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Nemtsova V, Vischer AS, Burkard T. Hypertensive Heart Disease: A Narrative Review Series-Part 3: Vasculature, Biomarkers and the Matrix of Hypertensive Heart Disease. J Clin Med 2024; 13:505. [PMID: 38256639 PMCID: PMC10816030 DOI: 10.3390/jcm13020505] [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: 11/08/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
Over the last few decades, research efforts have resulted in major advances in our understanding of the pathophysiology of hypertensive heart disease (HHD). This is the third part of a three-part review series. Here, we focus on the influence of high blood pressure on the micro- and macroalterations that occur in the vasculature in HHD. We also provide an overview of circulating cardiac biomarkers that may prove useful for a better understanding of the pathophysiology, development and progression of HHD, and may play a unique role in the diagnostic and prognostic evaluation of patients with HHD, taking into account their properties showing as abnormal long before the onset of the disease. In the conclusion, we propose an updated definition of HHD and a matrix for clinical classification, which we suspect will be useful in practice, allowing an individual approach to HHD patients.
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Affiliation(s)
- Valeriya Nemtsova
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (V.N.); (A.S.V.)
- Internal Diseases and Family Medicine Department, Educational and Scientific Medical Institute of National Technical University «Kharkiv Polytechnic Institute», 61000 Kharkiv, Ukraine
| | - Annina S. Vischer
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (V.N.); (A.S.V.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
| | - Thilo Burkard
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (V.N.); (A.S.V.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
- Department of Cardiology, University Hospital Basel, 4031 Basel, Switzerland
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Vlahodimitris I, Karangelis D, Moschaki M, Moyssakis I, Christodoulou KC, Perrea DN, Mourouzis I, Papadogiannis D. Cardiotrophin-1 in Asymptomatic Hypertensive Patients With Mild Diastolic Dysfunction: Potential Prognostic Value in Early Stages of Hypertensive Heart Disease. Cureus 2023; 15:e46516. [PMID: 37927758 PMCID: PMC10625173 DOI: 10.7759/cureus.46516] [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] [Accepted: 10/05/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Regardless of the advancements in modern technology and treatment options, heart failure (HF) exhibits impervious mortality and morbidity rates. Arterial hypertension poses one of the greatest risks for developing HF, yet the exact pathophysiological path and changes that lead from isolated hypertension to HF are still unclear. Cardiotrophin-1 (CT-1) serves as a promising prognostic biomarker for the onset of HF in hypertensive patients. The aim of this study was to investigate whether CT-1 levels are elevated in a selected group of asymptomatic hypertensive patients. METHODS In a selected cohort of 40 asymptomatic patients with early diastolic dysfunction (grade I), without any signs of increased filling pressures in the left ventricle, as well as 20 healthy individuals, the levels of CT-1 brain natriuretic peptide (BNP) along with various echocardiographic parameters were evaluated. RESULTS The mean age of the hypertensive patients was 56 ± 5 years and 52± 3.5 years for the normotensive controls. The hypertensive group exhibited higher levels of CT-1, which was not affected by left ventricular hypertrophy. Notably, in patients with normal E/E' < 8 (n = 30), CT-1 levels were 1165 ± 471 pg/ml compared to 2069 ± 576 pg/ml in patients with marginal E/E' > 8 and <14 (n = 10), p = 0.001. CONCLUSIONS Our study demonstrated elevated CT-1 levels in a cohort of asymptomatic hypertensive patients, exhibiting mild diastolic dysfunction. These findings are suggestive of the potentially prognostic value of this particular biomarker in the early stages of hypertensive heart disease.
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Affiliation(s)
| | - Dimos Karangelis
- Cardiothoracic Surgery, Democritus University of Thrace, Alexandroupolis, GRC
| | - Maria Moschaki
- Anesthesia, Evangelismos Hospital of Athens, Athens, GRC
| | | | | | - Despoina N Perrea
- Laboratory of Experimental Surgery and Surgical Research, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Iordanis Mourouzis
- Pharmacology, National and Kapodistrian University of Athens, Athens, GRC
| | - Dimitrios Papadogiannis
- First Department of Propaedeutic Medicine, Laiko General Hospital of Athens, National and Kapodistrian University of Athens, Athens, GRC
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Ojji D, Libhaber E, Lamont K, Thienemann F, Sliwa K. Circulating biomarkers in the early detection of hypertensive heart disease: usefulness in the developing world. Cardiovasc Diagn Ther 2020; 10:296-304. [PMID: 32420112 DOI: 10.21037/cdt.2019.09.10] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Although the varying phenotypic spectra of hypertensive heart disease (HHD) can be assessed by electrocardiography (ECG), echocardiography and cardiovascular magnetic resonance (CMR), ECG criteria for left ventricular hypertrophy (LVH) are insensitive, while echocardiography and CMR are expensive, less readily available and often lack requisite expertise. Consequently, the use of circulating biomarkers in the diagnosis and prognostication of HHD beyond the traditional N-terminal pro- b-type natriuretic peptide (NT-proBNP) and B-type natriuretic peptide (BNP) have become an attractive alternative. We carried out a PubMed and Google Scholar databases' search of original articles on circulating biomarkers used in the diagnosis of the different spectrum of HHD over the last 10 years [2005-2015] in humans. Fourteen studies met the inclusion criteria with NT-pro BNP being the most studied circulating biomarker in HHD followed by soluble ST2 (sST2). There is a lack of data on the use of circulating biomarkers in HHD. There is a need to explore further this area of investigative cardiology.
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Affiliation(s)
- Dike Ojji
- Cardiology Unit, Department of Medicine, University of Abuja Teaching Hospital, Abuja, Nigeria
| | - Elena Libhaber
- Soweto Cardiovascular Research Unit, University of Witwatersrand, Johannesburg, South Africa
| | - Kim Lamont
- Soweto Cardiovascular Research Unit, University of Witwatersrand, Johannesburg, South Africa
| | - Friedrich Thienemann
- Hatter Institute for Cardiovascular Research in Africa, Department of Medicine and Cardiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Department of Internal Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Karen Sliwa
- Soweto Cardiovascular Research Unit, University of Witwatersrand, Johannesburg, South Africa.,Hatter Institute for Cardiovascular Research in Africa, Department of Medicine and Cardiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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4
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Martínez-Martínez E, Brugnolaro C, Ibarrola J, Ravassa S, Buonafine M, López B, Fernández-Celis A, Querejeta R, Santamaria E, Fernández-Irigoyen J, Rábago G, Moreno MU, Jaisser F, Díez J, González A, López-Andrés N. CT-1 (Cardiotrophin-1)-Gal-3 (Galectin-3) Axis in Cardiac Fibrosis and Inflammation. Hypertension 2019; 73:602-611. [PMID: 30612490 DOI: 10.1161/hypertensionaha.118.11874] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Myocardial fibrosis is a main contributor to the development of heart failure (HF). CT-1 (cardiotrophin-1) and Gal-3 (galectin-3) are increased in HF and associated with myocardial fibrosis. The aim of this study is to analyze whether CT-1 regulates Gal-3. Proteomic analysis revealed that Gal-3 was upregulated by CT-1 in human cardiac fibroblasts in parallel with other profibrotic and proinflammatory markers. CT-1 upregulation of Gal-3 was mediated by ERK (extracellular signal-regulated kinase) 1/2 and Stat-3 (signal transducer and activator of transcription 3) pathways. Male Wistar rats and B6CBAF1 mice treated with CT-1 (20 µg/kg per day) presented higher cardiac Gal-3 levels and myocardial fibrosis. In CT-1-treated rats, direct correlations were found between cardiac CT-1 and Gal-3 levels, as well as between Gal-3 and perivascular fibrosis. Gal-3 genetic disruption in human cardiac fibroblasts and pharmacological Gal-3 inhibition in mice prevented the profibrotic and proinflammatory effects of CT-1. Dahl salt-sensitive hypertensive rats with diastolic dysfunction showed increased cardiac CT-1 and Gal-3 expression together with cardiac fibrosis and inflammation. CT-1 and Gal-3 directly correlated with myocardial fibrosis. In HF patients, myocardial and plasma CT-1 and Gal-3 were increased and directly correlated. In addition, HF patients with high CT-1 and Gal-3 plasma levels presented an increased risk of cardiovascular death. Our data suggest that CT-1 upregulates Gal-3 which, in turn, mediates the proinflammatory and profibrotic myocardial effects of CT-1. The elevation of both molecules in HF patients identifies a subgroup of patients with a higher risk of cardiovascular mortality. The CT-1/Gal-3 axis emerges as a candidate therapeutic target and a potential prognostic biomarker in HF.
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Affiliation(s)
- Ernesto Martínez-Martínez
- From the Cardiovascular Translational Research, Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona. Spain (E.M.-M., J.I., A.F.-C., N.L.-A.).,INSERM UMRS 1138 Team 1, Centre de Recherche des Cordeliers, University Pierre and Marie Curie, Paris, France (E.M.M., M.B., F.J.)
| | - Cristina Brugnolaro
- Program of Cardiovascular Diseases, CIMA University of Navarra and IdiSNA, Pamplona. Spain (C.B., S.R., B.L., M.U.M., J.D., A.G.)
| | - Jaime Ibarrola
- From the Cardiovascular Translational Research, Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona. Spain (E.M.-M., J.I., A.F.-C., N.L.-A.)
| | - Susana Ravassa
- Program of Cardiovascular Diseases, CIMA University of Navarra and IdiSNA, Pamplona. Spain (C.B., S.R., B.L., M.U.M., J.D., A.G.).,CIBERCV, Carlos III Institute of Health, Madrid. Spain (S.R., B.L., M.U.M., J.D., A.G.)
| | - Mathieu Buonafine
- INSERM UMRS 1138 Team 1, Centre de Recherche des Cordeliers, University Pierre and Marie Curie, Paris, France (E.M.M., M.B., F.J.)
| | - Begoña López
- Program of Cardiovascular Diseases, CIMA University of Navarra and IdiSNA, Pamplona. Spain (C.B., S.R., B.L., M.U.M., J.D., A.G.).,CIBERCV, Carlos III Institute of Health, Madrid. Spain (S.R., B.L., M.U.M., J.D., A.G.)
| | - Amaya Fernández-Celis
- From the Cardiovascular Translational Research, Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona. Spain (E.M.-M., J.I., A.F.-C., N.L.-A.)
| | - Ramón Querejeta
- Department of Cardiology, Donostia University Hospital, Biodonostia, Basque Country University, San Sebastián, Spain (R.Q.)
| | - Enrique Santamaria
- Proteored-ISCIII, Proteomics Unit, Navarrabiomed, Departamento de Salud, UPNA, IdiSNA, Pamplona, Spain (E.S., J.F.-I.)
| | - Joaquín Fernández-Irigoyen
- Proteored-ISCIII, Proteomics Unit, Navarrabiomed, Departamento de Salud, UPNA, IdiSNA, Pamplona, Spain (E.S., J.F.-I.)
| | - Gregorio Rábago
- Department of Cardiology and Cardiac Surgery (G.R., J.D.), Clinic Universtity of Navarra, Pamplona. Spain
| | - María U Moreno
- Program of Cardiovascular Diseases, CIMA University of Navarra and IdiSNA, Pamplona. Spain (C.B., S.R., B.L., M.U.M., J.D., A.G.).,CIBERCV, Carlos III Institute of Health, Madrid. Spain (S.R., B.L., M.U.M., J.D., A.G.)
| | - Frédéric Jaisser
- INSERM UMRS 1138 Team 1, Centre de Recherche des Cordeliers, University Pierre and Marie Curie, Paris, France (E.M.M., M.B., F.J.).,INSERM, Centre d'Investigations Cliniques-Plurithématique 1433, UMR 1116 Université de Lorraine, CHRU de Nancy, France (F.J., N.L.-A.)
| | - Javier Díez
- Program of Cardiovascular Diseases, CIMA University of Navarra and IdiSNA, Pamplona. Spain (C.B., S.R., B.L., M.U.M., J.D., A.G.).,CIBERCV, Carlos III Institute of Health, Madrid. Spain (S.R., B.L., M.U.M., J.D., A.G.).,Department of Cardiology and Cardiac Surgery (G.R., J.D.), Clinic Universtity of Navarra, Pamplona. Spain.,Department of Nephrology (J.D.), Clinic Universtity of Navarra, Pamplona. Spain
| | - Arantxa González
- Program of Cardiovascular Diseases, CIMA University of Navarra and IdiSNA, Pamplona. Spain (C.B., S.R., B.L., M.U.M., J.D., A.G.).,CIBERCV, Carlos III Institute of Health, Madrid. Spain (S.R., B.L., M.U.M., J.D., A.G.)
| | - Natalia López-Andrés
- From the Cardiovascular Translational Research, Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona. Spain (E.M.-M., J.I., A.F.-C., N.L.-A.).,INSERM, Centre d'Investigations Cliniques-Plurithématique 1433, UMR 1116 Université de Lorraine, CHRU de Nancy, France (F.J., N.L.-A.)
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Stephens J, Ravussin E, White U. The Expression of Adipose Tissue-Derived Cardiotrophin-1 in Humans with Obesity. BIOLOGY 2019; 8:biology8020024. [PMID: 31013924 PMCID: PMC6627495 DOI: 10.3390/biology8020024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/01/2019] [Accepted: 04/09/2019] [Indexed: 01/23/2023]
Abstract
Cardiotrophin-1 (CT-1) is a gp130 cytokine that was previously characterized for its effects on cardiomyocytes and identified as a marker of heart failure. More recent studies reported elevated circulating levels of CT-1 in humans with obesity and metabolic syndrome (MetS). However, a subsequent rodent study implicated CT-1 as a potential therapeutic target for obesity and MetS. Adipose tissue (AT) is broadly acknowledged as an endocrine organ and is a substantial source of CT-1. However, no study has examined the expression of adipose-derived CT-1 in humans. We present the first analysis of CT-1 mRNA expression in subcutaneous AT and its association with clinical variables in 22 women with obesity and 15 men who were 40% overfed for 8-weeks. We observed that CT-1 expression was higher in the subcutaneous abdominal (scABD) than the femoral (scFEM) depot. Importantly, we reveal that scFEM but not scABD, CT-1 expression was negatively associated with visceral adiposity and intrahepatic lipid, while positively correlated with insulin sensitivity in obese women. Also, men with higher CT-1 levels at baseline had less of a decline in insulin sensitivity in response to overfeeding. Our data provide new knowledge on the regulation of adipose-derived CT-1 in obesity and during weight gain in response to overfeeding in humans and suggest that CT-1 may play a protective role in obesity and related disorders.
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Affiliation(s)
| | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA.
| | - Ursula White
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA.
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Cardiotrophin-1 and leptin as cardiovascular risk markers in male patients with obstructive sleep apnea syndrome. ACTA ACUST UNITED AC 2019; 3:e123-e128. [PMID: 30775602 PMCID: PMC6374564 DOI: 10.5114/amsad.2018.79407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 08/01/2018] [Indexed: 11/19/2022]
Abstract
Introduction Elevated cardiotrophin-1 (CT-1) and leptin levels are important risk factors for cardiovascular diseases (CVDs). Obstructive sleep apnea syndrome (OSAS) has also been reported to increase this risk. The aim of this study is to evaluate serum concentrations of CT-1 and leptin in patients with OSAS and whether there is a possible association between CT-1, leptin and OSAS severity. Material and methods Fifty newly diagnosed OSAS patients and thirty nonapneic snoring subjects participated in this study. Fasting serum lipid profile markers were evaluated. The measurements of serum CT-1 and leptin levels were carried out using human ELISA kits. Results Significant differences were found in the serum CT-1 and leptin levels between the two groups. Serum median CT-1 levels in patient and control groups, respectively, were 19.47; 8.23 pg/ml and leptin levels were 2.07; 1.29 ng/ml (p < 0.001). In the severe patient group, serum median CT-1 level was statistically significantly higher than the median level in the mild/moderate group. There was no correlation between patients’ leptin and lipid profile parameters and CT-1 concentrations were not associated with triglyceride, cholesterol or LDL cholesterol levels except HDL cholesterol: CT-1 levels were positively correlated with HDL levels (p = 0.02). Conclusions Both CT-1 and leptin were significantly elevated in the patient group. Furthermore, CT-1 and leptin were associated with OSAS and CT-1 was associated with the disease severity.
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7
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Hogas S, Bilha SC, Branisteanu D, Hogas M, Gaipov A, Kanbay M, Covic A. Potential novel biomarkers of cardiovascular dysfunction and disease: cardiotrophin-1, adipokines and galectin-3. Arch Med Sci 2017; 13:897-913. [PMID: 28721158 PMCID: PMC5507105 DOI: 10.5114/aoms.2016.58664] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 12/30/2015] [Indexed: 12/22/2022] Open
Abstract
Cardiovascular disease is one of the main burdens of healthcare systems worldwide. Nevertheless, assessing cardiovascular risk in both apparently healthy individuals and low/high-risk patients remains a difficult issue. Already established biomarkers (e.g. brain natriuretic peptide, troponin) have significantly improved the assessment of major cardiovascular events and diseases but cannot be applied to all patients and in some cases do not provide sufficiently accurate information. In this context, new potential biomarkers that reflect various underlying pathophysiological cardiac and vascular modifications are needed. Also, a multiple biomarker evaluation that shows changes in the cardiovascular state is of interest. This review describes the role of selected markers of vascular inflammation, atherosclerosis, atherothrombosis, endothelial dysfunction and cardiovascular fibrosis in the pathogenesis and prognosis of cardiovascular disease: the potential use of cardiotrophin-1, leptin, adiponectin, resistin and galectin-3 as biomarkers for various cardiovascular conditions is discussed.
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Affiliation(s)
- Simona Hogas
- Nephrology Department, Dialysis and Renal Transplant Center, "C.I. Parhon" University Hospital, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Stefana C Bilha
- Endocrinology Department, "Sf. Spiridon" Hospital, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Dumitru Branisteanu
- Endocrinology Department, "Sf. Spiridon" Hospital, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Mihai Hogas
- Physiology Department, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Abduzhappar Gaipov
- Extracorporeal Hemocorrection Unit, JSC "National Scientific Medical Research Center", Astana, Kazakhstan
| | - Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey
| | - Adrian Covic
- Nephrology Department, Dialysis and Renal Transplant Center, "C.I. Parhon" University Hospital, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
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Minas JN, Thorwald MA, Conte D, Vázquez-Medina JP, Nishiyama A, Ortiz RM. Angiotensin and mineralocorticoid receptor antagonism attenuates cardiac oxidative stress in angiotensin II-infused rats. Clin Exp Pharmacol Physiol 2016; 42:1178-88. [PMID: 26234762 DOI: 10.1111/1440-1681.12473] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 06/30/2015] [Accepted: 06/30/2015] [Indexed: 11/30/2022]
Abstract
Angiotensin II (Ang II) and aldosterone contribute to hypertension, oxidative stress and cardiovascular damage, but the contributions of aldosterone during Ang II-dependent hypertension are not well defined because of the difficulty to assess each independently. To test the hypothesis that during Ang II infusion, oxidative and nitrosative damage is mediated through both the mineralocorticoid receptor (MR) and angiotensin type 1 receptor (AT1), five groups of Sprague-Dawley rats were studied: (i) control; (ii) Ang II infused (80 ng/min × 28 days); (iii) Ang II + AT1 receptor blocker (ARB; 10 mg losartan/kg per day × 21 days); (iv) Ang II + mineralocorticoid receptor (MR) antagonist (Epl; 100 mg eplerenone/day × 21 days); and (v) Ang II + ARB + Epl (Combo; × 21 days). Both ARB and combination treatments completely alleviated the Ang II-induced hypertension, whereas eplerenone treatment only prolonged the onset of the hypertension. Eplerenone treatment exacerbated the Ang II-mediated increase in plasma and heart aldosterone 2.3- and 1.8-fold, respectively, while ARB treatment reduced both. Chronic MR blockade was sufficient to ameliorate the AT1-mediated increase in oxidative damage. All treatments normalized protein oxidation (nitrotyrosine) levels; however, only ARB and Combo treatments completely reduced lipid peroxidation (4-hydroxynonenal) to control levels. Collectively, these data suggest that receptor signalling, and not the elevated arterial blood pressure, is the principal culprit in the oxidative stress-associated cardiovascular damage in Ang II-dependent hypertension.
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Affiliation(s)
- Jacqueline N Minas
- Molecular Cell Biology, School of Natural Sciences, University of California, Merced, CA, USA
| | - Max A Thorwald
- Molecular Cell Biology, School of Natural Sciences, University of California, Merced, CA, USA
| | - Debra Conte
- Molecular Cell Biology, School of Natural Sciences, University of California, Merced, CA, USA
| | | | - Akira Nishiyama
- Department of Pharmacology, Kagawa Medical University, Kagawa, Japan
| | - Rudy M Ortiz
- Molecular Cell Biology, School of Natural Sciences, University of California, Merced, CA, USA
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Gamella-Pozuelo L, Fuentes-Calvo I, Gómez-Marcos MA, Recio-Rodriguez JI, Agudo-Conde C, Fernández-Martín JL, Cannata-Andía JB, López-Novoa JM, García-Ortiz L, Martínez-Salgado C. Plasma Cardiotrophin-1 as a Marker of Hypertension and Diabetes-Induced Target Organ Damage and Cardiovascular Risk. Medicine (Baltimore) 2015; 94:e1218. [PMID: 26222851 PMCID: PMC4554114 DOI: 10.1097/md.0000000000001218] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The search for biomarkers of hypertension and diabetes-induced damage to multiple target organs is a priority. We analyzed the correlation between plasma cardiotrophin-1 (CT-1), a chemokine that participates in cardiovascular remodeling and organ fibrosis, and a wide range of parameters currently used to diagnose morphological and functional progressive injury in left ventricle, arteries, and kidneys of diabetic and hypertensive patients, in order to validate plasma levels of CT-1 as clinical biomarker.This is an observational study with 93 type 2-diabetic patients, 209 hypertensive patients, and 82 healthy controls in which we assessed the following parameters: plasma CT-1, basal glycaemia, systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), left ventricular hypertrophy (LVH by electrocardiographic indexes), peripheral vascular disease (by pulse wave velocity-PWV, carotid intima-media thickness-C-IMT, and ankle-brachial index-ABI), and renal impairment (by microalbuminuria, albumin/creatinine urinary ratio, plasma creatinine concentrations, and glomerular filtration rate).Hypertensive or diabetic patients have higher plasma CT-1 than control patients. CT-1 positively correlates with basal glycaemia, SBP, DBP, PP, LVH, arterial damage (increased IMT, decreased ABI), and early renal damage (microalbuminuria, elevated albumin/creatinine ratio). CT-1 also correlates with increased 10-year cardiovascular risk. Multiple linear regression analysis confirmed that CT-1 was associated with arterial injury assessed by PWV, IMT, ABI, and cardiac damage evaluated by Cornell voltage duration product.Increases in plasma CT-1 are strongly related to the intensity of several parameters associated to target organ damage supporting further investigation of its diagnostic capacity as single biomarker of cardiovascular injury and risk and, possibly, of subclinical renal damage.
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Affiliation(s)
- Luis Gamella-Pozuelo
- From the Unidad de Fisiopatología Renal y Cardiovascular (LG-P, IF-C, JML-N, CM-S), Departamento de Fisiología y Farmacología, Instituto Reina Sofía de Investigación Nefrológica, Universidad de Salamanca, Salamanca; Instituto de Investigación Biomédica de Salamanca (IBSAL) (IF-C, MAG-M, JIR-R, CA-C, JML-N, LG-O, CM-S), Salamanca; Unidad de Investigación (MAG-M, JIR-R, CA-C, LG-O), Centro de Salud La Alamedilla, SACYL, Salamanca; Servicio de Metabolismo Óseo y Mineral (JLF-M, JBC-A), Instituto Reina Sofía de Investigación Nefrológica, Hospital Universitario Central de Asturias, Oviedo; and Instituto de Estudios de Ciencias de la Salud de Castilla y León (IECSCYL) (CM-S), Unidad de Investigación, Hospital Universitario de Salamanca, Salamanca, Spain
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10
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Marazzi MG, Galliera E, Vianello E, Dozio E, Stella A, Tettamanti G, Tacchini L, Corsi Romanelli MM. Hypertension in adult Fabry's disease: is cardiotrophin-1 a diagnostic biomarker? IMMUNITY & AGEING 2014; 11:27. [PMID: 25598833 PMCID: PMC4296686 DOI: 10.1186/s12979-014-0027-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 12/11/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cardiotrophin-1 (CT-1), a cytokine produced by cardiomyocytes and non-cardiomyocytes in conditions of stress, can be used as a biomarker of left ventricular hypertrophy and dysfunction in hypertensive patients. Hypertension is one of the main adverse events in the third and last phase of Fabry's disease (FD). We measured CT-1 in order to examine its correlation with the vascular and cardiac alterations at different ages and assess its potential for use as a biomarker of hypertension in FD. FINDINGS The level of CT-1 was clearly higher in hypertensive adults than in adult FD patients. FD patients show a small, non-significant decrease in plasma CT-1 with age, while in hypertensive patients CT-1 in plasma rises strongly and highly significantly with age. CONCLUSIONS CT-1 can be considered a good biomarker of the progression of hypertension with age, but particular care is needed when following hypertension in FD patients, since CT-1 does not correlate the same way with this disease.
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Affiliation(s)
- Monica Gioia Marazzi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Emanuela Galliera
- Department of Biomedical, Surgical and Oral Sciences, Università degli Studi di Milano, Milan, Italy ; IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
| | - Elena Vianello
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Elena Dozio
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Andrea Stella
- Department of Sciences for Health, Università degli Studi di Milano - Bicocca, Milan, Italy
| | | | - Lorenza Tacchini
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Massimiliano M Corsi Romanelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy ; IRCCS Policlinico San Donato, San Donato, Milano, Italy
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Song K, Wang S, Huang B, Luciano A, Srivastava R, Mani A. Plasma cardiotrophin-1 levels are associated with hypertensive heart disease: a meta-analysis. J Clin Hypertens (Greenwich) 2014; 16:686-92. [PMID: 25052897 DOI: 10.1111/jch.12376] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 06/10/2014] [Accepted: 06/11/2014] [Indexed: 12/31/2022]
Abstract
Cardiotrophin-1 (CT-1) is a member of the interleukin 6 cytokine superfamily. Plasma CT-1 levels have been associated with heart failure and hypertension in small independent studies. Whether plasma CT-1 levels are associated with progression of hypertensive heart disease is poorly understood. The authors carried out a meta-analysis using published studies and electronic databases. Relevant data were extracted using standardized algorithms. Additional data were obtained directly from investigators when indicated. A total of 18 studies were included that reported on association between CT-1 level and hypertension (n=8), cardiac hypertrophy (n=9), and heart failure (HF) (n=10). The serum levels of CT-1 were significantly higher in patients with hypertension (standard mean difference [SMD], 0.85; 95% confidence interval [CI], 0.64-1.06 fmol/mL), left ventricular hypertrophy (SMD, 0.88; 95% CI 0.60-1.17 fmol/mL), or HF (SMD, 0.66; 95% CI, 0.51-0.80 fmol/mL) compared with controls. Subgroup analysis revealed CT-1 levels to be highest in patients with hypertension-induced hypertrophy with HF, followed by patients with hypertension-induced left ventricular hypertrophy without HF (SMD, 0.52; 95% CI, 0.30-0.75 fmol/mL), patients with hypertension without left ventricular hypertrophy (SMD, 0.67; 95% CI, 0.46-0.88 fmol/mL) as compared with normotensive patients (SMD, 0.74; 95% CI, 10.45-1.04 fmol/mL). Increased plasma CT-1 levels are associated with risk for HF in hypertensive patients. CT-1 may serve as a novel biomarker in determining prognosis in hypertensive patients.
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Affiliation(s)
- Kangxing Song
- Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT; The Cardiology Department, Chinese Peoples' Liberation Army General Hospital, Beijing, China
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Gkaliagkousi E, Gavriilaki E, Nikolaidou B, Chatzopoulou F, Anyfanti P, Triantafyllou A, Petidis K, Zamboulis C, Douma S. Association between cardiotrophin 1 levels and central blood pressure in untreated patients with essential hypertension. Am J Hypertens 2014; 27:651-5. [PMID: 24401751 DOI: 10.1093/ajh/hpt238] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cardiotrophin 1 (CT-1) is an interleukin 6-related cytokine recently implicated in cardiac hypertrophy and vascular damage in essential hypertension (EH). We aimed first to determine CT-1 levels in naive, untreated patients with grade I EH (UH) as compared with normotensive (NT) individuals and, second, to investigate a possible association of CT-1 levels with indices of arterial stiffness. METHODS We enrolled 45 consecutive untreated patients recently diagnosed with grade I EH by means of office and ambulatory blood pressure (BP) measurements and 25 age- and sex-matched NT subjects. CT-1 levels were measured with a commercially available enzyme-linked immunosorbent assay kit, and indices of arterial stiffness were determined by applanation tonometry. RESULTS CT-1 levels were significantly elevated in UH patients compared with NT subjects (P < 0.001). Furthermore, CT-1 levels correlated positively with office, ambulatory and central BP. A significant bivariable correlation was also found between CT-1 levels and pulse wave velocity (P = 0.02). In the multivariable analysis, central systolic and diastolic BP proved the only significant predictors of CT-1 levels after controlling for other related factors. CONCLUSIONS To our knowledge, this is the first study that correlates CT-1 levels with ambulatory and central BP, as well as with pulse wave velocity in patients with essential hypertension. Thus, studying the effects of CT-1 in the cardiovascular system in patients with EH represents a promising area of investigation in the future.
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Affiliation(s)
- Eugenia Gkaliagkousi
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Moreno MU, San José G, Pejenaute Á, Landecho MF, Díez J, Beloqui Ó, Fortuño A, Zalba G. Association of phagocytic NADPH oxidase activity with hypertensive heart disease: a role for cardiotrophin-1? Hypertension 2013; 63:468-74. [PMID: 24324051 DOI: 10.1161/hypertensionaha.113.01470] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Left ventricular hypertrophy (LVH) is an independent marker of mortality in hypertension. Although the mechanisms contributing to LVH are complex, inflammation and oxidative stress may favor its development. We analyzed the association of the phagocytic NADPH oxidase-mediated superoxide anion release and LVH in patients with essential hypertension and the role of cardiotrophin-1 (CT-1) and interleukin-6 (IL-6), cytokines implicated in cardiac growth. Blood pressure, echocardiography data, and serum CT-1 and IL-6 levels were obtained in 140 subjects: 18 normotensives without LVH, 42 hypertensives without LVH, and 80 hypertensives with LVH. The NADPH oxidase-dependent superoxide production was assessed by chemiluminescence in peripheral blood mononuclear cells. Peripheral blood mononuclear cells were stimulated with CT-1 in vitro. Superoxide anion production by peripheral blood mononuclear cells associated with LVH and correlated with the left ventricular mass index. Serum CT-1 and IL-6 levels, which associated with the left ventricular mass index, correlated with superoxide production. Serum CT-1 and IL-6 levels were correlated. CT-1 stimulated NADPH oxidase superoxide production in peripheral blood mononuclear cells, which resulted in an increased release of IL-6. Our results show that superoxide anion production by the phagocytic NADPH oxidase associates with hypertensive heart disease, being significantly enhanced in hypertensive patients with LVH. This may be attributable to the activation of the NADPH oxidase by CT-1 and the subsequent release of IL-6. The phagocytic NADPH oxidase may be a therapeutic target in hypertensive heart disease.
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Affiliation(s)
- María U Moreno
- Department of Biochemistry and Genetics, Irunlarrea 1, 31008-Pamplona, Spain.
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Serum cardiotrophin-1 and IL-6 levels in patients with obstructive sleep apnea syndrome. Inflammation 2013; 36:1344-7. [PMID: 23783568 DOI: 10.1007/s10753-013-9673-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Obstructive sleep apnea syndrome (OSAS) is associated with increased rates of cardiovascular diseases (CVD). Basic mechanisms involved in the increased cardiovascular risk of OSAS remain unclear. Inflammation has been shown to potentially play a critical role in this association. The aim of the present study was to investigate the level of cardiotrophin-1 (CT-1) in patients with OSAS. Forty-eight newly diagnosed OSAS patients and 37 nonapneic controls were enrolled in this study. Demographic data, cigarette smoking status, previous history of chronic diseases including CVD and metabolic diseases and drugs, and habits were obtained by a standardized questionnaire. All patients underwent polysomnographic evaluation. The mean age was 48.3 ± 12.3 (24-74) years in OSAS group. Median apnea-hypopnea index was 23.6 (6-91.8) and median body mass index was 30.4 (24.2-49.4) in the OSAS group. Plasma CT-1 levels in OSAS and control groups, respectively, were 12.03 ± 1.08 and 11.85 ± 1.18 pg/ml. There was no significant difference in the plasma levels of CT-1 and IL-6 between the OSAS group and the controls.
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González A, López B, Ravassa S, Beaumont J, Zudaire A, Gallego I, Brugnolaro C, Díez J. Cardiotrophin-1 in hypertensive heart disease. Endocrine 2012; 42:9-17. [PMID: 22418690 DOI: 10.1007/s12020-012-9649-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 02/27/2012] [Indexed: 01/19/2023]
Abstract
Hypertensive heart disease, here defined by the presence of pathologic left ventricular hypertrophy in the absence of a cause other than arterial hypertension, is characterized by complex changes in myocardial structure including enhanced cardiomyocyte growth and non-cardiomyocyte alterations that induce the remodeling of the myocardium, and ultimately, deteriorate left ventricular function and facilitate the development of heart failure. It is now accepted that a number of pathological processes mediated by mechanical, neurohormonal, and cytokine routes acting on the cardiomyocyte and the non-cardiomyocyte compartments are responsible for myocardial remodeling in the context of arterial hypertension. For instance, cardiotrophin-1 is a cytokine member of the interleukin-6 superfamily, produced by cardiomyocytes and non-cardiomyocytes in situations of biomechanical stress that once secreted interacts with its receptor, the heterodimer formed by gp130 and gp90 (also known as leukemia inhibitory factor receptor beta), activating different signaling pathways leading to cardiomyocyte hypertrophy, as well as myocardial fibrosis. Beyond its potential mechanistic contribution to the development of hypertensive heart disease, cardiotrophin-1 offers the opportunity for a new translational approach to this condition. In fact, recent evidence suggests that cardiotrophin-1 may serve as both a biomarker of left ventricular hypertrophy and dysfunction in hypertensive patients, and a potential target for therapies aimed to prevent and treat hypertensive heart disease beyond blood pressure control.
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Affiliation(s)
- Arantxa González
- Área de Ciencias Cardiovasculares, Centro de Investigación Médica Aplicada, Universidad de Navarra, Av. Pío XII 55, 31008, Pamplona, Spain
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López-Andrés N, Rousseau A, Akhtar R, Calvier L, Iñigo C, Labat C, Zhao X, Cruickshank K, Díez J, Zannad F, Lacolley P, Rossignol P. Cardiotrophin 1 is involved in cardiac, vascular, and renal fibrosis and dysfunction. Hypertension 2012; 60:563-73. [PMID: 22733458 DOI: 10.1161/hypertensionaha.112.194407] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cardiotrophin 1 (CT-1), a cytokine belonging to the interleukin 6 family, is increased in hypertension and in heart failure. We aimed to study the precise role of CT-1 on cardiac, vascular, and renal function; morphology; and remodeling in early stages without hypertension. CT-1 (20 μg/kg per day) or vehicle was administrated to Wistar rats for 6 weeks. Cardiac and vascular functions were analyzed in vivo using M-mode echocardiography, Doppler, and echo tracking device and ex vivo using a scanning acoustic microscopy method. Cardiovascular and renal histomorphology were measured by immunohistochemistry, RT-PCR, and Western blot. Kidney functional properties were assessed by serum creatinine and neutrophile gelatinase-associated lipocalin and microalbuminuria/creatininuria ratio. Without alterations in blood pressure levels, CT-1 treatment increased left ventricular volumes, reduced fractional shortening and ejection fraction, and induced myocardial dilatation and myocardial fibrosis. In the carotid artery of CT-1-treated rats, the circumferential wall stress-incremental elastic modulus curve was shifted leftward, and the acoustic speed of sound in the aorta was augmented, indicating increased arterial stiffness. Vascular media thickness, collagen, and fibronectin content were increased by CT-1 treatment. CT-1-treated rats presented unaltered serum creatinine concentrations but increased urinary and serum neutrophile gelatinase-associated lipocalin and microalbuminuria/creatininuria ratio. This paralleled a glomerular and tubulointerstitial fibrosis accompanied by renal epithelial-mesenchymal transition. CT-1 is a new potent fibrotic agent in heart, vessels, and kidney able to induce cardiovascular-renal dysfunction independent from blood pressure. Thus, CT-1 could be a new target simultaneously integrating alterations of heart, vessels, and kidney in early stages of heart failure.
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Affiliation(s)
- Natalia López-Andrés
- Institut National de la Santé et de la Recherche Médicale U961, Faculty of Medicine, Vandoeuvre-lès-Nancy, France.
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Celik A, Sahin S, Koc F, Karayakali M, Sahin M, Benli I, Kadi H, Burucu T, Ceyhan K, Erkorkmaz U. Cardiotrophin-1 plasma levels are increased in patients with diastolic heart failure. Med Sci Monit 2012; 18:CR25-31. [PMID: 22207116 PMCID: PMC3560678 DOI: 10.12659/msm.882197] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background Cardiotrophin-1 (CT-1) is a member of the interleukin (IL-6) family of cytokines and is increased in various cardiovascular diseases, including chronic heart failure. The aim of the study was to determine if plasma CT-1 is associated with diastolic heart failure (DHF) and to investigate the relationship between CT-1 and echocardiographic parameters. Material/Methods Fifty-seven consecutive patients (mean age 57±8 years, 24 males) diagnosed with DHF in our clinic and 33 controls (mean age 55±7 years, 12 males) were included in the study. All study participants underwent echocardiographic evaluation and blood samples were obtained. Results CT-1 and NT-proBNP values were significantly higher in DHF subjects than in controls (11.30 [8.09–16.51] vs. 17.5 [8.95–28.74] fmol/mL, P=0.017 and 64 [27.5–95] vs. 82 [55.5–241] pg/mL, P=0.009, respectively). The mitral peak velocity of early diastolic filling (E), mean ratio of E to early diastolic mitral annular velocity (E/Em), and the pulmonary capillary wedge pressure (PCWP) estimated from E/Em measurements were all significantly higher in the patient group (62.27±14.69 vs. 75.67±18.85 cm/sec, 6.40±1.48 vs. 10.30±3.48, and 10 [9–11]vs. 14[12–16] mmHg, P≤0.001 for all). Lateral and septal Em were significantly lower in the patient group (10.69±1.87 vs. 8.69±2.00 cm/sec and 8.91±1.22 vs. 6.65±1.58 cm/sec, P<0.001 for both). CT-1 positively correlated with NT-proBNP (P=0.001, r=0.349), mean E/Em (P=0.003, r=0.307), and estimated mean PCWP (P=0.001, r=0.308). Conclusions CT-1 is elevated in patients with DHF and is associated with NT-proBNP and estimated left ventricular filling pressures.
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Affiliation(s)
- Atac Celik
- Department of Cardiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey.
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Robador PA, San José G, Rodríguez C, Guadall A, Moreno MU, Beaumont J, Fortuño A, Díez J, Martínez-González J, Zalba G. HIF-1-mediated up-regulation of cardiotrophin-1 is involved in the survival response of cardiomyocytes to hypoxia. Cardiovasc Res 2011; 92:247-55. [PMID: 21771897 DOI: 10.1093/cvr/cvr202] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
AIMS Cardiotrophin-1 (CT-1) is a cytokine of the interleukin-6 superfamily which is up-regulated in cardiac diseases, in part via hypoxia-dependent mechanisms. However, no evidence for a direct regulation of CT-1 gene (CTF1) promoter by hypoxia inducible factor-1 (HIF-1) has been provided. METHODS AND RESULTS Hypoxia increased CT-1 mRNA levels in the murine adult cardiomyocyte cell line HL-1 in a time-dependent manner. Interestingly, in a murine model (C57BL/6), we show that systemic hypoxia also significantly up-regulated CT-1 in myocardial tissue. The effect of hypoxia on CT-1 expression was mediated through a transcriptional mechanism, since hypoxia increased luciferase activity of constructs containing CTF1 promoter sequences. The increase in CT-1 levels was significantly reduced by drugs that prevent calcium mobilization, such as lercanidipine, or that inhibit the activation of the PI3K/Akt pathway (wortmannin) or mammalian target of rapamycin (rapamycin). The CT-1 elevation was similarly induced by HIF-1α over-expression in co-transfection experiments and prevented by HIF-1α silencing. The direct interaction of HIF-1α with the CTF1 promoter was confirmed through site-directed mutagenesis of hypoxia response elements, electrophoreric mobility shift, and ChIP assays. Hypoxia induced HL-1 apoptosis (measured as annexin-V binding or caspase 3/7 activity) which was increased when CT-1 was silenced in knocked-down cells by lentiviral vectors. CONCLUSION Hypoxia increased CT-1 levels in cardiac cells (in vitro and in vivo) through a direct regulation of CTF1 promoter by HIF-1α. This CT-1 activation by hypoxia may protect cells from apoptosis, thus supporting a protective role for CT-1 as a survival factor for cardiomyocytes.
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Affiliation(s)
- Pablo A Robador
- Division of Cardiovascular Sciences, Center for Applied Medical Research, University of Navarra, Avda. Pío XII 55, 31008 Pamplona, Spain
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Abstract
Cardiotrophin (CT)-1 was discovered by coupling expression cloning with an embryonic stem cell-based model of cardiogenesis. Comparison of similarity in amino acid sequence and conformational structure indicates that CT-1 is a member of the interleukin (IL)-6 type cytokine family that shares the transmembrane signaling protein, glycoprotein (gp) 130 as a receptor. These cytokines mediate overlapping pleiotropic actions on a variety of cell types including cardiac myocytes, hepatocytes, megakaryocytes, osteoclasts, and neuronal cells. CT-lmediates its hypertrophic and cytoprotective properties through the Janus kinase/signal transducers and activators of transcription (JAK/STAT), mitogen-activated protein (MAP) kinase, phosphatidylinositol (PI) 3 kinase, and nuclear factor kappa B (NFkappaB) pathways. CT-1 gene and protein are distributed not only in the heart, but also in the pulmonary, renal, gastrointestinal, cerebral, and muscular tissues. CT-1 could also be synthesized and secreted from vascular endothelial cells and adipocytes. CT-1 has hypertrophic actions on the cardiac myocytes, skeletal muscle cells, and smooth muscle cells as well as cytoprotective actions on the cardiac myocytes, neuronal cells, and hepatocytes. CT-1 is circulating in the body, and its plasma concentration is increased in various cardiovascular and renal diseases such as hypertension, congestive heart failure, myocardial infarction, valvular heart disease, metabolic syndrome, and chronic kidney disease. Treatment with CT-1 is beneficial in experimental animal models of cardiovascular diseases. CT-1 specifically protects the cardiac myocytes from ischemic damage when CT-1 is given not only prior to the ischemia, but also given at the time of reoxygenation. Current evidence suggests that CT-1 plays an important role in the regulation of the cardiovascular system.
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Affiliation(s)
- Michihisa Jougasaki
- Institute for Clinical Research, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan.
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Protective effect of the 1742(C/G) polymorphism of human cardiotrophin-1 against left ventricular hypertrophy in essential hypertension. J Hypertens 2011; 28:2219-26. [PMID: 20683337 DOI: 10.1097/hjh.0b013e32833da326] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Experimental and clinical evidence supports a role of cardiotrophin-1 (CT-1) in the development of hypertensive left ventricular hypertrophy (LVH). The goal of this study was to investigate the relationship between human CT-1 genetic background and LVH in essential hypertension. METHODS A total of 900 individuals were genotyped for the 1742(C/G) polymorphism of the human CT-1 gene. Serum CT-1 levels were assessed by ELISA in 681 individuals. Left ventricular parameters were determined by two-dimensional echocardiography in 297 individuals. RESULTS The prevalence of the GG genotype of the 1742(C/G) polymorphism was reduced in essential hypertension (8.4% in normotensive individuals, 4.9% in hypertensive patients, P = 0.046 versus CC/CG individuals) and in LVH (11.5% in nonhypertrophic normotensive individuals, 12.2% in nonhypertrophic hypertensive patients, 2.6% in hypertensive patients with LVH, P = 0.008 versus CC/CG individuals). Apart from this, GG individuals presented lower serum concentration of CT-1 (GG, 147.1 ± 10.5 fmol/ml; CC/CG, 187.1 ± 4.8 fmol/ml; P = 0.036) and left ventricular mass index (GG, 91 ± 6 g/m; CC/CG, 119 ± 3 g/m; P = 0.002). Multivariate analyses showed that the 1742(C/G) polymorphism was a significant determinant of both left ventricular mass index and serum CT-1, after adjusting for confounding factors. Finally, in-vitro studies supported the functionality of the 1742(C/G) polymorphism. CONCLUSION Our results indicate that the 1742(C/G) polymorphism of the human CT-1 gene is associated with LVH in hypertension and that the GG genotype may have a protective role. It is suggested that CT-1 is one of the mediators of this association.
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Monserrat L, López B, González A, Hermida M, Fernández X, Ortiz M, Barriales-Villa R, Castro-Beiras A, Díez J. Cardiotrophin-1 plasma levels are associated with the severity of hypertrophy in hypertrophic cardiomyopathy. Eur Heart J 2010; 32:177-83. [PMID: 21059734 PMCID: PMC3021387 DOI: 10.1093/eurheartj/ehq400] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIMS Cardiotrophin-1 (CT-1) is a cytokine that induces hypertrophy in cardiomyocytes and is associated with left ventricular hypertrophy (LVH) in hypertensive patients. The objective of this study was to evaluate whether plasma CT-1 is associated with hypertrophic cardiomyopathy (HCM). METHODS AND RESULTS The study was performed in 124 patients with HCM. All patients underwent a full clinical evaluation and an echocardiogram. Left ventricular hypertrophy was evaluated by the measurement of the maximal LV wall thickness and the Spirito's LVH score. Plasma CT-1 was measured by an enzyme-linked immunosorbent assay. Compared with controls, patients with HCM exhibited higher (P < 0.001) plasma CT-1 levels. Significant correlations were found between CT-1 and maximal LV wall thickness (r = 0.284, P = 0.001) and the Spirito's LVH score (r = 0.287, P = 0.006) in HCM patients. In addition, the levels of CT-1 were higher (P = 0.02) in patients with severe LVH (maximal LV wall thickness ≥30 mm) than in patients with mild or moderate LVH (maximal LV wall thickness <30 mm). CONCLUSIONS These findings show that plasma CT-1 is associated with the severity of LVH in patients with HCM. Further studies are required to ascertain whether CT-1 is a diagnostic biomarker of this cardiomyopathy.
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Affiliation(s)
- Lorenzo Monserrat
- Insituto de Investigación Biomédica de A Coruña, Complejo Hospitalario Universitario A Coruña, As Xubias 84, A Coruña, Spain.
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Abstract
AIMS To investigate cardiotrophin-1 (CT-1) effects and regulation in vascular smooth muscle cells (VSMCs) in vitro and in aortic tunica media ex vivo in normotensive Wistar rats and spontaneously hypertensive rats (SHRs). METHODS AND RESULTS CT-1 expression was quantified by real-time reverse-transcription PCR and western blotting. CT-1-activated intracellular pathways were assessed by western bloting analysis. Proliferation was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and ki67 immunodetection, and cell hypertrophy by planimetry. Extracellular matrix components were quantified by real-time reverse-transcription PCR and western blot, and metalloproteinases activities by zymography. VSMCs from Wistar rats and SHRs expressed spontaneously CT-1 at the mRNA and the protein level, with a two-fold more increase in SHRs. CT-1 phosphorylated p42/44 mitogen-activated protein kinase, p38 mitogen-activated protein kinase, Akt and Stat-3 in both strains. CT-1 stimulated VSMCs proliferation and hypertrophy in both strains, with an enhanced stimulation in SHRs. CT-1 increased the secretion of collagen type I and fibronectin in VSMCs and aortic tunica media of Wistar rats and SHRs, with greater magnitude in SHRs. In SHRs VSMCs in vitro and ex vivo, CT-1 increased the secretion of collagen type III and elastin and the expression of tissue inhibitors of metalloproteinases, without altering metalloproteinase activity. These effects were blocked by CT-1 receptor antibodies. Aldosterone treatment increased CT-1 expression in VSMCs and aortic tunica media from both strains, with a greater magnitude in SHRs. CONCLUSION CT-1 induces VSMCs proliferation, hypertrophy and extracellular matrix production, and is upregulated in hypertension and by aldosterone. CT-1 may represent a new target of vascular wall remodeling in hypertension.
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Affiliation(s)
- Javier Díez
- From the Division of Cardiovascular Sciences (J.D.), Centre of Applied Medical Research, University of Navarra, Pamplona, Spain; Ochsner Clinic Foundation (E.D.F.), New Orleans, La
| | - Edward D. Frohlich
- From the Division of Cardiovascular Sciences (J.D.), Centre of Applied Medical Research, University of Navarra, Pamplona, Spain; Ochsner Clinic Foundation (E.D.F.), New Orleans, La
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Association of plasma cardiotrophin-1 with stage C heart failure in hypertensive patients: Potential diagnostic implications. J Hypertens 2009; 27:418-24. [DOI: 10.1097/hjh.0b013e32831ac981] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Novel insights into the role of cardiotrophin-1 in cardiovascular diseases. J Mol Cell Cardiol 2009; 46:142-8. [DOI: 10.1016/j.yjmcc.2008.11.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2008] [Revised: 10/31/2008] [Accepted: 11/05/2008] [Indexed: 01/19/2023]
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Stejskal D, Ruzicka V. Cardiotrophin-1. Review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2008; 152:9-19. [PMID: 18795069 DOI: 10.5507/bp.2008.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cardiotrophin-1 is newly discovered chemokin with a lot of functions. Aim of our work was to describe most important of them. METHODS systematically scan of available scientific resources. RESULTS Cardiotrophin-1 stimulates the proliferation of cardiomyocytes. Cardiotrophin-1 expression and plasma values are elevated in individuals with heart failure and have high diagnostic efficacy for the heart failure. Plasma values are also an independent prognostic factor. Preliminary findings suggest that the determination of plasma cardiotrophin-1 may be useful for the follow-up of hypertensive heart disease in routine clinical practice. Cardiotrophin-1 also plays an important cardioprotective effect on myocardial damage, is a potent regulator of signaling in adipocytes in vitro and in vivo and potentiates the elevation the acute-phase proteins. Cardiotrophin-1 may play also an important protective role in other organ systems (such as hematopoietic, neuronal, developmental). CONCLUSION Cardiotrophin is a newly discovered chemokin with a lot of system effects and is stable in system circulation hence permitting its development in the routine clinical investigation.
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Affiliation(s)
- David Stejskal
- Department of Laboratory Medicine, Sternberk Hospital, Czech Republic.
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Gonzalez A, Lopez B, Ravassa S, Beaumont J, Arias T, Hermida N, Zudaire A, Diez J. Biochemical markers of myocardial remodelling in hypertensive heart disease. Cardiovasc Res 2008; 81:509-18. [DOI: 10.1093/cvr/cvn235] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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López-Andrés N, Iñigo C, Gallego I, Díez J, Fortuño MA. Aldosterone induces cardiotrophin-1 expression in HL-1 adult cardiomyocytes. Endocrinology 2008; 149:4970-8. [PMID: 18566129 DOI: 10.1210/en.2008-0120] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Aldosterone (ALDO) may induce cardiac hypertrophy by nonhemodynamic mechanisms that are not completely defined. Cardiotrophin-1 (CT-1) is a cytokine that exerts hypertrophic actions on isolated cardiomyocytes and promotes cardiac hypertrophy in vivo. We investigated whether ALDO induces CT-1 expression in HL-1 cardiomyocytes aiming at the possibility that the cytokine is involved in ALDO-induced cardiomyocyte hypertrophy. mRNA and protein expression were quantified by RT-PCR and Western blot. Cardiomyocyte area, as an index of hypertrophy, was assayed by image analysis in phalloidin-stained HL-1 cells. ALDO addition to adult HL-1 cardiomyocytes increased (P<0.01) CT-1 mRNA and protein expression in a concentration-dependent manner. This effect was abrogated by actinomycin D, the mineralocorticoid and glucocorticoid receptor antagonists spironolactone and RU486, respectively, and the p38 MAPK blocker SB203580. CT-1 signaling pathway blockade with specific antibodies against the cytokine and its two receptor subunits avoided (P<0.01) alpha-sarcomeric actin and c-fos protein overexpression as well as cell size increase induced by ALDO in HL-1 cells. In vivo, a single ALDO injection acutely increased (P<0.01) the myocardial expression of CT-1 in C57BJ6 wild-type mice but not CT-1-null mice. The bolus of the mineralocorticoid increased (P<0.01) ANP and c-fos mRNA expression in the myocardium of wild-type mice, whereas no changes were observed in CT-1-null mice. In summary, ALDO induces CT-1 expression in adult HL-1 cardiomyocytes via genomic and nongenomic mechanisms. CT-1 up-regulation could have relevance in the direct hypertrophic effects of ALDO in cardiomyocytes.
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Affiliation(s)
- Natalia López-Andrés
- Centre for Applied Medical Research, Department of Cardiology and Cardiovascular Surgery, University Clinic, Universidad de Navarra, Avenida Pio XII, 55, 31008 Pamplona, Spain
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Perticone F, Maio R, Ruberto C, Cassano S, Tripepi G, Perticone M, Sesti G, Zoccali C. Kidney Function and Risk Factors for Left Ventricular Hypertrophy in Untreated Uncomplicated Essential Hypertension. Am J Kidney Dis 2008; 52:74-84. [DOI: 10.1053/j.ajkd.2008.02.302] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2007] [Accepted: 02/26/2008] [Indexed: 11/11/2022]
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Natal C, Fortuño MA, Restituto P, Bazán A, Colina I, Díez J, Varo N. Cardiotrophin-1 is expressed in adipose tissue and upregulated in the metabolic syndrome. Am J Physiol Endocrinol Metab 2008; 294:E52-60. [PMID: 17940213 DOI: 10.1152/ajpendo.00506.2007] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Adipose tissue is a target for cardiotrophin-1 (CT-1), a cytokine member of the IL-6 family of cytokines that is involved in cardiac growth and dysfunction. However, it is unknown whether adipocytes are a source of CT-1 and whether CT-1 is overexpressed in diseases characterized by increased fat depots [i.e., the metabolic syndrome (MS)]. Thus this work aimed 1) to test whether adipose tissue expresses CT-1 and whether CT-1 expression can be modulated and 2) to compare serum CT-1 levels in subjects with and without MS diagnosed by National Cholesterol Education Program Adult Treatment Panel III criteria. Gene and protein expression of CT-1 was determined by real-time RT-PCR, ELISA, and Western blotting. CT-1 expression progressively increased, along with differentiation time from preadipocyte to mature adipocyte in 3T3-L1 cells. CT-1 expression was enhanced by glucose in a dose-dependent manner in these cells. mRNA and protein CT-1 expression was also demonstrated in human adipose biopsies. Immunostaining showed positive staining in adipocytes. Finally, increased CT-1 serum levels were observed in patients with MS compared with control subjects (127 +/- 9 vs. 106 +/- 4 ng/ml, P < 0.05). Circulating levels of CT-1 were associated with glucose levels (r = 0.2, P < 0.05). Taken together, our data suggest that adipose tissue can be recognized as a source of CT-1, which could account for the high circulating levels of CT-1 in patients with MS.
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Affiliation(s)
- Cristina Natal
- Division of Cardiovascular Sciences, Center for Applied Medical Research, University of Navarra, Avda Pío XII 55, 31008 Pamplona, Spain
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López B, Castellano JM, González A, Barba J, Díez J. Association of increased plasma cardiotrophin-1 with inappropriate left ventricular mass in essential hypertension. Hypertension 2007; 50:977-83. [PMID: 17846346 DOI: 10.1161/hypertensionaha.107.098111] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Inappropriate left ventricular mass is present when the value of left ventricular mass exceeds individual needs to compensate hemodynamic load imposed by increased blood pressure. The goal of this study was to investigate whether plasma concentration of cardiotrophin-1, a cytokine that induces exaggerated hypertrophy in cardiomyocytes with hypertensive phenotype, is related to inappropriate left ventricular mass in patients with essential hypertension. The study was performed in 118 patients with never-treated hypertension and without prevalent cardiac disease. The left ventricular mass prediction from stroke work (systolic blood pressurexDoppler stroke volume), sex, and height (in meters(2.7)) was derived. An observed left ventricular mass/predicted left ventricular mass value >128% defined inappropriate left ventricular mass. Plasma cardiotrophin-1 was measured by an enzyme-linked immunosorbent assay. The studies were repeated in a group of 45 patients after 1 year of antihypertensive treatment. At baseline 67 and 51 patients presented with appropriate and inappropriate left ventricular mass, respectively. Plasma cardiotrophin-1 was higher (P<0.001) in patients with inappropriate mass than in patients with appropriate mass and normotensive controls. A direct correlation was found between cardiotrophin-1 and observed left ventricular mass/predicted left ventricular mass ratio (r=0.330, P<0.001) in all hypertensive patients. After treatment, plasma cardiotrophin-1 decreased and increased in patients in which inappropriate left ventricular mass regressed and persisted, respectively, despite a similar reduction of blood pressure in the 2 subgroups of patients. Albeit descriptive in nature, these results suggest the hypothesis that an excess of cardiotrophin-1 may contribute to inappropriate left ventricular growth in hypertensive patients.
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Affiliation(s)
- Begoña López
- Division of Cardiovascular Sciences, University Clinic, University of Navarra, Pamplona, Spain
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Fischer P, Hilfiker-Kleiner D. Survival pathways in hypertrophy and heart failure: the gp130-STAT3 axis. Basic Res Cardiol 2007; 102:279-97. [PMID: 17530315 DOI: 10.1007/s00395-007-0658-z] [Citation(s) in RCA: 122] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2007] [Revised: 04/23/2007] [Accepted: 04/24/2007] [Indexed: 12/26/2022]
Abstract
Circulating levels of interleukin (IL)-6 and related cytokines are elevated in patients with congestive heart failure and after myocardial infarction. Serum IL-6 concentrations are related to decreasing functional status of these patients and provide important prognostic information.Moreover, in the failing human heart, multiple components of the IL-6- glycoprotein (gp)130 receptor system are impaired, implicating an important role of this system in cardiac pathophysiology.Experimental studies have shown that the common receptor subunit of IL-6 cytokines is phosphorylated in response to pressure overload and myocardial infarction and that it subsequently activates at least three different downstream signaling pathways, the signal transducers and activators of transcription 1 and 3 (STAT1/3), the Src-homology tyrosine phosphatase 2 (SHP2)-Ras-ERK, and the PI3K-Akt system. Gp130 receptor mediated signaling promotes cardiomyocyte survival, induces hypertrophy, modulates cardiac extracellular matrix and cardiac function. In this regard, the gp130 receptor system and its main downstream mediator STAT3 play a key role in cardioprotection. This review summarizes the current knowledge of IL-6 cytokines, gp130 receptor and STAT3 signaling in the heart exposed to physiological (aging, pregnancy) and pathophysiological stress (ischemia, pressure overload, inflammation and cardiotoxic agents) with a special focus on the potential role of individual IL-6 cytokines.
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Affiliation(s)
- P Fischer
- Dept. of Cardiology & Angiology, Medical School Hannover, Hannover, Germany
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Schmidt BMW, Schmieder RE. Cardiotrophin: its importance as a pathogenetic factor and as a measure of left ventricular hypertrophy. J Hypertens 2005; 23:2151-3. [PMID: 16269955 DOI: 10.1097/01.hjh.0000191526.68612.49] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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