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Primavesi F, Senoner T, Schindler S, Nikolajevic A, Di Fazio P, Csukovich G, Eller S, Neumayer B, Anliker M, Braunwarth E, Oberhuber R, Resch T, Maglione M, Cardini B, Niederwieser T, Gasteiger S, Klieser E, Tilg H, Schneeberger S, Neureiter D, Öfner D, Troppmair J, Stättner S. The Interplay between Perioperative Oxidative Stress and Hepatic Dysfunction after Human Liver Resection: A Prospective Observational Pilot Study. Antioxidants (Basel) 2024; 13:590. [PMID: 38790695 PMCID: PMC11118143 DOI: 10.3390/antiox13050590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/02/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Post-hepatectomy liver failure (PHLF) remains the major contributor to death after liver resection. Oxidative stress is associated with postoperative complications, but its impact on liver function is unclear. This first in-human, prospective, single-center, observational pilot study evaluated perioperative oxidative stress and PHLF according to the ISGLS (International Study Group for Liver Surgery). Serum 8-isoprostane, 4-hydroxynonenal (4-HNE), total antioxidative capacity, vitamins A and E, and intraoperative, sequential hepatic tissue 4-HNE and UCP2 (uncoupling protein 2) immunohistochemistry (IHC) were assessed. The interaction with known risk factors for PHLF and the predictive potential of oxidative stress markers were analyzed. Overall, 52 patients were included (69.2% major liver resection). Thirteen patients (25%) experienced PHLF, a major factor for 90-day mortality (23% vs. 0%; p = 0.013). Post-resection, pro-oxidative 8-isoprostane significantly increased (p = 0.038), while 4-HNE declined immediately (p < 0.001). Antioxidative markers showed patterns of consumption starting post-resection (p < 0.001). Liver tissue oxidative stress increased stepwise from biopsies taken after laparotomy to post-resection in situ liver and resection specimens (all p < 0.001). Cholangiocarcinoma patients demonstrated significantly higher serum and tissue oxidative stress levels at various timepoints, with consistently higher preoperative values in advanced tumor stages. Combining intraoperative, post-resection 4-HNE serum levels and in situ IHC early predicted PHLF with an AUC of 0.855 (63.6% vs. 0%; p < 0.001). This was also associated with grade B/C PHLF (36.4% vs. 0%; p = 0.021) and 90-day mortality (18.2% vs. 0%; p = 0.036). In conclusion, distinct patterns of perioperative oxidative stress levels occur in patients with liver dysfunction. Combining intraoperative serum and liver tissue markers predicts subsequent PHLF. Cholangiocarcinoma patients demonstrated pronounced systemic and hepatic oxidative stress, with increasing levels in advanced tumor stages, thus representing a worthwhile target for future exploratory and therapeutic studies.
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Affiliation(s)
- Florian Primavesi
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.S.); (E.B.); (R.O.); (T.R.); (M.M.); (B.C.); (S.G.); (S.S.); (D.Ö.)
- Daniel Swarovski Research Laboratory, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (A.N.); (S.E.); (J.T.)
- Department of General, Visceral and Vascular Surgery, Salzkammergutklinikum, 4840 Vöcklabruck, Austria;
| | - Thomas Senoner
- Department of Anaesthesiology and Intensive Care Medicine, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Sophie Schindler
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.S.); (E.B.); (R.O.); (T.R.); (M.M.); (B.C.); (S.G.); (S.S.); (D.Ö.)
| | - Aleksandar Nikolajevic
- Daniel Swarovski Research Laboratory, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (A.N.); (S.E.); (J.T.)
| | - Pietro Di Fazio
- Department of Visceral, Thoracic and Vascular Surgery, Philipps-Universität Marburg, 35043 Marburg, Germany;
| | - Georg Csukovich
- Daniel Swarovski Research Laboratory, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (A.N.); (S.E.); (J.T.)
- Small Animal Internal Medicine, Vetmeduni, 1210 Vienna, Austria
| | - Silvia Eller
- Daniel Swarovski Research Laboratory, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (A.N.); (S.E.); (J.T.)
| | - Bettina Neumayer
- Institute of Pathology, Paracelsus Medical University/University Hospital Salzburg (SALK), 5020 Salzburg, Austria; (B.N.); (E.K.); (D.N.)
| | - Markus Anliker
- Central Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Eva Braunwarth
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.S.); (E.B.); (R.O.); (T.R.); (M.M.); (B.C.); (S.G.); (S.S.); (D.Ö.)
| | - Rupert Oberhuber
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.S.); (E.B.); (R.O.); (T.R.); (M.M.); (B.C.); (S.G.); (S.S.); (D.Ö.)
| | - Thomas Resch
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.S.); (E.B.); (R.O.); (T.R.); (M.M.); (B.C.); (S.G.); (S.S.); (D.Ö.)
| | - Manuel Maglione
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.S.); (E.B.); (R.O.); (T.R.); (M.M.); (B.C.); (S.G.); (S.S.); (D.Ö.)
- Daniel Swarovski Research Laboratory, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (A.N.); (S.E.); (J.T.)
| | - Benno Cardini
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.S.); (E.B.); (R.O.); (T.R.); (M.M.); (B.C.); (S.G.); (S.S.); (D.Ö.)
| | - Thomas Niederwieser
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.S.); (E.B.); (R.O.); (T.R.); (M.M.); (B.C.); (S.G.); (S.S.); (D.Ö.)
| | - Silvia Gasteiger
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.S.); (E.B.); (R.O.); (T.R.); (M.M.); (B.C.); (S.G.); (S.S.); (D.Ö.)
| | - Eckhard Klieser
- Institute of Pathology, Paracelsus Medical University/University Hospital Salzburg (SALK), 5020 Salzburg, Austria; (B.N.); (E.K.); (D.N.)
| | - Herbert Tilg
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Stefan Schneeberger
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.S.); (E.B.); (R.O.); (T.R.); (M.M.); (B.C.); (S.G.); (S.S.); (D.Ö.)
| | - Daniel Neureiter
- Institute of Pathology, Paracelsus Medical University/University Hospital Salzburg (SALK), 5020 Salzburg, Austria; (B.N.); (E.K.); (D.N.)
| | - Dietmar Öfner
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.S.); (E.B.); (R.O.); (T.R.); (M.M.); (B.C.); (S.G.); (S.S.); (D.Ö.)
- Daniel Swarovski Research Laboratory, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (A.N.); (S.E.); (J.T.)
| | - Jakob Troppmair
- Daniel Swarovski Research Laboratory, Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria; (A.N.); (S.E.); (J.T.)
| | - Stefan Stättner
- Department of General, Visceral and Vascular Surgery, Salzkammergutklinikum, 4840 Vöcklabruck, Austria;
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Ivanov AV, Popov MA, Metelkin AA, Aleksandrin VV, Agafonov EG, Kruglova MP, Silina EV, Stupin VA, Maslennikov RA, Kubatiev AA. Influence of Coronary Artery Bypass Grafts on Blood Aminothiols in Patients with Coronary Artery Disease. Metabolites 2023; 13:743. [PMID: 37367901 PMCID: PMC10305081 DOI: 10.3390/metabo13060743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/03/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023] Open
Abstract
Coronary artery disease (CAD) and the coronary artery bypass graft (CABG) are associated with a decreased blood glutathione (bGSH) level. Since GSH metabolism is closely related to other aminothiols (homocysteine and cysteine) and glucose, the aim of this study was to reveal the associations of bGSH with glucose and plasma aminothiols in CAD patients (N = 35) before CABG and in the early postoperative period. Forty-three volunteers with no history of cardiovascular disease formed the control group. bGSH and its redox status were significantly lower in CAD patients at admission. CABG had no significant effect on these parameters, with the exception of an increase in the bGSH/hemoglobin ratio. At admission, CAD patients were characterized by negative associations of homocysteine and cysteine with bGSH. All these associations disappeared after CABG. An association was found between an increase in oxidized GSH in the blood in the postoperative period and fasting glucose levels. Thus, CAD is associated with the depletion of the intracellular pool and the redox status of bGSH, in which hyperhomocysteinemia and a decrease in the bioavailability of the extracellular pool of cysteine play a role. The present study indicates that CABG causes disruptions in aminothiol metabolism and induces the synthesis of bGSH. Moreover, glucose becomes an important factor in the dysregulation of GSH metabolism in CABG.
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Affiliation(s)
- Alexander Vladimirovich Ivanov
- Institute of General Pathology and Pathophysiology, Baltiyskaya St., 8, 125315 Moscow, Russia; (A.A.M.); (V.V.A.); (M.P.K.); (A.A.K.)
| | - Mikhail Aleksandrovich Popov
- Moscow Regional Research and Clinical Institute n.a. M.F. Vladimirskiy, Shchepkin St., 61/2, 129110 Moscow, Russia; (M.A.P.); (E.G.A.); (R.A.M.)
| | - Arkady Andreevich Metelkin
- Institute of General Pathology and Pathophysiology, Baltiyskaya St., 8, 125315 Moscow, Russia; (A.A.M.); (V.V.A.); (M.P.K.); (A.A.K.)
| | - Valery Vasil’evich Aleksandrin
- Institute of General Pathology and Pathophysiology, Baltiyskaya St., 8, 125315 Moscow, Russia; (A.A.M.); (V.V.A.); (M.P.K.); (A.A.K.)
| | - Evgeniy Gennad’evich Agafonov
- Moscow Regional Research and Clinical Institute n.a. M.F. Vladimirskiy, Shchepkin St., 61/2, 129110 Moscow, Russia; (M.A.P.); (E.G.A.); (R.A.M.)
| | - Maria Petrovna Kruglova
- Institute of General Pathology and Pathophysiology, Baltiyskaya St., 8, 125315 Moscow, Russia; (A.A.M.); (V.V.A.); (M.P.K.); (A.A.K.)
- Department of Human Pathology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St., 8, 119991 Moscow, Russia;
| | - Ekaterina Vladimirovna Silina
- Department of Human Pathology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St., 8, 119991 Moscow, Russia;
| | - Victor Aleksandrovich Stupin
- Department of Hospital Surgery No. 1, Pirogov Russian National Research Medical University, Ostrovityanova St., 1, 117997 Moscow, Russia;
| | - Ruslan Andreevich Maslennikov
- Moscow Regional Research and Clinical Institute n.a. M.F. Vladimirskiy, Shchepkin St., 61/2, 129110 Moscow, Russia; (M.A.P.); (E.G.A.); (R.A.M.)
| | - Aslan Amirkhanovich Kubatiev
- Institute of General Pathology and Pathophysiology, Baltiyskaya St., 8, 125315 Moscow, Russia; (A.A.M.); (V.V.A.); (M.P.K.); (A.A.K.)
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Moschetta D, Di Minno MND, Porro B, Perrucci GL, Valerio V, Alfieri V, Massaiu I, Orekhov AN, Di Minno A, Songia P, Cavalca V, Myasoedova VA, Poggio P. Relationship Between Plasma Osteopontin and Arginine Pathway Metabolites in Patients With Overt Coronary Artery Disease. Front Physiol 2020; 11:982. [PMID: 32848891 PMCID: PMC7424048 DOI: 10.3389/fphys.2020.00982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 07/20/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction Osteopontin (OPN) is involved in ectopic calcification. Its circulating form is upregulated in coronary artery disease (CAD) patients. Circulating OPN levels positively correlate with oxidative stress, one of the major triggers of endothelial dysfunction. Endothelial dysfunction is, in turn, associated with reduced nitric oxide (NO) bioavailability due to the impaired arginine pathway. The aim of this study was to better understand the correlations between OPN, oxidative stress markers, and the arginine pathway metabolites. Methods and Results ELISA and mass spectrometry techniques have been used to evaluate circulating OPN and arginine pathway/oxidative stress metabolites, respectively, in twenty-five control subjects and thirty-three patients with overt atherosclerosis. OPN positively correlates with 2,3-dinor-8isoPGF2a levels (p = 0.02), ornithine (p = 0.01), ADMA (p = 0.001), SDMA (p = 0.03), and citrulline (p = 0.008) levels only in CAD patients. In addition, citrulline positively correlated with ADMA (p = 0.02) levels, possibly as result of other sources of citrulline biosynthetic pathways. Conclusion The association between OPN and impaired arginine/NO pathway could play a role in the inhibition of endothelial NO synthase (eNOS) and/or in the arginase activation in the context of CAD patients. However, further studies are needed to verify the cause-effect relationship between OPN, oxidative stress, and arginine/NO pathway dysregulation.
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Affiliation(s)
- Donato Moschetta
- Unità per lo Studio delle Patologie Aortiche, Valvolari e Coronariche, Centro Cardiologico Monzino IRCCS, Milan, Italy.,Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy
| | | | - Benedetta Porro
- Unità di Metabolomica, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Gianluca L Perrucci
- Unità di Medicina Rigenerativa e Biologia Vascolare, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Vincenza Valerio
- Unità per lo Studio delle Patologie Aortiche, Valvolari e Coronariche, Centro Cardiologico Monzino IRCCS, Milan, Italy.,Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Valentina Alfieri
- Unità per lo Studio delle Patologie Aortiche, Valvolari e Coronariche, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Ilaria Massaiu
- Unità per lo Studio delle Patologie Aortiche, Valvolari e Coronariche, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Alexander N Orekhov
- Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow, Russia
| | - Alessandro Di Minno
- Dipartimento di Farmacia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Paola Songia
- Unità per lo Studio delle Patologie Aortiche, Valvolari e Coronariche, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Viviana Cavalca
- Unità di Metabolomica, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Veronika A Myasoedova
- Unità per lo Studio delle Patologie Aortiche, Valvolari e Coronariche, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Paolo Poggio
- Unità per lo Studio delle Patologie Aortiche, Valvolari e Coronariche, Centro Cardiologico Monzino IRCCS, Milan, Italy
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Hassanien MA. Ameliorating Effects of Ginger on Isoproterenol-Induced Acute Myocardial Infarction in Rats and its Impact on Cardiac Nitric Oxide. J Microsc Ultrastruct 2020; 8:96-103. [PMID: 33282684 PMCID: PMC7703011 DOI: 10.4103/jmau.jmau_70_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/01/2020] [Accepted: 01/30/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Myocardial infarction is a major heart disease and is considered a significant reason for mortality and morbidity around the world. The model of Isoproterenol (ISO)-induced myocardial infarction provides a supported method for investigating the impacts of numerous possible cardioprotective bioactive substances. Nitric Oxide (NO) could react with reactive oxygen intermediates and free radicals to create harmful species. For several years, researchers have investigated the use of herbs and natural products as antioxidants to protect the body's organs against toxins and drug metabolites. However, studies on the antioxidant effects of ginger against cardiotoxicity induced by drugs and toxic agents remain insufficient, especially its effects on NO. Aims and Objectives: This study aimed to investigate the possible antioxidant and protective role of ginger in ISO-induced acute myocardial infarction in experimental rats. Special emphasis was given to the impact of ginger on NO levels. Materials and Methods: Forty adult male albino rats were used in this study. The animals were randomly divided into four equal groups. Group I served as control and received a normal mouse diet. Group II received ginger extract orally, Group III received normal diet for eight weeks, followed by ISO administration subcutaneously to induce myocardial infarction, Group IV received ginger extracts, followed by ISO. Results and Conclusions: The results of this study illustrated ginger's protective role against ISO-induced acute myocardial infarction. This role is mainly due to ginger's antioxidant and anti-inflammatory properties. We assume that sufficient intake of ginger by individuals who are regularly exposed to ISO would be beneficial in overcoming the cardiotoxicity of ISO. The effects of ginger may take place through inhibition of NOS enzymes, which needs further immunohistochemical and biochemical studies to reveal the underlying different mechanisms of the effects of ginger at the molecular and structural levels.
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Affiliation(s)
- Mohammed Ahmed Hassanien
- Department of Pharmacy Practice, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Medical Biochemistry, Faculty of Medicine, Tanta University, Tanta, Egypt
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Role of nitric oxide in mediating the cardioprotective effect of agomelatine against isoproterenol-induced myocardial injury in rats. Naunyn Schmiedebergs Arch Pharmacol 2020; 393:1809-1823. [DOI: 10.1007/s00210-020-01860-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 03/24/2020] [Indexed: 12/19/2022]
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Early Oxidative Stress Response in Patients with Severe Aortic Stenosis Undergoing Transcatheter and Surgical Aortic Valve Replacement: A Transatlantic Study. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:6217837. [PMID: 31827686 PMCID: PMC6881568 DOI: 10.1155/2019/6217837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/20/2019] [Accepted: 09/17/2019] [Indexed: 11/18/2022]
Abstract
Myocardial ischemia/reperfusion-related oxidative stress as a result of cardiopulmonary bypass is thought to contribute to the adverse clinical outcomes following surgical aortic valve replacement (SAVR). Although the acute response following this procedure has been well characterized, much less is known about the nature and extent of oxidative stress induced by the transcatheter aortic valve replacement (TAVR) procedure. We therefore sought to examine and directly compare the oxidative stress response in patients undergoing TAVR and SAVR. A total of 60 patients were prospectively enrolled in this exploratory study, 38 patients undergoing TAVR and 22 patients SAVR. Reduced and oxidized glutathione (GSH, GSSG) in red blood cells as well as the ferric-reducing ability of plasma (FRAP) and plasma concentrations of 8-isoprostanes were measured at baseline (S1), during early reperfusion (S2), and 6-8 hours (S3) following aortic valve replacement (AVR). TAVR and SAVR were successful in all patients. Patients undergoing TAVR were older (79.3 ± 9.5 vs. 74.2 ± 4.1 years; P < 0.01) and had a higher mean STS risk score (6.6 ± 4.8 vs. 3.2 ± 3.0; P < 0.001) than patients undergoing SAVR. At baseline, FRAP and 8-isoprostane plasma concentrations were similar between the two groups, but erythrocytic GSH concentrations were significantly lower in the TAVR group. After AVR, FRAP was markedly higher in the TAVR group, whereas 8-isoprostane concentrations were significantly elevated in the SAVR group. In conclusion, TAVR appears not to cause acute oxidative stress and may even improve the antioxidant capacity in the extracellular compartment.
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Porro B, Songia P, Myasoedova VA, Valerio V, Moschetta D, Gripari P, Fusini L, Cavallotti L, Canzano P, Turnu L, Alamanni F, Camera M, Cavalca V, Poggio P. Endothelial Dysfunction in Patients with Severe Mitral Regurgitation. J Clin Med 2019; 8:jcm8060835. [PMID: 31212807 PMCID: PMC6616454 DOI: 10.3390/jcm8060835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 01/05/2023] Open
Abstract
Mitral valve prolapse (MVP) is the most common cause of severe mitral regurgitation. It has been reported that MVP patients—candidates for mitral valve repair (MVRep)—showed an alteration in the antioxidant defense systems as well as in the L-arginine metabolic pathway. In this study, we investigate if oxidative stress and endothelial dysfunction are an MVP consequence or driving factors. Forty-five patients undergoing MVRep were evaluated before and 6 months post surgery and compared to 29 controls. Oxidized (GSSG) and reduced (GSH) forms of glutathione, and L-arginine metabolic pathway were analyzed using liquid chromatography-tandem mass spectrometry methods while osteoprotegerin (OPG) through the ELISA kit and circulating endothelial microparticles (EMP) by flow cytometry. Six-month post surgery, in MVP patients, the GSSG/GSH ratio decreased while symmetric and asymmetric dimethylarginines levels remained comparable to the baseline. Conversely, OPG levels significantly increased when compared to their baseline. Finally, pre-MVRep EMP levels were significantly higher in patients than in controls and did not change post surgery. Overall, these results highlight that MVRep completely restores the increased oxidative stress levels, as evidenced in MVP patients. Conversely, no amelioration of endothelial dysfunction was evidenced after surgery. Thus, therapies aimed to restore a proper endothelial function before and after surgical repair could benefit MVP patients.
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Affiliation(s)
- Benedetta Porro
- Centro Cardiologico Monzino, I.R.C.C.S., 20138 Milan, Italy.
| | - Paola Songia
- Centro Cardiologico Monzino, I.R.C.C.S., 20138 Milan, Italy.
| | | | - Vincenza Valerio
- Centro Cardiologico Monzino, I.R.C.C.S., 20138 Milan, Italy.
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, 80138 Naples, Italy.
| | | | - Paola Gripari
- Centro Cardiologico Monzino, I.R.C.C.S., 20138 Milan, Italy.
| | - Laura Fusini
- Centro Cardiologico Monzino, I.R.C.C.S., 20138 Milan, Italy.
| | | | - Paola Canzano
- Centro Cardiologico Monzino, I.R.C.C.S., 20138 Milan, Italy.
| | - Linda Turnu
- Centro Cardiologico Monzino, I.R.C.C.S., 20138 Milan, Italy.
| | | | - Marina Camera
- Centro Cardiologico Monzino, I.R.C.C.S., 20138 Milan, Italy.
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy.
| | - Viviana Cavalca
- Centro Cardiologico Monzino, I.R.C.C.S., 20138 Milan, Italy.
| | - Paolo Poggio
- Centro Cardiologico Monzino, I.R.C.C.S., 20138 Milan, Italy.
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8
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Valerio V, Myasoedova VA, Moschetta D, Porro B, Perrucci GL, Cavalca V, Cavallotti L, Songia P, Poggio P. Impact of Oxidative Stress and Protein S-Glutathionylation in Aortic Valve Sclerosis Patients with Overt Atherosclerosis. J Clin Med 2019; 8:jcm8040552. [PMID: 31022838 PMCID: PMC6517913 DOI: 10.3390/jcm8040552] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 04/16/2019] [Accepted: 04/18/2019] [Indexed: 12/15/2022] Open
Abstract
Aortic valve sclerosis (AVSc) is characterized by non-uniform thickening of the leaflets without hemodynamic changes. Endothelial dysfunction, also caused by dysregulation of glutathione homeostasis expressed as ratio between its reduced (GSH) and its oxidised form (GSSG), could represent one of the pathogenic triggers of AVSc. We prospectively enrolled 58 patients with overt atherosclerosis and requiring coronary artery bypass grafting (CABG). The incidence of AVSc in the studied population was 50%. The two groups (No-AVSc and AVSc) had similar clinical characteristics. Pre-operatively, AVSc group showed significantly lower GSH/GSSG ratio than No-AVSc group (p = 0.02). Asymmetric dimethylarginine (ADMA) concentration was significantly higher in AVSc patients compared to No-AVSc patients (p < 0.0001). Explanted sclerotic aortic valves presented a significantly increased protein glutathionylation (Pr-SSG) than No-AVSc ones (p = 0.01). In vitro, inhibition of glutathione reductase caused β-actin glutathionylation, activation of histone 2AX, upregulation of α2 smooth muscle actin (ACTA2), downregulation of platelet and endothelial cell adhesion molecule 1 (PECAM1) and cadherin 5 (CDH5). In this study, we showed for the first time that the dysregulation of glutathione homeostasis is associated with AVSc. We found that Pr-SSG is increased in AVSc leaflets and it could lead to EndMT via DNA damage. Further studies are warranted to elucidate the causal role of Pr-SSG in aortic valve degeneration.
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Affiliation(s)
- Vincenza Valerio
- Centro Cardiologico Monzino IRCCS, Unit for the Study of Aortic, Valvular and Coronary Pathologies, 20138 Milan, Italy.
- Università degli Studi di Napoli Federico II, Dipartimento di Medicina Clinica e Chirurgia, 80131 Napoli, Italy.
| | - Veronika A Myasoedova
- Centro Cardiologico Monzino IRCCS, Unit for the Study of Aortic, Valvular and Coronary Pathologies, 20138 Milan, Italy.
| | - Donato Moschetta
- Centro Cardiologico Monzino IRCCS, Unit for the Study of Aortic, Valvular and Coronary Pathologies, 20138 Milan, Italy.
| | - Benedetta Porro
- Centro Cardiologico Monzino IRCCS, Unit of Metabolomics and Cellular Biochemistry of Atherothrombosis, 20138 Milan, Italy.
| | - Gianluca L Perrucci
- Centro Cardiologico Monzino IRCCS, Unit of Vascular Biology and Regenerative Medicine, 20138 Milan, Italy.
| | - Viviana Cavalca
- Centro Cardiologico Monzino IRCCS, Unit of Metabolomics and Cellular Biochemistry of Atherothrombosis, 20138 Milan, Italy.
| | - Laura Cavallotti
- Centro Cardiologico Monzino IRCCS, Cardiac Surgery Unit, 20138 Milan, Italy.
| | - Paola Songia
- Centro Cardiologico Monzino IRCCS, Unit for the Study of Aortic, Valvular and Coronary Pathologies, 20138 Milan, Italy.
| | - Paolo Poggio
- Centro Cardiologico Monzino IRCCS, Unit for the Study of Aortic, Valvular and Coronary Pathologies, 20138 Milan, Italy.
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Dietary total antioxidant capacity (TAC) among candidates for coronary artery bypass grafting (CABG) surgery: Emphasis to possible beneficial role of TAC on serum vitamin D. PLoS One 2018; 13:e0208806. [PMID: 30540842 PMCID: PMC6291249 DOI: 10.1371/journal.pone.0208806] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 11/25/2018] [Indexed: 12/15/2022] Open
Abstract
Aims Recently, the clinical importance of total antioxidant capacity (TAC) and its protective role against several chronic diseases like cardiovascular disease, osteoporosis and several types of cancers has been reported. However, its association with cardio-metabolic risk factors among patients candidate for coronary artery bypass graft surgery (CABG) has not been evaluated yet. CABG is associated with increased oxidative stress and free radicals; so, the current study was aimed to evaluate the potential association of TAC with cardiovascular risk factors among patients candidate for CABG. Methods and materials In the current cross-sectional study, 454 patients aged 35–80 years as candidates of CABG and hospitalized in Tehran Heart Center were enrolled. Anthropometric and demographic characteristics were obtained from all participants. Total dietary antioxidant capacity (TAC) was calculated according to the findings of semi-quantitative food-frequency questionnaire (FFQ). Biochemical parameters including serum lipids, albumin, creatinine, HbA1C, C-reactive protein (CRP), lipoprotein (a), creatinine, blood urea nitrogen (BUN) and serum vitamin D concentrations were also assessed by commercial laboratory methods. Results Male patients in the top quintiles of TAC had significantly lower prevalence of hypertension (35.1% vs 45.9%). Moreover, male patients at fifth quintile of TAC were 2% more serum vitamin D concentrations, 3% lower serum cholesterol concentrations compared with lowest quintile. Top quintiles of TAC make patients more likely to have low hematocrit and high serum albumin concentrations compared with lowest quintiles (P < 0.05). However, in female participants, only serum creatinine concentration was in negative association with TAC. In comparison of clinical parameters, females in the fifth quintile of TAC had 9% higher EF compared with patients in the first quintile (P = 0.021). Conclusion To our findings, higher dietary antioxidant capacity was associated with lower prevalence of hypertension, lower hematocrit, total cholesterol and higher albumin and vitamin D concentrations. Therefore, high dietary TAC could be considered as a potent protective tool against cardio-metabolic risk factors in patients CABG candidate for especially in male patients.
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10
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Ibrahim MA, Geddawy A, Abdel-Wahab S. Sitagliptin prevents isoproterenol-induced myocardial infarction in rats by modulating nitric oxide synthase enzymes. Eur J Pharmacol 2018; 829:63-69. [DOI: 10.1016/j.ejphar.2018.04.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 04/04/2018] [Accepted: 04/09/2018] [Indexed: 02/04/2023]
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11
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Assessing Free-Radical-Mediated DNA Damage during Cardiac Surgery: 8-Oxo-7,8-dihydro-2'-deoxyguanosine as a Putative Biomarker. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:9715898. [PMID: 28660009 PMCID: PMC5474244 DOI: 10.1155/2017/9715898] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 04/09/2017] [Indexed: 02/07/2023]
Abstract
Coronary artery bypass grafting (CABG), one of the most common cardiac surgical procedures, is characterized by a burst of oxidative stress. 8-Oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG), produced following DNA repairing, is used as an indicator of oxidative DNA damage in humans. The effect of CABG on oxidative-induced DNA damage, evaluated through the measurement of urinary 8-oxodG by a developed and validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method in 52 coronary artery disease (CAD) patients, was assessed before (T0), five days (T1), and six months (T2) after CABG procedure. These results were compared with those obtained in 40 subjects with cardiovascular risk factors and without overt cardiovascular disease (CTR). Baseline (T0) 8-oxodG was higher in CAD than in CTR (p = 0.035). A significant burst was detected at T1 (p = 0.019), while at T2, 8-oxodG levels were significantly lower than those measured at T0 (p < 0.0001) and comparable to those found in CTR (p = 0.73). A similar trend was observed for urinary 8-iso-prostaglandin F2α (8-isoPGF2α), a reliable marker of oxidative stress. In the whole population baseline, 8-oxodG significantly correlated with 8-isoPGF2α levels (r = 0.323, p = 0.002). These data argue for CABG procedure in CAD patients as inducing a short-term increase in oxidative DNA damage, as revealed by 8-oxodG concentrations, and a long-term return of such metabolite toward physiological levels.
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12
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Casós K, Ferrer-Curriu G, Soler-Ferrer P, Pérez ML, Permanyer E, Blasco-Lucas A, Gracia-Baena JM, Castro MA, Sureda C, Barquinero J, Galiñanes M. Response of the human myocardium to ischemic injury and preconditioning: The role of cardiac and comorbid conditions, medical treatment, and basal redox status. PLoS One 2017; 12:e0174588. [PMID: 28380047 PMCID: PMC5381881 DOI: 10.1371/journal.pone.0174588] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 03/02/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The diseased human myocardium is highly susceptible to ischemia/reoxygenation (I/R)-induced injury but its response to protective interventions such as ischemic preconditioning (IPreC) is unclear. Cardiac and other pre-existing clinical conditions as well as previous or ongoing medical treatment may influence the myocardial response to I/R injury and protection. This study investigated the effect of both on myocardial susceptibility to I/R-induced injury and the protective effects of IPreC. METHODS AND RESULTS Atrial myocardium from cardiac surgery patients (n = 300) was assigned to one of three groups: aerobic control, I/R alone, and IPreC. Lactate dehydrogenase leakage, as a marker of cell injury, and cell viability were measured. The basal redox status was determined in samples from 90 patients. The response to I/R varied widely. Myocardium from patients with aortic valve disease was the most susceptible to injury whereas myocardium from dyslipidemia patients was the least susceptible. Tissue from females was better protected than tissue from males. Myocardium from patients with mitral valve disease was the least responsive to IPreC. The basal redox status was altered in the myocardium from patients with mitral and aortic valve disease. CONCLUSIONS The response of the myocardium to I/R and IPreC is highly variable and influenced by the underlying cardiac pathology, dyslipidemia, sex, and the basal redox status. These results should be taken into account in the design of future clinical studies on the prevention of I/R injury and protection.
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Affiliation(s)
- Kelly Casós
- Reparative Therapy of the Heart, Vall d’Hebron Research Institute (VHIR), University Hospital Vall d’Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Gemma Ferrer-Curriu
- Reparative Therapy of the Heart, Vall d’Hebron Research Institute (VHIR), University Hospital Vall d’Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Paula Soler-Ferrer
- Reparative Therapy of the Heart, Vall d’Hebron Research Institute (VHIR), University Hospital Vall d’Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - María L Pérez
- Reparative Therapy of the Heart, Vall d’Hebron Research Institute (VHIR), University Hospital Vall d’Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Eduard Permanyer
- Department of Cardiac Surgery, University Hospital Vall d’Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Arnau Blasco-Lucas
- Department of Cardiac Surgery, University Hospital Vall d’Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Juan Manuel Gracia-Baena
- Department of Cardiac Surgery, University Hospital Vall d’Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Miguel A Castro
- Department of Cardiac Surgery, University Hospital Vall d’Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Carlos Sureda
- Department of Cardiac Surgery, University Hospital Vall d’Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | | | - Manuel Galiñanes
- Reparative Therapy of the Heart, Vall d’Hebron Research Institute (VHIR), University Hospital Vall d’Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain
- Department of Cardiac Surgery, University Hospital Vall d’Hebron, Autonomous University of Barcelona (UAB), Barcelona, Spain
- * E-mail:
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Identification of Patients Affected by Mitral Valve Prolapse with Severe Regurgitation: A Multivariable Regression Model. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:6838921. [PMID: 28261377 PMCID: PMC5312449 DOI: 10.1155/2017/6838921] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 12/30/2016] [Accepted: 01/11/2017] [Indexed: 12/26/2022]
Abstract
Background. Mitral valve prolapse (MVP) is the most common cause of severe mitral regurgitation. Besides echocardiography, up to now there are no reliable biomarkers available for the identification of this pathology. We aim to generate a predictive model, based on circulating biomarkers, able to identify MVP patients with the highest accuracy. Methods. We analysed 43 patients who underwent mitral valve repair due to MVP and compared to 29 matched controls. We assessed the oxidative stress status measuring the oxidized and the reduced form of glutathione by liquid chromatography-tandem mass spectrometry method. Osteoprotegerin (OPG) plasma levels were measured by an enzyme-linked immunosorbent assay. The combination of these biochemical variables was used to implement several logistic regression models. Results. Oxidative stress levels and OPG concentrations were significantly higher in patients compared to control subjects (0.116 ± 0.007 versus 0.053 ± 0.013 and 1748 ± 100.2 versus 1109 ± 45.3 pg/mL, respectively; p < 0.0001). The best regression model was able to correctly classify 62 samples out of 72 with accuracy in terms of area under the curve of 0.92. Conclusions. To the best of our knowledge, this is the first study to show a strong association between OPG and oxidative stress status in patients affected by MVP with severe regurgitation.
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Reimann MJ, Häggström J, Møller JE, Lykkesfeldt J, Falk T, Olsen LH. Markers of Oxidative Stress in Dogs with Myxomatous Mitral Valve Disease are Influenced by Sex, Neuter Status, and Serum Cholesterol Concentration. J Vet Intern Med 2017; 31:295-302. [PMID: 28132441 PMCID: PMC5354038 DOI: 10.1111/jvim.14647] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 11/09/2016] [Accepted: 11/28/2016] [Indexed: 12/19/2022] Open
Abstract
Background Cardiovascular disease has been associated with oxidative stress, which has been suggested to contribute to myocardial remodeling in human patients. Little is known about the relationship between myxomatous mitral valve disease (MMVD) and oxidative stress in dogs. Objective To determine whether clinical stage of MMVD is associated with changes in the plasma concentrations of certain markers of oxidative stress in clinically healthy dogs and dogs with MMVD. Animals Seventy five privately owned dogs: 59 cavalier King Charles Spaniels (CKCS) with different severities of MMVD and 16 dogs of different breeds with clinical signs of congestive heart failure (CHF) caused by MMVD. Methods Markers of oxidative stress including malondialdehyde (MDA), oxidized low‐density lipoprotein (oxLDL), and vitamin E (α‐tocopherol and γ‐tocopherol) were measured in plasma and their association with clinical stage of MMVD was assessed by regression analyses. Results Plasma oxLDL concentration was significantly lower in female dogs compared with males (P = .01). Significantly higher plasma γ‐tocopherol concentrations were found in neutered (P = .003) dogs. Vitamin E (α‐tocopherol [P = .0004] and γ‐tocopherol [P = .003]) was associated with body condition score (BCS), but the association disappeared when cholesterol was included in the analyses. All markers of oxidative stress (MDA, oxLDL, and vitamin E) were positively associated with serum cholesterol concentration (P ≤ .04), but none were associated with clinical stage of MMVD. Conclusions In conclusion, markers of oxidative stress are associated with sex, BCS, neuter status, and cholesterol. The results cannot confirm a relationship between oxidative stress and clinical stage of the disease in dogs with MMVD.
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Affiliation(s)
- M J Reimann
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - J Häggström
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - J E Møller
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - J Lykkesfeldt
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - T Falk
- Din Veterinär, Helsingborg, Sweden
| | - L H Olsen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
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15
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Change in Free Radical and Antioxidant Enzyme Levels in the Patients Undergoing Open Heart Surgery with Cardiopulmonary Bypass. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:1783728. [PMID: 28101295 PMCID: PMC5214539 DOI: 10.1155/2016/1783728] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 11/07/2016] [Accepted: 11/29/2016] [Indexed: 01/24/2023]
Abstract
Objective. The purpose of this study is to determine the changes in oxidative damage and antioxidant parameters in open heart surgeries with cardiopulmonary bypass (CPB) in preoperative and early postoperative periods. Methods. A total of three consecutive arterial blood samples were obtained from the patients in the study group, in preoperative, early postoperative, and postoperative periods, respectively. Oxidative damage indicator (MDA) and antioxidant indicators (GPx, GSH, CAT, and SOD) were examined. Results. A statistically significant increase was observed in MDA level in postoperative period compared to preoperative and early postoperative periods. GSH levels and CAT activities increased significantly in early postoperative and postoperative periods. Analyses revealed an increase in GPx and SOD enzyme activities only in the postoperative period. Conclusion. Even though the increase in MDA level was suppressed by the increased GSH level and CAT activity like in early postoperative period, efficiency can be brought for the increases in insufficient significant antioxidant parameters in postoperative period by administering antioxidant supplements to the patients and thus the increase in MDA in postoperative period can be significantly suppressed.
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16
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Songia P, Branchetti E, Parolari A, Myasoedova V, Ferrari G, Alamanni F, Tremoli E, Poggio P. Mitral valve endothelial cells secrete osteoprotegerin during endothelial mesenchymal transition. J Mol Cell Cardiol 2016; 98:48-57. [PMID: 27338002 DOI: 10.1016/j.yjmcc.2016.06.061] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 06/16/2016] [Accepted: 06/18/2016] [Indexed: 12/20/2022]
Abstract
AIMS Mitral valve prolapse (MVP) has a prevalence of 3% in the general population, affecting >176 million people worldwide. Despite this, little is known about the molecular and cellular mechanisms involved in the progression of MVP and surgical intervention is the only available option. In this study we investigated the role of osteoprotegerin (OPG) during endothelial to mesenchymal transition (EndMT) in MVP. METHODS AND RESULTS VECs and VICs were isolated from posterior mitral valve leaflets of patients undergoing mitral valve repair (n=25). Plasma was collected from 57 subjects (29 controls and 28 MVP patients). Overexpression of OPG during EndMT followed by autocrine effects characterised by reactive oxygen species increment and accelerated migration was documented. In addition, OPG increased VIC proliferation. Finally, OPG plasma levels were significantly higher in MVP patients compared to control subjects and the area under the ROC curve was 0.92. CONCLUSION EndMT has been recognised as a possible pathological mechanism for MVP. For the first time, we report the involvement of OPG in cellular and molecular changes in MVP isolated cells. In addition, we detected elevated circulating OPG levels in MVP patients when compared to controls, which supports the hypothesis that OPG is involved in MVP development and progression.
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Affiliation(s)
- Paola Songia
- Centro Cardiologico Monzino IRCCS, Milan, Italy; Università degli Studi di Milano, Dipartimento di Scienze Farmacologiche e Biomolecolari, Milan, Italy
| | | | - Alessandro Parolari
- Policlinico San Donato IRCCS, U.O. Cardiochirurgia e Ricerca traslazionale, San Donato Milanese, Italy; Università degli Studi di Milano, Dipartimento di Scienze Biomediche per la Salute, Milan, Italy
| | | | - Giovanni Ferrari
- University of Pennsylvania, Department of Surgery, Philadelphia, PA, USA
| | - Francesco Alamanni
- Centro Cardiologico Monzino IRCCS, Milan, Italy; Università degli Studi di Milano, Dipartimento di Scienze Cliniche e di Comunità, Sezione Cardiovascolare, Milan, Italy
| | | | - Paolo Poggio
- Centro Cardiologico Monzino IRCCS, Milan, Italy.
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Huk DJ, Austin BF, Horne TE, Hinton RB, Ray WC, Heistad DD, Lincoln J. Valve Endothelial Cell-Derived Tgfβ1 Signaling Promotes Nuclear Localization of Sox9 in Interstitial Cells Associated With Attenuated Calcification. Arterioscler Thromb Vasc Biol 2015; 36:328-38. [PMID: 26634652 DOI: 10.1161/atvbaha.115.306091] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 11/18/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Aortic valve disease, including calcification, affects >2% of the human population and is caused by complex interactions between multiple risk factors, including genetic mutations, the environment, and biomechanics. At present, there are no effective treatments other than surgery, and this is because of the limited understanding of the mechanisms that underlie the condition. Previous work has shown that valve interstitial cells within the aortic valve cusps differentiate toward an osteoblast-like cell and deposit bone-like matrix that leads to leaflet stiffening and calcific aortic valve stenosis. However, the mechanisms that promote pathological phenotypes in valve interstitial cells are unknown. APPROACH AND RESULTS Using a combination of in vitro and in vivo tools with mouse, porcine, and human tissue, we show that in valve interstitial cells, reduced Sox9 expression and nuclear localization precedes the onset of calcification. In vitro, Sox9 nuclear export and calcific nodule formation is prevented by valve endothelial cells. However, in vivo, loss of Tgfβ1 in the endothelium leads to reduced Sox9 expression and calcific aortic valve disease. CONCLUSIONS Together, these findings suggest that reduced nuclear localization of Sox9 in valve interstitial cells is an early indicator of calcification, and therefore, pharmacological targeting to prevent nuclear export could serve as a novel therapeutic tool in the prevention of calcification and stenosis.
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Affiliation(s)
- Danielle J Huk
- From the Molecular and Cellular Pharmacology Graduate Program, Leonard M. Miller School of Medicine, Miami, FL (D.J.H.); Center for Cardiovascular Research and The Heart Center at Nationwide Children's Hospital Research Institute, Columbus, OH (D.J.H., B.F.A., T.E.H., J.L.); Division of Cardiology, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH (R.B.H.); Battelle Center for Mathematical Medicine, Nationwide Children's Hospital Research Institute, Columbus, OH (W.C.R.); The Ohio State University Interdisciplinary Graduate Program in Biophysics, Columbus, OH (W.C.R.); Department of Pediatrics, The Ohio State University, Columbus, OH (W.C.R., J.L.); and Division of Cardiovascular Medicine and Department of Pharmacology, University of Iowa Carver College of Medicine, Iowa City, IA (D.D.H.)
| | - Blair F Austin
- From the Molecular and Cellular Pharmacology Graduate Program, Leonard M. Miller School of Medicine, Miami, FL (D.J.H.); Center for Cardiovascular Research and The Heart Center at Nationwide Children's Hospital Research Institute, Columbus, OH (D.J.H., B.F.A., T.E.H., J.L.); Division of Cardiology, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH (R.B.H.); Battelle Center for Mathematical Medicine, Nationwide Children's Hospital Research Institute, Columbus, OH (W.C.R.); The Ohio State University Interdisciplinary Graduate Program in Biophysics, Columbus, OH (W.C.R.); Department of Pediatrics, The Ohio State University, Columbus, OH (W.C.R., J.L.); and Division of Cardiovascular Medicine and Department of Pharmacology, University of Iowa Carver College of Medicine, Iowa City, IA (D.D.H.)
| | - Tori E Horne
- From the Molecular and Cellular Pharmacology Graduate Program, Leonard M. Miller School of Medicine, Miami, FL (D.J.H.); Center for Cardiovascular Research and The Heart Center at Nationwide Children's Hospital Research Institute, Columbus, OH (D.J.H., B.F.A., T.E.H., J.L.); Division of Cardiology, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH (R.B.H.); Battelle Center for Mathematical Medicine, Nationwide Children's Hospital Research Institute, Columbus, OH (W.C.R.); The Ohio State University Interdisciplinary Graduate Program in Biophysics, Columbus, OH (W.C.R.); Department of Pediatrics, The Ohio State University, Columbus, OH (W.C.R., J.L.); and Division of Cardiovascular Medicine and Department of Pharmacology, University of Iowa Carver College of Medicine, Iowa City, IA (D.D.H.)
| | - Robert B Hinton
- From the Molecular and Cellular Pharmacology Graduate Program, Leonard M. Miller School of Medicine, Miami, FL (D.J.H.); Center for Cardiovascular Research and The Heart Center at Nationwide Children's Hospital Research Institute, Columbus, OH (D.J.H., B.F.A., T.E.H., J.L.); Division of Cardiology, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH (R.B.H.); Battelle Center for Mathematical Medicine, Nationwide Children's Hospital Research Institute, Columbus, OH (W.C.R.); The Ohio State University Interdisciplinary Graduate Program in Biophysics, Columbus, OH (W.C.R.); Department of Pediatrics, The Ohio State University, Columbus, OH (W.C.R., J.L.); and Division of Cardiovascular Medicine and Department of Pharmacology, University of Iowa Carver College of Medicine, Iowa City, IA (D.D.H.)
| | - William C Ray
- From the Molecular and Cellular Pharmacology Graduate Program, Leonard M. Miller School of Medicine, Miami, FL (D.J.H.); Center for Cardiovascular Research and The Heart Center at Nationwide Children's Hospital Research Institute, Columbus, OH (D.J.H., B.F.A., T.E.H., J.L.); Division of Cardiology, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH (R.B.H.); Battelle Center for Mathematical Medicine, Nationwide Children's Hospital Research Institute, Columbus, OH (W.C.R.); The Ohio State University Interdisciplinary Graduate Program in Biophysics, Columbus, OH (W.C.R.); Department of Pediatrics, The Ohio State University, Columbus, OH (W.C.R., J.L.); and Division of Cardiovascular Medicine and Department of Pharmacology, University of Iowa Carver College of Medicine, Iowa City, IA (D.D.H.)
| | - Donald D Heistad
- From the Molecular and Cellular Pharmacology Graduate Program, Leonard M. Miller School of Medicine, Miami, FL (D.J.H.); Center for Cardiovascular Research and The Heart Center at Nationwide Children's Hospital Research Institute, Columbus, OH (D.J.H., B.F.A., T.E.H., J.L.); Division of Cardiology, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH (R.B.H.); Battelle Center for Mathematical Medicine, Nationwide Children's Hospital Research Institute, Columbus, OH (W.C.R.); The Ohio State University Interdisciplinary Graduate Program in Biophysics, Columbus, OH (W.C.R.); Department of Pediatrics, The Ohio State University, Columbus, OH (W.C.R., J.L.); and Division of Cardiovascular Medicine and Department of Pharmacology, University of Iowa Carver College of Medicine, Iowa City, IA (D.D.H.)
| | - Joy Lincoln
- From the Molecular and Cellular Pharmacology Graduate Program, Leonard M. Miller School of Medicine, Miami, FL (D.J.H.); Center for Cardiovascular Research and The Heart Center at Nationwide Children's Hospital Research Institute, Columbus, OH (D.J.H., B.F.A., T.E.H., J.L.); Division of Cardiology, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH (R.B.H.); Battelle Center for Mathematical Medicine, Nationwide Children's Hospital Research Institute, Columbus, OH (W.C.R.); The Ohio State University Interdisciplinary Graduate Program in Biophysics, Columbus, OH (W.C.R.); Department of Pediatrics, The Ohio State University, Columbus, OH (W.C.R., J.L.); and Division of Cardiovascular Medicine and Department of Pharmacology, University of Iowa Carver College of Medicine, Iowa City, IA (D.D.H.).
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Zakkar M, Guida G, Suleiman MS, Angelini GD. Cardiopulmonary bypass and oxidative stress. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2015; 2015:189863. [PMID: 25722792 PMCID: PMC4334937 DOI: 10.1155/2015/189863] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 01/19/2015] [Indexed: 12/13/2022]
Abstract
The development of the cardiopulmonary bypass (CPB) revolutionized cardiac surgery and contributed immensely to improved patients outcomes. CPB is associated with the activation of different coagulation, proinflammatory, survival cascades and altered redox state. Haemolysis, ischaemia, and perfusion injury and neutrophils activation during CPB play a pivotal role in oxidative stress and the associated activation of proinflammatory and proapoptotic signalling pathways which can affect the function and recovery of multiple organs such as the myocardium, lungs, and kidneys and influence clinical outcomes. The administration of agents with antioxidant properties during surgery either intravenously or in the cardioplegia solution may reduce ROS burst and oxidative stress during CPB. Alternatively, the use of modified circuits such as minibypass can modify both proinflammatory responses and oxidative stress.
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Affiliation(s)
- Mustafa Zakkar
- Bristol Royal Infirmary, Level 7, Upper Maudlin Street, Bristol BS2 8HW, UK
| | - Gustavo Guida
- Bristol Royal Infirmary, Level 7, Upper Maudlin Street, Bristol BS2 8HW, UK
| | - M-Saadeh Suleiman
- Bristol Royal Infirmary, Level 7, Upper Maudlin Street, Bristol BS2 8HW, UK
| | - Gianni D. Angelini
- Bristol Royal Infirmary, Level 7, Upper Maudlin Street, Bristol BS2 8HW, UK
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