isoforms for their cGMP production independently and in combination with WT NPR-A in various percentages. All three NPR-A isoforms failed to produce cGMP in the presence of ANP, DGD-ANP, or DRD-ANP. Co-expression of isoforms with WT NPR-A were found to significantly impair cGMP production. Considering the differential tissue expression levels of all three spliced isoforms in rodents have previously been demonstrated, the existence of these non-functional receptor isoforms may act as negative regulator for ANP/NPR-A activation and fine-tune cGMP production by WT NPR-A to different degree in different tissues. Thus, NPR-A isoforms potentially contribute to tissue-specific functions of ANP.
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Affiliation(s)
- Wei Fong Ang
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, 117558, Singapore
- NUS Graduate School of Integrative Sciences and Engineering, National University of Singapore, Singapore, 119077, Singapore
| | - Dan Liao
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117559, Singapore
| | - Cho Yeow Koh
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117559, Singapore.
| | - R Manjunatha Kini
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, 117558, Singapore.
- NUS Graduate School of Integrative Sciences and Engineering, National University of Singapore, Singapore, 119077, Singapore.
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117600, Singapore.
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Monocrotaline-Induced Pulmonary Arterial Hypertension and Bosentan Treatment in Rats: Focus on Plasma and Erythrocyte Parameters. Pharmaceuticals (Basel) 2022; 15:ph15101227. [PMID: 36297339 PMCID: PMC9611329 DOI: 10.3390/ph15101227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/23/2022] [Accepted: 09/30/2022] [Indexed: 12/12/2022] Open
Abstract
The objective of our study was to contribute to the characterization of monocrotaline-induced pulmonary arterial hypertension (PAH) in a rat model, with emphasis on the renin-angiotensin-aldosterone system, parameters of oxidative stress, the activity of matrix metalloproteinases, and erythrocyte parameters. Moreover, we aimed to analyze the effects of bosentan. Experiments were performed on 12-week-old male Wistar rats randomly assigned to 3 groups: control, monocrotaline-treated (60 mg/kg), and monocrotaline combined with bosentan (300 mg/kg/day). Our study confirmed the well-known effects of monocrotaline administration on lungs and the right ventricle, as well as pulmonary arterial pressure. In addition, we observed activation of the alternative pathway of the renin-angiotensin system, namely an increase in angiotensin (Ang) 1-7 and Ang 1-5 together with an increase in Ang I, but without any change in Ang II level, and downregulation of aldosterone 4 weeks after monocrotaline administration. For the first time, modifications of erythrocyte Na,K-ATPase enzyme kinetics were demonstrated as well. Our observations do not support data obtained in PAH patients showing an increase in Ang II levels, increase in oxidative stress, and deterioration in RBC deformability. Although bosentan primarily targets the vascular smooth muscle, our study confirmed its antioxidant effect. The obtained data suggest that besides the known action of bosentan, it decreases heart rate and increases erythrocyte deformability, and hence could have a beneficial hemodynamic effect in the PAH condition.
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Ang WF, Koh CY, Kini RM. From Snake Venoms to Therapeutics: A Focus on Natriuretic Peptides. Pharmaceuticals (Basel) 2022; 15:ph15091153. [PMID: 36145374 PMCID: PMC9502559 DOI: 10.3390/ph15091153] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 11/26/2022] Open
Abstract
Snake venom is a cocktail of multifunctional biomolecules that has evolved with the purpose of capturing prey and for defense. These biomolecules are classified into different classes based on their functions. They include three-finger toxins, natriuretic peptides, phospholipases and metalloproteinases. The focus for this review is on the natriuretic peptide (NP), which is an active component that can be isolated from the venoms of vipers and mambas. In these venoms, NPs contribute to the lowering of blood pressure, causing a rapid loss of consciousness in the prey such that its mobility is reduced, paralyzing the prey, and often death follows. Over the past 30 years since the discovery of the first NP in the venom of the green mamba, venom NPs have shown potential in the development of drug therapy for heart failure. Venom NPs have long half-lives, different pharmacological profiles, and may also possess different functions in comparison to the mammalian NPs. Understanding their mechanisms of action provides the strategies needed to develop new NPs for treatment of heart failure. This review summarizes the venom NPs that have been identified over the years and how they can be useful in drug development.
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Affiliation(s)
- Wei Fong Ang
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore 117558, Singapore
- NUS Graduate School of Integrative Sciences and Engineering, National University of Singapore, Singapore 119077, Singapore
| | - Cho Yeow Koh
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117559, Singapore
- Correspondence: (C.Y.K.); (R.M.K.); Tel.: +65-6601-1387 (C.Y.K.); +65-6516-5235 (R.M.K.)
| | - R. Manjunatha Kini
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore 117558, Singapore
- NUS Graduate School of Integrative Sciences and Engineering, National University of Singapore, Singapore 119077, Singapore
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore
- Department of Biochemistry and Molecular Biology, Virginia Commonwealth University, Richmond, VA 23298-0614, USA
- Correspondence: (C.Y.K.); (R.M.K.); Tel.: +65-6601-1387 (C.Y.K.); +65-6516-5235 (R.M.K.)
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Niu Y, Zhang S, Gu X, Zhou T, Li F, Liu M, Wu Q, Dong N. Recombinant Soluble Corin Improves Cardiac Function in Mouse Models of Heart Failure. J Am Heart Assoc 2021; 10:e019961. [PMID: 33759549 PMCID: PMC8174325 DOI: 10.1161/jaha.120.019961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Corin is a transmembrane protease that activates ANP and BNP (atrial and B‐type natriuretic peptides). Impaired corin expression and function are associated with heart failure. In this study, we characterized a soluble form of corin (sCorin) and examined its effects on cardiac morphology and function in mouse heart failure models. Methods and Results sCorin, consisting of the full‐length extracellular fragment of human corin with an engineered activation site, was expressed in Chinese hamster ovary cells, purified from the conditioned medium with affinity chromatography, and characterized in pro‐ANP processing assays in vitro and pharmacokinetic studies in mice. Effects of sCorin on mouse models of heart failure induced by left coronary artery ligation and transverse aortic constriction were assessed by ELISA analysis of plasma markers, histologic examination, and echocardiography. We showed that purified and activated sCorin converted pro‐ANP to ANP that stimulated cGMP production in cultured cells. In mice, intravenously and intraperitoneally administered sCorin had plasma half‐lives of 3.5±0.1 and 8.3±0.3 hour, respectively. In the mouse heart failure models, intraperitoneal injection of sCorin increased plasma ANP, BNP, and cGMP levels; lowered plasma levels of NT‐proANP (N‐terminal‐pro‐ANP), angiotensin II, and aldosterone; reduced cardiac hypertrophy and fibrosis; and improved cardiac function. Conclusions We show that sCorin treatment enhanced natriuretic peptide processing and activity, suppressed the renin‐angiotensin‐aldosterone system, and improved cardiac morphology and function in mice with failing hearts.
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Affiliation(s)
- Yayan Niu
- Cyrus Tang Hematology Center Collaborative Innovation Center of Hematology State Key Laboratory of Radiation Medicine and Prevention The First Affiliated HospitalMedical CollegeSoochow University Suzhou China.,MOH Key Laboratory of Thrombosis and Hemostasis Jiangsu Institute of HematologySoochow University Suzhou China
| | - Shengnan Zhang
- Cyrus Tang Hematology Center Collaborative Innovation Center of Hematology State Key Laboratory of Radiation Medicine and Prevention The First Affiliated HospitalMedical CollegeSoochow University Suzhou China.,MOH Key Laboratory of Thrombosis and Hemostasis Jiangsu Institute of HematologySoochow University Suzhou China
| | - Xiabing Gu
- Cyrus Tang Hematology Center Collaborative Innovation Center of Hematology State Key Laboratory of Radiation Medicine and Prevention The First Affiliated HospitalMedical CollegeSoochow University Suzhou China.,MOH Key Laboratory of Thrombosis and Hemostasis Jiangsu Institute of HematologySoochow University Suzhou China
| | - Tiantian Zhou
- Cyrus Tang Hematology Center Collaborative Innovation Center of Hematology State Key Laboratory of Radiation Medicine and Prevention The First Affiliated HospitalMedical CollegeSoochow University Suzhou China
| | - Feng Li
- Cyrus Tang Hematology Center Collaborative Innovation Center of Hematology State Key Laboratory of Radiation Medicine and Prevention The First Affiliated HospitalMedical CollegeSoochow University Suzhou China.,MOH Key Laboratory of Thrombosis and Hemostasis Jiangsu Institute of HematologySoochow University Suzhou China
| | - Meng Liu
- Cyrus Tang Hematology Center Collaborative Innovation Center of Hematology State Key Laboratory of Radiation Medicine and Prevention The First Affiliated HospitalMedical CollegeSoochow University Suzhou China
| | - Qingyu Wu
- Cyrus Tang Hematology Center Collaborative Innovation Center of Hematology State Key Laboratory of Radiation Medicine and Prevention The First Affiliated HospitalMedical CollegeSoochow University Suzhou China.,Cardiovascular & Metabolic Sciences Lerner Research InstituteCleveland Clinic Cleveland OH
| | - Ningzheng Dong
- Cyrus Tang Hematology Center Collaborative Innovation Center of Hematology State Key Laboratory of Radiation Medicine and Prevention The First Affiliated HospitalMedical CollegeSoochow University Suzhou China.,MOH Key Laboratory of Thrombosis and Hemostasis Jiangsu Institute of HematologySoochow University Suzhou China
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Kini RM. Toxinology provides multidirectional and multidimensional opportunities: A personal perspective. Toxicon X 2020; 6:100039. [PMID: 32550594 PMCID: PMC7285919 DOI: 10.1016/j.toxcx.2020.100039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/28/2020] [Accepted: 05/05/2020] [Indexed: 01/16/2023] Open
Abstract
In nature, toxins have evolved as weapons to capture and subdue the prey or to counter predators or competitors. When they are inadvertently injected into humans, they cause symptoms ranging from mild discomfort to debilitation and death. Toxinology is the science of studying venoms and toxins that are produced by a wide variety of organisms. In the past, the structure, function and mechanisms of most abundant and/or most toxic components were characterized to understand and to develop strategies to neutralize their toxicity. With recent technical advances, we are able to evaluate and determine the toxin profiles using transcriptomes of venom glands and proteomes of tiny amounts of venom. Enormous amounts of data from these studies have opened tremendous opportunities in many directions of basic and applied research. The lower costs for profiling venoms will further fuel the expansion of toxin database, which in turn will provide greater exciting and bright opportunities in toxin research.
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Affiliation(s)
- R. Manjunatha Kini
- Protein Science Laboratory, Department of Biological Sciences, Faculty of Science and Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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