Histamine release from human right atrium

Mast Cells: Key Contributors to Cardiac Fibrosis

Historically, increased numbers of mast cells have been associated with fibrosis in numerous cardiac pathologies, implicating mast cells in the development of cardiac fibrosis. Subsequently, several approaches have been utilised to demonstrate a causal role for mast cells in animal models of cardiac fibrosis including mast cell stabilising compounds, rodents deficient in mast cells, and inhibition of the actions of mast cell-specific proteases such as chymase and tryptase. Whilst most evidence supports a pro-fibrotic role for mast cells, there is evidence that in some settings these cells can oppose fibrosis. A major gap in our current understanding of cardiac mast cell function is identification of the stimuli that activate these cells causing them to promote a pro-fibrotic environment. This review will present the evidence linking mast cells to cardiac fibrosis, as well as discuss the major questions that remain in understanding how mast cells contribute to cardiac fibrosis.

Mast cells, peptides and cardioprotection - an unlikely marriage?

1 Mast cells have classically been regarded as the 'bad guys' in the setting of acute myocardial ischaemia, where their released contents are believed to contribute both to tissue injury and electrical disturbances resulting from ischaemia. Recent evidence suggests, however, that if mast cell degranulation occurs in advance of ischaemia onset, this may be cardioprotective by virtue of the depletion of mast cell contents that can no longer act as instruments of injury when the tissue becomes ischaemic. 2 Many peptides, such as ET-1, adrenomedullin, relaxin and atrial natriuretic peptide, have been demonstrated to be cardioprotective when given prior to the onset of myocardial ischaemia, although their physiological functions are varied and the mechanisms of their cardioprotective actions appear to be diverse and often ill defined. However, one common denominator that is emerging is the ability of these peptides to modulate mast cell degranulation, raising the possibility that peptide-induced mast cell degranulation or stabilization may hold the key to a common mechanism of their cardioprotection. 3 The aim of this review was to consolidate the evidence implying that mast cell degranulation could play both a detrimental and protective role in myocardial ischaemia, depending upon when it occurs, and that this may underlie the cardioprotective effects of a range of diverse peptides that exerts physiological effects within the cardiovascular system.

Human umbilical cord blood-derived mast cells: a unique model for the study of neuro-immuno-endocrine interactions

Findings obtained using animal models have often failed to reflect the processes involved in human disease. Moreover, human cultured cells do not necessarily function as their actual tissue counterparts. Therefore, there is great demand for sources of human progenitor cells that may be directed to acquire specific tissue characteristics and be available in sufficient quantities to carry out functional and pharmacological studies. Acase in point is the mast cell, well known for its involvement in allergic reactions, but also implicated in inflammatory diseases. Mast cells can be activated by allergens, anaphylatoxins, immunoglobulin-free light chains, superantigens, neuropeptides, and cytokines, leading to selective release of mediators. These could be involved in many inflammatory diseases, such as asthma and atopic dermatitis, which worsen by stress, through activation by local release of corticotropin-releasing hormone or related peptides. Umbilical cord blood and cord matrix-derived mast cell progenitors can be separated magnetically and grown in the presence of stem cell factor, interleukin-6, interleukin-4, and other cytokines to yield distinct mast cell populations. The recent use of live cell array, with its ability to study such interactions rapidly at the single-cell level, provides unique new opportunities for fast output screening of mast cell triggers and inhibitors.

The critical role of mast cells in allergy and inflammation

Mast cells are well known for their involvement in allergic and anaphylactic reactions, but recent findings implicate them in a variety of inflammatory diseases affecting different organs, including the heart, joints, lungs, and skin. In these cases, mast cells appear to be activated by triggers other than aggregation of their IgE receptors (FcepsilonRI), such as anaphylatoxins, immunoglobulin-free light chains, superantigens, neuropeptides, and cytokines leading to selective release of mediators without degranulation. These findings could explain inflammatory diseases, such as asthma, atopic dermatitis, coronary inflammation, and inflammatory arthritis, all of which worsen by stress. It is proposed that the pathogenesis of these diseases involve mast cell activation by local release of corticotropin-releasing hormone (CRH) or related peptides. Combination of CRH receptor antagonists and mast cell inhibitors may present novel therapeutic interventions.

Critical role of mast cells in inflammatory diseases and the effect of acute stress

Mast cells are not only necessary for allergic reactions, but recent findings indicate that they are also involved in a variety of neuroinflammatory diseases, especially those worsened by stress. In these cases, mast cells appear to be activated through their Fc receptors by immunoglobulins other than IgE, as well as by anaphylatoxins, neuropeptides and cytokines to secrete mediators selectively without overt degranulation. These facts can help us better understand a variety of sterile inflammatory conditions, such as multiple sclerosis (MS), migraines, inflammatory arthritis, atopic dermatitis, coronary inflammation, interstitial cystitis and irritable bowel syndrome, in which mast cells are activated without allergic degranulation.

Cardiotoxicity of histamine and the possible role of histamine in the arrhythmogenesis produced by certain antihistamines

Since 1990 it has repeatedly been reported that some histamine H1 receptor antagonists (e.g. terfenadine and astemizole) are able to produce ventricular arrhythmias (e.g. torsade de pointes) when they are given at dosages above the therapeutic range and/or administered together with cytochrome P-450 3A4 inhibitors, such as ketoconazole or erythromycin. Although the mechanism by which these arrhythmias are produced remains unclear, the recently reported ability of these drugs to block outward K+ currents has been suggested as the cause of their arrhythmogenic effects. Alternatively, we have observed that some H1 antihistamines, including terfenadine and astemizole, are able to release histamine from guinea-pig cardiac mast cells. Thus, we have proposed that the liberated histamine, acting through an H2 receptor-stimulating mechanism, can prolong the action potential duration and hence induce arrhythmogenic effects. This paper describes experimental observations supporting the hypothesis that some H1 antihistamines can induce severe cardiac arrhythmias via the local release of histamine.

Chronic beta 1-adrenoceptor blockade sensitises the H1 and H2 receptor systems in human atrium: rôle of cyclic nucleotides

We have reported that chronic treatment of patients with beta 1-adrenoceptor blockers sensitises isolated atrial preparations to adrenaline, noradrenaline and 5-Ht. We have now examined the effect of chronic treatment with beta-adrenoceptor blockers on responses to histamine of human right atrial appendages. We compared the effects of histamine on contractile force, cyclic AMP and cyclic GMP levels as well as cyclic AMP-dependent protein kinase (PKA) activity and explored the arrhythmogenic effects of histamine in preparations obtained from patients chronically treated or not treated with beta-adrenoceptor blockers. Histamine increased contractile force in paced preparations; the effects were blocked by the H2 receptor antagonist famotidine (0.1-30 mumol/l). The maximum inotropic response to histamine was doubled and the inotropic potency of histamine 0.4 log units greater in atria from beta-adrenoceptor blocker-treated compared to non beta-adrenoceptor blocker-treated patients. Histamine elicited frequency-dependent arrhythmias that were blocked by famotidine (30 mumol/l) but not by mepyramine (1 mumol/l). The incidence of arrhythmias was higher in atria from beta-adrenoceptor blocker-treated compared to untreated patients. Histamine increased both cyclic AMP and cyclic GMP levels, as well as PKA activity, significantly more in atria from beta-adrenoceptor blocker-treated compared to those from untreated patients. Mepyramine 1 mumol/l prevented the histamine-evoked increase in cyclic GMP levels, reduced the inotropic hyperresponsiveness and abolished the hyperresponsiveness in cyclic AMP levels and PKA activity observed in patients chronically treated with beta blockers. Sodium nitroprusside 10 mumol/l caused smaller increase of cyclic GMP levels than histamine and restored the contracile force depressed by mepyramine to its original level in atria from beta-adrenoceptor blocker-treated patients. The evidence is consistent with sensitisation of both the histamine H1 and histamine H2 receptor systems by chronic beta 1-adrenoceptor blockade. H1 receptor-mediated increases in cyclic GMP, enhanced through an as yet unknown mechanism by chronic beta 1-adrenoceptor blockade, may inhibit phosphodiesterase 3 activity, thereby causing enhanced histamine-evoked increases in cyclic AMP levels and PKA activity, and accounting partially for the increased inotropic responses to histamine through H2 receptors.

Effect of picumast on histamine release from rat cardiac and peritoneal mast cells

Compound 48/80-induced histamine release (HR) from the isolated perfused rat heart was markedly and significantly inhibited by picumast (PIC), possibly by acting as a calmodulin antagonist (CMA) or membrane stabilizer. Trifluoperazine (TFP, another CMA in clinical use) had a similar effect. However, an action as CMA being the basis of inhibition of HR could not be confirmed in another 'allergy' model, namely HR from rat peritoneal mast cells (RPMC). PIC, TFP and two other CMA, W7 and N-(4-aminobutyl)-5-chloro-1-naphthalenesulfonamide) failed consistently to inhibit 48/80-induced HR from RPMC, and when used on their own at high concentration these compounds caused HR. PIC and TFP also potentiated the heat-induced haemolysis of rat erythrocytes, i.e. lacked membrane stabilizing effect in this model.

Ventricular histamine concentrations and mast cell counts in the rat heart during acute ischaemia

The ventricular histamine concentrations and mast cell counts of naive and disodium cromoglycate-treated rats subjected to acute left coronary artery ligation under pentobarbitone anaesthesia were examined. In naive animals, there was a significant increase in the right ventricular histamine level at 2 min following left coronary artery ligation. Left ventricular histamine concentrations tended to decrease, and were significantly lower than those of the right ventricle at 5 min. However there were no significant changes in mast cell counts of the right or left ventricles after left coronary artery ligation. Treatment with disodium cromoglycate did not significantly alter the ventricular mast cell counts, interfere with the changes in ventricular histamine concentrations, or the occurrence of early ventricular arrhythmias and haemodynamic changes in response to acute left coronary artery ligation. It is suggested that the increase in the right and decrease in the left ventricular histamine concentrations during acute myocardial ischaemia involves mainly the non-mast cell stores, instead of mast cell sources, of cardiac histamine.

Ventricular histamine concentrations in naive and morphine-treated rats during acute myocardial ischaemia

The ventricular histamine concentrations of naive and morphine-treated rats subjected to acute left coronary artery ligation were examined. In naive animals, there was a significant increase in the right ventricular histamine level at 5 min following ligation, but not at 3 or 10 min. Left ventricular histamine concentrations tended to decrease, but the changes were not statistically significant. In shamoperated rats, neither acute nor chronic morphine treatment significantly altered either right or left ventricular histamine levels. Acute morphine treatment also did not significantly affect the ventricular histamine content at 5 min following coronary artery ligation. However, both right and left ventricular histamine concentrations were found to be significantly lower in chronic morphine-treated rats than in the naive animals when they were subjected to acute myocardial ischaemia. If the hypothesis that histamine release may contribute to the genesis of early ventricular arrhythmias resulting from acute myocardial ischaemia is accepted, the present findings suggest that the previously reported decreased incidence and delayed onset of early ventricular arrhythmias induced by acute left coronary artery ligation in chronic morphine-treated rats may be attributed to the reduced ventricular histamine concentrations.

Ventricular histamine concentrations and arrhythmias during acute myocardial ischaemia in rats

The relation between ventricular histamine concentrations and the occurrence of early ventricular arrhythmias during acute myocardial ischaemia was investigated in pentobarbitone-anaesthetized rats. There was significant decrease in the left, but not the right, ventricular histamine level at 5 min following acute left coronary artery ligation. Pretreatment with rhodanine caused remarkable reduction in ventricular histamine concentrations as well as significantly lower incidence and slower onset of ventricular tachycardia and fibrillation resulting from acute myocardial ischaemia. On the contrary, aminoguanidine pretreatment did not significantly alter ventricular histamine levels nor did it influence the occurrence of early ventricular arrhythmias induced by coronary artery ligation. The responses of blood pressure and heart rate to acute coronary artery ligation were not noticeably affected by rhodanine or aminoguanidine pretreatment. These findings support the hypothesis that histamine release from cardiac tissues may contribute to the genesis of early ventricular arrhythmias, but not to the changes in blood pressure and heart rate, during acute myocardial ischaemia.

Comparison of the release of various mediators from atrial and ventricular tissues of sensitized guinea-pig hearts

By comparison with ventricular tissues, collagenase-dispersed cell suspensions obtained from atrial tissues of sensitized guinea-pigs showed a higher histamine content, a higher proportion of mast cells, and a higher release with antigen or antisera to IgG, IgG1 and IgG2 of the following mediators: histamine, thromboxane B2 and leukotriene C4.

The role of the renin-angiotensin system in compound 48/80-induced thirst in rats

The role of the renin-angiotensin system in compound 48/80 (3 mg/kg s.c.)-induced thirst in rats was investigated. Bilateral nephrectomy attenuated drinking induced by compound 48/80 but not by polyethylene glycol (PEG) (30%, 5 ml s.c.). Pretreatment with tripelennamine (histamine H1-receptor antagonist, 40 mg/kg i.p.) prior to the administration of compound 48/80 reduced the effect of compound 48/80 on drinking, but pretreatment with cimetidine (histamine H2-receptor antagonist, 40 mg/kg i.p.) or propranolol (beta-adrenoceptor antagonist, 10 mg/kg i.p.) had no effect. The effect of SQ 14,225 (angiotensin converting enzyme inhibitor) in various concentrations (0.5-100 mg/kg s.c.) was investigated on the drinking response caused by compound 48/80 (3 mg/kg s.c.), PEG (30%, 5 ml s.c.), isoprenaline (0.5 mg/kg s.c.) and hypertonic saline (5.8%, 2 ml s.c.). SQ 14,225 at a dose of 50 mg/kg significantly attenuated the compound 48/80-induced water intake when administered within 30 min prior to the injection of compound 48/80. Pretreatment with a high dose of SQ 14,225 (50 or 100 mg/kg s.c.) 15 min prior to the injection of dipsogens caused inhibition of the drinking response to compound 48/80 or isoprenaline, but not to PEG or hypertonic saline. Pretreatment with lower doses of SQ 14,225 (0.5 or 5 mg/kg, s.c.) had no inhibitory effect on compound 48/80- or isoprenaline-induced water intake. The inhibition of water intake by SQ 14,225 seems to be dependent on the dose and time between administration of SQ 14,225 and compound 48/80 or isoprenaline. Compound 48/80 and hypertonic saline were additively effective in producing the drinking response.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of compound 48/80, substance P and pentagastrin on the isolated guinea pig atrium

It has been shown that histamine is present in guinea pig hearts. In the present work, the effect of some substances, known to liberate mast cell histamine, on the isolated guinea pig atria was studied. Compound 48/80 (100 micrograms/ml), pentagastrin (10(-6) M) and substance P (10(-5) M) were added 2-3 times to the isolated organs and the frequency of contractions was measured. At the end of experiments, the atria were examined histologically for mast cell degranulation. Compound 48/80 and pentagastrin increased the frequency of contractions of isolated atria. Substance P provoked a dose-dependent decrease of contraction frequency; this effect was diminished by atropine (10(-5) M). All three substances provoked pronounced degranulation of mast cells present in the atrium, the effect of substance P being significantly greater than the effects of the other two substances. It can be concluded that mast cells, present in guinea pig atrium, are sensitive to the histamine liberators used; histamine is released in quantities high enough to produce an effect.

Effects of ranitidine and cimetidine on experimentally induced ventricular arrhythmias in anaesthetized rats

The effects of two histamine H2-receptor antagonists, ranitidine and cimetidine, on ventricular arrhythmias induced by acute coronary artery ligation and by aconitine infusion were studied in pentobarbitone-anaesthetized rats. The changes in arterial blood pressure and heart rate were also observed. It was found that both drugs significantly reduced the incidence, and prolonged the time of onset, of ventricular tachycardia and ventricular fibrillation following acute coronary artery ligation; however, they did not significantly alter the incidence or time of onset of ventricular dysrhythmias caused by aconitine infusion. These findings further support the hypothesis that histamine release may contribute to the genesis of early ventricular arrhythmias resulting from acute myocardial ischaemia. Since the decreased blood pressure induced by coronary artery ligation was not significantly prevented by pretreatment with either histamine H2-receptor blocker, this suggests that histamine may not be responsible for the blood pressure changes during acute myocardial ischaemia.

Increase of plasma renin activity after subcutaneous application of compound 48/80 in the rat

Subcutaneous (s.c.) administration of compound 48/80 (3.0 mg/kg) to conscious rats produced a time-dependent long-lasting increase of plasma renin activity (PRA). A dose-related increase of the hematocrit was also observed after injection of compound 48/80. The onset of the hematocrit increase preceded that of PRA increase. Pretreatment with a dose of more than 20 mg/kg of histamine H1-receptor antagonists such as tripelennamine or diphenhydramine prior to the injection of compound 48/80 (3.0 mg/kg s.c.) attenuated or abolished the effects of compound 48/80 on PRA, hematocrit and plasma extravasation. Pretreatment with cimetidine (histamine H2-receptor antagonist, 40 mg/kg i.p.) had no effect on these plasma variables. The increase of PRA caused by s.c. administration of compound 48/80 was not affected by the pretreatment with propranolol (beta-adrenoceptor antagonist, 10 mg/kg i.p.), which completely inhibited the isoproterenol (0.5 mg/kg s.c.)-induced PRA increase. Administration of compound 48/80 did not induce a significant PRA increase in the nephrectomized rats although the increase of hematocrit following s.c. administration of compound 48/80 persisted despite the absence of kidneys. S.c. administration of compound 48/80 (3.0 mg/kg) led to a significant decrease of histamine content at the site of injection and to a significant increase in plasma histamine concentration without affecting arterial blood pressure. The present data suggest that s.c. administration of compound 48/80 stimulates the release of histamine from cutaneous mast cells, which cause an increase in vascular permeability to plasma protein via the stimulation of histamine H1-receptors, then leads to hypovolemia. The resulting hypovolemia may directly stimulate the juxtraglomerular cells of the kidney to release renin.

Effects of SK&F 93479 on experimentally induced ventricular arrhythmias in dogs, rats and mice

The effects of SK&F 93479, a potent histamine H2-receptor antagonist, on ventricular arrhythmias induced by coronary artery ligation in dogs and rats, and by aconitine infusion in mice were investigated. It was found that SK&F 93479 in large doses, significantly prevented the occurrence of spontaneous ventricular fibrillation and the changes in ventricular fibrillation threshold following coronary artery ligation in dogs. In rats subjected to ligation of the main left coronary artery, it significantly reduced the incidence of ventricular fibrillation, and significantly prolonged the time of onset of ventricular tachycardia and ventricular fibrillation. On the contrary, SK&F 93479 did not significantly alter the incidence or the time of onset of cardiac dysrhythmias caused by aconitine infusion in mice. These findings suggest that SK&F 93479 lacks non-specific antiarrhythmic activity and that its protective effects against coronary artery ligation may be mediated by its histamine H2-receptor antagonizing action. They also support the hypothesis that histamine may contribute to the genesis of ventricular arrhythmias resulting from acute myocardial ischaemia.

The effects of histamine H2-receptor antagonists on PHA induced lymphocyte proliferation

Histamine H2-receptor antagonists must be used with caution to define the pharmacology of histamine effects on lymphocyte mitogenesis induced by PHA, because they can enhance and/or suppress in their own right, because these effects are similar to those of histamine itself, because mitogenic doses of PHA can release significant amounts of histamine from supposedly pure mononuclear cell preparations.

Mechanism of the indirect adrenergic effect of histamine in cat cerebral arteries

KCl (50 mM), tyramine (10(-7) M), and histamine (10(-4) M) induced an increase in tritium release from cat cerebral arteries preincubated with [3H]noradrenaline, this increase being due in part to noradrenaline. When calcium was absent from the superfusion medium, only tyramine (10(-7) M) enhanced the tritium outflow. Colchicine (10(-3) M) partially inhibited the increase in radioactivity brought about by 10(-4) M histamine. KCl (50 mM) also evoked release of radioactivity from cerebral arteries preloaded with [3H]histamine; this release was unaffected by reserpine pretreatment or removal of both superior cervical sympathetic ganglia. Neither tyramine (10(-7) M) nor compound 48/80 (300 micrograms ml-1) altered the spontaneous tritium outflow from cerebral blood vessels preincubated with [3H]histamine. These results suggest that histamine is not accumulated by sympathetic nerve endings and elicits its noradrenaline-releasing effect by means of an exocytotic process.

Different effects of compound 48/80 and histamine on plasma renin activity

The effects of subcutaneous injection of compound 48/80 and histamine on the water intake, plasma renin activity (PRA) and plasma histamine levels were investigated in the rat. The results suggest that compound 48/80 and histamine stimulate water intake by different mechanisms. The compound 48/80-induced water intake seems to be mainly mediated by stimulation of the renin-angiotensin system. On the other hand, the histamine-induced water intake seems to be directly mediated by its action in the brain.

Effects of histamine on mechanical performance and biochemical and electrical activity in the heart of monkeys (Macaca fuscata)

The properties of the cardiac effects of histamine on the isolated heart muscles of the Japanese monkey (Macaca fuscata) were investigated. Histamine had a concentration-dependent positive inotropic effect on left atria and papillary muscles and a positive chronotropic effect on right atria. Histamine increased the levels of cyclic AMP and shortened the duration of the action potential in Purkinje fibers, measures of its biochemical and electrophysiological effects. All of these effects of histamine were blocked by 10(-5) M cimetidine. These results indicate that histamine H2-receptors mediate the cardiac effects of histamine on the monkey heart. Histamine (10(-5) M) also restored the action potentials and contractility of K+-depolarized preparations. These effects were inhibited by verapamil (10(-6)-10(-5) M) but not by TTX (10(-5) M), suggesting that, in the monkey heart, histamine may act by increasing the slow inward current.