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Žarak M, Perović A, Njire Bratičević M, Šupraha Goreta S, Dumić J. Adaptive response triggered by the repeated SCUBA diving is reflected in cardiovascular, muscular, and immune biomarkers. Physiol Rep 2021; 9:e14691. [PMID: 33463896 PMCID: PMC7814492 DOI: 10.14814/phy2.14691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/16/2020] [Accepted: 12/03/2020] [Indexed: 02/02/2023] Open
Abstract
It has been shown that one recreational SCUBA (rSCUBA) diving session is sufficient to cause changes in plasma level of cardiovascular (CV) and muscular biomarkers. To explore whether repetitive rSCUBA diving triggers an adaptive response of the CV, muscular, and immune system, we measured the cardiac damage (NT-proBNP, hs-TnI, and CK-MB), muscle damage (myoglobin (Mb), galectin-3, CK, and LDH), vascular endothelial activation (ET-1 and VEGF), and inflammatory (leukocyte count (Lkc), CRP, and IL-6) biomarkers. A longitudinal intervention study included divers (N = 14) who conducted one dive per week over 5 weeks at the depth of 20-30 m for 30 min after a non-dive period of 5 months. The blood samples were collected before and after the first, third, and fifth dives and specific biomarkers were measured in plasma or serum by the standard laboratory methods. The concentrations of the majority of measured biomarkers increased after every single dive; the exception was ET-1 concentration that decreased. The cumulative effect of five dives has been reflected in diminishing changes in hs-TnI, Mb, galectin-3, ET-1, VEGF, and IL-6 levels, and more pronounced increases in NT-proBNP and hs-CRP levels. The median values of all measured biomarkers in all time points, except Mb, remained within the corresponding reference range. Repeatedly performed rSCUBA diving activates an adaptive response of the CV, muscular, and immune system that is reflected in changes in the specific biomarker concentration.
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Affiliation(s)
- Marko Žarak
- Clinical Department of Laboratory DiagnosticsDubrava University HospitalZagrebCroatia
| | - Antonija Perović
- Department of Laboratory DiagnosticsDubrovnik General HospitalDubrovnikCroatia
| | | | - Sandra Šupraha Goreta
- Faculty of Pharmacy and BiochemistryDepartment of Biochemistry and Molecular BiologyUniversity of ZagrebZagrebCroatia
| | - Jerka Dumić
- Faculty of Pharmacy and BiochemistryDepartment of Biochemistry and Molecular BiologyUniversity of ZagrebZagrebCroatia
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Liu Y, Meng HY, Khurwolah MR, Liu JB, Tang H, Aa N, Yang ZJ. Acupuncture therapy for the treatment of stable angina pectoris: An updated meta-analysis of randomized controlled trials. Complement Ther Clin Pract 2018; 34:247-253. [PMID: 30712735 DOI: 10.1016/j.ctcp.2018.12.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 12/23/2018] [Accepted: 12/23/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND PURPOSE Stable angina pectoris is a common symptom imperiling patients' life quality. The purpose of this meta-analysis is to assess the effectiveness of acupuncture alone or acupuncture plus medicine for the treatment of stable angina pectoris. METHODS Seven databases were searched ranging from 1959 to February 2018. Quantitative analysis of randomized controlled trials (RCTs) was performed by RevMan 5.3 software and STATA 12.0 program, and Cochrane criteria for risk-of-bias was used to assess the methodological quality of the trials. RESULTS A total of 12 RCTs involving 974 patients were enrolled in this study. The pooled results showed that both acupuncture group (RR: 0.35, P < 0.00001; RR: 0.49, P < 0.00001) and acupuncture plus medicine group (RR: 0.26, P < 0.00001; RR: 0.52, P = 0.03) were associated with a higher percentage of improved anginal symptoms as well as electrocardiographic (ECG) results compared to medicine group. The acupuncture plus medicine group also had a lower intake rate of nitroglycerin than medicine group (Non-event RR: 0.79, P = 0.03). However, there was no significant difference in the reduction or discontinuation of nitroglycerin intake between acupuncture group and medicine group. No acupuncture-related adverse effects were observed or reported in the included trials. CONCLUSION Acupuncture therapy may improve anginal symptoms and ECG results in patients with stable angina pectoris, and can serve as an adjunctive treatment for this condition.
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Affiliation(s)
- Yuan Liu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medicine University, Nanjing, China
| | - Hao-Yu Meng
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medicine University, Nanjing, China
| | - Mohammad Reeaze Khurwolah
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medicine University, Nanjing, China
| | - Jia-Bao Liu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medicine University, Nanjing, China
| | - Heng Tang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medicine University, Nanjing, China
| | - Nan Aa
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medicine University, Nanjing, China
| | - Zhi-Jian Yang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medicine University, Nanjing, China.
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Wang N, Lu SF, Chen H, Wang JF, Fu SP, Hu CJ, Yang Y, Liang FR, Zhu BM. A protocol of histone modification-based mechanistic study of acupuncture in patients with stable angina pectoris. Altern Ther Health Med 2015; 15:139. [PMID: 25925670 PMCID: PMC4465012 DOI: 10.1186/s12906-015-0653-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 04/15/2015] [Indexed: 12/20/2022]
Abstract
Background Angina pectoris (Angina) is a medical condition related to myocardial ischemia. Although acupuncture has been widely accepted as a clinical approach for angina, there is no sufficient evidence of its effectiveness against this syndrome, and its mechanisms have not yet been well elucidated. We develop this protocol to confirm the clinical efficacy of electro-acupuncture on stable angina pectoris by needling on acupoint Neiguan (PC6). Furthermore, we employ high-throughput sequencing technology to investigate the gene expression profiling and determine involvement of histone modifications in the regulation of genes after electro-acupuncture treatment. Methods/Design A randomized, controlled, double-blinded (assessor and patients) trial will be carried out. Sixty participants will be randomly assigned to two acupuncture treatment groups and one control group in a 1:1:1 ratio. Participants in acupuncture groups will receive 12 sessions of electro-acupuncture treatment across 4 weeks, followed by a 12-week randomization period. The acupuncture groups are divided into Neiguan (PC6) on Pericardium Meridian of Hand-jueyin or a non-acupoint. The primary clinical measure of effect is the frequency of angina attacks between these groups for four weeks after randomization. RNAs are extracted from peripheral neutrophils collected from all participants on day 0, day 30, and week 16, and are processed to RNA-Seq. We then investigate profiles of histone modifications by ChIP-Seq, for H3 Lysine 4 (H3K4me) and acetylation of H3 Lysine 27 (H3K27ac), in the presence or absence of acupuncture treatment. Discussion This study determines the efficacy and mechanisms of electro-acupuncture on stable angina pectoris. We focus on effectiveness of acupuncture on alleviating symptoms of myocardial ischemia and the gene regulation and the chromatin remodeling marks, including H3K4me1, H3K4me2, and H3K27ac, which could be key factors for regulating gene expressions caused by electro-acupuncture treatment at Neiguan. This is the first genome-wide study of electro-acupuncture treatment in angina patients, and will provide valuable information for future studies in the fields of acupuncture and its underlying mechanisms. Fourteen patients have been recruited since recruitment opened in November of 2012. This study is scheduled to end in November of 2014. Trials registration ChiCTR-TRC-12002668
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Rohrbach S, Troidl C, Hamm C, Schulz R. Ischemia and reperfusion related myocardial inflammation: A network of cells and mediators targeting the cardiomyocyte. IUBMB Life 2015; 67:110-9. [PMID: 25850820 DOI: 10.1002/iub.1352] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 01/14/2015] [Indexed: 12/15/2022]
Abstract
Occlusion of a coronary artery if maintained for longer period of time results in damage of the cardiac tissue. However, restoration of blood flow to previously ischemic tissue can itself induce further cardiac damage, a phenomenon known as myocardial reperfusion injury. Cardiac homoeostasis is supported by a network of direct and indirect interactions between cardiomyocytes and resident cell types such as fibroblasts, adipocytes, and endothelial cells or invading blood cells. This review will discuss the role of the cellular interplay in ischemia-reperfusion injury from a cardiomyocyte-centered view, although we are aware that other cellular interactions are equally important. We will try to work out currently unresolved questions and potential future directions in the field.
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Affiliation(s)
- Susanne Rohrbach
- Institute of Physiology, Justus Liebig University Giessen, Giessen, Germany
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Cao L, Huang C, Wang N, Li J. ET-1/NO: a controversial target for myocardial ischemia-reperfusion injury. Cardiology 2014; 127:140. [PMID: 24434334 DOI: 10.1159/000355536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 09/09/2013] [Indexed: 11/19/2022]
Affiliation(s)
- Lu Cao
- School of Pharmacy, Anhui Medical University, Hefei, China
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Zoerner F, Wiklund L, Miclescu A, Martijn C. Therapeutic hypothermia activates the endothelin and nitric oxide systems after cardiac arrest in a pig model of cardiopulmonary resuscitation. PLoS One 2013; 8:e64792. [PMID: 23717659 PMCID: PMC3662665 DOI: 10.1371/journal.pone.0064792] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Accepted: 04/18/2013] [Indexed: 12/04/2022] Open
Abstract
Post-cardiac arrest myocardial dysfunction is a major cause of mortality in patients receiving successful cardiopulmonary resuscitation (CPR). Mild therapeutic hypothermia (MTH) is the recommended treatment after resuscitation from cardiac arrest (CA) and is known to exert neuroprotective effects and improve short-term survival. Yet its cytoprotective mechanisms are not fully understood. In this study, our aim was to determine the possible effect of MTH on vasoactive mediators belonging to the endothelin/nitric oxide axis in our porcine model of CA and CPR. Pigs underwent either untreated CA or CA with subsequent CPR. After state-of-the-art resuscitation, the animals were either left untreated, cooled between 32–34°C after ROSC or treated with a bolus injection of S-PBN (sodium 4-[(tert-butylimino) methyl]benzene-3-sulfonate N-oxide) until 180 min after ROSC, respectively. The expression of endothelin 1 (ET-1), endothelin converting enzyme 1 (ECE-1), and endothelin A and B receptors (ETAR and ETBR) transcripts were measured using quantitative real-time PCR while protein levels for the ETAR, ETBR and nitric oxide synthases (NOS) were assessed using immunohistochemistry and Western Blot. Our results indicated that the endothelin system was not upregulated at 30, 60 and 180 min after ROSC in untreated postcardiac arrest syndrome. Post-resuscitative 3 hour-long treatments either with MTH or S-PBN stimulated ET-1, ECE-1, ETAR and ETBR as well as neuronal NOS and endothelial NOS in left ventricular cardiomyocytes. Our data suggests that the endothelin and nitric oxide pathways are activated by MTH in the heart.
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Affiliation(s)
- Frank Zoerner
- Department of Surgical Sciences/Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
- Department of Operative and Intensive Care Medicine, Hallands Hospital Halmstad, Halmstad, Sweden
| | - Lars Wiklund
- Department of Surgical Sciences/Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
| | - Adriana Miclescu
- Department of Surgical Sciences/Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
| | - Cecile Martijn
- Department of Surgical Sciences/Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
- Science for Life Laboratory, Uppsala, Sweden
- Department of Chemistry-BMC, Uppsala University, Uppsala, Sweden
- * E-mail:
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Yang M, Angel MF, Pang Y, Angel JJ, Wang Z, Neumeister MW, Wetter N, Zhang F. Expression of inducible nitric oxide synthase in muscle flaps treated with ischemic postconditioning. Hand (N Y) 2012; 7:297-302. [PMID: 23997736 PMCID: PMC3418363 DOI: 10.1007/s11552-012-9423-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND/OBJECTIVE Preconditioning has been considered promising for the treatment of ischemic flaps. In this study, the therapeutic effect of postconditioning was compared with that of preconditioning during ischemia/reperfusion (I/R) injury, and a role of inducible nitric oxide synthase (iNOS) in postconditioning treatment was also explored. METHODS Sixty rats were randomly divided into four groups with 15 rats in each group. Ischemic injury was induced in a rat's gracilis muscle flap model. Preconditioning and postconditioning were performed respectively on the flaps in the pre-con group and the post-con group. No treatment was given to the flaps in the control group, and flaps without I/R injury were used as a sham control. Muscle viability ratio, histology, and gene expression of iNOS were examined at different time intervals (3, 12, and 18 h). RESULTS A significantly higher survival ratio was observed in both the pre-con group (78.98 ± 3.39, 62.74 ± 3.7, and 54.42 ± 4.45 %) and the post-con group (77.42 ± 4.14, 59.74 ± 6.67, and 49.52 ± 4.13 %) than the control group (45.22 ± 3.69, 42.44 ± 3.76, and 33.2 ± 3.29 %) at 3, 12, and 18 h postoperatively (P < 0.05). There was no statistical difference between the pre-con group and the post-con group (P > 0.05). Histological examination showed delayed and attenuated tissue damage in both the pre-con group and the post-con group when compared to that of the control group. A higher expression of iNOS was observed in both the pre-con group and the post-con group than the control group and the sham group (P < 0.05). CONCLUSIONS Significant improvement of flap survival could be achieved by both preconditioning and postconditioning treatments; however, better protection could be provided by preconditioning. The higher expression of iNOS may play an important role in the therapeutic effect of postconditioning during I/R injury.
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Affiliation(s)
- Mei Yang
- Division of Plastic Surgery, Southern Illinois University School of Medicine, Springfield, IL USA
| | - Michael F. Angel
- Division of Plastic Surgery, Department of Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216 USA
| | - Yi Pang
- Division of Plastic Surgery, Department of Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216 USA
| | - John J. Angel
- Division of Plastic Surgery, Department of Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216 USA
| | - Zhe Wang
- Division of Plastic Surgery, Department of Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216 USA
| | - Michael W. Neumeister
- Division of Plastic Surgery, Southern Illinois University School of Medicine, Springfield, IL USA
| | - Nathan Wetter
- Division of Plastic Surgery, Southern Illinois University School of Medicine, Springfield, IL USA
| | - Feng Zhang
- Division of Plastic Surgery, Department of Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216 USA
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Endothelin-1 and norepinephrine overflow from cardiac sympathetic nerve endings in myocardial ischemia. Cardiol Res Pract 2012; 2012:789071. [PMID: 22792506 PMCID: PMC3389657 DOI: 10.1155/2012/789071] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 05/14/2012] [Accepted: 05/15/2012] [Indexed: 12/20/2022] Open
Abstract
In protracted myocardial ischemia, sympathetic activation with carrier-mediated excessive norepinephrine (NE) release from its nerve endings due to reversal of NE transporter in an outward direction is a prominent cause of arrhythmias and cardiac dysfunction. Endothelin-1 (ET-1) and its receptors are intimately involved in the regulation of this carrier-mediated NE overflow in protracted myocardial ischemia. The ET-1 system is often complex, sometimes involving opposing actions depending on which receptor subtype is activated, which cells are affected, and whether stimuli are endogenously generated or exogenously applied. Therefore, a detailed understanding of the ET-1 system is important for applying drugs acting on this system in clinical settings for the treatment of ischemic cardiac disease. This article provides a detailed analysis of how the ET-1 system is involved in the regulation of carrier-mediated NE release from sympathetic nerve endings in protracted myocardial ischemia.
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