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Abbas W, Altemimi M, Qassam H, Hameed AA, Zigam Q, Abbas L, Jabir M, Hadi N. Fimasartan ameliorates renal ischemia reperfusion injury via modulation of oxidative stress, inflammatory and apoptotic cascades in a rat model. J Med Life 2022; 15:241-251. [PMID: 35419091 PMCID: PMC8999095 DOI: 10.25122/jml-2021-0154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 09/30/2021] [Indexed: 11/19/2022] Open
Abstract
Ischemia-reperfusion injury (IRI) can be defined as changes in the functions and structures of the tissues resulting from the restoration of blood after a period of ischemia. This study aimed to assess the potential protective effect of Fimasartan (angiotensin receptor antagonist) in the bilateral renal IRI in male rats through its potential effect on renal functions, modulation of the inflammatory cascade, oxidative stress, and apoptotic effect. The animals were equally assigned into four groups. The sham (negative control) group was exposed to surgical conditions without induction of IRI. The control group was exposed to ischemia by occluding the renal pedicles by clamps for 30 min, followed by restoration of blood for 2h. The vehicle-treated group received dimethyl sulfoxide (DMSO) by intraperitoneal injection (IP) 30 minutes before clamping. Fimasartan-treated group: rats pretreated with Fimasartan a dose of 3 mg/kg IP; this was half hour before occluding the renal pedicles. Animals were then exposed to 30 min ischemia (clamping the renal pedicles) followed by 2h reperfusion by releasing the clamps. Blood samples were collected to examine the levels of serum urea and creatinine. Renal tissue was used to measure the levels of cytokines (TNFα, IL-6) and total antioxidant capacity (TAC). Immunohistochemistry was used to assess the levels of Bax, caspase 3, and Bcl-2. Histopathological analyses were performed to detect the parenchymal injury. The present study shows that pretreatment with Fimasartan improves kidney function through its effects on oxidative stress, cytokines, and apoptotic markers.
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Affiliation(s)
- Weaam Abbas
- Department of Pharmacology & Therapeutics, Faculty of Medicine, University of Kufa, Kufa, Iraq
| | - Murooj Altemimi
- Department of Pharmacology & Therapeutics, Faculty of Medicine, University of Kufa, Kufa, Iraq
| | - Heider Qassam
- Department of Pharmacology & Therapeutics, Faculty of Medicine, University of Kufa, Kufa, Iraq
| | - Ahmed Abdul Hameed
- Department of Pharmacology & Therapeutics, Faculty of Medicine, Jabir Ibn Hayyan Medical University, Najaf, Iraq
| | - Qassim Zigam
- Department of Pharmacology, Al-Mustaqbal University College, Babylon, Hilla, Iraq
| | - Lamaan Abbas
- Al-Sadr Medical City, Al-Najaf Health Directorate, Al-Najaf Al-Ashraf, Iraq
| | - Majid Jabir
- Department of Applied Science, University of Technology, Baghdad, Iraq
| | - Najah Hadi
- Department of Pharmacology & Therapeutics, Faculty of Medicine, University of Kufa, Kufa, Iraq,Corresponding Author: Najah Hadi, Department of Pharmacology & Therapeutics, Faculty of Medicine, University of Kufa, Kufa, Iraq. E-mail: ;
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Quan H, Oh GC, Seok SH, Lee HY. Fimasartan, an angiotensin II receptor antagonist, ameliorates an in vivo zebrafish model of heart failure. Korean J Intern Med 2020; 35:1400-1410. [PMID: 32164398 PMCID: PMC7652659 DOI: 10.3904/kjim.2019.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 06/04/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND/AIMS Angiotensin II in the failing heart initially helps to maintain cardiac output and blood pressure, but ultimately accelerates its deterioration. In this study, we established a model of arrhythmia-induced heart failure (HF) in zebrafish and investigated the role of renin-angiotensin-aldosterone system (RAAS) modulation by using an angiotensin II type 1 receptor blocker, fimasartan, through the assessment of cellular and physiologic responses, morbidity, and mortality. METHODS HF was induced in zebrafish larvae by exposure to 20 μM terfenadine. Morphologic, physiologic, and functional parameters were assessed in the presence or absence of fimasartan treatment. RESULTS Zebrafish exposed to terfenadine showed marked dilatation of the ventricle and reduced systolic function. Treatment with terfenadine was associated with 10-fold higher expression of atrial natriuretic peptide (p < 0.001 vs. vehicle), increased p53 mRNA expression, and chromatin fragmentation in the TUNEL assay, all of which were significantly reduced by fimasartan treatment. Moreover, fimasartan improved fractional shortening (terfenadine + fimasartan 16.9% ± 3.1% vs. terfenadine + vehicle 11.4% ± 5.6%, p < 0.05) and blood flow (terfenadine + fimasartan 479.1 ± 124.1 nL/sec vs. terfenadine + vehicle 273.0 ± 109.0 nL/sec, p < 0.05). Finally, treatment with fimasartan remarkably reduced mortality (terfenadine + fimasartan 36.0% vs. terfenadine + vehicle 96.0%, p < 0.001). CONCLUSION Fimasartan effectively protected against the progression of HF in zebrafish by improving hemodynamic indices, which improved survival. A reduction in apoptotic cell death and an improvement in hemodynamics may be the mechanisms behind these effects. Further human studies are warranted to evaluate the possible role of fimasartan in the treatment of HF.
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Affiliation(s)
- Hailian Quan
- Department of Microbiology and Immunology, Institute of Endemic Disease, Seoul National University College of Medicine, Seoul, Korea
| | - Gyu Chul Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seung Hyeok Seok
- Department of Microbiology and Immunology, Institute of Endemic Disease, Seoul National University College of Medicine, Seoul, Korea
- Seung Hyeok Seok, Ph.D. Department of Microbiology and Immunology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-740-8302 Fax: +82-2-763-5206 E-mail:
| | - Hae-Young Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Correspondence to Hae-Young Lee, M.D. Department of Internal Medicine, Seoul National University Hospital, 101 Daehakro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-2072-0698 Fax: +82-2-3674-0805 E-mail:
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Fimasartan reduces neointimal formation and inflammation after carotid arterial injury in apolipoprotein E knockout mice. Mol Med 2019; 25:33. [PMID: 31307370 PMCID: PMC6632006 DOI: 10.1186/s10020-019-0095-0] [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: 01/17/2019] [Accepted: 05/26/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The beneficial effects of angiotensin II type 1 receptor blockers (ARBs) on atherosclerosis have been demonstrated in numerous studies. We investigated the effects of fimasartan on reducing neointimal formation and systemic inflammation after carotid artery (CA) injury in Apolipoprotein E knockout (ApoE KO) mice. METHODS ApoE KO mice were randomly allocated to Group I (without CA injury), Group II (without CA injury + Fimasartan), Group III (CA injury), and Group IV (CA injury + Fimasartan). Fimasartan was orally administered everyday starting 3 days before iatrogenic left CA injury. RESULTS At 28 days, neointimal hyperplasia and the inflammatory cytokines including TNFα, IL-6, ICAM, and MMP-9 in the peripheral blood were significantly reduced in Groups II and IV compared to Groups I and III, respectively. All fimasartan-administered groups revealed significant increases of CD4+CD25+Foxp3+ regulatory T (Treg) cells with increased plasma levels of IL-10 and TGFβ. In addition, increased CD8+ T cells by fimasartan were correlated with reduced smooth muscle cell (SMC) proliferation in the neointima in Groups II and IV. Furthermore, the populations of Treg and CD8+ T cells in total splenocytes were increased in Groups II and IV compared to Groups I and III, respectively. The enlargement of spleens due to CA injury in the Group III was attenuated by fimasartan, as shown in the Group IV. These data indicate that fimasartan significantly reduced SMC proliferation in neointima and increased Treg cells in ApoE KO CA injury mice. CONCLUSIONS This study suggests fimasartan could be an efficient strategy for reduction of atherosclerotic progression, with a decrease in immune response and systemic inflammation.
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Oh M, Lee CW, Ahn JM, Park DW, Kang SJ, Lee SW, Kim YH, Moon DH, Park SW, Park SJ. Comparison of fimasartan and amlodipine therapy on carotid atherosclerotic plaque inflammation. Clin Cardiol 2018; 42:241-246. [PMID: 30537083 PMCID: PMC6712325 DOI: 10.1002/clc.23133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 12/05/2018] [Accepted: 12/06/2018] [Indexed: 01/13/2023] Open
Abstract
Background The renin‐angiotensin system plays an important role in promoting atherosclerotic plaque inflammation, which may be inhibited by angiotension‐II receptor blockers. Hypothesis We investigated the effects of fimasartan and amlodipine therapy on carotid atherosclerotic plaque inflammation using 18F‐fluorodeoxyglucose (18FDG) positron emission tomography (PET) imaging. Methods Fifty patients with acute coronary syndrome (ACS) and at least one lesion with 18FDG uptake in the carotid artery (target‐to‐background ratio [TBR] ≥ 1.6) were randomly assigned to receive either fimasartan (60 mg once a day) or amlodipine (5 mg once a day). 18FDG PET examinations were performed in all patients at baseline and 6 months. The primary endpoint was the percent change in the index vessel TBR for the most diseased segment (MDS TBR). Results The two groups had similar baseline characteristics. At the 6‐month follow‐up, index vessel and aorta MDS TBR significantly decreased in both groups. However, the percent change in index vessel MDS TBR was similar between the two groups (−9.33 ± 14.2% vs −7.73 ± 19.1%, respectively, P = 0.9). No significant difference was found for the percent change in the whole vessel TBR for the index vessel between the two groups, with similar findings for changes in MDS TBR or whole vessel TBR for the aorta. Total cholesterol, low‐density lipoprotein cholesterol levels, and blood pressure improved to a similar degree in both groups. Conclusions Fimasartan and amlodipine reduce carotid atherosclerotic plaque inflammation similarly in patients with ACS, offering the same level of effectiveness.
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Affiliation(s)
- Minyoung Oh
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Cheol Whan Lee
- Department of Medicine, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jung-Min Ahn
- Department of Medicine, University of Ulsan College of Medicine, Seoul, South Korea
| | - Duk-Woo Park
- Department of Medicine, University of Ulsan College of Medicine, Seoul, South Korea
| | - Soo-Jin Kang
- Department of Medicine, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seung-Whan Lee
- Department of Medicine, University of Ulsan College of Medicine, Seoul, South Korea
| | - Young-Hak Kim
- Department of Medicine, University of Ulsan College of Medicine, Seoul, South Korea
| | - Dae Hyuk Moon
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seong-Wook Park
- Department of Medicine, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seung-Jung Park
- Department of Medicine, University of Ulsan College of Medicine, Seoul, South Korea
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Cho JH, Choi SY, Ryu HM, Oh EJ, Yook JM, Ahn JS, Jung HY, Choi JY, Park SH, Kim CD, Kim YL. Fimasartan attenuates renal ischemia-reperfusion injury by modulating inflammation-related apoptosis. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2018; 22:661-670. [PMID: 30402026 PMCID: PMC6205936 DOI: 10.4196/kjpp.2018.22.6.661] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/22/2018] [Accepted: 09/17/2018] [Indexed: 12/19/2022]
Abstract
Fimasartan, a new angiotensin II receptor antagonist, reduces myocyte damage and stabilizes atherosclerotic plaque through its anti-inflammatory effect in animal studies. We investigated the protective effects of pretreatment with fimasartan on ischemia-reperfusion injury (IRI) in a mouse model of ischemic renal damage. C57BL/6 mice were pretreated with or without 5 (IR-F5) or 10 (IR-F10) mg/kg/day fimasartan for 3 days. Renal ischemia was induced by clamping bilateral renal vascular pedicles for 30 min. Histology, pro-inflammatory cytokines, and apoptosis assays were evaluated 24 h after IRI. Compared to the untreated group, blood urea nitrogen and serum creatinine levels were significantly lower in the IR-F10 group. IR-F10 kidneys showed less tubular necrosis and interstitial fibrosis than untreated kidneys. The expression of F4/80, a macrophage infiltration marker, and tumor necrosis factor (TNF)-α, decreased in the IR-F10 group. High-dose fimasartan treatment attenuated the upregulation of TNF-α, interleukin (IL)-1β, and IL-6 in ischemic kidneys. Fewer TUNEL positive cells were observed in IR-F10 compared to control mice. Fimasartan caused a significant decrease in caspase-3 activity and the level of Bax, and increased the Bcl-2 level. Fimasartan preserved renal function and tubular architecture from IRI in a mouse ischemic renal injury model. Fimasartan also attenuated upregulation of inflammatory cytokines and decreased apoptosis of renal tubular cells. Our results suggest that fimasartan inhibited the process of tubular injury by preventing apoptosis induced by the inflammatory pathway.
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Affiliation(s)
- Jang-Hee Cho
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Soon-Youn Choi
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Hye-Myung Ryu
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Eun-Joo Oh
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Ju-Min Yook
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Ji-Sun Ahn
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Hee-Yeon Jung
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Ji-Young Choi
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Sun-Hee Park
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Chan-Duck Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
| | - Yong-Lim Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
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Angeli F, Verdecchia P, Trapasso M, Pane M, Signorotti S, Reboldi G. PK/PD evaluation of fimasartan for the treatment of hypertension Current evidences and future perspectives. Expert Opin Drug Metab Toxicol 2018; 14:533-541. [PMID: 29676941 DOI: 10.1080/17425255.2018.1468435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Fimasartan is the ninth and latest Angiotensin Receptor Blockers for the treatment of hypertension. Fimasartan is a derivative of losartan in which the imidazole ring has been replaced. It provides a selective type 1 angiotensin II receptor antagonist effect with noncompetitive, in surmountable binding. Fimasartan is rapidly absorbed following oral administration with an oral bioavailability of 18.6 ± 7.2%. Fimasartan is relatively stable in terms of metabolism and more than 90% of circulating fimasartan moieties in the plasma are in the parent form; fecal elimination and biliary excretion are the predominant elimination pathways of fimasartan. Areas covered: We reviewed data from clinical trials that investigated safety and efficacy of fimasartan in hypertension. Expert opinion: Fimasartan proved good efficacy in blood pressure reduction. In large clinical studies,fimasartan showed an excellent safety profile and when combined with hydrochlorothiazide oram lodipine, it showed a better effect on controlling blood pressure than monotherapy. Fimasartan 60-120 mg once daily has also shown an antihypertensive effect over 24-h. Moreover, preclinical studies demonstrated organ-protecting effects of fimasartan. These results make fimasartan an attractive candidate for the treatment of hypertension. However, it remains to test the benefit of using fimasartan on clinical outcomes.
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Affiliation(s)
- Fabio Angeli
- a Department of Cardiology and Cardiovascular Pathophysiology , Hospital and University of Perugia , Perugia , Italy
| | - Paolo Verdecchia
- b Department of Internal Medicine , Hospital of Assisi , Assisi , Italy
| | - Monica Trapasso
- c Department of Medicine , University of Perugia , Perugia , Italy
| | - Marina Pane
- c Department of Medicine , University of Perugia , Perugia , Italy
| | - Sara Signorotti
- c Department of Medicine , University of Perugia , Perugia , Italy
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Abstract
Previous epidemiological studies have suggested that uric acid is an independent risk factor for incident hypertension, whereas few studies have evaluated the effect of hyperuricemia on blood pressure control in hypertensive patients. We investigated whether hyperuricemia predicts uncontrolled hypertension through a large-scale prospective cohort study with hypertensive patients treated with fimasartan in the Republic of Korea (the Kanarb-Metabolic Syndrome study).Of the 10,601 hypertensive patients who were recruited from 582 private clinics and 11 university hospitals at baseline, 7725 completed the follow-up after 3 months of fimasartan medication, and 6506 were included in the analysis after excluding those with missing values. We estimated the risk of uncontrolled hypertension after 3 months (≥130/80 mm Hg in those with diabetes or chronic renal failure and ≥140/90 mm Hg in the remaining patients) related with baseline hyperuricemia (serum uric acid ≥7 mg/dL in males ≥6 mg/dL in females) using multiple logistic regression models.Hyperuricemia increased the risk of uncontrolled hypertension after 3 months of fimasartan medication (odds ratio, 1.247; 95% confidence interval, 1.063-1.462). Males in the highest quartile of uric acid level were at a 1.322 (95% confidence interval, 1.053-1.660) times higher risk of uncontrolled hypertension in reference to the lowest quartile; the same analyses in females were not significant. Patients without metabolic syndrome had significantly higher odds of uncontrolled hypertension with hyperuricemia (odds ratio, 1.328; 95% confidence interval, 1.007-1.751).Hyperuricemia predicted uncontrolled hypertension even after 3 months of fimasartan treatment in hypertensive patients.
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Affiliation(s)
- Jaelim Cho
- Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, Incheon
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul
- Correspondence: Changsoo Kim, Department of Preventive Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (e-mail: ); Dae Ryong Kang, Department of Humanities and Social Medicine, Ajou University School of Medicine, Yeongtong-gu, Suwon, Korea (e-mail: )
| | - Dae Ryong Kang
- Department of Humanities and Social Medicine, Ajou University School of Medicine, Suwon
- Correspondence: Changsoo Kim, Department of Preventive Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (e-mail: ); Dae Ryong Kang, Department of Humanities and Social Medicine, Ajou University School of Medicine, Yeongtong-gu, Suwon, Korea (e-mail: )
| | - Jeong Bae Park
- Department of Medicine/Cardiology, Cheil General Hospital, Kwandong University College of Medicine, Seoul, Korea
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Abstract
Fimasartan is the ninth, and most recent, angiotensin II receptor antagonist approved as an antihypertensive agent. Fimasartan, a pyrimidin-4(3H)-one derivative of losartan with the imidazole ring replaced, which enables higher potency and longer duration than losartan. Fecal elimination and biliary excretion are the predominant elimination pathways of fimasartan and the urinary excretion was found to be less than 3 % 24 h after administration. Fimasartan is primarily catabolized by cytochrome P450 isoform 3A and no significant drug interaction was observed when used in combination with hydrochlorothiazide, amlodipine, warfarin, or digoxin. Fimasartan at a dosage range of 60-120 mg once daily showed an antihypertensive effect over 24 h. In a large, population-based observational study, fimasartan showed an excellent safety profile. Anti-inflammatory and organ-protecting effects of fimasartan have been shown in various preclinical studies, including aortic balloon injury, myocardial infarct ischemia/reperfusion, doxorubicin cardiotoxicity, and ischemic stroke models.
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Affiliation(s)
- Hae-Young Lee
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Byung-Hee Oh
- Seoul National University Hospital, Seoul, Republic of Korea.
- Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-Ro, Chongno-gu, Seoul, 03080, Korea.
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Effect of Long-Term Treatment with Fimasartan on Transient Focal Ischemia in Rat Brain. BIOMED RESEARCH INTERNATIONAL 2015; 2015:295925. [PMID: 26448932 PMCID: PMC4584036 DOI: 10.1155/2015/295925] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 08/19/2015] [Accepted: 08/31/2015] [Indexed: 02/01/2023]
Abstract
Fimasartan is a newly developed angiotensin receptor blocker, which may have protective effects during myocardial infarction or atherosclerosis. In this context, we investigated the effects of long-term treatment with low-dose fimasartan on focal ischemia in rat brain. We induced focal ischemia in brain by transient intraluminal occlusion of middle cerebral artery (MCA) and administered low-dose (0.5 mg/kg) or regular doses (1 or 3 mg/kg) of fimasartan via intravenous routes. After the administration of low-dose (0.5 mg/kg) fimasartan, blood pressure did not decrease compared to the phosphate-buffered saline- (PBS-) control with MCA occlusion (MCAO) group. The infarct volume and ischemic cell death were reduced in the low-dose fimasartan-treated group (46 ± 41 mm3 for 0.5 mg/kg and 153 ± 47 mm3 for PBS-control with MCAO; P < 0.01) but not in the regular-dose groups. Low-dose fimasartan treatment improved functional recovery after ischemia and significantly decreased mortality. In our study, fimasartan reduced the degradation of IκB and the formation of an inflammatory end-product, COX-2. As a result, the recruitment of inflammatory cells in the peri-infarct area decreased in fimasartan-treated group. We have demonstrated that long-term, low-dose fimasartan treatment improved outcomes after focal ischemia in the brain via a reduction of inflammation.
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Arumugam S, Sreedhar R, Thandavarayan RA, Karuppagounder V, Krishnamurthy P, Suzuki K, Nakamura M, Watanabe K. Angiotensin receptor blockers: Focus on cardiac and renal injury. Trends Cardiovasc Med 2015; 26:221-8. [PMID: 26169314 DOI: 10.1016/j.tcm.2015.06.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 05/13/2015] [Accepted: 06/04/2015] [Indexed: 12/31/2022]
Abstract
Angiotensin II, an important component of renin angiotensin system, is a potent vasopressor and its actions are mostly mediated via angiotensin II type 1 receptor (AT1R) and role of AT2R in counterbalancing the actions of AT1R stimulation are under extensive research. In addition to its physiological actions, angiotensin II plays important roles in the pathogenesis of atherosclerosis, hypertension, left ventricular hypertrophy, and heart failure. The effects of angiotensin II can be blocked by either suppressing its production by blocking angiotensin converting enzyme or by antagonizing its actions on AT1R using angiotensin II receptor blockers (ARBs). Instead of the extensive use of ARBs in the treatment of various cardiovascular diseases, proper selection of a particular ARB is crucial as the clinical condition of individual patient is different and also their economic status would play an essential role in medication compliance. Thus a critical review of the proven and promising actions of ARBs against various pathological conditions will be of great importance for the clinicians as well as for the researchers.
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Affiliation(s)
- Somasundaram Arumugam
- Department of Clinical Pharmacology, Niigata University of Pharmacy and Applied Life Sciences, Higashijima, Akiha-Ku, Niigata, Japan
| | - Remya Sreedhar
- Department of Clinical Pharmacology, Niigata University of Pharmacy and Applied Life Sciences, Higashijima, Akiha-Ku, Niigata, Japan
| | - Rajarajan A Thandavarayan
- Department of Clinical Pharmacology, Niigata University of Pharmacy and Applied Life Sciences, Higashijima, Akiha-Ku, Niigata, Japan; Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX
| | - Vengadeshprabhu Karuppagounder
- Department of Clinical Pharmacology, Niigata University of Pharmacy and Applied Life Sciences, Higashijima, Akiha-Ku, Niigata, Japan
| | - Prasanna Krishnamurthy
- Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX
| | - Kenji Suzuki
- Department of Gastroenterology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masahiko Nakamura
- Department of Cardiology, Yamanashi Prefectural Central Hospital, Kofu, Yamanashi, Japan
| | - Kenichi Watanabe
- Department of Clinical Pharmacology, Niigata University of Pharmacy and Applied Life Sciences, Higashijima, Akiha-Ku, Niigata, Japan.
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Kim S, Kim SJ, Yoon HE, Chung S, Choi BS, Park CW, Shin SJ. Fimasartan, a Novel Angiotensin-Receptor Blocker, Protects against Renal Inflammation and Fibrosis in Mice with Unilateral Ureteral Obstruction: the Possible Role of Nrf2. Int J Med Sci 2015; 12:891-904. [PMID: 26640409 PMCID: PMC4643080 DOI: 10.7150/ijms.13187] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 09/20/2015] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES A newly developed angiotensin II receptor blocker, fimasartan, is effective in lowering blood pressure through its action on the renin-angiotensin system. Renal interstitial fibrosis, believed to be due to oxidative injury, is an end-stage process in the progression of chronic kidney disease. Nuclear factor erythroid 2-related factor 2 (Nrf2) is known to regulate cellular oxidative stress and induce expression of antioxidant genes. In this study we investigated the role of Nrf2 in fimasartan-mediated antioxidant effects in mice with renal fibrosis induced by unilateral ureteral obstruction (UUO). MATERIALS AND METHODS UUO was induced surgically in mice, followed by either no treatment with fimasartan or the intraperitoneal administration of fimasartan (3 mg/kg/day). On day 7, we evaluated the changes in the renin-angiotensin system (RAS) and the expression of Nrf2 and its downstream antioxidant genes, as well as renal inflammation, apoptosis, and fibrosis in the obstructed kidneys. The effect of fimasartan on the Nrf2 pathway was also investigated in HK-2 cells stimulated by tumor necrosis factor-α. RESULTS The mice with surgically induced UUO showed increased renal inflammation and fibrosis as evidenced by histopathologic findings and total collagen content in the kidney. These effects were attenuated in the obstructed kidneys of the fimasartan-treated mice. Fimasartan treatment inhibited RAS activation and the expression of Nox1, Nox2, and Nox4. In contrast, fimasartan upregulated the renal expression of Nrf2 and its downstream signaling molecules (such as NQO1; HO-1; GSTa2 and GSTm3). Furthermore, it increased the expression of antioxidant enzymes, including CuSOD, MnSOD, and catalase. The fimasartan-treated mice had significantly less apoptosis on TUNEL staining, with decreased levels of pro-apoptotic protein and increased levels of anti-apoptotic protein. In the HK-2 cells, fimasartan treatment inhibited RAS activation, decreased expression of mitogen-activated protein kinases (MAPKs), and upregulated the Nrf2 pathway. CONCLUSIONS These results suggest that fimasartan has beneficial effects in reducing renal oxidative stress, inflammation, and fibrosis. Possible mechanisms to explain these effects are inhibition of RAS and MAPKs and upregulation of Nrf2 signaling, with subsequent induction of antioxidant pathways.
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Affiliation(s)
- Soojeong Kim
- 1. Division of of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea
| | - Sung Jun Kim
- 2. Division of of Nephrology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | - Hye Eun Yoon
- 2. Division of of Nephrology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea
| | - Sungjin Chung
- 1. Division of of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea
| | - Bum Soon Choi
- 1. Division of of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea
| | - Cheol Whee Park
- 1. Division of of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea
| | - Seok Joon Shin
- 2. Division of of Nephrology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea
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Sim DS, Jeong MH, Song HC, Kim J, Chong A, Bom HS, Jeong IS, Oh SG, Kim JM, Park DS, Kim JH, Lim KS, Kim MS, Ryu SH, Kim HK, Kim SS, Jang SY, Cho JY, Jeong HC, Lee KH, Park KH, Yoon NS, Yoon HJ, Kim KH, Hong YJ, Park HW, Kim JH, Ahn Y, Cho JG, Park JC, Kang JC. Cardioprotective effect of fimasartan, a new angiotensin receptor blocker, in a porcine model of acute myocardial infarction. J Korean Med Sci 2015; 30:34-43. [PMID: 25552881 PMCID: PMC4278025 DOI: 10.3346/jkms.2015.30.1.34] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 08/29/2014] [Indexed: 01/13/2023] Open
Abstract
Cardioprotective effect of fimasartan, a new angiotensin receptor blocker (ARB), was evaluated in a porcine model of acute myocardial infarction (MI). Fifty swine were randomized to group 1 (sham, n=10), group 2 (no angiotensin-converting enzyme inhibitor [ACEI] or ARB, n=10), group 3 (perindopril 2 mg daily, n=10), group 4 (valsartan 40 mg daily, n=10), or group 5 (fimasartan 30 mg daily, n=10). Acute MI was induced by occlusion of the left anterior descending artery for 50 min. Echocardiography, single photon emission computed tomography (SPECT), and F-18 fluorodeoxyglucose cardiac positron emission tomography (PET) were performed at baseline, 1 week, and 4 weeks. Iodine-123 meta-iodobenzylguanidine (MIBG) scan was done at 6 weeks for visualization of cardiac sympathetic activity. Left ventricular function and volumes at 4 weeks were similar between the 5 groups. No difference was observed in groups 2 to 5 in SPECT perfusion defect, matched and mismatched segments between SPECT and PET at 1 week and 4 weeks. MIBG scan showed similar uptake between the 5 groups. Pathologic analysis showed similar infarct size in groups 2 to 5. Infarct size reduction was not observed with use of fimasartan as well as other ACEI and ARB in a porcine model of acute MI.
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Affiliation(s)
- Doo Sun Sim
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Myung Ho Jeong
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Ho Chun Song
- Department of Nuclear Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Jahae Kim
- Department of Nuclear Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Ari Chong
- Department of Nuclear Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Hee Seung Bom
- Department of Nuclear Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - In Seok Jeong
- Department of Cardiothoracic Surgery, Chonnam National University Hospital, Gwangju, Korea
| | - Sang Gi Oh
- Department of Cardiothoracic Surgery, Chonnam National University Hospital, Gwangju, Korea
| | - Jong Min Kim
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Dae Sung Park
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Jung Ha Kim
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Kyung Seob Lim
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Min Suk Kim
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Shi Hyun Ryu
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Hyun Kuk Kim
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Sung Soo Kim
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Su Young Jang
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Jae Yeong Cho
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Hae Chang Jeong
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Ki Hong Lee
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Keun Ho Park
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Nam Sik Yoon
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Hyun Ju Yoon
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Kye Hun Kim
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Young Joon Hong
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Hyung Wook Park
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Ju Han Kim
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Youngkeun Ahn
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Jeong Gwan Cho
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Jong Chun Park
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
| | - Jung Chaee Kang
- The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea
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