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Pàmies A, Llop D, Ibarretxe D, Rosales R, Masana L, Vallvé JC, Paredes S. Angiopoietin-2, vascular endothelial growth factor family, and heparin binding endothelial growth factor are associated with subclinical atherosclerosis in rheumatoid arthritis. Comput Struct Biotechnol J 2024; 23:1680-1688. [PMID: 38689721 PMCID: PMC11059138 DOI: 10.1016/j.csbj.2024.04.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/16/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Patients with RA are at a higher risk of developing CV diseases than the general population. The precise mechanisms are still unknown. We evaluated the associations between 8 plasma growth factors (GFs) (angiopoietin-2, EGF, HB-EGF, PLGF, TGF-α, VEGFa, VEGFc, and VEGFd) and subclinical arteriosclerosis in RA patients. Materials and methods A total of 199 patients with RA treated at the Hospital Universitari Sant Joan de Reus (Spain) between 2011 and 2015 were included in this cross-sectional study. Carotid intima media thickness (cIMT), carotid plaque presence (cPP) and pulse wave velocity (PWV) were measured. GFs were measured with Bio-Plex Pro Human Cancer Biomarker Panel 2 (Bio-Rad). Multivariate models and partial least square discriminant analysis (PLS-DA) were used for analysis (RStudio, version 4.0.1). Results Multivariate models showed that angiopoietin-2 was associated with cPP and PWV in the overall cohort (OR = 1.53 and β = 0.20, respectively). VEGFc (β = 0.29), VEGFa (β = 0.26) and HB-EGF (β = 0.22) were also associated with PWV. VEGFa (OR = 2.36), VEGFd (OR = 2.29), EGF (OR = 2.62), PLGF (OR = 2.54), and HB-EGF (OR = 2.24) were associated with cPP in men. According to PLS-DA, GFs were able to distinguish between patients with and without cPP in the overall cohort, male cohort, and female cohort. In women, angiopoietin-2 was associated with PWV (β = 0.18). Conclusions The selected GFs were closely related to atherosclerosis in patients with RA and are potential predictors of CV disease in patients with RA.
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Affiliation(s)
- Anna Pàmies
- Secció de Reumatologia, Hospital Verge de la Cinta, Tortosa, Spain
| | - Dídac Llop
- Unitat Medicina Vascular i Metabolisme, Unitat de Recerca en Lípids i Arteriosclerosi, Hospital Universitari Sant Joan, Universitat Rovira i Virgili, IISPV, Reus, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Daiana Ibarretxe
- Unitat Medicina Vascular i Metabolisme, Unitat de Recerca en Lípids i Arteriosclerosi, Hospital Universitari Sant Joan, Universitat Rovira i Virgili, IISPV, Reus, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Roser Rosales
- Unitat Medicina Vascular i Metabolisme, Unitat de Recerca en Lípids i Arteriosclerosi, Hospital Universitari Sant Joan, Universitat Rovira i Virgili, IISPV, Reus, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Luis Masana
- Unitat Medicina Vascular i Metabolisme, Unitat de Recerca en Lípids i Arteriosclerosi, Hospital Universitari Sant Joan, Universitat Rovira i Virgili, IISPV, Reus, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Joan-Carles Vallvé
- Unitat Medicina Vascular i Metabolisme, Unitat de Recerca en Lípids i Arteriosclerosi, Hospital Universitari Sant Joan, Universitat Rovira i Virgili, IISPV, Reus, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Silvia Paredes
- Unitat Medicina Vascular i Metabolisme, Unitat de Recerca en Lípids i Arteriosclerosi, Hospital Universitari Sant Joan, Universitat Rovira i Virgili, IISPV, Reus, Spain
- Secció de Reumatologia, Hospital Universitari Sant Joan de Reus, Reus, Spain
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McHill AW, Melanson EL, Wright KP, Depner CM. Circadian misalignment disrupts biomarkers of cardiovascular disease risk and promotes a hypercoagulable state. Eur J Neurosci 2024. [PMID: 39053917 DOI: 10.1111/ejn.16468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 06/24/2024] [Accepted: 07/01/2024] [Indexed: 07/27/2024]
Abstract
The circadian system regulates 24-h time-of-day patterns of cardiovascular physiology, with circadian misalignment resulting in adverse cardiovascular risk. Although many proteins in the coagulation-fibrinolysis axis show 24-h time-of-day patterns, it is not understood if these temporal patterns are regulated by circadian or behavioral (e.g., sleep and food intake) cycles, or how circadian misalignment influences these patterns. Thus, we utilized a night shiftwork protocol to analyze circadian versus behavioral cycle regulation of 238 plasma proteins linked to cardiovascular physiology. Six healthy men aged 26.2 ± 5.6 years (mean ± SD) completed the protocol involving two baseline days with 8-h nighttime sleep opportunities (circadian alignment), a transition to shiftwork day, followed by 2 days of simulated night shiftwork with 8-h daytime sleep opportunities (circadian misalignment). Plasma was collected for proteomics every 4 h across 24 h during baseline and during daytime sleep and the second night shift. Cosinor analyses identified proteins with circadian or behavioral cycle-regulated 24-h time-of-day patterns. Five proteins were circadian regulated (plasminogen activator inhibitor-1, angiopoietin-2, insulin-like growth factor binding protein-4, follistatin-related protein-3, and endoplasmic reticulum resident protein-29). No cardiovascular-related proteins showed regulation by behavioral cycles. Within the coagulation pathway, circadian misalignment decreased tissue factor pathway inhibitor, increased tissue factor, and induced a 24-h time-of-day pattern in coagulation factor VII (all FDR < 0.10). Such changes in protein abundance are consistent with changes observed in hypercoagulable states. Our analyses identify circadian regulation of proteins involved in cardiovascular physiology and indicate that acute circadian misalignment could promote a hypercoagulable state, possibly contributing to elevated cardiovascular disease risk among shift workers.
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Affiliation(s)
- Andrew W McHill
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Health & Science University, Portland, Oregon, USA
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, Oregon, USA
| | - Edward L Melanson
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Kenneth P Wright
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Christopher M Depner
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah, USA
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Khan H, Abu-Raisi M, Feasson M, Shaikh F, Saposnik G, Mamdani M, Qadura M. Current Prognostic Biomarkers for Abdominal Aortic Aneurysm: A Comprehensive Scoping Review of the Literature. Biomolecules 2024; 14:661. [PMID: 38927064 PMCID: PMC11201473 DOI: 10.3390/biom14060661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
Abdominal aortic aneurysm (AAA) is a progressive dilatation of the aorta that can lead to aortic rupture. The pathophysiology of the disease is not well characterized but is known to be caused by the general breakdown of the extracellular matrix within the aortic wall. In this comprehensive literature review, all current research on proteins that have been investigated for their potential prognostic capabilities in patients with AAA was included. A total of 45 proteins were found to be potential prognostic biomarkers for AAA, predicting incidence of AAA, AAA rupture, AAA growth, endoleak, and post-surgical mortality. The 45 proteins fell into the following seven general categories based on their primary function: (1) cardiovascular health, (2) hemostasis, (3) transport proteins, (4) inflammation and immunity, (5) kidney function, (6) cellular structure, (7) and hormones and growth factors. This is the most up-to-date literature review on current prognostic markers for AAA and their functions. This review outlines the wide pathophysiological processes that are implicated in AAA disease progression.
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Affiliation(s)
- Hamzah Khan
- Division of Vascular Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
| | - Mohamed Abu-Raisi
- Division of Vascular Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
| | - Manon Feasson
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
| | - Farah Shaikh
- Division of Vascular Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
| | - Gustavo Saposnik
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Muhammad Mamdani
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
| | - Mohammad Qadura
- Division of Vascular Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada
- Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
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Peker Y, Celik Y, Behboudi A, Redline S, Lyu J, Wei Y, Gottlieb DJ, Jelic S. CPAP may promote an endothelial inflammatory milieu in sleep apnoea after coronary revascularization. EBioMedicine 2024; 101:105015. [PMID: 38403558 PMCID: PMC10944158 DOI: 10.1016/j.ebiom.2024.105015] [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: 09/26/2023] [Revised: 01/22/2024] [Accepted: 02/03/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Continuous positive airway pressure (CPAP) has failed to reduce cardiovascular risk in obstructive sleep apnoea (OSA) in randomized trials. CPAP increases angiopoietin-2, a lung distension-responsive endothelial proinflammatory marker associated with increased cardiovascular risk. We investigated whether CPAP has unanticipated proinflammatory effects in patients with OSA and cardiovascular disease. METHODS Patients with OSA (apnoea-hypopnea index [AHI] ≥15 events/h without excessive sleepiness) in the Randomized Intervention with CPAP in Coronary Artery Disease and OSA study were randomized to CPAP or usual care following coronary revascularization. Changes in plasma levels of biomarkers of endothelial (angiopoietin-2, Tie-2, E-selectin, vascular endothelial growth factor [VEGF-A]) and lung epithelial (soluble receptor of advanced glycation end-products [sRAGE]) function from baseline to 12-month follow-up were compared across groups and associations with cardiovascular morbidity and mortality assessed. FINDINGS Patients with OSA (n = 189; 84% men; age 66 ± 8 years, BMI 28 ± 3.5 kg/m2, AHI 41 ± 23 events/h) and 91 patients without OSA participated. Angiopoietin-2 remained elevated whereas VEGF-A declined significantly over 12 months in the CPAP group (n = 91). In contrast, angiopoietin-2 significantly declined whereas VEGF-A remained elevated in the usual care (n = 98) and OSA-free groups. The changes in angiopoietin-2 and VEGF-A were significantly different between CPAP and usual care, whereas Tie-2, sRAGE and E-selectin were similar. Greater 12-month levels of angiopoietin-2 were associated with greater mortality. Greater CPAP levels were associated with worse cardiovascular outcomes. INTERPRETATION Greater CPAP levels increase proinflammatory, lung distension-responsive angiopoietin-2 and reduce cardioprotective angiogenic factor VEGF-A compared to usual care, which may counteract the expected cardiovascular benefits of treating OSA. FUNDING National Institutes of Health/National Heart, Lung, and Blood Institute; Swedish Research Council; Swedish Heart-Lung Foundation; ResMed Foundation.
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Affiliation(s)
- Yuksel Peker
- Koç University School of Medicine, Istanbul, Turkey; University of Gothenburg, Gothenburg, Sweden; Brigham & Women's Hospital, Boston, MA, USA; University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Lund University, Lund, Sweden
| | - Yeliz Celik
- Koç University School of Medicine, Istanbul, Turkey; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | | | | | - Jing Lyu
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Ying Wei
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Daniel J Gottlieb
- Brigham & Women's Hospital, Boston, MA, USA; VA Boston Healthcare System, Boston, MA, USA.
| | - Sanja Jelic
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
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Nakamura M, Imamura T, Ueno H, Kinugawa K. Impact of the elevated angiopoietin-2 levels during Impella support on the short-term prognosis. J Artif Organs 2023; 26:184-191. [PMID: 35932355 DOI: 10.1007/s10047-022-01347-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/06/2022] [Indexed: 10/15/2022]
Abstract
Elevated serum angiopoietin-2 levels in patients with acute myocardial infarction-related cardiogenic shock with and without intra-aortic balloon pump as well as acute decompensated heart failure are associated with short-term mortality. However, its prognostic impact in patients with cardiogenic shock supported by Impella-incorporated mechanical circulatory support (MCS) remains unknown. Patients who received temporary MCS (Impella alone or Impella and veno-arterial extracorporeal membrane oxygenation) in our institute between August 2018 and January 2022 were included in this prospective study. The serum levels of angiopoietin-2 were measured just before and following the initiation of temporary MCS therapy. Association between the levels of serum angiopoietin-2 and 30-day mortality was investigated. A total of 38 patients (median 72 years old, 63% men) were included. The median levels of serum angiopoetin-2 tended to decrease from baseline to 4 days following the initiation of temporary MCS from 5.2 (3.3, 10.5) ng/mL to 4.8 (2.7, 6.8) ng/mL (p = 0.132). A higher angiopoietin-2 (> 6.8 ng/mL) following the initiation of temporary MCS was associated with higher 30-day mortality (89.7% versus 44.4%, p = 0.0048) with an odds ratio 18.946 (95% confidence interval 1.624-218.695, p = 0.018) adjusted for potential confounders. A higher serum angiopoietin-2 level following the initiation of Impella-incorporated temporary MCS, instead of baseline angiopoetin-2 level, was associated with higher short-term mortality.
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Affiliation(s)
- Makiko Nakamura
- Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama-shi, Toyama, 930-0194, Japan
| | - Teruhiko Imamura
- Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama-shi, Toyama, 930-0194, Japan.
| | - Hiroshi Ueno
- Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama-shi, Toyama, 930-0194, Japan
| | - Koichiro Kinugawa
- Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama-shi, Toyama, 930-0194, Japan
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Benz AP, Hijazi Z, Lindbäck J, Connolly SJ, Eikelboom JW, Kastner P, Ziegler A, Alexander JH, Granger CB, Lopes RD, Oldgren J, Siegbahn A, Wallentin L. Plasma angiopoietin-2 and its association with heart failure in patients with atrial fibrillation. Europace 2023; 25:euad200. [PMID: 37461214 PMCID: PMC10359110 DOI: 10.1093/europace/euad200] [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: 05/04/2023] [Accepted: 05/24/2023] [Indexed: 07/22/2023] Open
Abstract
AIMS Several biomarkers are associated with clinical outcomes in patients with atrial fibrillation (AF), but a causal relationship has not been established. This study aimed to evaluate angiopoietin-2, a novel candidate biomarker of endothelial inflammation and vascular remodelling, in patients with AF. METHODS AND RESULTS Angiopoietin-2 was measured in plasma obtained from patients with AF treated with aspirin monotherapy (exploration cohort, n = 2987) or with oral anticoagulation (validation cohort, n = 13 079). Regression models were built to assess the associations between angiopoietin-2, clinical characteristics, and outcomes. In both cohorts, plasma angiopoietin-2 was independently associated with AF on the baseline electrocardiogram and persistent/permanent AF, age, history of heart failure, female sex, tobacco use/smoking, body mass index, renal dysfunction, diabetes, and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Angiopoietin-2 was independently associated with subsequent hospitalization for heart failure after adjusting for age, creatinine, and clinical characteristics in the exploration cohort [c-index 0.79, 95% confidence interval (CI) 0.75-0.82; third vs. first quartile, hazard ratio (HR) 1.74, 95% CI 1.26-2.41] and in the validation cohort (c-index 0.76, 95% CI 0.74-0.78; HR 1.58, 95% CI 1.37-1.82). In both cohorts, the association persisted when also adjusting for NT-proBNP (P ≤ 0.001). In full multivariable models also adjusted for NT-proBNP, angiopoietin-2 did not show statistically significant associations with ischaemic stroke, cardiovascular and all-cause death, or major bleeding that were consistent across the two cohorts. CONCLUSIONS In patients with AF, plasma levels of angiopoietin-2 were independently associated with subsequent hospitalization for heart failure and provided incremental prognostic value to clinical risk factors and NT-proBNP.
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Affiliation(s)
- Alexander P Benz
- Population Health Research Institute, McMaster University, 237 Barton St. E., Hamilton, Ontario L8L 2X2, Canada
- Department of Cardiology, University Medical Center Mainz, Johannes Gutenberg-University, Langenbeckstr. 1, Mainz 55131, Germany
| | - Ziad Hijazi
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden
| | - Johan Lindbäck
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Stuart J Connolly
- Population Health Research Institute, McMaster University, 237 Barton St. E., Hamilton, Ontario L8L 2X2, Canada
| | - John W Eikelboom
- Population Health Research Institute, McMaster University, 237 Barton St. E., Hamilton, Ontario L8L 2X2, Canada
| | | | | | - John H Alexander
- Duke Clinical Research Institute, Duke University, Durham, NC, USA
| | | | - Renato D Lopes
- Duke Clinical Research Institute, Duke University, Durham, NC, USA
| | - Jonas Oldgren
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden
| | - Agneta Siegbahn
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Lars Wallentin
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden
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Gottlieb DJ. CPAP therapy for obstructive sleep apnoea: are the right questions being asked? Eur Respir J 2023; 62:2300575. [PMID: 37474149 DOI: 10.1183/13993003.00575-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/19/2023] [Indexed: 07/22/2023]
Affiliation(s)
- Daniel J Gottlieb
- Medical Service, VA Boston Healthcare System, Boston, MA, USA
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
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8
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Shah R, Patel N, Emin M, Celik Y, Jimenez A, Gao S, Garfinkel J, Wei Y, Jelic S. Statins Restore Endothelial Protection against Complement Activity in Obstructive Sleep Apnea: A Randomized Clinical Trial. Ann Am Thorac Soc 2023; 20:1029-1037. [PMID: 36912897 DOI: 10.1513/annalsats.202209-761oc] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/13/2023] [Indexed: 03/14/2023] Open
Abstract
Rationale: Increased cardiovascular risk in obstructive sleep apnea (OSA) persists after continuous positive airway pressure (CPAP) and alternative therapies are needed. Impaired endothelial protection against complement is a cholesterol-dependent process that initiates endothelial inflammation in OSA, which increases cardiovascular risk. Objectives: To investigate directly whether lowering cholesterol improves endothelial protection against complement and its proinflammatory effects in OSA. Methods: Newly diagnosed patients with OSA (n = 87) and OSA-free controls (n = 32) participated. Endothelial cells and blood were collected at baseline, after 4 weeks of CPAP therapy, and again after 4 weeks of 10 mg atorvastatin versus placebo using a randomized, double-blind, parallel-group design. Primary outcome was the proportion of a complement inhibitor, CD59, on the endothelial cell plasma membrane in OSA patients after 4 weeks of statins versus placebo. Secondary outcomes were complement deposition on endothelial cells and circulating levels of its downstream proinflammatory factor, angiopoietin-2, after statins versus placebo. Results: Baseline expression of CD59 was lower, whereas complement deposition on endothelial cells and levels of angiopoietin-2 were greater, in patients with OSA compared with controls. CPAP did not affect expression of CD59 or complement deposition on endothelial cells in patients with OSA, regardless of adherence. Compared with placebo, statins increased expression of endothelial complement protector CD59 and lowered complement deposition in patients with OSA. Good CPAP adherence was associated with increased angiopoietin-2 levels, which was reversed by statins. Conclusions: Statins restore endothelial protection against complement and reduce its downstream proinflammatory effects, suggesting a potential approach to reduce residual cardiovascular risk after CPAP in patients with OSA. Clinical trial registered with www.clinicaltrials.gov (NCT03122639).
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Affiliation(s)
- Riddhi Shah
- Division of Pulmonary, Allergy, and Critical Care Medicine
| | | | - Memet Emin
- Division of Pulmonary, Allergy, and Critical Care Medicine
| | - Yeliz Celik
- Division of Pulmonary, Allergy, and Critical Care Medicine
| | | | - Su Gao
- Division of Pulmonary, Allergy, and Critical Care Medicine
| | - Jared Garfinkel
- Department of Biostatistics, Columbia University College of Physicians and Surgeons, New York, New York
| | - Ying Wei
- Department of Biostatistics, Columbia University College of Physicians and Surgeons, New York, New York
| | - Sanja Jelic
- Division of Pulmonary, Allergy, and Critical Care Medicine
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Jiang R, Hauser ER, Kwee LC, Shah SH, Regan JA, Huebner JL, Kraus VB, Kraus WE, Ward-Caviness CK. The association of accelerated epigenetic age with all-cause mortality in cardiac catheterization patients as mediated by vascular and cardiometabolic outcomes. Clin Epigenetics 2022; 14:165. [PMID: 36461124 PMCID: PMC9719253 DOI: 10.1186/s13148-022-01380-x] [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: 10/20/2022] [Accepted: 11/16/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Epigenetic age is a DNA methylation-based biomarker of aging that is accurate across the lifespan and a range of cell types. The difference between epigenetic age and chronological age, termed age acceleration (AA), is a strong predictor of lifespan and healthspan. The predictive capabilities of AA for all-cause mortality have been evaluated in the general population; however, its utility is less well evaluated in those with chronic conditions. Additionally, the pathophysiologic pathways whereby AA predicts mortality are unclear. We hypothesized that AA predicts mortality in individuals with underlying cardiovascular disease; and the association between AA and mortality is mediated, in part, by vascular and cardiometabolic measures. METHODS We evaluated 562 participants in an urban, three-county area of central North Carolina from the CATHGEN cohort, all of whom received a cardiac catheterization procedure. We analyzed three AA biomarkers, Horvath epigenetic age acceleration (HAA), phenotypic age acceleration (PhenoAA), and Grim age acceleration (GrimAA), by Cox regression models, to assess whether AAs were associated with all-cause mortality. We also evaluated if these associations were mediated by vascular and cardiometabolic outcomes, including left ventricular ejection fraction (LVEF), blood cholesterol concentrations, angiopoietin-2 (ANG2) protein concentration, peripheral artery disease, coronary artery disease, diabetes, and hypertension. The total effect, direct effect, indirect effect, and percentage mediated were estimated using pathway mediation tests with a regression adjustment approach. RESULTS PhenoAA (HR = 1.05, P < 0.0001), GrimAA (HR = 1.10, P < 0.0001) and HAA (HR = 1.03, P = 0.01) were all associated with all-cause mortality. The association of mortality and PhenoAA was partially mediated by ANG2, a marker of vascular function (19.8%, P = 0.016), and by diabetes (8.2%, P = 0.043). The GrimAA-mortality association was mediated by ANG2 (12.3%, P = 0.014), and showed weaker evidence for mediation by LVEF (5.3%, P = 0.065). CONCLUSIONS Epigenetic age acceleration remains strongly predictive of mortality even in individuals already burdened with cardiovascular disease. Mortality associations were mediated by ANG2, which regulates endothelial permeability and angiogenic functions, suggesting that specific vascular pathophysiology may link accelerated epigenetic aging with increased mortality risks.
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Affiliation(s)
- Rong Jiang
- grid.26009.3d0000 0004 1936 7961Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC USA
| | - Elizabeth R. Hauser
- grid.26009.3d0000 0004 1936 7961Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC USA
| | - Lydia Coulter Kwee
- grid.26009.3d0000 0004 1936 7961Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC USA
| | - Svati H. Shah
- grid.26009.3d0000 0004 1936 7961Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Division of Cardiology, Department of Medicine, Duke University School of Medicine, Duke University, Durham, NC USA
| | - Jessica A. Regan
- grid.26009.3d0000 0004 1936 7961Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Division of Cardiology, Department of Medicine, Duke University School of Medicine, Duke University, Durham, NC USA
| | - Janet L. Huebner
- grid.26009.3d0000 0004 1936 7961Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC USA
| | - Virginia B. Kraus
- grid.26009.3d0000 0004 1936 7961Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC USA
| | - William E. Kraus
- grid.26009.3d0000 0004 1936 7961Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Division of Cardiology, Department of Medicine, Duke University School of Medicine, Duke University, Durham, NC USA
| | - Cavin K. Ward-Caviness
- grid.418698.a0000 0001 2146 2763Center for Public Health and Environmental Assessment, US Environmental Protection Agency, Chapel Hill, NC USA
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10
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Varricchi G, Poto R, Ferrara AL, Gambino G, Marone G, Rengo G, Loffredo S, Bencivenga L. Angiopoietins, vascular endothelial growth factors and secretory phospholipase A 2 in heart failure patients with preserved ejection fraction. Eur J Intern Med 2022; 106:111-119. [PMID: 36280524 DOI: 10.1016/j.ejim.2022.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/27/2022] [Accepted: 10/17/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Heart failure (HF) is a growing public health burden, with high prevalence and mortality rates. A proportion of patients with HF have a normal ventricular ejection fraction (EF), referred to as HF with preserved EF (HFpEF), as opposed to patients with HF with reduced ejection fraction (HFrEF). HFpEF currently accounts for about 50% of all HF patients, and its prevalence is rising. Angiopoietins (ANGPTs), vascular endothelial growth factors (VEGFs) and secretory phospholipases A2 (sPLA2s) are proinflammatory mediators and key regulators of endothelial cells. METHODS The aim of this study was to analyze the plasma concentrations of angiogenic (ANGPT1, ANGPT2, VEGF-A) and lymphangiogenic (VEGF-C, VEGF-D) factors and the plasma activity of sPLA2 in patients with HFpEF and HFrEF compared to healthy controls. RESULTS The concentration of ANGPT1 was reduced in HFrEF compared to HFpEF patients and healthy controls. ANGPT2 levels were increased in both HFrEF and HFpEF subjects compared to controls. The ANGPT2/ANGPT1 ratio was increased in HFrEF patients compared to controls. The concentrations of both VEGF-A and VEGF-C did not differ among the three groups examined. VEGF-D was increased in both HFrEF and HFpEF patients compared to controls. Plasma activity of sPLA2 was increased in HFrEF but not in HFpEF patients compared to controls. CONCLUSIONS Our results indicate that three different classes of proinflammatory regulators of vascular permeability and smoldering inflammation are selectively altered in HFrEF or HFpEF patients. Studies involving larger cohorts of these patients will be necessary to demonstrate the clinical implications of our findings.
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Affiliation(s)
- Gilda Varricchi
- Department of Translational Medical Sciences, University of Naples Federico II, 80131, Naples, Italy; Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131, Naples, Italy; World Allergy Organization (WAO), Center of Excellence, 80131, Naples, Italy; Institute of Experimental Endocrinology and Oncology "G. Salvatore" (IEOS), National Research Council (CNR), 80131, Naples, Italy.
| | - Remo Poto
- Department of Translational Medical Sciences, University of Naples Federico II, 80131, Naples, Italy; World Allergy Organization (WAO), Center of Excellence, 80131, Naples, Italy; Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, 00161, Rome, Italy
| | - Anne Lise Ferrara
- Department of Translational Medical Sciences, University of Naples Federico II, 80131, Naples, Italy; World Allergy Organization (WAO), Center of Excellence, 80131, Naples, Italy; Institute of Experimental Endocrinology and Oncology "G. Salvatore" (IEOS), National Research Council (CNR), 80131, Naples, Italy
| | - Giuseppina Gambino
- Department of Translational Medical Sciences, University of Naples Federico II, 80131, Naples, Italy
| | - Gianni Marone
- Department of Translational Medical Sciences, University of Naples Federico II, 80131, Naples, Italy; Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131, Naples, Italy; World Allergy Organization (WAO), Center of Excellence, 80131, Naples, Italy; Institute of Experimental Endocrinology and Oncology "G. Salvatore" (IEOS), National Research Council (CNR), 80131, Naples, Italy
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, University of Naples Federico II, 80131, Naples, Italy; Istituti Clinici Scientifici Maugeri SpA Società Benefit, 82037, Telese, (BN), Italy
| | - Stefania Loffredo
- Department of Translational Medical Sciences, University of Naples Federico II, 80131, Naples, Italy; Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131, Naples, Italy; World Allergy Organization (WAO), Center of Excellence, 80131, Naples, Italy; Institute of Experimental Endocrinology and Oncology "G. Salvatore" (IEOS), National Research Council (CNR), 80131, Naples, Italy
| | - Leonardo Bencivenga
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131, Naples, Italy; Gèrontopole de Toulouse, Institut du Vieillissement, CHU de Toulouse, 31000, Toulouse, France
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11
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Gottlieb DJ, Lederer DJ, Kim JS, Tracy RP, Gao S, Redline S, Jelic S. Effect of positive airway pressure therapy of obstructive sleep apnea on circulating Angiopoietin-2. Sleep Med 2022; 96:119-121. [PMID: 35636149 PMCID: PMC9813950 DOI: 10.1016/j.sleep.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 04/27/2022] [Accepted: 05/11/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) has been identified as a possible contributor to interstitial lung disease. While positive airway pressure (PAP) is effective therapy for OSA, it causes large increases in lung volumes during the night that are potentially deleterious, analogous to ventilator-induced lung injury, although this has not been previously studied. The goal of this study was to assess the impact of PAP therapy on four biomarkers of alveolar epithelial and endothelial injury and extracellular matrix remodeling in patients with OSA. METHODS In 82 patients with moderate to severe OSA who were adherent to PAP therapy, surfactant protein D, osteopontin, angiopoietin-2, and matrix metalloprotease-7 were measured by ELISA in serum samples collected before and 3- to 6-months after initiation of PAP therapy. RESULTS An increase in angiopoietin-2 level of 0.28 ng/mL following PAP therapy was observed (p = 0.007). This finding was replicated in an independent sample of OSA patients. No significant change was detected in surfactant protein D, osteopontin, or matrix metalloprotease-7. CONCLUSIONS This finding raises concern for a possible adverse impact of PAP therapy on vascular endothelium.
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Affiliation(s)
- Daniel J. Gottlieb
- Medical Service, VA Boston Healthcare System, Boston, MA, USA,Brigham & Women’s Hospital, Boston, MA, USA,Corresponding author. Medical Service, VA Boston Healthcare System, Boston, MA, USA. (D.J. Gottlieb)
| | | | - John S. Kim
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Russell P. Tracy
- University of Vermont Larner College of Medicine, Colchester, VT, USA
| | - Su Gao
- Columbia University Medical Center, New York, NY, USA
| | | | - Sanja Jelic
- Columbia University Medical Center, New York, NY, USA
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12
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Chu C, Chen X, Hasan AA, Szakallova A, Krämer BK, Tepel M, Hocher B. Angiopoietin-2 predicts all-cause mortality in male but not female end-stage kidney disease patients on hemodialysis. Nephrol Dial Transplant 2021; 37:1348-1356. [PMID: 34792167 PMCID: PMC9217660 DOI: 10.1093/ndt/gfab332] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Indexed: 11/29/2022] Open
Abstract
Background Angiopoietin-2 (Ang-2) plays a pivotal role in pathological vascular remodeling and angiogenesis. Both vascular mechanisms are active in patients with end-stage renal disease (ESRD) and may contribute to the high mortality in these patients. The aim of this multicenter prospective cohort study was to investigate baseline serum Ang-2 concentrations in ESRD patients on hemodialysis (HD) for their ability to predict all-cause mortality. Methods We conducted a prospective cohort study in 340 stable HD patients from different chronic dialysis centers in Berlin, Germany. The primary endpoint was all-cause mortality during a 5-year follow-up period. Blood samples and clinical data were collected at baseline. Serum Ang-2 was measured with a validated enzyme-linked immunosorbent assay (Biomedica, Vienna, Austria). Results A total of 313 HD patients (206 men and 107 women) were finally included in the study. Receiver operating characteristic (ROC) analysis of Ang-2 concentrations yielded an area under the curve (AUC) of 0.65 (P < 0.0001) for predicting all-cause mortality in the entire study population and was used to determine the optimal cut-off (111.0 pmol/L) for all-cause mortality. Kaplan–Meier survival analysis indicated that male but not female end-stage kidney disease patients on HD with higher Ang-2 concentrations had a significantly lower survival (log-rank test, P < 0.0001 and P = 0.380 for male and female patients, respectively). Multivariable Cox regression analyses adjusted for age, comorbidity, smoking, dialysis vintage, serum creatinine, hemoglobin, C-reactive protein, serum albumin, intact parathyroid hormone (iPTH), low-density lipoprotein (LDL) and Kt/V likewise indicated that elevated Ang-2 concentrations are associated with all-cause mortality in male {hazard ratio [HR] 3.294 [95% confidence interval (CI) 1.768–6.138]; P = 0.0002} but not in female end-stage kidney disease patients on HD [HR 1.084 (95% CI 0.476–2.467); P = 0.847]. Conclusion Ang-2 at baseline is independently associated with all-cause mortality in male ESRD patients on HD.
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Affiliation(s)
- Chang Chu
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.,Department of Nephrology, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Xin Chen
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.,Department of Nephrology, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Ahmed A Hasan
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | | | - Bernhard K Krämer
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.,European Center for Angioscience ECAS, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Martin Tepel
- Department of Nephrology, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany.,Department of Nephrology, Odense University Hospital, Odense, Denmark
| | - Berthold Hocher
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.,Institute of Medical Diagnostics, IMD Berlin-Potsdam, Berlin, Germany.,Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China.,Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
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13
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Aarsetøy R, Ueland T, Aukrust P, Michelsen AE, de la Fuente RL, Pönitz V, Brügger-Andersen T, Grundt H, Staines H, Nilsen DWT. Angiopoietin-2 and angiopoietin-like 4 protein provide prognostic information in patients with suspected acute coronary syndrome. J Intern Med 2021; 290:894-909. [PMID: 34237166 DOI: 10.1111/joim.13339] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Plasma levels of angiopoietin-2 (ANGPT2) and angiopoietin-like 4 protein (ANGPTL4) reflect different pathophysiological aspects of cardiovascular disease. We evaluated their association with outcome in a hospitalized Norwegian patient cohort (n = 871) with suspected acute coronary syndrome (ACS) and validated our results in a similar Argentinean cohort (n = 982). METHODS A cox regression model, adjusting for traditional cardiovascular risk factors, was fitted for ANGPT2 and ANGPTL4, respectively, with all-cause mortality and cardiac death within 24 months and all-cause mortality within 60 months as the dependent variables. RESULTS At 24 months follow-up, 138 (15.8%) of the Norwegian and 119 (12.1%) of the Argentinian cohort had died, of which 86 and 66 deaths, respectively, were classified as cardiac. At 60 months, a total of 259 (29.7%) and 173 (17.6%) patients, respectively, had died. ANGPT2 was independently associated with all-cause mortality in both cohorts at 24 months [hazard ratio (HR) 1.27 (95% confidence interval (CI), 1.08-1.50) for Norway, and HR 1.57 (95% CI, 1.27-1.95) for Argentina], with similar results at 60 months [HR 1.19 (95% CI, 1.05-1.35) (Norway), and HR 1.56 (95% CI, 1.30-1.88) (Argentina)], and was also significantly associated with cardiac death [HR 1.51 (95% CI, 1.14-2.00)], in the Argentinean population. ANGPTL4 was significantly associated with all-cause mortality in the Argentinean cohort at 24 months [HR 1.39 (95% CI, 1.15-1.68)] and at 60 months [HR 1.43 (95% CI, 1.23-1.67)], enforcing trends in the Norwegian population. CONCLUSIONS ANGPT2 and ANGPTL4 were significantly associated with outcome in similar ACS patient cohorts recruited on two continents. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT00521976. ClinicalTrials.gov Identifier: NCT01377402.
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Affiliation(s)
- Reidun Aarsetøy
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Annika E Michelsen
- Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | | | - Volker Pönitz
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
| | | | - Heidi Grundt
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Respiratory Medicine, Stavanger University Hospital, Stavanger, Norway
| | | | - Dennis W T Nilsen
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
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14
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Ricciardi CA, Gnudi L. Vascular growth factors as potential new treatment in cardiorenal syndrome in diabetes. Eur J Clin Invest 2021; 51:e13579. [PMID: 33942293 DOI: 10.1111/eci.13579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/11/2021] [Accepted: 04/21/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cardiorenal syndrome in diabetes is characterised by alterations of the cardiovascular system paralleled by kidney disease with progressive renal function decline. In diabetes, chronic metabolic and haemodynamic perturbations drive endothelial dysfunction, inflammation, oxidative stress and progressive tissue fibrosis which, in turn, lead to heart and renal anatomo-functional damage. In physiology, vascular growth factors have been implicated in vascular homeostasis; their imbalance, in disease setting such as diabetes, leads to vascular dysfunction and cardiorenal damage. AIMS To define the role of vascular growth factors and angiopoietins in cardiorenal syndrome. MATERIAL AND METHODS We will focus on the two most studied vascular growth factors, vascular endothelial growth factor (VEGF) and angiopoietins (Angpt). The balance and crosstalk between these growth factors are important in organ development and in the maintenance of a healthy vasculature, heart and kidney. The observed alterations in expression/function of these vascular growth factors, as seen in diabetes, are a protective response against external perturbations. RESULTS The chronic insults driving diabetes-mediated cardiorenal damage results in a paradoxical situation, whereby the vascular growth factors imbalance becomes a mechanism of disease. Studies have explored the possibility of modulating the expression/action of vascular growth factors to improve disease outcome. Experimental work has been conducted in animals and has been gradually translated in humans. DISCUSSION Difficulties have been encountered especially when considering the magnitude, timing and duration of interventions targeting a selective vascular growth factor. Targeting VEGF in cardiovascular disease has been challenging, while modulation of the Angpt system seems more promising. CONCLUSION Future studies will establish the translatability of therapies targeting vascular growth factors for heart and kidney disease in patients with diabetes.
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Affiliation(s)
- Carlo Alberto Ricciardi
- Section Vascular Biology and Inflammation, School of Cardiovascular Medicine & Sciences, British Heart Foundation Centre for Research Excellence, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Luigi Gnudi
- Section Vascular Biology and Inflammation, School of Cardiovascular Medicine & Sciences, British Heart Foundation Centre for Research Excellence, Faculty of Life Sciences & Medicine, King's College London, London, UK
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15
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Peplinski BS, Houston BA, Bluemke DA, Kawut SM, Kolb TM, Kronmal RA, Lima JAC, Ralph DD, Rayner SG, Steinberg ZL, Tedford RJ, Leary PJ. Associations of Angiopoietins With Heart Failure Incidence and Severity. J Card Fail 2021; 27:786-795. [PMID: 33872759 PMCID: PMC8277723 DOI: 10.1016/j.cardfail.2021.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/30/2021] [Accepted: 04/02/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Angiopoietin-1 and 2 (Ang1, Ang2) are important mediators of angiogenesis. Angiopoietin levels are perturbed in cardiovascular disease, but it is unclear whether angiopoietin signaling is causative, an adaptive response, or merely epiphenomenon of disease activity. METHODS AND RESULTS In a cohort free of cardiovascular disease at baseline (Multi-Ethnic Study of Atherosclerosis [MESA]), relationships between angiopoietins, cardiac morphology, and subsequent incidence of heart failure or cardiovascular death were evaluated. In cohorts with pulmonary arterial hypertension or left heart disease, associations between angiopoietins, invasive hemodynamics, and adverse clinical outcomes were evaluated. In MESA, Ang2 was associated with a higher incidence of heart failure or cardiovascular death (hazard ratio 1.21 per standard deviation, P < .001). Ang2 was associated with increased right atrial pressure (pulmonary arterial hypertension cohort) and increased wedge pressure and right atrial pressure (left heart disease cohort). Elevated Ang2 was associated with mortality in the pulmonary arterial hypertension cohort. CONCLUSIONS Ang2 was associated with incident heart failure or death among adults without cardiovascular disease at baseline and with disease severity in individuals with existing heart failure. Our finding that Ang2 is increased before disease onset and that elevations reflect disease severity, suggests Ang2 may contribute to heart failure pathogenesis.
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Affiliation(s)
| | - Brian A Houston
- Medical University of South Carolina, Department of Medicine, Charleston, SC
| | - David A Bluemke
- University of Wisconsin, Department of Radiology, Madison, WI
| | - Steven M Kawut
- Perelman School of Medicine at the University of Pennsylvania, Departments of Medicine and Epidemiology, Philadelphia, PA
| | - Todd M Kolb
- Johns Hopkins Hospital, Department of Medicine, Baltimore, MD
| | | | - Joao A C Lima
- Johns Hopkins Hospital, Department of Medicine, Baltimore, MD; Johns Hopkins Hospital, Department of Radiology, Baltimore, MD
| | - David D Ralph
- University of Washington, Department of Medicine, Seattle, WA
| | - Samuel G Rayner
- University of Washington, Department of Medicine, Seattle, WA
| | | | - Ryan J Tedford
- Medical University of South Carolina, Department of Medicine, Charleston, SC
| | - Peter J Leary
- University of Washington, Department of Medicine, Seattle, WA; University of Washington, Department of Epidemiology, Seattle, WA.
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16
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Sánchez-de-la-Torre M, Barbé F. Exploring the underlying prothrombotic mechanisms promoted by intermittent hypoxia: a potential therapeutic target? Sleep 2021; 44:6205722. [PMID: 33835163 DOI: 10.1093/sleep/zsab011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Manuel Sánchez-de-la-Torre
- Group of Precision Medicine in Chronic Diseases, Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Ferran Barbé
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Group of Traslational Research in Respiratory Medicine, Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
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17
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Gao S, Emin M, Thoma T, Pastellas K, Castagna F, Shah R, Jimenez A, Patel N, Wei Y, Jelic S. Complement promotes endothelial von Willebrand factor and angiopoietin-2 release in obstructive sleep apnea. Sleep 2020; 44:6044216. [PMID: 33351148 PMCID: PMC8033461 DOI: 10.1093/sleep/zsaa286] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/03/2020] [Indexed: 01/13/2023] Open
Abstract
STUDY OBJECTIVE Obstructive sleep apnea (OSA) is highly prevalent and triples vascular thromboembolic risk. Intermittent hypoxia (IH) during transient cessation of breathing in OSA impairs endothelial protection against complement. Complement activation stimulates the endothelial release of a pro-thrombotic von Willebrand factor (vWF). We investigated whether increased complement activity in OSA promotes the endothelial release of vWF and pro-inflammatory angiopoietin-2. We further investigated whether improving complement protection with statins reverses these changes. METHODS Using endothelial cells (ECs) and blood collected from OSA patients (n = 109) and controls (n = 67), we assessed whether altered cellular localization of complement inhibitor CD59 in OSA modulates exocytosis of Weibel-Palade bodies (WPB), secretory granules that store vWF and angiopoietin-2. These interactions were also assessed in vitro in ECs exposed to normoxia or IH with or without recombinant complement C9 and with or without atorvastatin. RESULTS Circulating levels of angiopoietin-2 were greater in OSA than controls and levels of vWF cleavage products correlated with OSA severity. In cultured ECs, IH enhanced complement-stimulated angiopoietin-2 and vWF release by reducing EC surface and increasing intracellular expression of complement inhibitor CD59. Intracellular CD59 co-localized with WPB in OSA. IH increased binding of intracellular CD59 to syntaxin-3, which dissociated syntaxin-3 from voltage-sensitive calcium channel Cav1.2, and activated WPB exocytosis in a calcium-dependent manner. Atorvastatin reversed IH-enhanced endothelial release of vWF and angiopoietin-2. CONCLUSIONS IH promotes the complement-mediated release of vWF and angiopoietin-2, which may contribute to pro-thrombotic and pro-inflammatory conditions in OSA. Statin reversed these effects, suggesting a potential approach to reduce cardiovascular risk in OSA.
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Affiliation(s)
- Su Gao
- Division of Pulmonary, Allergy, and Critical Care Medicine
| | - Memet Emin
- Division of Pulmonary, Allergy, and Critical Care Medicine
| | | | | | | | - Riddhi Shah
- Division of Pulmonary, Allergy, and Critical Care Medicine
| | | | - Neha Patel
- Division of Pulmonary, Allergy, and Critical Care Medicine
| | - Ying Wei
- Division of Biostatistics, Columbia University College of Physicians and Surgeons, New York, NY
| | - Sanja Jelic
- Division of Pulmonary, Allergy, and Critical Care Medicine,Corresponding author. Sanja Jelic, Columbia University College of Physicians and Surgeons, Division of Pulmonary, Allergy, and Critical Care Medicine, 630 West 168th Street, PH8 Center, Room 101, New York, NY 10032.
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18
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Higher serum angiopoietin 2 levels are independently associated with coronary microvascular dysfunction in patients with angina in the absence of obstructive coronary artery disease. Chin Med J (Engl) 2020; 133:1662-1668. [PMID: 32541356 PMCID: PMC7401764 DOI: 10.1097/cm9.0000000000000812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Angiopoietin-2 (Ang-2) is a type of endothelial growth factor involved in angiogenesis and vascular remodeling. Circulating Ang-2 levels are elevated in patients with obstructive coronary artery disease (CAD). This study aimed to evaluate the association between serum Ang-2 levels and coronary microvascular dysfunction in patients without obstructive CAD. Methods A total of 125 patients with angina in the absence of obstructive CAD were included in this cross-sectional study. Coronary flow reserve (CFR) was measured in the distal left anterior descending coronary artery by trans-thoracic Doppler echocardiography. The patients were divided into the following two sub-groups according to CFR: the impaired CFR group with CFR values <2.5 and the preserved CFR group with CFR values ≥2.5. Serum Ang-2 levels were determined using enzyme-linked immunosorbent assay. Independent predictors for impaired CFR were identified by binary logistic regression analysis. The receiver-operating characteristic curve was determined to evaluate the ability of serum Ang-2 in predicting impaired CFR. Results We found that age, percentage of female sex, N-terminal pro-B-type natriuretic peptide levels, Ang-2 levels (763.3 ± 264.9 vs. 579.7 ± 169.3 pg/mL, P < 0.001), and the left atrial volume index were significantly higher in patients with impaired CFR than in patients with preserved CFR. Serum Ang-2 levels were negatively correlated with CFR (r = −0.386, P < 0.001). Binary logistic regression analysis showed that Ang-2 (odds ratio: 1.004, 95% confidence interval [CI]: 1.001–1.006, P = 0.003) and age (odds ratio: 1.088, 95% CI: 1.023–1.156, P = 0.007) were independently associated with impaired CFR. Furthermore, Ang-2 was a significant predictor of impaired CFR on the receiver-operating characteristic curve (P < 0.001). The area under the curve was 0.712 (95% CI: 0.612–0.813). Conclusions High serum Ang-2 levels are independently associated with impaired CFR in patients with angina in the absence of obstructive CAD.
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19
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Varricchi G, Loffredo S, Bencivenga L, Ferrara AL, Gambino G, Ferrara N, de Paulis A, Marone G, Rengo G. Angiopoietins, Vascular Endothelial Growth Factors and Secretory Phospholipase A 2 in Ischemic and Non-Ischemic Heart Failure. J Clin Med 2020; 9:jcm9061928. [PMID: 32575548 PMCID: PMC7356305 DOI: 10.3390/jcm9061928] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 02/06/2023] Open
Abstract
Heart failure (HF) is a growing public health burden, with high prevalence and mortality rates. In contrast to ischemic heart failure (IHF), the diagnosis of non-ischemic heart failure (NIHF) is established in the absence of coronary artery disease. Angiopoietins (ANGPTs), vascular endothelial growth factors (VEGFs) and secretory phospholipases A2 (sPLA2s) are proinflammatory mediators and key regulators of endothelial cells. In the present manuscript, we analyze the plasma concentrations of angiogenic (ANGPT1, ANGPT2, VEGF-A) and lymphangiogenic (VEGF-C, VEGF-D) factors and the plasma activity of sPLA2 in patients with IHF and NIHF compared to healthy controls. The concentrations of ANGPT1, ANGPT2 and their ratio significantly differed between HF patients and healthy controls. Similarly, plasma levels of VEGF-D and sPLA2 activity were higher in HF as compared to controls. Concentrations of ANGPT2 and the ANGPT2/ANGPT1 ratio (an index of vascular permeability) were increased in NIHF patients. VEGF-A and VEGF-C concentrations did not differ among the three examined groups. Interestingly, VEGF-D was selectively increased in IFH patients compared to controls. Plasma activity of sPLA2 was increased in IHF and NIHF patients compared to controls. Our results indicate that several regulators of vascular permeability and smoldering inflammation are specifically altered in IHF and NIHF patients. Studies involving larger cohorts of these patients will be necessary to demonstrate the clinical implications of our findings.
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Affiliation(s)
- Gilda Varricchi
- Department of Translational Medical Sciences, University of Naples Federico II, 80100 Naples, Italy; (L.B.); (A.L.F.); (G.G.); (N.F.); (A.d.P.); (G.M.); (G.R.)
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80100 Naples, Italy
- World Allergy Organization (WAO), Center of Excellence, 80100 Naples, Italy
- Institute of Experimental Endocrinology and Oncology “G. Salvatore” (IEOS), National Research Council (CNR), 80100 Naples, Italy
- Correspondence: (G.V.); (S.L.)
| | - Stefania Loffredo
- Department of Translational Medical Sciences, University of Naples Federico II, 80100 Naples, Italy; (L.B.); (A.L.F.); (G.G.); (N.F.); (A.d.P.); (G.M.); (G.R.)
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80100 Naples, Italy
- World Allergy Organization (WAO), Center of Excellence, 80100 Naples, Italy
- Institute of Experimental Endocrinology and Oncology “G. Salvatore” (IEOS), National Research Council (CNR), 80100 Naples, Italy
- Correspondence: (G.V.); (S.L.)
| | - Leonardo Bencivenga
- Department of Translational Medical Sciences, University of Naples Federico II, 80100 Naples, Italy; (L.B.); (A.L.F.); (G.G.); (N.F.); (A.d.P.); (G.M.); (G.R.)
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80100 Naples, Italy
| | - Anne Lise Ferrara
- Department of Translational Medical Sciences, University of Naples Federico II, 80100 Naples, Italy; (L.B.); (A.L.F.); (G.G.); (N.F.); (A.d.P.); (G.M.); (G.R.)
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80100 Naples, Italy
- World Allergy Organization (WAO), Center of Excellence, 80100 Naples, Italy
| | - Giuseppina Gambino
- Department of Translational Medical Sciences, University of Naples Federico II, 80100 Naples, Italy; (L.B.); (A.L.F.); (G.G.); (N.F.); (A.d.P.); (G.M.); (G.R.)
| | - Nicola Ferrara
- Department of Translational Medical Sciences, University of Naples Federico II, 80100 Naples, Italy; (L.B.); (A.L.F.); (G.G.); (N.F.); (A.d.P.); (G.M.); (G.R.)
| | - Amato de Paulis
- Department of Translational Medical Sciences, University of Naples Federico II, 80100 Naples, Italy; (L.B.); (A.L.F.); (G.G.); (N.F.); (A.d.P.); (G.M.); (G.R.)
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80100 Naples, Italy
- World Allergy Organization (WAO), Center of Excellence, 80100 Naples, Italy
| | - Gianni Marone
- Department of Translational Medical Sciences, University of Naples Federico II, 80100 Naples, Italy; (L.B.); (A.L.F.); (G.G.); (N.F.); (A.d.P.); (G.M.); (G.R.)
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80100 Naples, Italy
- World Allergy Organization (WAO), Center of Excellence, 80100 Naples, Italy
- Institute of Experimental Endocrinology and Oncology “G. Salvatore” (IEOS), National Research Council (CNR), 80100 Naples, Italy
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, University of Naples Federico II, 80100 Naples, Italy; (L.B.); (A.L.F.); (G.G.); (N.F.); (A.d.P.); (G.M.); (G.R.)
- Istituti Clinici Scientifici Maugeri SpA Società Benefit, Via Bagni Vecchi, 1, 82037 Telese BN, Italy
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20
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Nicolini G, Forini F, Kusmic C, Iervasi G, Balzan S. Angiopoietin 2 signal complexity in cardiovascular disease and cancer. Life Sci 2019; 239:117080. [PMID: 31756341 DOI: 10.1016/j.lfs.2019.117080] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 12/12/2022]
Abstract
The angiopoietin signal transduction system is a complex of vascular-specific kinase pathways that plays a crucial role in angiogenesis and maintenance of vascular homeostasis. Angiopoietin1 (Ang1) and 2 (Ang2), the ligand proteins of the pathway, belong to a family of glycoproteins that signal primarily through the transmembrane Tyrosine-kinase-2 receptor. Despite a considerable sequence homology, Ang1 and Ang2 manifest antagonistic effects in pathophysiological conditions. While Ang1 promotes the activation of survival pathways and the stabilization of the normal mature vessels, Ang2 can either favor vessel destabilization and leakage or promote abnormal EC proliferation in a context-dependent manner. Altered Ang1/Ang2 balance has been reported in various pathological conditions in association with inflammation and deregulated angiogenesis. In particular, increased Ang2 levels have been documented in human cancer and cardiovascular disease (CVD), including ischemic myocardial injury, heart failure and other cardiovascular complications secondary to diabetes, chronic renal damage and hypertension. Despite the obvious phenotypic differences, CVD and cancer share some common Ang2-dependent etiopathological mechanisms such as inflammation, epithelial (or endothelial) to mesenchymal transition, and adverse vascular network remodeling. Interestingly, both cancer and CVD are negatively affected by thyroid hormone dyshomeostasis. This review provides an overview of the complex Ang2-dependent signaling involved in CVD and cancer, as well as a survey of the related clinical literature. Moreover, on the basis of recent molecular acquisitions in an experimental model of post ischemic cardiac disease, the putative novel role of the thyroid hormone in the regulation of Ang1/Ang2 balance is also briefly discussed.
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Affiliation(s)
| | - Francesca Forini
- Institute of Clinical Physiology, CNR, Via G.Moruzzi 1, 56124 Pisa, Italy.
| | - Claudia Kusmic
- Institute of Clinical Physiology, CNR, Via G.Moruzzi 1, 56124 Pisa, Italy.
| | - Giorgio Iervasi
- Institute of Clinical Physiology, CNR, Via G.Moruzzi 1, 56124 Pisa, Italy.
| | - Silvana Balzan
- Institute of Clinical Physiology, CNR, Via G.Moruzzi 1, 56124 Pisa, Italy.
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21
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Davis JS, Young M, Lennox S, Jones T, Piera K, Pickles R, Oakley S. The effect of curing hepatitis C with direct-acting antiviral treatment on endothelial function. Antivir Ther 2019; 23:687-694. [PMID: 30048244 DOI: 10.3851/imp3257] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Epidemiological data suggest that chronic HCV infection (CHC) is associated with increased cardiovascular risk, but it is unknown if it is associated with endothelial dysfunction. We aimed to assess the effect of antiviral treatment on endothelial function in non-cirrhotic adults with CHC. METHODS Self-controlled before and after study. All patients had genotype-1 CHC and were treated with 12 weeks of paritaprevir/ritonavir, ombitasvir and dasabuvir (PrOD), with ribavirin added for those with genotype-1a infection. Endothelial function was assessed at three time points before antiviral treatment, at treatment weeks 1, 4, 8 and 12, and 12 weeks after the end of treatment. The main assessment tools were reactive hyperaemia peripheral arterial tonometry (RHPAT) and serum concentrations of angiopoietin-2 (Ang-2) and E-selectin. RESULTS A total of 16 patients were enrolled. Mean (sd) age was 51.4 (6.9) years and 11 participants (69%) were male. All 16 patients achieved a sustained virological response. The mean (sd) baseline RHPAT index was 2.05 (0.48), and there was no significant change during treatment (mean within-patient change from baseline to end of treatment =-0.23 [0.45]; P= not significant). There was a significant improvement in both mean Ang-2 (baseline 2.44 [0.79] ng/ml, within-patient change -0.60 [0.44]; P<0.001) and E-selectin (baseline 48.7 [21.5] ng/ml, within-patient change -14.4 [13.0]; P<0.001). CONCLUSIONS Removing HCV viraemia is associated with a significant improvement in endothelial function as measured by serum markers, but not in bedside microvascular reactivity. Chronic HCV viraemia may be associated with endothelial cell dysfunction and therefore long-term cardiovascular risk.
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Affiliation(s)
- Joshua S Davis
- Division of Medicine, John Hunter Hospital, Newcastle, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.,Menzies School of Health Research, Darwin, NT, Australia
| | - Melissa Young
- Division of Medicine, John Hunter Hospital, Newcastle, NSW, Australia
| | - Sandra Lennox
- Division of Medicine, John Hunter Hospital, Newcastle, NSW, Australia
| | - Tracey Jones
- Division of Medicine, John Hunter Hospital, Newcastle, NSW, Australia
| | - Kim Piera
- Menzies School of Health Research, Darwin, NT, Australia
| | - Robert Pickles
- Division of Medicine, John Hunter Hospital, Newcastle, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Stephen Oakley
- Division of Medicine, John Hunter Hospital, Newcastle, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
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22
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Jian W, Li L, Wei XM, Wu CQ, Gui C. Prognostic value of angiopoietin-2 for patients with coronary heart disease after elective PCI. Medicine (Baltimore) 2019; 98:e14216. [PMID: 30702576 PMCID: PMC6380730 DOI: 10.1097/md.0000000000014216] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Patients with coronary heart disease (CHD) frequently have cardiovascular complications after undergoing PCI. Angiopoietin-2 (Ang-2) is an important proangiogenic factor that also plays an important role in atherosclerosis. This study aimed to evaluate the value of Ang-2 in predicting cardiovascular events after elective PCI.This prospective study enrolled 97 patients with CHD who underwent elective PCI from 2013 to 2014. Blood samples were collected in the first morning after admission and within 24 to 48 h after PCI. The primary endpoint was cardiovascular events, defined as a composite of cardiac death, nonfatal myocardial infarction/repeat revascularization, readmission for severe deterioration of angina and readmission for new onset heart failure. Based on the median level of pre-PCI or post-PCI Ang-2, the patients were divided into a low level group and a high level group.During the whole follow-up period (mean, 53 ± 13 months), Kaplan-Meier curves of cardiovascular events showed that there was no significant difference between the two pre-PCI groups (χ = 2.22, P = .137, and log-rank test) or the two post-PCI groups (χ = 2.83, P = .093, and log-rank test). However, in a multivariable Cox regression model, landmark analysis showed that the patients in high level group of post-PCI, not pre-PCI, were associated with remarkable higher risks of cardiovascular events compared to the low level group during the first 1.5 years of follow-up (adjusted HR = 9.99, 95%CI = 1.99-50.13, P = .005). However, that was of no significance from 1.5 years to maximum follow-up years (adjusted HR = 0.82, 95%CI = 0.26-2.59, P = .733).High Ang-2 levels of post-PCI can predict the occurrence of cardiovascular events in the short to medium term.
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Affiliation(s)
- Wen Jian
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University
- Guangxi Key Laboratory Base of Precision Medicine in Cardio-Cerebrovascular Diseases Control and Prevention
- Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, Nanning
| | - Lang Li
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University
- Guangxi Key Laboratory Base of Precision Medicine in Cardio-Cerebrovascular Diseases Control and Prevention
- Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, Nanning
| | - Xiao-Min Wei
- Department of Cardiology, Gongren Hospital of Wuzhou, Wuzhou
| | - Cheng-Qiang Wu
- Department of Cardiology, The First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi, People's Republic of China
| | - Chun Gui
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University
- Guangxi Key Laboratory Base of Precision Medicine in Cardio-Cerebrovascular Diseases Control and Prevention
- Guangxi Clinical Research Center for Cardio-Cerebrovascular Diseases, Nanning
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23
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Yang X, Zhang H, Shi Y, Yu Z, Yan H, Ni Z, Qian J, Fang W. Association of serum angiopoietin-2 with malnutrition, inflammation, atherosclerosis and valvular calcification syndrome and outcome in peritoneal dialysis patients: a prospective cohort study. J Transl Med 2018; 16:312. [PMID: 30445969 PMCID: PMC6240212 DOI: 10.1186/s12967-018-1687-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/09/2018] [Indexed: 01/20/2023] Open
Abstract
Background To examine serum angiopoietin-2 (Angpt-2) in relation to malnutrition, inflammation, atherosclerosis and cardiac valvular calcification, so-called MIAC syndrome and its predictive role in outcomes of peritoneal dialysis (PD) patients. Methods A prospective observational study was conducted in 324 chronic PD patients. Biochemical analysis was performed at baseline for serum angiopoietins, albumin and high sensitive C-reactive protein (hs-CRP) and echocardiography was done to detect cardiac valvular calcification. Primary study end points were fatal or nonfatal cardiovascular events and mortality. Results The median of serum Angpt-2 levels was 5.44 ng/mL (interquartile range, 3.41–7.85). Across the three tertiles of serum Angpt-2, a significant trend effect was observed for body mass index, normalized protein catabolic rate, calcium × phosphorus product, hs-CRP, brain natriuretic peptide, lower-density lipoprotein cholesterol, left ventricular ejection fraction, total weekly urea clearance and residual renal function (all p < 0.05). Serum Angpt-2 showed a significant increase across the four groups of patients with increasing components of MIAC syndrome (p < 0.001). There were 77 deaths and 57 cardiovascular events. High serum Angpt-2 was an independent predictor of fatal and nonfatal cardiovascular events in PD patients (p = 0.02), however serum Angpt-2 was not an independent predictor of all-cause mortality (p = 0.3). Conclusions Serum Angpt-2 showed close association with valvular calcification, atherosclerosis, inflammation and malnutrition, having significant independent prognostic value and is useful for cardiovascular event stratification in chronic PD patients. Angpt-2 might be a potential mediator of increased cardiovascular risk in patients undergoing PD treatment. Electronic supplementary material The online version of this article (10.1186/s12967-018-1687-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiaoxiao Yang
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Pudong District, Shanghai, 200127, People's Republic of China.,Shanghai Center for Peritoneal Dialysis Research, Shanghai, People's Republic of China
| | - He Zhang
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Pudong District, Shanghai, 200127, People's Republic of China.,Shanghai Center for Peritoneal Dialysis Research, Shanghai, People's Republic of China
| | - Yuanyuan Shi
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Pudong District, Shanghai, 200127, People's Republic of China.,Shanghai Center for Peritoneal Dialysis Research, Shanghai, People's Republic of China
| | - Zanzhe Yu
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Pudong District, Shanghai, 200127, People's Republic of China.,Shanghai Center for Peritoneal Dialysis Research, Shanghai, People's Republic of China
| | - Hao Yan
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Pudong District, Shanghai, 200127, People's Republic of China.,Shanghai Center for Peritoneal Dialysis Research, Shanghai, People's Republic of China
| | - Zhaohui Ni
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Pudong District, Shanghai, 200127, People's Republic of China.,Shanghai Center for Peritoneal Dialysis Research, Shanghai, People's Republic of China
| | - Jiaqi Qian
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Pudong District, Shanghai, 200127, People's Republic of China.,Shanghai Center for Peritoneal Dialysis Research, Shanghai, People's Republic of China
| | - Wei Fang
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Pudong District, Shanghai, 200127, People's Republic of China. .,Shanghai Center for Peritoneal Dialysis Research, Shanghai, People's Republic of China.
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24
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Serum angiogenesis profile in gestational trophoblastic neoplasm using multiplex immunoassay. Life Sci 2018; 211:25-30. [PMID: 30195618 DOI: 10.1016/j.lfs.2018.08.070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/22/2018] [Accepted: 08/30/2018] [Indexed: 11/23/2022]
Abstract
AIMS Gestational trophoblastic neoplasms (GTN) exemplify a rare, mostly curable but highly aggressive disease. It is often associated with a rapid formation of distant metastases and most likely with an intense neoangiogenesis processes. The aim of the study was to analyze markers in serum of patients with GTN before chemotherapy compared to healthy pregnant women. MAIN METHODS In this study sixteen protein angiogenesis markers were evaluated in serum of 21 patients with GTN before chemotherapy and compared with healthy pregnant women. Markers were measured using BioPlex Pro Human Cancer Biomarker Panel 1 immunoassay. t-Tests and receiver operating characteristic curves were used for statistical analysis. KEY FINDINGS Receiver operator curve analysis identified six proteins (sTIE-2, osteopontin, sIL-6α, sVEGFR-2, sEGFR, PECAM-1) which had sufficient sensitivity and specificity (AUC > 0,70) to distinguish GTN patients before the treatment from pregnant controls. The levels of three proteins (sTIE-2, osteopontin and sIL-6α) were altered in GTN patients before the treatment as compared to healthy controls (p = 0,0112; p = 0,0442; p = 0,0488, respectively) and thereby may serve as potential disease markers. SIGNIFICANCE Serum concentration of proteins related to angiogenesis changes in the course of GTN and may appear useful in the diagnostic process of this disease.
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25
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Lee SJ, Lee CK, Kang S, Park I, Kim YH, Kim SK, Hong SP, Bae H, He Y, Kubota Y, Koh GY. Angiopoietin-2 exacerbates cardiac hypoxia and inflammation after myocardial infarction. J Clin Invest 2018; 128:5018-5033. [PMID: 30295643 DOI: 10.1172/jci99659] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 08/21/2018] [Indexed: 12/15/2022] Open
Abstract
Emerging evidence indicates that angiopoietin-2 (Angpt2), a well-recognized vascular destabilizing factor, is a biomarker of poor outcome in ischemic heart disease. However, its precise role in postischemic cardiovascular remodeling is poorly understood. Here, we show that Angpt2 plays multifaceted roles in the exacerbation of cardiac hypoxia and inflammation after myocardial ischemia. Angpt2 was highly expressed in endothelial cells at the infarct border zone after myocardial infarction (MI) or ischemia/reperfusion injury in mice. In the acute phase of MI, endothelial-derived Angpt2 antagonized Angpt1/Tie2 signaling, which was greatly involved in pericyte detachment, vascular leakage, increased adhesion molecular expression, degradation of the glycocalyx and extracellular matrix, and enhanced neutrophil infiltration and hypoxia in the infarct border area. In the chronic remodeling phase after MI, endothelial- and macrophage-derived Angpt2 continuously promoted abnormal vascular remodeling and proinflammatory macrophage polarization through integrin α5β1 signaling, worsening cardiac hypoxia and inflammation. Accordingly, inhibition of Angpt2 either by gene deletion or using an anti-Angpt2 blocking antibody substantially alleviated these pathological findings and ameliorated postischemic cardiovascular remodeling. Blockade of Angpt2 thus has potential as a therapeutic option for ischemic heart failure.
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Affiliation(s)
- Seung-Jun Lee
- Center for Vascular Research, Institute for Basic Science, Daejeon, South Korea
| | - Choong-Kun Lee
- Center for Vascular Research, Institute for Basic Science, Daejeon, South Korea.,Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Seok Kang
- Center for Vascular Research, Institute for Basic Science, Daejeon, South Korea.,Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Intae Park
- Center for Vascular Research, Institute for Basic Science, Daejeon, South Korea.,Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Yoo Hyung Kim
- Center for Vascular Research, Institute for Basic Science, Daejeon, South Korea.,Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Seo Ki Kim
- Center for Vascular Research, Institute for Basic Science, Daejeon, South Korea.,Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Seon Pyo Hong
- Center for Vascular Research, Institute for Basic Science, Daejeon, South Korea.,Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Hosung Bae
- Center for Vascular Research, Institute for Basic Science, Daejeon, South Korea.,Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Yulong He
- Cyrus Tang Hematology Center, Soochow University, Suzhou, China
| | - Yoshiaki Kubota
- The Laboratory of Vascular Biology, School of Medicine, Keio University, Tokyo, Japan
| | - Gou Young Koh
- Center for Vascular Research, Institute for Basic Science, Daejeon, South Korea.,Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
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26
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Tsai YC, Lee CS, Chiu YW, Lee JJ, Lee SC, Hsu YL, Kuo MC. Angiopoietin-2, Renal Deterioration, Major Adverse Cardiovascular Events and All-Cause Mortality in Patients with Diabetic Nephropathy. Kidney Blood Press Res 2018; 43:545-554. [PMID: 29642068 DOI: 10.1159/000488826] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 03/28/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Diabetic nephropathy is the leading cause of end-stage renal disease and accounts for 30∼40% of patients requiring maintenance dialysis, thereby increasing the burden on health insurance programs. Diabetic nephropathy is also the strongest predictor of cardiovascular morbidity and mortality. The aim of this study was to examine whether angiopoietin-2 (Angpt2), a modulator of endothelial function, affects the clinical outcomes of diabetic patients. METHODS This study enrolled 236 patients with diabetes mellitus with estimated glomerular filtration rate (eGFR) < 60ml/min/1.73m2 from January 2006 to December 2011, who were followed until June 2017. Clinical outcomes included renal outcomes (commencing dialysis and rapid decline in renal function (eGFR decline > 3 ml/min per 1.73 m2/year)), major adverse cardiovascular events (MACEs), and all-cause mortality. RESULTS Over a mean follow-up period of 3.9±2.7 years, 135 (57.2%) patients commenced dialysis, 106 (44.9%) had rapid decline in renal function, and 50 (21.2%) had MACEs or died from all-causes. Log-formed Angpt2 was significantly associated with increased risks of commencing dialysis (HR: 3.91, 95% CI: 1.56-9.76), rapid renal function decline (OR: 6.81, 95% CI: 1.06-43.88), and MACEs or all-cause mortality (HR: 6.34, 95% CI: 1.18-33.97) in the adjusted analysis. Patients in the highest quartile had hazard ratios of 2.90 and 3.11 for commencing dialysis and rapid renal function decline, respectively, compared to those in the lowest quartile after adjustments. Similar significant dose-response results were found in composite outcomes of either MACEs or all-cause mortality. CONCLUSION Angpt2 is an independent predictor of adverse clinical outcomes in diabetic patients. Further studies are needed to identify the pathogenic role of Angpt2 in renal deterioration and cardiovascular complications of diabetes mellitus.
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Affiliation(s)
- Yi-Chun Tsai
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chee-Siong Lee
- Division of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Division of Cardiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yi-Wen Chiu
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jia-Jung Lee
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Su-Chu Lee
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ya-Ling Hsu
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Mei-Chuan Kuo
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan
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27
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Wang H, Cade BE, Chen H, Gleason KJ, Saxena R, Feng T, Larkin EK, Vasan RS, Lin H, Patel SR, Tracy RP, Liu Y, Gottlieb DJ, Below JE, Hanis CL, Petty LE, Sunyaev SR, Frazier-Wood AC, Rotter JI, Post W, Lin X, Redline S, Zhu X. Variants in angiopoietin-2 (ANGPT2) contribute to variation in nocturnal oxyhaemoglobin saturation level. Hum Mol Genet 2017; 25:5244-5253. [PMID: 27798093 DOI: 10.1093/hmg/ddw324] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 09/19/2016] [Indexed: 12/30/2022] Open
Abstract
Genetic determinants of sleep-disordered breathing (SDB), a common set of disorders that contribute to significant cardiovascular and neuropsychiatric morbidity, are not clear. Overnight nocturnal oxygen saturation (SaO2) is a clinically relevant and easily measured indicator of SDB severity but its genetic contribution has never been studied. Our recent study suggests nocturnal SaO2 is heritable. We performed linkage analysis, association analysis and haplotype analysis of average nocturnal oxyhaemoglobin saturation in participants in the Cleveland Family Study (CFS), followed by gene-based association and additional tests in four independent samples. Linkage analysis identified a peak (LOD = 4.29) on chromosome 8p23. Follow-up association analysis identified two haplotypes in angiopoietin-2 (ANGPT2) that significantly contributed to the variation of SaO2 (P = 8 × 10-5) and accounted for a portion of the linkage evidence. Gene-based association analysis replicated the association of ANGPT2 and nocturnal SaO2. A rare missense SNP rs200291021 in ANGPT2 was associated with serum angiopoietin-2 level (P = 1.29 × 10-4), which was associated with SaO2 (P = 0.002). Our study provides the first evidence for the association of ANGPT2, a gene previously implicated in acute lung injury syndromes, with nocturnal SaO2, suggesting that this gene has a broad range of effects on gas exchange, including influencing oxygenation during sleep.
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Affiliation(s)
- Heming Wang
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA
| | - Brian E Cade
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Han Chen
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kevin J Gleason
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Richa Saxena
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Center for Human Genetic Research and Department of Anesthesia, Pain, and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Tao Feng
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA
| | - Emma K Larkin
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ramachandran S Vasan
- Preventive Medicine & Epidemiology, Boston University School of Medicine, Boston, MA, USA.,Framingham Heart Study, Framingham, MA
| | - Honghuang Lin
- Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Sanjay R Patel
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Russell P Tracy
- Department of Pathology & Laboratory Medicine, University of Vermont, Burlington, VT, USA
| | - Yongmei Liu
- Epidemiology and Prevention Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Daniel J Gottlieb
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Sleep Disorders Center, VA Boston Healthcare System, Boston, MA, USA
| | - Jennifer E Below
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Craig L Hanis
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Lauren E Petty
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Shamil R Sunyaev
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA.,Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Wendy Post
- Division of Cardiology, Johns Hopkins University, Baltimore, MD, USA
| | - Xihong Lin
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Xiaofeng Zhu
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA
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Hu S, Cao S, Liu J. Role of angiopoietin-2 in the cardioprotective effect of fibroblast growth factor 21 on ischemia/reperfusion-induced injury in H9c2 cardiomyocytes. Exp Ther Med 2017; 14:771-779. [PMID: 28672998 PMCID: PMC5488700 DOI: 10.3892/etm.2017.4564] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 02/10/2017] [Indexed: 11/25/2022] Open
Abstract
Fibroblast growth factor 21 (FGF21) exerts a protective effect in ischemia/reperfusion (I/R)-induced cardiac injury. However, the exact molecular mechanism underlying the FGF21 action remains unclear. The present study aimed to evaluate the role of angiopoietin-2 (Angpt2) in the cardioprotective effect of FGF21. For this purpose, the H9C2 cell line was subjected to simulated I/R or aerobic conditions with or without FGF21 administration. Certain groups were also transfected with Angpt2 small interfering RNA (siRNA). Cell viability, apoptosis rate and cell migration were examined, and the expression levels of Angpt2, glucose transporter 1 (GLUT1) and caspase-3 were measured by quantitative polymerase chain reaction (qPCR) and western blot analyses. The results demonstrated that FGF21 administration suppressed apoptosis and increased the cell migration ability following I/R-induced injury. qPCR and western blot data showed a decreased level of GLUT1 after I/R-induced injury, which was reversed by FGF21 administration. Furthermore, inhibition of Angpt2 expression using siRNA enhanced the cardioprotective effect of FGF21 by upregulation of GLUT1. In conclusion, FGF21 administration protected against I/R-induced injury in cardiomyocytes, and further inhibition of Angpt2 with FGF21 administration induced the expression of GLUT1, which may promote the energy metabolism in cardiomyocytes, consequently resulting in a more efficient cardioprotective effect. These results suggested that FGF21 administration and inhibition of Angpt2 could be a novel therapeutic approach for I/R-induced cardiac injury.
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Affiliation(s)
- Shuoqiang Hu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, P.R. China
| | - Shujun Cao
- Department of Cardiology, Beijing Daxing Hospital, Capital Medical University, Beijing 102600, P.R. China
| | - Jinghua Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, P.R. China
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Saharinen P, Eklund L, Alitalo K. Therapeutic targeting of the angiopoietin-TIE pathway. Nat Rev Drug Discov 2017; 16:635-661. [PMID: 28529319 DOI: 10.1038/nrd.2016.278] [Citation(s) in RCA: 332] [Impact Index Per Article: 47.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The endothelial angiopoietin (ANG)-TIE growth factor receptor pathway regulates vascular permeability and pathological vascular remodelling during inflammation, tumour angiogenesis and metastasis. Drugs that target the ANG-TIE pathway are in clinical development for oncological and ophthalmological applications. The aim is to complement current vascular endothelial growth factor (VEGF)-based anti-angiogenic therapies in cancer, wet age-related macular degeneration and macular oedema. The unique function of the ANG-TIE pathway in vascular stabilization also renders this pathway an attractive target in sepsis, organ transplantation, atherosclerosis and vascular complications of diabetes. This Review covers key aspects of the function of the ANG-TIE pathway in vascular disease and describes the recent development of novel therapeutics that target this pathway.
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Affiliation(s)
- Pipsa Saharinen
- Wihuri Research Institute and Translational Cancer Biology Program, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, P.O. Box 63, FI-00014 Helsinki, Finland
| | - Lauri Eklund
- Oulu Center for Cell-Matrix Research, Faculty of Biochemistry and Molecular Medicine, Biocenter Oulu, Aapistie 5A, University of Oulu, 90220 Oulu, Finland
| | - Kari Alitalo
- Wihuri Research Institute and Translational Cancer Biology Program, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, P.O. Box 63, FI-00014 Helsinki, Finland
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Affiliation(s)
- Antigone Koliopoulou
- Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Craig H Selzman
- Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah, USA
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Angiopoietin-2, Angiopoietin-1 and subclinical cardiovascular disease in Chronic Kidney Disease. Sci Rep 2016; 6:39400. [PMID: 27991547 PMCID: PMC5171919 DOI: 10.1038/srep39400] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 11/21/2016] [Indexed: 01/20/2023] Open
Abstract
Angiopoietins (Angpt) and vascular endothelial growth factor (VEGF) have been associated with cardiovascular disease. The study enrolled 270 pre-dialysis stage 3–5 CKD patients to assess the link between circulating Angpt2, Angpt1 and VEGF-A and subclinical measures of cardiovascular structure and function. Serum markers of angiogenesis were measured using commercial enzyme-linked immunosorbent assays. Cardiac structure and function were examined by echocardiography. Brachial-ankle pulse wave velocity (baPWV) was measured by the ankle-brachial index. The adjusted mean of left ventricular mass index (LVMI) was 2.05 in patients of Angpt2 quartile 4 and 1.99 in those of Angpt2 quartile 1 (P = 0.04). Angpt2 was significantly associated with LV hypertrophy (LVH) (Angpt2 quartile 4 compared with Angpt2 quartile 1: adjusted OR: 2.68, 95% CI: 1.15–6.20). Angpt1 was negatively correlated with left atrial diameter (adjusted mean of LAD: 3.59 in Angpt1 quartile 4, 3.92 in Angpt1 quartile 1, P = 0.03). A positive and significant correlation was found between Angpt2 level and baPWV in spearman’s correlation, but not in adjusted model. In conclusion, high Angpt2 and low Angpt1 levels were positively associated with abnormal cardiac structure in stages 3–5 CKD patients, which is compatible with the viewpoint that angiopoietins participates in cardiovascular burdens.
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Yeboah K, Kyei-Baafour E, Antwi DA, Asare-Anane H, Gyan B, Amoah AGB. Circulating angiogenic factors in diabetes patients in a tertiary hospital in Ghana. J Diabetes Metab Disord 2016; 15:44. [PMID: 27777900 PMCID: PMC5057505 DOI: 10.1186/s40200-016-0267-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 10/04/2016] [Indexed: 11/27/2022]
Abstract
Background Impaired angiogenesis is amongst the underlining mechanisms of organ damage in diabetes and hypertensive patients. In diabetes and hypertensive patients without proteinuria and overt CVDs, we studied the levels of angiogenic growth factors, angiopoietin (Ang)-1, Ang-2 and vascular endothelial growth factor (VEGF), and the relationship between these angiogenic growth factors and renal function, measured as estimated glomerular filtration rate (eGFR). Method In a case control design, 107 type 2 diabetes (T2DM) patients and 93 non-diabetes controls were recruited into the study. Levels of plasma glucose, lipids, creatinine and angiogenic growth factors; Ang-1, Ang-2 and VEGF measured from fasting blood samples. Estimated glomerular filtration rate (eGFR) was computed using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) algorithm and eGFR < 60 ml/min/1.73 m2 was considered to be low. Multivariable logistic regression was used to assess the odds of change in angiogenic growth factors among patients with diabetes and hypertension, and patients with low eGFR, compared to those without these conditions. Results In a total of 200 participants with 49 % females and mean age of 54.1 ± 10.2 years, 22.7 % of T2DM patients and 13.3 % of non-diabetes participant had low eGFR. The levels of Ang-1 and Ang-2 were highest in hypertensive T2DM patients, followed by patients with either T2DM or hypertension alone, with the controls having the lowest levels. The odds of change in circulating Ang-2 levels increased in patients with both diabetes and hypertension [11.76 (7.97–16.63), p < 0.01] compared to patients with either diabetes [5.45 (3.31–9.71), p = 0.02] or hypertension [5.45 (3.31–9.71), p = 0.02] alone. Compared to those with normal eGFR, the odds of change in serum Ang-2 levels were increased in patients with low eGFR in both the crude [1.26 (1.08–2.110), p = 0.023] and adjusted [1.14 (1.03–2.34), p = 0.043] regression models. Conclusion In our study population, having diabetes and hypertension increased the levels of Ang-1 and Ang-2. Also, low eGFR status was associated with increased levels of Ang-2 after adjustment for other risk factors.
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Affiliation(s)
- Kwame Yeboah
- Department of Physiology, School of Biomedical and Allied Health Sciences, University of Ghana, P O Box KB143, Korle-Bu, Accra, Ghana
| | - Eric Kyei-Baafour
- Department of Immunology, Noguchi Memorial Institute of Medical Research, University of Ghana, Accra, Ghana
| | - Daniel A Antwi
- Department of Physiology, School of Biomedical and Allied Health Sciences, University of Ghana, P O Box KB143, Korle-Bu, Accra, Ghana
| | - Henry Asare-Anane
- Department of Chemical Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Ben Gyan
- Department of Immunology, Noguchi Memorial Institute of Medical Research, University of Ghana, Accra, Ghana
| | - Albert G B Amoah
- Department of Medicine & Therapeutics, School of Medicine and Dentistry, University of Ghana, Accra, Ghana ; National Diabetes Management & Research Centre, Korle-Bu Teaching Hospital, Accra, Ghana
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Lorbeer R, Baumeister SE, Dörr M, Nauck M, Grotevendt A, Schlesinger S, Teumer A, Völzke H, Grabe HJ, Wallaschofski H, Vasan RS, Lieb W. Angiopoietin-2, its soluble receptor Tie-2, and metabolic syndrome components in a population-based sample. Obesity (Silver Spring) 2016; 24:2038-41. [PMID: 27601273 DOI: 10.1002/oby.21632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 06/30/2016] [Accepted: 07/01/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Since angiopoietin-2 (Ang-2) levels strongly correlate with cardiovascular mortality and subclinical cardiovascular disease, it was hypothesized that levels of Ang-2 and its soluble receptor (sTie-2) were associated with the metabolic syndrome (MetS) and individual MetS components. METHODS Within the population-based Study of Health in Pomerania, two sets of analyses were performed. First, Ang-2 and sTie-2 were related to the prevalence of MetS and its components cross-sectionally (n = 3,205). Second, the association between baseline Ang-2 and sTie-2 and incident MetS or longitudinal changes in its components in 1,295 individuals was investigated. RESULTS High Ang-2 levels (90th percentile), compared with low Ang-2 levels (10th percentile), were positively associated with MetS (OR: 1.78) and with the following MetS criteria: increased triglycerides, lower HDL cholesterol, and higher non-fasting glucose. Furthermore, high sTie-2 levels (90th percentile), compared with low levels (10th percentile), were positively related to MetS (OR: 1.58) and most of its components. However, Ang-2 and sTie-2 levels were not associated with incident MetS or longitudinal change in components of MetS. CONCLUSIONS Ang-2 and sTie-2 levels were cross-sectionally associated with MetS and several of its components. However, Ang-2 and sTie-2 levels were not associated with incident MetS or changes in individual MetS components during follow-up.
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Affiliation(s)
- Roberto Lorbeer
- Institute for Community Medicine, Section of Clinical Epidemiology, University Medicine, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Sebastian E Baumeister
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site, Greifswald, Germany
| | - Matthias Nauck
- DZHK (German Centre for Cardiovascular Research), Partner Site, Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - Anne Grotevendt
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | | | - Alexander Teumer
- Institute for Community Medicine, Section of Clinical Epidemiology, University Medicine, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, Section of Clinical Epidemiology, University Medicine, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site, Greifswald, Germany
| | - Hans-Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - Henri Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - Ramachandran S Vasan
- Preventive Medicine & Epidemiology Section, Boston University School of Medicine and Framingham Heart Study, Framingham, Massachusetts, USA
| | - Wolfgang Lieb
- Institute of Epidemiology, Christian Albrecht University, Kiel, Germany.
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Angiopoietin-2-induced blood-brain barrier compromise and increased stroke size are rescued by VE-PTP-dependent restoration of Tie2 signaling. Acta Neuropathol 2016; 131:753-73. [PMID: 26932603 PMCID: PMC4835530 DOI: 10.1007/s00401-016-1551-3] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 02/19/2016] [Accepted: 02/20/2016] [Indexed: 12/20/2022]
Abstract
The homeostasis of the central nervous system is maintained by the blood-brain barrier (BBB). Angiopoietins (Ang-1/Ang-2) act as antagonizing molecules to regulate angiogenesis, vascular stability, vascular permeability and lymphatic integrity. However, the precise role of angiopoietin/Tie2 signaling at the BBB remains unclear. We investigated the influence of Ang-2 on BBB permeability in wild-type and gain-of-function (GOF) mice and demonstrated an increase in permeability by Ang-2, both in vitro and in vivo. Expression analysis of brain endothelial cells from Ang-2 GOF mice showed a downregulation of tight/adherens junction molecules and increased caveolin-1, a vesicular permeability-related molecule. Immunohistochemistry revealed reduced pericyte coverage in Ang-2 GOF mice that was supported by electron microscopy analyses, which demonstrated defective intra-endothelial junctions with increased vesicles and decreased/disrupted glycocalyx. These results demonstrate that Ang-2 mediates permeability via paracellular and transcellular routes. In patients suffering from stroke, a cerebrovascular disorder associated with BBB disruption, Ang-2 levels were upregulated. In mice, Ang-2 GOF resulted in increased infarct sizes and vessel permeability upon experimental stroke, implicating a role of Ang-2 in stroke pathophysiology. Increased permeability and stroke size were rescued by activation of Tie2 signaling using a vascular endothelial protein tyrosine phosphatase inhibitor and were independent of VE-cadherin phosphorylation. We thus identified Ang-2 as an endothelial cell-derived regulator of BBB permeability. We postulate that novel therapeutics targeting Tie2 signaling could be of potential use for opening the BBB for increased CNS drug delivery or tighten it in neurological disorders associated with cerebrovascular leakage and brain edema.
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Prognostic value of angiopoietin-2 in patients with chronic heart failure. Int J Cardiol 2016; 212:364-8. [PMID: 27057957 DOI: 10.1016/j.ijcard.2016.03.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 03/12/2016] [Indexed: 12/25/2022]
Abstract
PURPOSE The analysis of biomarkers with a prognostic value in chronic heart failure (CHF) is in constant progress. This study aimed to evaluate the short-term prognostic value of angiopoietin-2 (Ang2), galectin-3 (Gal-3), myeloperoxidase (MPO), endostatin (End), and pro-brain natriuretic peptide (pro-BNP) as a conventionally accepted prognosis biomarker in CHF patients. METHODS AND RESULTS 146 consecutive patients with CHF due to left ventricular systolic dysfunction (LVEF<40% at echocardiography) were enrolled, and underwent serum/blood sample analysis after 12-h fasting. Within 1year, 25 (17%) patients died (D) or underwent heart transplantation (HT). D+HT patients showed higher values of Ang2 (Log Ang2: 8.97±0.52 vs. 8.45±0.69, p=0.0004), myeloperoxidase (MPO) (Log MPO: 5±1.1 vs. 4.2±1.3, p=0.005) and pro-BNP (Log pro-BNP: 8.70±0.9 vs. 7.45±1.3, p<0.00001). At univariate Cox regression, pro-BNP and Ang2 were the best predictors of 1-year mortality, with area under the curve (AUC)=0.78 for pro-BNP (68% sensitivity and 82% specificity to predict outcome for a cut-off value of 5109pg/mL, 95% confidence interval [CI] 0.70-0.85, p<0.0001) and AUC=0.73 for Ang2 (84% sensitivity and 61% specificity to predict outcome for a cut-off value of 5175pg/mL, 95% CI 0.65-0.80, p<0.0001). At multivariate analysis, pro-BNP was the only predictor of one-year D/HT. CONCLUSION In our series of CHF patients, Ang2 and pro-BNP showed the best predictive value for 1-year outcome, while only pro-BNP could independently predict D/HT.
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Gerstein HC, Paré G, McQueen MJ, Haenel H, Lee SF, Pogue J, Maggioni AP, Yusuf S, Hess S. Identifying Novel Biomarkers for Cardiovascular Events or Death in People With Dysglycemia. Circulation 2015; 132:2297-304. [PMID: 26518765 DOI: 10.1161/circulationaha.115.015744] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 09/24/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Serum biomarkers may identify people at risk for cardiovascular (CV) outcomes. Biobanked serum samples from 8494 participants with dysglycemia in the completed Outcome Reduction With Initial Glargine Intervention trial were assayed for 284 biomarkers to identify those that could identify people at risk for a CV outcome or death when added to clinical measurements. METHODS AND RESULTS A multiplex analysis measured a panel of cardiometabolic biomarkers in 1 mL of stored frozen serum from every participant who provided biobanked blood. After eliminating undetectable or unanalyzable biomarkers, 8401 participants who each had a set of 237 biomarkers were analyzed. Forward-selection Cox regression models were used to identify biomarkers that were each independent determinants of 3 different incident outcomes: (1) the composite of myocardial infarction, stroke, or CV death; (2) these plus heart failure hospitalization or revascularization; and (3) all-cause death. When added to clinical variables, 10 biomarkers were independent determinants of the 1405 CV composite outcomes observed during follow-up; 9 biomarkers (including 8 of these 10) were independent determinants of the 2435 expanded composite outcomes; and 15 (including the 10 CV composite biomarkers) were independent determinants of the 1340 deaths. Adjusted C statistics increased from 0.64 for the clinical variables to 0.71 and 0.68 for the 2 CV composite outcomes, respectively, with the greatest increase to 0.75 for death (P<0.001 for the change). CONCLUSIONS A systematic hypothesis-free approach identified combinations of up to 15 cardiometabolic biomarkers as independent determinants of CV outcomes or death in people with dysglycemia. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00069784.
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Affiliation(s)
- Hertzel C Gerstein
- From Population Health Research Institute (H.C.G., G.P., M.J.M., S.F.L., J.P., S.Y.) and Thrombosis and Atherosclerosis Research Institute (G.P.), Hamilton Health Sciences and McMaster University, Ontario, Canada; Sanofi Aventis Deutschland GmbH R&D Division Diabetes (H.H., S.H.), Frankfurt, Germany; and ANMCO Research Centre (A.P.M.), Florence, Italy.
| | - Guillaume Paré
- From Population Health Research Institute (H.C.G., G.P., M.J.M., S.F.L., J.P., S.Y.) and Thrombosis and Atherosclerosis Research Institute (G.P.), Hamilton Health Sciences and McMaster University, Ontario, Canada; Sanofi Aventis Deutschland GmbH R&D Division Diabetes (H.H., S.H.), Frankfurt, Germany; and ANMCO Research Centre (A.P.M.), Florence, Italy
| | - Matthew J McQueen
- From Population Health Research Institute (H.C.G., G.P., M.J.M., S.F.L., J.P., S.Y.) and Thrombosis and Atherosclerosis Research Institute (G.P.), Hamilton Health Sciences and McMaster University, Ontario, Canada; Sanofi Aventis Deutschland GmbH R&D Division Diabetes (H.H., S.H.), Frankfurt, Germany; and ANMCO Research Centre (A.P.M.), Florence, Italy
| | - Heinz Haenel
- From Population Health Research Institute (H.C.G., G.P., M.J.M., S.F.L., J.P., S.Y.) and Thrombosis and Atherosclerosis Research Institute (G.P.), Hamilton Health Sciences and McMaster University, Ontario, Canada; Sanofi Aventis Deutschland GmbH R&D Division Diabetes (H.H., S.H.), Frankfurt, Germany; and ANMCO Research Centre (A.P.M.), Florence, Italy
| | - Shun Fu Lee
- From Population Health Research Institute (H.C.G., G.P., M.J.M., S.F.L., J.P., S.Y.) and Thrombosis and Atherosclerosis Research Institute (G.P.), Hamilton Health Sciences and McMaster University, Ontario, Canada; Sanofi Aventis Deutschland GmbH R&D Division Diabetes (H.H., S.H.), Frankfurt, Germany; and ANMCO Research Centre (A.P.M.), Florence, Italy
| | - Janice Pogue
- From Population Health Research Institute (H.C.G., G.P., M.J.M., S.F.L., J.P., S.Y.) and Thrombosis and Atherosclerosis Research Institute (G.P.), Hamilton Health Sciences and McMaster University, Ontario, Canada; Sanofi Aventis Deutschland GmbH R&D Division Diabetes (H.H., S.H.), Frankfurt, Germany; and ANMCO Research Centre (A.P.M.), Florence, Italy
| | - Aldo P Maggioni
- From Population Health Research Institute (H.C.G., G.P., M.J.M., S.F.L., J.P., S.Y.) and Thrombosis and Atherosclerosis Research Institute (G.P.), Hamilton Health Sciences and McMaster University, Ontario, Canada; Sanofi Aventis Deutschland GmbH R&D Division Diabetes (H.H., S.H.), Frankfurt, Germany; and ANMCO Research Centre (A.P.M.), Florence, Italy
| | - Salim Yusuf
- From Population Health Research Institute (H.C.G., G.P., M.J.M., S.F.L., J.P., S.Y.) and Thrombosis and Atherosclerosis Research Institute (G.P.), Hamilton Health Sciences and McMaster University, Ontario, Canada; Sanofi Aventis Deutschland GmbH R&D Division Diabetes (H.H., S.H.), Frankfurt, Germany; and ANMCO Research Centre (A.P.M.), Florence, Italy
| | - Sibylle Hess
- From Population Health Research Institute (H.C.G., G.P., M.J.M., S.F.L., J.P., S.Y.) and Thrombosis and Atherosclerosis Research Institute (G.P.), Hamilton Health Sciences and McMaster University, Ontario, Canada; Sanofi Aventis Deutschland GmbH R&D Division Diabetes (H.H., S.H.), Frankfurt, Germany; and ANMCO Research Centre (A.P.M.), Florence, Italy
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Tsai YC, Lee CS, Chiu YW, Kuo HT, Lee SC, Hwang SJ, Kuo MC, Chen HC. Angiopoietin-2 as a Prognostic Biomarker of Major Adverse Cardiovascular Events and All-Cause Mortality in Chronic Kidney Disease. PLoS One 2015; 10:e0135181. [PMID: 26274392 PMCID: PMC4537136 DOI: 10.1371/journal.pone.0135181] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 07/18/2015] [Indexed: 11/29/2022] Open
Abstract
Background Chronic kidney disease (CKD) patients have higher prevalence of major adverse cardiovascular events (MACE) and all-cause mortality. Endothelial damage and dysfunction have been regarded as early portents of MACE in CKD patients. Angiopoietin-2 (Ang-2) impairs endothelial function and promotes aberrant neovascularization. The aim of the study was to assess the relationship between circulating Ang-2 and MACE or all-cause mortality in a CKD cohort. Methods A total of 621 pre-dialysis stage 3–5 CKD patients were enrolled from January 2006 to December 2011 and were followed up till October 2014. Plasma Ang-2 was measured in duplicate using commercial enzyme-linked immunosorbent assays (ELISA). Clinical outcomes included MACE or all-cause mortality Results Of all patients, 122 (19.8%) reached MACE or all-cause mortality. Seventy-two had MACE, 79 died, and 29 had both MACE and all-cause mortality during the follow-up period of 41.5±28.3 months. Ang-2 quintile was divided at 1405.0, 1730.0, 2160.9, and 2829.9 pg/ml. The adjusted HR of MACE or all-cause mortality for every single higher log Ang-2 was 5.69 (95% CI: 2.00–16.20, P = 0.001). The adjusted HR of MACE or all-cause mortality was 2.48 (95% CI: 1.25–4.90) for patients of quintile 5 compared with those of quintile 1. A longitudinal association between MACE or all-cause mortality and stepwise increases in Ang-2 levels was found (P-trend = 0.008). Conclusions Ang-2 is an independent predictor of MACE or all-cause mortality in CKD patients. Additional study is necessary in order to explore the mechanism of the association of Ang-2 with adverse outcomes in patients with CKD.
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Affiliation(s)
- Yi-Chun Tsai
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chee-Siong Lee
- Division of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Division of Cardiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yi-Wen Chiu
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Tien Kuo
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Su-Chu Lee
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shang-Jyh Hwang
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan
- Institute of Population Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Mei-Chuan Kuo
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan
- * E-mail:
| | - Hung-Chun Chen
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan
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Lieb W, Chen MH, Larson MG, Safa R, Teumer A, Baumeister SE, Lin H, Smith HM, Koch M, Lorbeer R, Völker U, Nauck M, Völzke H, Wallaschofski H, Sawyer DB, Vasan RS. Genome-wide association study for endothelial growth factors. ACTA ACUST UNITED AC 2014; 8:389-97. [PMID: 25552591 DOI: 10.1161/circgenetics.114.000597] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 11/12/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Endothelial growth factors including angiopoietin-2 (Ang-2), its soluble receptor Tie-2 (sTie-2), and hepatocyte growth factor play important roles in angiogenesis, vascular remodeling, local tumor growth, and metastatic potential of various cancers. Circulating levels of these biomarkers have a heritable component (between 13% and 56%), but the underlying genetic variation influencing these biomarker levels is largely unknown. METHODS AND RESULTS We performed a genome-wide association study for circulating Ang-2, sTie-2, and hepatocyte growth factor in 3571 Framingham Heart Study participants and assessed replication of the top hits for Ang-2 and sTie-2 in 3184 participants of the Study of Health in Pomerania. In multivariable-adjusted models, sTie-2 and hepatocyte growth factor concentrations were associated with single-nucleotide polymorphisms in the genes encoding the respective biomarkers (top P=2.40×10(-65) [rs2273720] and 3.64×10(-19) [rs5745687], respectively). Likewise, rs2442517 in the MCPH1 gene (in which the Ang-2 gene is embedded) was associated with Ang-2 levels (P=5.05×10(-8) in Framingham Heart Study and 8.39×10(-5) in Study of Health in Pomerania). Furthermore, single-nucleotide polymorphisms in the AB0 gene were associated with sTie-2 (top single-nucleotide polymorphism rs8176693 with P=1.84×10(-33) in Framingham Heart Study; P=2.53×10(-30) in Study of Health in Pomerania) and Ang-2 (rs8176746 with P=2.07×10(-8) in Framingham Heart Study; P=0.001 in Study of Health in Pomerania) levels on a genome-wide significant level. The top genetic loci were explained between 1.7% (Ang-2) and 11.2% (sTie-2) of the interindividual variation in biomarker levels. CONCLUSIONS Genetic variation contributes to the interindividual variation in growth factor levels and explains a modest proportion of circulating hepatocyte growth factor, Ang-2, and Tie-2. This may potentially contribute to the familial susceptibility to cancer, a premise that warrants further studies.
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Affiliation(s)
- Wolfgang Lieb
- From the Framingham Heart Study, MA (W.L., M.-H.C., M.G.L., H.L., R.S.V.); Christian-Albrechts-University Kiel, Institute of Epidemiology, Kiel, Germany (W.L., M.K.); Department of Neurology (M.-H.C.), Division of Graduate Medical Sciences (R.S.), Department of Medicine (H.L.), Section of Epidemiology and Prevention, School of Medicine (R.S.V.), Department of Mathematics (M.G.L.), and Department of Epidemiology, School of Public Health (R.S.V.), Boston University, MA; Interfaculty Institute for Genetics and Functional Genomics (A.T., U.V.), Section Study of Health in Pomerania - Clinical-Epidemiological Research, Institute for Community Medicine (A.T., S.E.B., R.L., H.V.), and Institute for Clinical Chemistry and Laboratory Medicine (M.N., H.W.), University Medicine, Greifswald, Germany; Cardiovascular Division, Vanderbilt University, Nashville, TN (H.M.S., D.B.S.); and German Center of Cardiovascular Research, Partner Site Greifswald, Germany (U.V., M.N., H.V., H.W.)
| | - Ming-Huei Chen
- From the Framingham Heart Study, MA (W.L., M.-H.C., M.G.L., H.L., R.S.V.); Christian-Albrechts-University Kiel, Institute of Epidemiology, Kiel, Germany (W.L., M.K.); Department of Neurology (M.-H.C.), Division of Graduate Medical Sciences (R.S.), Department of Medicine (H.L.), Section of Epidemiology and Prevention, School of Medicine (R.S.V.), Department of Mathematics (M.G.L.), and Department of Epidemiology, School of Public Health (R.S.V.), Boston University, MA; Interfaculty Institute for Genetics and Functional Genomics (A.T., U.V.), Section Study of Health in Pomerania - Clinical-Epidemiological Research, Institute for Community Medicine (A.T., S.E.B., R.L., H.V.), and Institute for Clinical Chemistry and Laboratory Medicine (M.N., H.W.), University Medicine, Greifswald, Germany; Cardiovascular Division, Vanderbilt University, Nashville, TN (H.M.S., D.B.S.); and German Center of Cardiovascular Research, Partner Site Greifswald, Germany (U.V., M.N., H.V., H.W.)
| | - Martin G Larson
- From the Framingham Heart Study, MA (W.L., M.-H.C., M.G.L., H.L., R.S.V.); Christian-Albrechts-University Kiel, Institute of Epidemiology, Kiel, Germany (W.L., M.K.); Department of Neurology (M.-H.C.), Division of Graduate Medical Sciences (R.S.), Department of Medicine (H.L.), Section of Epidemiology and Prevention, School of Medicine (R.S.V.), Department of Mathematics (M.G.L.), and Department of Epidemiology, School of Public Health (R.S.V.), Boston University, MA; Interfaculty Institute for Genetics and Functional Genomics (A.T., U.V.), Section Study of Health in Pomerania - Clinical-Epidemiological Research, Institute for Community Medicine (A.T., S.E.B., R.L., H.V.), and Institute for Clinical Chemistry and Laboratory Medicine (M.N., H.W.), University Medicine, Greifswald, Germany; Cardiovascular Division, Vanderbilt University, Nashville, TN (H.M.S., D.B.S.); and German Center of Cardiovascular Research, Partner Site Greifswald, Germany (U.V., M.N., H.V., H.W.)
| | - Radwan Safa
- From the Framingham Heart Study, MA (W.L., M.-H.C., M.G.L., H.L., R.S.V.); Christian-Albrechts-University Kiel, Institute of Epidemiology, Kiel, Germany (W.L., M.K.); Department of Neurology (M.-H.C.), Division of Graduate Medical Sciences (R.S.), Department of Medicine (H.L.), Section of Epidemiology and Prevention, School of Medicine (R.S.V.), Department of Mathematics (M.G.L.), and Department of Epidemiology, School of Public Health (R.S.V.), Boston University, MA; Interfaculty Institute for Genetics and Functional Genomics (A.T., U.V.), Section Study of Health in Pomerania - Clinical-Epidemiological Research, Institute for Community Medicine (A.T., S.E.B., R.L., H.V.), and Institute for Clinical Chemistry and Laboratory Medicine (M.N., H.W.), University Medicine, Greifswald, Germany; Cardiovascular Division, Vanderbilt University, Nashville, TN (H.M.S., D.B.S.); and German Center of Cardiovascular Research, Partner Site Greifswald, Germany (U.V., M.N., H.V., H.W.)
| | - Alexander Teumer
- From the Framingham Heart Study, MA (W.L., M.-H.C., M.G.L., H.L., R.S.V.); Christian-Albrechts-University Kiel, Institute of Epidemiology, Kiel, Germany (W.L., M.K.); Department of Neurology (M.-H.C.), Division of Graduate Medical Sciences (R.S.), Department of Medicine (H.L.), Section of Epidemiology and Prevention, School of Medicine (R.S.V.), Department of Mathematics (M.G.L.), and Department of Epidemiology, School of Public Health (R.S.V.), Boston University, MA; Interfaculty Institute for Genetics and Functional Genomics (A.T., U.V.), Section Study of Health in Pomerania - Clinical-Epidemiological Research, Institute for Community Medicine (A.T., S.E.B., R.L., H.V.), and Institute for Clinical Chemistry and Laboratory Medicine (M.N., H.W.), University Medicine, Greifswald, Germany; Cardiovascular Division, Vanderbilt University, Nashville, TN (H.M.S., D.B.S.); and German Center of Cardiovascular Research, Partner Site Greifswald, Germany (U.V., M.N., H.V., H.W.)
| | - Sebastian E Baumeister
- From the Framingham Heart Study, MA (W.L., M.-H.C., M.G.L., H.L., R.S.V.); Christian-Albrechts-University Kiel, Institute of Epidemiology, Kiel, Germany (W.L., M.K.); Department of Neurology (M.-H.C.), Division of Graduate Medical Sciences (R.S.), Department of Medicine (H.L.), Section of Epidemiology and Prevention, School of Medicine (R.S.V.), Department of Mathematics (M.G.L.), and Department of Epidemiology, School of Public Health (R.S.V.), Boston University, MA; Interfaculty Institute for Genetics and Functional Genomics (A.T., U.V.), Section Study of Health in Pomerania - Clinical-Epidemiological Research, Institute for Community Medicine (A.T., S.E.B., R.L., H.V.), and Institute for Clinical Chemistry and Laboratory Medicine (M.N., H.W.), University Medicine, Greifswald, Germany; Cardiovascular Division, Vanderbilt University, Nashville, TN (H.M.S., D.B.S.); and German Center of Cardiovascular Research, Partner Site Greifswald, Germany (U.V., M.N., H.V., H.W.)
| | - Honghuang Lin
- From the Framingham Heart Study, MA (W.L., M.-H.C., M.G.L., H.L., R.S.V.); Christian-Albrechts-University Kiel, Institute of Epidemiology, Kiel, Germany (W.L., M.K.); Department of Neurology (M.-H.C.), Division of Graduate Medical Sciences (R.S.), Department of Medicine (H.L.), Section of Epidemiology and Prevention, School of Medicine (R.S.V.), Department of Mathematics (M.G.L.), and Department of Epidemiology, School of Public Health (R.S.V.), Boston University, MA; Interfaculty Institute for Genetics and Functional Genomics (A.T., U.V.), Section Study of Health in Pomerania - Clinical-Epidemiological Research, Institute for Community Medicine (A.T., S.E.B., R.L., H.V.), and Institute for Clinical Chemistry and Laboratory Medicine (M.N., H.W.), University Medicine, Greifswald, Germany; Cardiovascular Division, Vanderbilt University, Nashville, TN (H.M.S., D.B.S.); and German Center of Cardiovascular Research, Partner Site Greifswald, Germany (U.V., M.N., H.V., H.W.)
| | - Holly M Smith
- From the Framingham Heart Study, MA (W.L., M.-H.C., M.G.L., H.L., R.S.V.); Christian-Albrechts-University Kiel, Institute of Epidemiology, Kiel, Germany (W.L., M.K.); Department of Neurology (M.-H.C.), Division of Graduate Medical Sciences (R.S.), Department of Medicine (H.L.), Section of Epidemiology and Prevention, School of Medicine (R.S.V.), Department of Mathematics (M.G.L.), and Department of Epidemiology, School of Public Health (R.S.V.), Boston University, MA; Interfaculty Institute for Genetics and Functional Genomics (A.T., U.V.), Section Study of Health in Pomerania - Clinical-Epidemiological Research, Institute for Community Medicine (A.T., S.E.B., R.L., H.V.), and Institute for Clinical Chemistry and Laboratory Medicine (M.N., H.W.), University Medicine, Greifswald, Germany; Cardiovascular Division, Vanderbilt University, Nashville, TN (H.M.S., D.B.S.); and German Center of Cardiovascular Research, Partner Site Greifswald, Germany (U.V., M.N., H.V., H.W.)
| | - Manja Koch
- From the Framingham Heart Study, MA (W.L., M.-H.C., M.G.L., H.L., R.S.V.); Christian-Albrechts-University Kiel, Institute of Epidemiology, Kiel, Germany (W.L., M.K.); Department of Neurology (M.-H.C.), Division of Graduate Medical Sciences (R.S.), Department of Medicine (H.L.), Section of Epidemiology and Prevention, School of Medicine (R.S.V.), Department of Mathematics (M.G.L.), and Department of Epidemiology, School of Public Health (R.S.V.), Boston University, MA; Interfaculty Institute for Genetics and Functional Genomics (A.T., U.V.), Section Study of Health in Pomerania - Clinical-Epidemiological Research, Institute for Community Medicine (A.T., S.E.B., R.L., H.V.), and Institute for Clinical Chemistry and Laboratory Medicine (M.N., H.W.), University Medicine, Greifswald, Germany; Cardiovascular Division, Vanderbilt University, Nashville, TN (H.M.S., D.B.S.); and German Center of Cardiovascular Research, Partner Site Greifswald, Germany (U.V., M.N., H.V., H.W.)
| | - Roberto Lorbeer
- From the Framingham Heart Study, MA (W.L., M.-H.C., M.G.L., H.L., R.S.V.); Christian-Albrechts-University Kiel, Institute of Epidemiology, Kiel, Germany (W.L., M.K.); Department of Neurology (M.-H.C.), Division of Graduate Medical Sciences (R.S.), Department of Medicine (H.L.), Section of Epidemiology and Prevention, School of Medicine (R.S.V.), Department of Mathematics (M.G.L.), and Department of Epidemiology, School of Public Health (R.S.V.), Boston University, MA; Interfaculty Institute for Genetics and Functional Genomics (A.T., U.V.), Section Study of Health in Pomerania - Clinical-Epidemiological Research, Institute for Community Medicine (A.T., S.E.B., R.L., H.V.), and Institute for Clinical Chemistry and Laboratory Medicine (M.N., H.W.), University Medicine, Greifswald, Germany; Cardiovascular Division, Vanderbilt University, Nashville, TN (H.M.S., D.B.S.); and German Center of Cardiovascular Research, Partner Site Greifswald, Germany (U.V., M.N., H.V., H.W.)
| | - Uwe Völker
- From the Framingham Heart Study, MA (W.L., M.-H.C., M.G.L., H.L., R.S.V.); Christian-Albrechts-University Kiel, Institute of Epidemiology, Kiel, Germany (W.L., M.K.); Department of Neurology (M.-H.C.), Division of Graduate Medical Sciences (R.S.), Department of Medicine (H.L.), Section of Epidemiology and Prevention, School of Medicine (R.S.V.), Department of Mathematics (M.G.L.), and Department of Epidemiology, School of Public Health (R.S.V.), Boston University, MA; Interfaculty Institute for Genetics and Functional Genomics (A.T., U.V.), Section Study of Health in Pomerania - Clinical-Epidemiological Research, Institute for Community Medicine (A.T., S.E.B., R.L., H.V.), and Institute for Clinical Chemistry and Laboratory Medicine (M.N., H.W.), University Medicine, Greifswald, Germany; Cardiovascular Division, Vanderbilt University, Nashville, TN (H.M.S., D.B.S.); and German Center of Cardiovascular Research, Partner Site Greifswald, Germany (U.V., M.N., H.V., H.W.)
| | - Matthias Nauck
- From the Framingham Heart Study, MA (W.L., M.-H.C., M.G.L., H.L., R.S.V.); Christian-Albrechts-University Kiel, Institute of Epidemiology, Kiel, Germany (W.L., M.K.); Department of Neurology (M.-H.C.), Division of Graduate Medical Sciences (R.S.), Department of Medicine (H.L.), Section of Epidemiology and Prevention, School of Medicine (R.S.V.), Department of Mathematics (M.G.L.), and Department of Epidemiology, School of Public Health (R.S.V.), Boston University, MA; Interfaculty Institute for Genetics and Functional Genomics (A.T., U.V.), Section Study of Health in Pomerania - Clinical-Epidemiological Research, Institute for Community Medicine (A.T., S.E.B., R.L., H.V.), and Institute for Clinical Chemistry and Laboratory Medicine (M.N., H.W.), University Medicine, Greifswald, Germany; Cardiovascular Division, Vanderbilt University, Nashville, TN (H.M.S., D.B.S.); and German Center of Cardiovascular Research, Partner Site Greifswald, Germany (U.V., M.N., H.V., H.W.)
| | - Henry Völzke
- From the Framingham Heart Study, MA (W.L., M.-H.C., M.G.L., H.L., R.S.V.); Christian-Albrechts-University Kiel, Institute of Epidemiology, Kiel, Germany (W.L., M.K.); Department of Neurology (M.-H.C.), Division of Graduate Medical Sciences (R.S.), Department of Medicine (H.L.), Section of Epidemiology and Prevention, School of Medicine (R.S.V.), Department of Mathematics (M.G.L.), and Department of Epidemiology, School of Public Health (R.S.V.), Boston University, MA; Interfaculty Institute for Genetics and Functional Genomics (A.T., U.V.), Section Study of Health in Pomerania - Clinical-Epidemiological Research, Institute for Community Medicine (A.T., S.E.B., R.L., H.V.), and Institute for Clinical Chemistry and Laboratory Medicine (M.N., H.W.), University Medicine, Greifswald, Germany; Cardiovascular Division, Vanderbilt University, Nashville, TN (H.M.S., D.B.S.); and German Center of Cardiovascular Research, Partner Site Greifswald, Germany (U.V., M.N., H.V., H.W.)
| | - Henri Wallaschofski
- From the Framingham Heart Study, MA (W.L., M.-H.C., M.G.L., H.L., R.S.V.); Christian-Albrechts-University Kiel, Institute of Epidemiology, Kiel, Germany (W.L., M.K.); Department of Neurology (M.-H.C.), Division of Graduate Medical Sciences (R.S.), Department of Medicine (H.L.), Section of Epidemiology and Prevention, School of Medicine (R.S.V.), Department of Mathematics (M.G.L.), and Department of Epidemiology, School of Public Health (R.S.V.), Boston University, MA; Interfaculty Institute for Genetics and Functional Genomics (A.T., U.V.), Section Study of Health in Pomerania - Clinical-Epidemiological Research, Institute for Community Medicine (A.T., S.E.B., R.L., H.V.), and Institute for Clinical Chemistry and Laboratory Medicine (M.N., H.W.), University Medicine, Greifswald, Germany; Cardiovascular Division, Vanderbilt University, Nashville, TN (H.M.S., D.B.S.); and German Center of Cardiovascular Research, Partner Site Greifswald, Germany (U.V., M.N., H.V., H.W.)
| | - Douglas B Sawyer
- From the Framingham Heart Study, MA (W.L., M.-H.C., M.G.L., H.L., R.S.V.); Christian-Albrechts-University Kiel, Institute of Epidemiology, Kiel, Germany (W.L., M.K.); Department of Neurology (M.-H.C.), Division of Graduate Medical Sciences (R.S.), Department of Medicine (H.L.), Section of Epidemiology and Prevention, School of Medicine (R.S.V.), Department of Mathematics (M.G.L.), and Department of Epidemiology, School of Public Health (R.S.V.), Boston University, MA; Interfaculty Institute for Genetics and Functional Genomics (A.T., U.V.), Section Study of Health in Pomerania - Clinical-Epidemiological Research, Institute for Community Medicine (A.T., S.E.B., R.L., H.V.), and Institute for Clinical Chemistry and Laboratory Medicine (M.N., H.W.), University Medicine, Greifswald, Germany; Cardiovascular Division, Vanderbilt University, Nashville, TN (H.M.S., D.B.S.); and German Center of Cardiovascular Research, Partner Site Greifswald, Germany (U.V., M.N., H.V., H.W.)
| | - Ramachandran S Vasan
- From the Framingham Heart Study, MA (W.L., M.-H.C., M.G.L., H.L., R.S.V.); Christian-Albrechts-University Kiel, Institute of Epidemiology, Kiel, Germany (W.L., M.K.); Department of Neurology (M.-H.C.), Division of Graduate Medical Sciences (R.S.), Department of Medicine (H.L.), Section of Epidemiology and Prevention, School of Medicine (R.S.V.), Department of Mathematics (M.G.L.), and Department of Epidemiology, School of Public Health (R.S.V.), Boston University, MA; Interfaculty Institute for Genetics and Functional Genomics (A.T., U.V.), Section Study of Health in Pomerania - Clinical-Epidemiological Research, Institute for Community Medicine (A.T., S.E.B., R.L., H.V.), and Institute for Clinical Chemistry and Laboratory Medicine (M.N., H.W.), University Medicine, Greifswald, Germany; Cardiovascular Division, Vanderbilt University, Nashville, TN (H.M.S., D.B.S.); and German Center of Cardiovascular Research, Partner Site Greifswald, Germany (U.V., M.N., H.V., H.W.)
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Lorbeer R, Baumeister SE, Dörr M, Felix SB, Nauck M, Grotevendt A, Markus MRP, von Sarnowski B, Völzke H, Vasan RS, Wallaschofski H, Lieb W. Angiopoietin-2, its soluble receptor Tie-2 and subclinical cardiovascular disease in a population-based sample. Heart 2014; 101:178-84. [DOI: 10.1136/heartjnl-2014-306056] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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Sorror ML, Martin PJ, Storb RF, Bhatia S, Maziarz RT, Pulsipher MA, Maris MB, Davis C, Deeg HJ, Lee SJ, Maloney DG, Sandmaier BM, Appelbaum FR, Gooley TA. Pretransplant comorbidities predict severity of acute graft-versus-host disease and subsequent mortality. Blood 2014; 124:287-95. [PMID: 24797298 PMCID: PMC4093684 DOI: 10.1182/blood-2014-01-550566] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 04/21/2014] [Indexed: 12/19/2022] Open
Abstract
Whether the hematopoietic cell transplantation comorbidity index (HCT-CI) can provide prognostic information about development of acute graft-versus-host disease (GVHD) and subsequent mortality is unknown. Five institutions contributed information on 2985 patients given human leukocyte antigen-matched grafts to address this question. Proportional hazards models were used to estimate the hazards of acute GVHD and post-GVHD mortality after adjustment for known risk variables. Higher HCT-CI scores predicted increased risk of grades 3 to 4 acute GVHD (P < .0001 and c-statistic of 0.64), and tests of interaction suggested that this association was consistent among different conditioning intensities, donor types, and stem cell sources. Probabilities of grades 3 to 4 GVHD were 13%, 18%, and 24% for HCT-CI risk groups of 0, 1 to 4, and ≥5. The HCT-CI was statistically significantly associated with mortality rates following diagnosis of grade 2 (hazard ratio [HR] = 1.24; P < .0001) or grades 3 to 4 acute GVHD (HR = 1.19; P < .0001). Patients with HCT-CI scores of ≥3 who developed grades 3 to 4 acute GVHD had a 2.63-fold higher risk of mortality than those with scores of 0 to 2 and did not develop acute GVHD. Thus, pretransplant comorbidities are associated with the development and severity of acute GVHD and with post-GVHD mortality. The HCT-CI could be useful in designing trials for GVHD prevention and could inform expectations for GVHD treatment trials.
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Affiliation(s)
- Mohamed L Sorror
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Paul J Martin
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Rainer F Storb
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | | | - Richard T Maziarz
- Center for Hematologic Malignancies, Knight Cancer Institute, and Division of Hematology and Medical Oncology, Oregon Health and Science University Knight Cancer Institute, Portland, OR
| | - Michael A Pulsipher
- Division of Hematology, University of Utah School of Medicine, Salt Lake City, UT; Pediatric Blood and Marrow Transplant Program, Primary Children's Medical Center, Huntsman Cancer Institute, Salt Lake City, UT
| | - Michael B Maris
- Colorado Blood Cancer Institute at Presbyterian/St. Luke's Medical Center, Denver, CO
| | - Christopher Davis
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - H Joachim Deeg
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Stephanie J Lee
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - David G Maloney
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Brenda M Sandmaier
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Frederick R Appelbaum
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Theodore A Gooley
- Clinical Statistics Program, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; and Department of Biostatistics, University of Washington School of Public Health, Seattle, WA
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Grabe HJ, Assel H, Bahls T, Dörr M, Endlich K, Endlich N, Erdmann P, Ewert R, Felix SB, Fiene B, Fischer T, Flessa S, Friedrich N, Gadebusch-Bondio M, Salazar MG, Hammer E, Haring R, Havemann C, Hecker M, Hoffmann W, Holtfreter B, Kacprowski T, Klein K, Kocher T, Kock H, Krafczyk J, Kuhn J, Langanke M, Lendeckel U, Lerch MM, Lieb W, Lorbeer R, Mayerle J, Meissner K, zu Schwabedissen HM, Nauck M, Ott K, Rathmann W, Rettig R, Richardt C, Saljé K, Schminke U, Schulz A, Schwab M, Siegmund W, Stracke S, Suhre K, Ueffing M, Ungerer S, Völker U, Völzke H, Wallaschofski H, Werner V, Zygmunt MT, Kroemer HK. Cohort profile: Greifswald approach to individualized medicine (GANI_MED). J Transl Med 2014; 12:144. [PMID: 24886498 PMCID: PMC4040487 DOI: 10.1186/1479-5876-12-144] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 05/17/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Individualized Medicine aims at providing optimal treatment for an individual patient at a given time based on his specific genetic and molecular characteristics. This requires excellent clinical stratification of patients as well as the availability of genomic data and biomarkers as prerequisites for the development of novel diagnostic tools and therapeutic strategies. The University Medicine Greifswald, Germany, has launched the "Greifswald Approach to Individualized Medicine" (GANI_MED) project to address major challenges of Individualized Medicine. Herein, we describe the implementation of the scientific and clinical infrastructure that allows future translation of findings relevant to Individualized Medicine into clinical practice. METHODS/DESIGN Clinical patient cohorts (N > 5,000) with an emphasis on metabolic and cardiovascular diseases are being established following a standardized protocol for the assessment of medical history, laboratory biomarkers, and the collection of various biosamples for bio-banking purposes. A multi-omics based biomarker assessment including genome-wide genotyping, transcriptome, metabolome, and proteome analyses complements the multi-level approach of GANI_MED. Comparisons with the general background population as characterized by our Study of Health in Pomerania (SHIP) are performed. A central data management structure has been implemented to capture and integrate all relevant clinical data for research purposes. Ethical research projects on informed consent procedures, reporting of incidental findings, and economic evaluations were launched in parallel.
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Affiliation(s)
- Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, Greifswald 17475, Germany
| | - Heinrich Assel
- Faculty of Theology, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany
| | - Thomas Bahls
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
| | - Marcus Dörr
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, partner site Greifswald, Greifswald, Germany
| | - Karlhans Endlich
- Institute of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany
| | - Nicole Endlich
- Institute of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany
| | - Pia Erdmann
- DZNE (German Center for Neurodegenerative Diseases), partner site Rostock/Greifswald, Greifswald, Germany
| | - Ralf Ewert
- Department of Internal Medicine, Pulmonary Diseases, University Medicine Greifswald, Greifswald, Germany
| | - Stephan B Felix
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, partner site Greifswald, Greifswald, Germany
| | - Beate Fiene
- Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Tobias Fischer
- Institute of the History of Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Steffen Flessa
- Department of Health Care Management, Faculty of Law and Economics, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany
| | - Nele Friedrich
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Mariacarla Gadebusch-Bondio
- Institute of the History of Medicine, University Medicine Greifswald, Greifswald, Germany
- Institute of History and Ethics of Medicine, Technical University Munich, Munich, Germany
| | - Manuela Gesell Salazar
- Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Elke Hammer
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Robin Haring
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Christoph Havemann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Michael Hecker
- Institute for Microbiology, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- DZNE (German Center for Neurodegenerative Diseases), partner site Rostock/Greifswald, Greifswald, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology and Endodontology, University Medicine Greifswald, Greifswald, Germany
| | - Tim Kacprowski
- Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Kathleen Klein
- Department of Pharmacology, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology and Endodontology, University Medicine Greifswald, Greifswald, Germany
| | - Holger Kock
- Strategic Research Management, University Medicine Greifswald, Greifswald, Germany
| | - Janina Krafczyk
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Jana Kuhn
- Institute of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany
| | - Martin Langanke
- Faculty of Theology, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany
| | - Uwe Lendeckel
- Institute of Medical Biochemistry and Molecular Biology, University Medicine Greifswald, Greifswald, Germany
| | - Markus M Lerch
- Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Wolfgang Lieb
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- Institute of Epidemiology, Christian-Albrechts University Kiel, Kiel, Germany
| | - Roberto Lorbeer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Julia Mayerle
- Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Konrad Meissner
- Department of Anaesthesiology and Intensive Care, University Medicine Greifswald, Greifswald, Germany
| | - Henriette Meyer zu Schwabedissen
- Department of Pharmacology, University Medicine Greifswald, Greifswald, Germany
- Department of Pharmaceutical Research, University Basel, Basel, Switzerland
| | - Matthias Nauck
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Konrad Ott
- Department of Philosophy, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany
- Department of Philosophy, Christian-Albrechts University Kiel, Kiel, Germany
| | - Wolfgang Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Rainer Rettig
- Institute of Physiology, University Medicine Greifswald, Greifswald, Germany
| | - Claudia Richardt
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Karen Saljé
- Department of Pharmacology, University Medicine Greifswald, Greifswald, Germany
| | - Ulf Schminke
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Andrea Schulz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, Greifswald 17475, Germany
| | - Matthias Schwab
- Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- Department of Clinical Pharmacology, University Hospital, Tuebingen, Germany
| | - Werner Siegmund
- Department of Pharmacology, University Medicine Greifswald, Greifswald, Germany
| | - Sylvia Stracke
- Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Karsten Suhre
- Institute for Bioinformatics and Systems Biology, Helmholtz Zentrum, München, Germany
- Bioinformatics Core, Weill Cornell Medical College, Doha, Qatar
| | - Marius Ueffing
- Resarch Unit of Protein Science, Helmholtz Zentrum, München, Germany
- Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
| | - Saskia Ungerer
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Uwe Völker
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
| | - Henri Wallaschofski
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Vivian Werner
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Marek T Zygmunt
- Department of Obstetrics and Gynaecology, University Medicine, Greifswald, Germany
| | - Heyo K Kroemer
- Department of Pharmacology, University Medicine Greifswald, Greifswald, Germany
- Dean’s office, University Medicine Göttingen, Göttingen, Germany
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42
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Molnar MZ, Kümpers P, Kielstein JT, Schiffer M, Czira ME, Ujszaszi A, Kovesdy CP, Mucsi I. Circulating Angiopoietin-2 levels predict mortality in kidney transplant recipients: a 4-year prospective case-cohort study. Transpl Int 2014; 27:541-52. [PMID: 24628855 DOI: 10.1111/tri.12293] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 10/31/2013] [Accepted: 02/24/2014] [Indexed: 12/16/2022]
Abstract
Angiopoietin 2 (Angpt2) impairs endothelial function by preventing angiopoietin 1 from binding to their common endothelial-specific receptor Tie2. Here, we examined whether circulating Angpt2 predicts outcome in kidney transplant recipients. For this case-cohort study, we selected 130 kidney transplant recipients who had died or returned to dialysis within the first 2 years of follow-up of our cohort study, as well as 130 age- and gender-matched kidney transplant recipients without an event (controls) from a total of 993 kidney transplant recipients. The total of 260 selected patients were followed in median 4 years. Serum Angpt2 at baseline was measured using an in-house immunoluminometric assay. Median Angpt2 concentrations were significantly higher in patients who died [median (interquartile range--IQR) 3.6 (2.8-5.9) ng/ml] as compared to patients who did not die during the study period [2.8 (2.1-4.1) ng/ml; P < 0.001]. Ln (natural log) Angpt2 levels correlated positively with C-reactive protein levels (r = 0.315, P < 0.001) and the Charlson Comorbidity Index (r = 0.188, P = 0.002) and were inversely associated with eGFR (r = -0.301, P < 0.001) hemoglobin (r = -0.269, P < 0.001), and serum albumin concentrations (r = -0.382, P < 0.001). On multivariate analyses, baseline Angpt2 levels independently predicted all-cause mortality (multivariable-adjusted hazard ratio associated with one natural log unit higher Angpt2 level: 1.70 (95% confidence interval: 1.10-2.61)). In our analysis, circulating Angpt2 was an independent predictor of all-cause mortality in stable, prevalent kidney transplant recipients.
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Affiliation(s)
- Miklos Z Molnar
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine Medical Center, Orange, CA, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, ON, Canada
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