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Hamel AR, Yan W, Rouhana JM, Monovarfeshani A, Jiang X, Mehta PA, Advani J, Luo Y, Liang Q, Rajasundaram S, Shrivastava A, Duchinski K, Mantena S, Wang J, van Zyl T, Pasquale LR, Swaroop A, Gharahkhani P, Khawaja AP, MacGregor S, Chen R, Vitart V, Sanes JR, Wiggs JL, Segrè AV. Integrating genetic regulation and single-cell expression with GWAS prioritizes causal genes and cell types for glaucoma. Nat Commun 2024; 15:396. [PMID: 38195602 PMCID: PMC10776627 DOI: 10.1038/s41467-023-44380-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 12/12/2023] [Indexed: 01/11/2024] Open
Abstract
Primary open-angle glaucoma (POAG), characterized by retinal ganglion cell death, is a leading cause of irreversible blindness worldwide. However, its molecular and cellular causes are not well understood. Elevated intraocular pressure (IOP) is a major risk factor, but many patients have normal IOP. Colocalization and Mendelian randomization analysis of >240 POAG and IOP genome-wide association study (GWAS) loci and overlapping expression and splicing quantitative trait loci (e/sQTLs) in 49 GTEx tissues and retina prioritizes causal genes for 60% of loci. These genes are enriched in pathways implicated in extracellular matrix organization, cell adhesion, and vascular development. Analysis of single-nucleus RNA-seq of glaucoma-relevant eye tissues reveals that the POAG and IOP colocalizing genes and genome-wide associations are enriched in specific cell types in the aqueous outflow pathways, retina, optic nerve head, peripapillary sclera, and choroid. This study nominates IOP-dependent and independent regulatory mechanisms, genes, and cell types that may contribute to POAG pathogenesis.
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Affiliation(s)
- Andrew R Hamel
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Wenjun Yan
- Department of Molecular and Cellular Biology and Center for Brain Science, Harvard University, Cambridge, MA, USA
| | - John M Rouhana
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Aboozar Monovarfeshani
- Department of Molecular and Cellular Biology and Center for Brain Science, Harvard University, Cambridge, MA, USA
| | - Xinyi Jiang
- MRC Human Genetics Unit, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, The University of Edinburgh, Edinburgh, UK
| | - Puja A Mehta
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Jayshree Advani
- Neurobiology, Neurodegeneration and Repair Laboratory, National Eye Institute, National Institutes of Health, Bethesda, MA, USA
| | - Yuyang Luo
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Qingnan Liang
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Skanda Rajasundaram
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
- Faculty of Medicine, Imperial College London, London, UK
| | - Arushi Shrivastava
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Katherine Duchinski
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Bioinformatics and Integrative Genomics (BIG) PhD Program, Harvard Medical School, Boston, MA, USA
| | - Sreekar Mantena
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
- Harvard/MIT MD-PhD Program, Harvard Medical School, Boston, MA, USA
| | - Jiali Wang
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Tavé van Zyl
- Department of Molecular and Cellular Biology and Center for Brain Science, Harvard University, Cambridge, MA, USA
- Department of Ophthalmology and Visual Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anand Swaroop
- Neurobiology, Neurodegeneration and Repair Laboratory, National Eye Institute, National Institutes of Health, Bethesda, MA, USA
| | - Puya Gharahkhani
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4029, Australia
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Stuart MacGregor
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4029, Australia
| | - Rui Chen
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Veronique Vitart
- MRC Human Genetics Unit, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
| | - Joshua R Sanes
- Department of Molecular and Cellular Biology and Center for Brain Science, Harvard University, Cambridge, MA, USA
| | - Janey L Wiggs
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Ayellet V Segrè
- Ocular Genomics Institute, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA.
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.
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Liu J, Zhang B, Zhu G, Liu C, Wang S, Zhao Z. Discovering genetic linkage between periodontitis and type 1 diabetes: A bioinformatics study. Front Genet 2023; 14:1147819. [PMID: 37051594 PMCID: PMC10083320 DOI: 10.3389/fgene.2023.1147819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/15/2023] [Indexed: 03/29/2023] Open
Abstract
Background: Relationship between periodontitis (PD) and type 1 diabetes (T1D) has been reported, but the detailed pathogenesis requires further elucidation. This study aimed to reveal the genetic linkage between PD and T1D through bioinformatics analysis, thereby providing novel insights into scientific research and clinical treatment of the two diseases.Methods: PD-related datasets (GSE10334, GSE16134, GSE23586) and T1D-related datasets(GSE162689)were downloaded from NCBI Gene Expression Omnibus (GEO). Following batch correction and merging of PD-related datasets as one cohort, differential expression analysis was performed (adjusted p-value <0.05 and ∣log2 fold change| > 0.5), and common differentially expressed genes (DEGs) between PD and T1D were extracted. Functional enrichment analysis was conducted via Metascape website. The protein-protein interaction (PPI) network of common DEGs was generated in The Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database. Hub genes were selected by Cytoscape software and validated by receiver operating characteristic (ROC) curve analysis.Results: 59 common DEGs of PD and T1D were identified. Among these DEGs, 23 genes were commonly upregulated, and 36 genes were commonly downregulated in both PD- and T1D-related cohorts. Functional enrichment analysis indicated that common DEGs were mainly enriched in tube morphogenesis, supramolecular fiber organization, 9 + 0 non-motile cilium, plasma membrane bounded cell projection assembly, glomerulus development, enzyme-linked receptor protein signaling pathway, endochondral bone morphogenesis, positive regulation of kinase activity, cell projection membrane and regulation of lipid metabolic process. After PPI construction and modules selection, 6 hub genes (CD34, EGR1, BBS7, FMOD, IGF2, TXN) were screened out and expected to be critical in linking PD and T1D. ROC analysis showed that the AUC values of hub genes were all greater than 70% in PD-related cohort and greater than 60% in T1D-related datasets.Conclusion: Shared molecular mechanisms between PD and T1D were revealed in this study, and 6 hub genes were identified as potential targets in treating PD and T1D.
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Affiliation(s)
- Junqi Liu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bo Zhang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Guanyin Zhu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chenlu Liu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shuangcheng Wang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- *Correspondence: Zhihe Zhao,
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Sener H, Evereklioglu C, Horozoglu F, Sener ABG. Optic nerve head vessel density using OCTA in patients with primary angle closure disease: A systematic review and network meta-analysis. Photodiagnosis Photodyn Ther 2023; 41:103209. [PMID: 36493693 DOI: 10.1016/j.pdpdt.2022.103209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/11/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Elevated intraocular presure secondary to angle closure in angle closure glaucoma is considered the primary mechanism in the development of optic nerve damage. There is evidence that vascular mechanisms may play a role in the pathogenesis of primary angle closure disease (PACD). We aimed to evaluate optic nerve head vessel density in PACD. METHODS PubMed, Scopus, and Web of Science were searched. Observational investigations were included. A frequentist network meta-analysis was performed. The primary outcome was circumpapillary vessel density (cpVD), and the secondary outcome was peripapillary retinal nerve fiber layer (pRNFL) thickness. RESULTS One thousand twenty four eyes from eleven studies were included in the study. There was no difference in cpVD between the primary angle closure glaucoma (PACG) and acute primary angle closure (APAC) group however, there was a significant decreasing in pRNFL thickness in the PACG group compared to APAC group. In the PACG and APAC group, cpVD and pRNFL thickness were decreased compared to primary angle closure (PAC), primary angle closure suspect (PACS), and control group. There was no difference in cpVD and pRNFL thickness between PAC, PACS and control group. CONCLUSION This study has shown that the elevated intraocular pressure is an important factor affecting optical nerve perfusion in PACD. The decreasing in cpVD and RNFL thickness was more severe in the PACG and APAC group.
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Association of glaucoma and lifestyle with incident cardiovascular disease: a longitudinal prospective study from UK Biobank. Sci Rep 2023; 13:2712. [PMID: 36792671 PMCID: PMC9931750 DOI: 10.1038/s41598-023-29613-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 02/07/2023] [Indexed: 02/17/2023] Open
Abstract
The shared pathophysiological features of the cerebrovascular disease (CVD) and glaucoma suggest an association between the two diseases. Using the prospective UK Biobank cohort, we examined the associations between glaucoma and incident CVD and assessed the extent to which a healthy lifestyle reduced the CVD risk in subjects with glaucoma, using a scoring system consisting of four factors: current smoking, obesity, regular physical activity, and a healthy diet. During a mean follow-up time of 8.9 years, 22,649 (4.9%) incident CVD cases were documented. Multivariable Cox regression analyses revealed that subjects with glaucoma were significantly more likely to exhibit incident CVD (hazard ratio [HR]:1.19, 95% confidence interval [CI] 1.03-1.37; p = 0.016) than controls. In the further subgroup analyses, glaucoma increased incident CVD risk both in the young (40-55 years) and the old (56-70 years) and in both sexes, with higher risk in the young (HR: 1.33, CI 1.02-1.74) and female subjects (HR: 1.32, CI 1.14-1.52). When we analyze the associations between glaucoma and incident CVD by lifestyle factors, the highest absolute risks were observed in individuals with both glaucoma and an unhealthy lifestyle (HR: 2.66, CI 2.22-3.19). In conclusion, glaucoma was an independent risk factor for incident CVD. A healthy lifestyle was associated with a substantially lower risk for CVD incidence among adults with glaucoma.
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Haider AA, Rex TS, Wareham LK. cGMP Signaling in the Neurovascular Unit—Implications for Retinal Ganglion Cell Survival in Glaucoma. Biomolecules 2022; 12:biom12111671. [PMID: 36421684 PMCID: PMC9687235 DOI: 10.3390/biom12111671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
Glaucoma is a progressive age-related disease of the visual system and the leading cause of irreversible blindness worldwide. Currently, intraocular pressure (IOP) is the only modifiable risk factor for the disease, but even as IOP is lowered, the pathology of the disease often progresses. Hence, effective clinical targets for the treatment of glaucoma remain elusive. Glaucoma shares comorbidities with a multitude of vascular diseases, and evidence in humans and animal models demonstrates an association between vascular dysfunction of the retina and glaucoma pathology. Integral to the survival of retinal ganglion cells (RGCs) is functional neurovascular coupling (NVC), providing RGCs with metabolic support in response to neuronal activity. NVC is mediated by cells of the neurovascular unit (NVU), which include vascular cells, glial cells, and neurons. Nitric oxide-cyclic guanosine monophosphate (NO-cGMP) signaling is a prime mediator of NVC between endothelial cells and neurons, but emerging evidence suggests that cGMP signaling is also important in the physiology of other cells of the NVU. NO-cGMP signaling has been implicated in glaucomatous neurodegeneration in humans and mice. In this review, we explore the role of cGMP signaling in the different cell types of the NVU and investigate the potential links between cGMP signaling, breakdown of neurovascular function, and glaucoma pathology.
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Bojic L, Rogosic V, Markovic D, Rogosic LV, Glavas D. Brachial flow-mediated dilation and carotid intima-media thickness in glaucoma patients. BMC Ophthalmol 2022; 22:275. [PMID: 35739540 PMCID: PMC9229099 DOI: 10.1186/s12886-022-02498-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 06/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of the study was to assess the ultrasound measurements of the brachial artery flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT) and their relationship in glaucoma patients. Methods Thirty-seven patients with glaucoma and thirty-one healthy controls were included in the study. All glaucoma patients and controls underwent ultrasound measurement of FMD of the brachial artery and ultrasound measurement of IMT of the carotid artery. Results The mean values of brachial FMD were significantly lower among the glaucoma compared with controls (16.4 ± 10.6% vs 20.3 ± 8.5%, p = 0.034). No significant difference was found in carotid IMT (1.2 ± 0.4 vs. 1.1 ± 0.4, p = 0.3), and brachial artery diameter at rest (4.7 ± 0.6 vs. 4.9 ± 0.3, p = 0.2) between the glaucoma patients and controls. The significant difference in brachial artery diameter in hyperemia between the glaucoma patients and controls (5.5 ± 0.6 vs. 5.9 ± 0.4 p = 0.002) was found. A negative correlation among brachial FMD and carotid IMT as well as among brachial FMD and brachial artery diameter at rest was found. Conclusions Impaired brachial FMD indicates presence of systemic vascular endothelial dysfunction in glaucoma; glaucoma patients with lower values of the brachial FMD are at increased risk of having thickened carotid IMT.
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Affiliation(s)
| | - Veljko Rogosic
- Department of Ophthalmology, University Hospital Split, Split, Croatia
| | - Domagoj Markovic
- Clinic for Heart and Cardiovascular Diseases, University Hospital Split, Spinciceva 1, 21000, Split, Croatia.
| | | | - Duska Glavas
- Clinic for Heart and Cardiovascular Diseases, University Hospital Split, Spinciceva 1, 21000, Split, Croatia
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Holden JM, Al Hussein Al Awamlh S, Croteau LP, Boal AM, Rex TS, Risner ML, Calkins DJ, Wareham LK. Dysfunctional cGMP Signaling Leads to Age-Related Retinal Vascular Alterations and Astrocyte Remodeling in Mice. Int J Mol Sci 2022; 23:ijms23063066. [PMID: 35328488 PMCID: PMC8954518 DOI: 10.3390/ijms23063066] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 12/17/2022] Open
Abstract
The nitric oxide-guanylyl cyclase-1-cyclic guanylate monophosphate (NO-GC-1-cGMP) pathway is integral to the control of vascular tone and morphology. Mice lacking the alpha catalytic domain of guanylate cyclase (GC1-/-) develop retinal ganglion cell (RGC) degeneration with age, with only modest fluctuations in intraocular pressure (IOP). Increasing the bioavailability of cGMP in GC1-/- mice prevents neurodegeneration independently of IOP, suggesting alternative mechanisms of retinal neurodegeneration. In continuation to these studies, we explored the hypothesis that dysfunctional cGMP signaling leads to changes in the neurovascular unit that may contribute to RGC degeneration. We assessed retinal vasculature and astrocyte morphology in young and aged GC1-/- and wild type mice. GC1-/- mice exhibit increased peripheral retinal vessel dilation and shorter retinal vessel branching with increasing age compared to Wt mice. Astrocyte cell morphology is aberrant, and glial fibrillary acidic protein (GFAP) density is increased in young and aged GC1-/- mice, with areas of dense astrocyte matting around blood vessels. Our results suggest that proper cGMP signaling is essential to retinal vessel morphology with increasing age. Vascular changed are preceded by alterations in astrocyte morphology which may together contribute to retinal neurodegeneration and loss of visual acuity observed in GC1-/- mice.
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Effect of SCUBA Diving on Ophthalmic Parameters. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58030408. [PMID: 35334584 PMCID: PMC8949343 DOI: 10.3390/medicina58030408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 11/17/2022]
Abstract
Background and Objective: Several cases of central serous chorioretinopathy (CSC) in divers have been reported in our medical retina center over the past few years. This study was designed to evaluate possible changes induced by SCUBA diving in ophthalmic parameters and especially subfoveal choroidal thickness (SFCT), since the choroid seems to play a crucial role in physiopathology of CSC. Materials and Methods: Intraocular pressure (IOP), SFCT, pachymetry, flow-mediated dilation (FMD), blood pressure, and heart rate were measured in 15 healthy volunteer divers before diving, 30 and 60 min after a standard deep dive of 25 m depth for 25 min in a dedicated diving pool (NEMO 33). Results: SFCT reduces significantly to 96.63 ± 13.89% of pre-dive values (p = 0.016) 30 min after diving. It recovers after 60 min reaching control values. IOP decreases to 88.05 ± 10.04% of pre-dive value at 30 min, then increases to 91.42 ± 10.35% of its pre-dive value (both p < 0.0001). Pachymetry shows a slight variation, but is significantly increased to 101.63 ± 1.01% (p = 0.0159) of the pre-dive value, and returns to control level after 60 min. FMD pre-dive was 107 ± 6.7% (p < 0.0001), but post-dive showed a diminished increase to 103 ± 6.5% (p = 0.0132). The pre-post difference was significant (p = 0.03). Conclusion: Endothelial dysfunction leading to arterial stiffness after diving may explain the reduced SFCT observed, but SCUBA diving seems to have miscellaneous consequences on eye parameters. Despite this clear influence on SFCT, no clear relationship between CSC and SCUBA diving can be drawn.
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Nicoară SD, Brie I, Jurj A, Sorițău O. The Future of Stem Cells and Their Derivates in the Treatment of Glaucoma. A Critical Point of View. Int J Mol Sci 2021; 22:ijms222011077. [PMID: 34681739 PMCID: PMC8540760 DOI: 10.3390/ijms222011077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/07/2021] [Accepted: 10/09/2021] [Indexed: 12/24/2022] Open
Abstract
This review focuses on the clinical translation of preclinical studies, especially those that have used stem cells in the treatment of glaucoma, with an emphasis on optic nerve regeneration. The studies referred to in the review aim to treat optic nerve atrophy, while cell therapies targeting other sites in the eye, such as the trabecular meshwork, have not been addressed. Such complex and varied pathophysiological mechanisms that lead to glaucoma may explain the fact that although stem cells have a high capacity of neuronal regeneration, the treatments performed did not have the expected results and the promise offered by animal studies was not achieved. By analyzing the facts associated with failure, important lessons are to be learned: the type of stem cells that are used, the route of administration, the selection of patients eligible for these treatments, additional therapies that support stem cells transplantation and their mode of action, methods of avoiding the host’s immune response. Many of these problems could be solved using exosomes (EV), but also miRNA, which allows more targeted approaches with minimal side effects.
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Affiliation(s)
- Simona Delia Nicoară
- Department of Ophthalmology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 8 Victor Babeș Street, 400012 Cluj-Napoca, Romania
- Clinic of Ophthalmology, Emergency County Hospital, 3–5 Clinicilor Street, 40006 Cluj-Napoca, Romania
- Correspondence: or ; Tel.: +40-264592771
| | - Ioana Brie
- “Ion Chiricuță” Institute of Oncology, Laboratory of Cell Biology and Radiobiology, 34–36 Republicii Street, 400010 Cluj-Napoca, Romania; (I.B.); (O.S.)
| | - Ancuța Jurj
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 8 Victor Babeș Street, 400012 Cluj-Napoca, Romania;
| | - Olga Sorițău
- “Ion Chiricuță” Institute of Oncology, Laboratory of Cell Biology and Radiobiology, 34–36 Republicii Street, 400010 Cluj-Napoca, Romania; (I.B.); (O.S.)
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Shoji MK, Cousins CC, Saini C, Nascimento E Silva R, Wang M, Brauner SC, Greenstein SH, Pasquale LR, Shen LQ. Paired Optic Nerve Microvasculature and Nailfold Capillary Measurements in Primary Open-Angle Glaucoma. Transl Vis Sci Technol 2021; 10:13. [PMID: 34110389 PMCID: PMC8196412 DOI: 10.1167/tvst.10.7.13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Purpose To assess microvascular beds in the optic nerve head (ONH), peripapillary tissue, and the nailfold in patients with primary open-angle glaucoma (POAG) versus controls. Methods Patients with POAG (n = 22) and controls (n = 12) underwent swept-source optical coherence tomography angiography of ophthalmic microvasculature and nailfold video capillaroscopy of the hand. The main outcomes were vessel density (VD) and blood flow of the ONH, the peripapillary and the nailfold microvasculatures. Results Patients with POAG were younger than controls (63.5 ± 9.4 vs. 69.9 ± 6.5 years, P = 0.03). Deep ONH VD and blood flow were lower in patients with POAG than controls (39.1% ± 3.5% vs. 43.8% ± 5.7%; 37.8% ± 5.3% vs. 46.0% ± 7.8%, respectively, P < 0.02 for both); similar results were observed with peripapillary VD (37.9 ± 2.6%, 43.4 ± 7.6%, respectively, P = 0.03). Nailfold capillary density and blood flow were lower in patients with POAG than controls (8.8 ± 1.0 vs. 9.8 ± 0.9 capillaries/mm; 19.9 ± 9.4 vs. 33.7 ± 9.8 pL/s, respectively; P < 0.009 for both). After adjusting for age and gender, deep ONH VD and blood flow, peripapillary VD, and nailfold capillary blood flow were lower in POAG than controls (β = −0.04, −0.07, −0.05, −13.19, respectively, P ≤ 0.046 for all). Among all participants, there were positive correlations between deep ONH and nailfold capillary blood flow (Pearson's correlation coefficient r = 0.42, P = 0.02), peripapillary and nailfold capillary density (r = 0.43, P = 0.03), and peripapillary and nailfold capillary blood flow (r = 0.49, P = 0.01). Conclusions Patients with POAG demonstrated morphologic and hemodynamic alterations in both ophthalmic and nailfold microvascular beds compared to controls. Translational Relevance The concomitant abnormalities in nailfold capillaries and relevant ocular vascular beds in POAG suggest that the microvasculature may be a target for POAG treatment.
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Affiliation(s)
- Marissa K Shoji
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Clara C Cousins
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Chhavi Saini
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | | | - Mengyu Wang
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Stacey C Brauner
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Scott H Greenstein
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lucy Q Shen
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
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11
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[The role of citicoline in glaucoma]. Ophthalmologe 2021; 118:439-448. [PMID: 33730306 PMCID: PMC7967777 DOI: 10.1007/s00347-021-01362-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 11/05/2022]
Abstract
Hintergrund In den letzten Jahren wurde in vielen experimentellen und klinischen Studien gezeigt, dass bei der Glaukomerkrankung die neuronale Degeneration nicht nur auf der Höhe von Netzhaut und Sehnerv, sondern im Verlauf der gesamten Sehbahn und des Gehirns erfolgt. Fragestellung Dargestellt werden die neuroprotektive Wirkung und ihre Mechanismen von Citicolin bei der Glaukomerkrankung. Material und Methode Vor dem Hintergrund der Neuroanatomie, des Neuroimaging und der Pathogenese der Glaukomerkrankung wird die Relevanz erläutert. Die Daten der experimentellen und klinischen Studien werden dargelegt und ein Fazit für die klinische Anwendung gezogen. Ergebnisse Citicolin wirkt neuroprotektiv über glaukomrelevante Mechanismen. Die neuroprotektive Wirkung von Citicolin bei Offenwinkelglaukomen ist funktionell und morphologisch nachweisbar. Sie ist unabhängig vom Glaukomschaden und Augeninnendruck und tritt i. d. R. erst nach einem Jahr auf. Die Effekte von oralem Citicolin treten bei einer Tagesdosis von 500–1000 mg auf. Die Einnahme von Citicolin kann dauerhaft oder in Zyklen erfolgen. In den Studien traten bei der Einnahme von Citicolin keine Nebenwirkungen auf. Citicolin kann kognitive Leistungen und somit Therapieadhärenz sowie die Lebensqualität bei Glaukompatienten verbessern Schlussfolgerung Diese relativ alte nootrope Substanz, welche jetzt als Nahrungsergänzungsmittel vertrieben wird, scheint eine wertvolle Ergänzung zur konventionellen Therapie der Glaukomerkrankung und eine rationale Option zur Neuroprotektion und Prophylaxe zu sein.
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Reina-Torres E, De Ieso ML, Pasquale LR, Madekurozwa M, van Batenburg-Sherwood J, Overby DR, Stamer WD. The vital role for nitric oxide in intraocular pressure homeostasis. Prog Retin Eye Res 2020; 83:100922. [PMID: 33253900 DOI: 10.1016/j.preteyeres.2020.100922] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/13/2020] [Accepted: 11/23/2020] [Indexed: 02/07/2023]
Abstract
Catalyzed by endothelial nitric oxide (NO) synthase (eNOS) activity, NO is a gaseous signaling molecule maintaining endothelial and cardiovascular homeostasis. Principally, NO regulates the contractility of vascular smooth muscle cells and permeability of endothelial cells in response to either biochemical or biomechanical cues. In the conventional outflow pathway of the eye, the smooth muscle-like trabecular meshwork (TM) cells and Schlemm's canal (SC) endothelium control aqueous humor outflow resistance, and therefore intraocular pressure (IOP). The mechanisms by which outflow resistance is regulated are complicated, but NO appears to be a key player as enhancement or inhibition of NO signaling dramatically affects outflow function; and polymorphisms in NOS3, the gene that encodes eNOS modifies the relation between various environmental exposures and glaucoma. Based upon a comprehensive review of past foundational studies, we present a model whereby NO controls a feedback signaling loop in the conventional outflow pathway that is sensitive to changes in IOP and its oscillations. Thus, upon IOP elevation, the outflow pathway tissues distend, and the SC lumen narrows resulting in increased SC endothelial shear stress and stretch. In response, SC cells upregulate the production of NO, relaxing neighboring TM cells and increasing permeability of SC's inner wall. These IOP-dependent changes in the outflow pathway tissues reduce the resistance to aqueous humor drainage and lower IOP, which, in turn, diminishes the biomechanical signaling on SC. Similar to cardiovascular pathogenesis, dysregulation of the eNOS/NO system leads to dysfunctional outflow regulation and ocular hypertension, eventually resulting in primary open-angle glaucoma.
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Affiliation(s)
| | | | - Louis R Pasquale
- Eye and Vision Research Institute of New York Eye and Ear Infirmary at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Darryl R Overby
- Department of Bioengineering, Imperial College London, London, UK.
| | - W Daniel Stamer
- Department of Ophthalmology, Duke University, Durham, NC, USA.
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Rong X, Cai Y, Li M, Chen X, Kang L, Yang L. Relationship between nailfold capillary morphology and retinal thickness and retinal vessel density in primary open-angle and angle-closure glaucoma. Acta Ophthalmol 2020; 98:e882-e887. [PMID: 32243735 DOI: 10.1111/aos.14416] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 03/03/2020] [Indexed: 02/01/2023]
Abstract
PURPOSE To compare the morphological characteristics of the nailfold capillaries in glaucoma patients with those in healthy subjects. To evaluate the relationship of nailfold capillary morphology with retinal thickness and retinal vessel density in patients with primary open-angle (POAG) and primary angle-closure glaucoma (PACG). METHODS Fifty-one patients with normal-tension glaucoma, thirty-two patients with hypertension glaucoma, thirty-two PACG patients and sixty-one healthy subjects were included in this cross-sectional study. Patients with connective tissue diseases or taking anticoagulation or antiplatelet agents were excluded. Nailfold capillaroscopy, spectral-domain optical coherence tomography and optical coherence tomography angiography were used to evaluate the nailfold capillary morphology, retinal thickness and retinal vessel density, respectively. RESULTS Nailfold capillary morphological features, including lower capillary density, greater tortuosity, more dilated capillaries >50 μm and more avascular zones >100 μm, were more common in POAG and PACG patients than in control subjects (all p < 0.001). In the POAG group, nailfold vessel density was negatively correlated with ganglion cell complex (GCC) thickness (odds ratio [OR] = 0.908, p = 0.010) and radial peripapillary capillary (RPC) density (OR = 0.787, p = 0.025). Tortuosity degree was negatively associated with RPC density (OR = 0.804, p = 0.016). In the PACG group, no evident relationship between nailfold capillary morphology and retinal thickness or retinal vessel density was detected (all p > 0.05). CONCLUSIONS Nailfold capillary bed abnormalities were observed in both POAG and PACG patients. The nailfold capillary features, especially microvascular density and tortuosity degree, had a significant association with GCC thickness and RPC density in subjects with POAG but not in those with PACG.
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Affiliation(s)
- Xin Rong
- Department of Ophthalmology Peking University First Hospital Beijing China
| | - Yu Cai
- Department of Ophthalmology Peking University First Hospital Beijing China
| | - Mei Li
- Department of Ophthalmology Peking University First Hospital Beijing China
| | - Xuling Chen
- Department of Ophthalmology Peking University First Hospital Beijing China
| | - Lei Kang
- Department of Ophthalmology Peking University First Hospital Beijing China
| | - Liu Yang
- Department of Ophthalmology Peking University First Hospital Beijing China
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Malishevskaya TN, Kiseleva TN, Filippova YE, Vlasova AS, Nemtsova IV, Vasilchenko VV, Zaytsev MS. [Structural and functional features of peripheral vasculature in patients with glaucoma]. Vestn Oftalmol 2020; 136:67-76. [PMID: 33056966 DOI: 10.17116/oftalma202013605167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE To study the reactivity of the vascular endothelium and the elastic properties of the upper and lower extremities, and assess the vascular innervation effect of Cytoflavin in patients with stable and rapidly progressive primary open-angle glaucoma (POAG). MATERIAL AND METHODS The study included 67 patients with POAG (mean age 66.3±1.5 years), among them 31 with stable and 36 with rapidly progressive glaucoma. During the first stage of the study, the reactivity of the vascular endothelium was assessed with reactive hyperemia test; the viscoelastic properties of the upper and lower extremities were evaluated using volumetric sphygmomanometry. For the second stage of the study, patients were divided into the main group (n=20) that received intravenous injections of 10 ml Cytoflavin with 200 ml of 5% glucose solution for 10 days and then 2 tablets twice a day for 60 days, and the control group (n=16). RESULTS The function of the vascular endothelium was significantly reduced in patients with rapidly progressive POAG. Correlation analysis revealed a negative correlation between the flow-dependent vasodilation (FDV), and the duration of POAG and initial diameter of the brachial artery (r=0.5, p<0.05 and r=0.6, p<0.05, respectively). Pathological response of vessel endothelium was detected in 88% of patients with stable and 96% of patients with rapidly progressive POAG. Cytoflavin was found to have positive effects on the endothelium in patients with POAG. CONCLUSION The obtained data can be used for identification of risk factors for rapid POAG progression and optimization of its treatment.
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Affiliation(s)
- T N Malishevskaya
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - T N Kiseleva
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - Yu E Filippova
- Tyumen Regional Ophthalmological Dispensary, Tyumen, Russia.,West-Siberian Institute of Postgraduate Medical Education, Tyumen, Russia
| | - A S Vlasova
- Tyumen Regional Ophthalmological Dispensary, Tyumen, Russia.,West-Siberian Institute of Postgraduate Medical Education, Tyumen, Russia
| | - I V Nemtsova
- Tyumen Regional Ophthalmological Dispensary, Tyumen, Russia.,West-Siberian Institute of Postgraduate Medical Education, Tyumen, Russia
| | - V V Vasilchenko
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - M S Zaytsev
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
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Nailfold Capillary Hemorrhages: Microvascular Risk Factors for Primary Open-Angle Glaucoma. J Ophthalmol 2020; 2020:8324319. [PMID: 32587763 PMCID: PMC7301193 DOI: 10.1155/2020/8324319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 05/12/2020] [Accepted: 05/20/2020] [Indexed: 11/18/2022] Open
Abstract
Background Primary open-angle glaucoma (POAG) is associated with systemic microvascular dysfunction including hemorrhages and other abnormalities of the nailfold capillary bed. This study aimed to verify the specificity of nailfold capillary hemorrhages and other abnormalities as risk factors for POAG. Methods Nailfold video capillaroscopy was performed using a JH-1004 capillaroscope on the fourth and fifth digits of the nondominant hand in control (n = 277), POAG (n = 206), OHT (n = 57), and SG (n = 29) subjects. The number of hemorrhages, dilated capillaries >50 µm, and avascular zones ≥200 µm were counted and adjusted to counts per 100 capillaries. Descriptive analyses as well as univariate- and multivariable-adjusted logistic regression were performed comparing all groups with controls and POAG with OHT and SG. Subanalyses were conducted in POAG patients examining the association between nailfold capillary outcomes and previous glaucoma surgery, successful IOP control, or disease severity. Results All nailfold capillary outcomes were significantly increased in POAG, no outcomes were increased in SG, and only hemorrhages were mildly increased in OHT. Hemorrhages were significantly more frequent in POAG compared with both OHT (P < 0.0001) and SG (P=0.001). There were significant trends between higher numbers of hemorrhages and POAG compared with controls, OHT, and SG, with odds ratios of 18.3 (8.5-39.4), 9.1 (1.9-13.4), and 11.8 (1.7-7.3), respectively, for the presence of two or more hemorrhages per 100 capillaries. Hemorrhages were not significantly associated with previous glaucoma surgery, successful postoperative IOP control, or disease severity in POAG. Conclusions These findings suggest that systemic microvascular dysfunction is frequent in POAG and occurs early in the disease process. The high specificity of nailfold hemorrhages makes them viable clinical risk factors for POAG.
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Joshi S, Mahoney S, Jahan J, Pitts L, Hackney KJ, Jarajapu YP. Blood flow restriction exercise stimulates mobilization of hematopoietic stem/progenitor cells and increases the circulating ACE2 levels in healthy adults. J Appl Physiol (1985) 2020; 128:1423-1431. [PMID: 32324479 DOI: 10.1152/japplphysiol.00109.2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Adult CD34+ hematopoietic stem/progenitor cells (HSPC) in the systemic circulation are bone marrow-derived and have the propensity of maintaining cardiovascular health. Activation of angiotensin-converting enzyme-2 (ACE2)-angiotensin-(1-7)-Mas receptor pathway, the vascular protective axis of the renin-angiotensin system (RAS), stimulates vasculogenic functions of HSPCs. In a previous study, exposure to hypoxia increased the expressions of ACE2 and Mas, and stimulated ACE2 shedding. The current study tested if blood flow restriction exercise (BFR)-induced regional hypoxia recapitulates the in vitro observations in healthy adults. Hypoxia was induced by 80% limb occlusion pressure (LOP) via inflation cuff. Muscle oxygen saturation was determined using near-infrared spectroscopy. Peripheral blood was collected 30 min after quiet sitting (control) or after BFR. Lin-CD45lowCD34+ HSPCs were enumerated by flow cytometry, and ACE and ACE2 activities were determined in plasma and cell lysates and supernatants. Regional hypoxia resulted in muscle oxygen saturation of 17.5% compared with 49.7% in the control condition (P < 0.0001, n = 9). Circulating HSPCs were increased following BFR (834.8 ± 62.1/mL) compared with control (365 ± 59, P < 0.001, n = 7), which was associated with increased stromal-derived factor 1α and vascular endothelial growth factor receptor levels by four- and threefold, respectively (P < 0.001). ACE2 activity was increased in the whole cell lysates of HSPCs, resulting in an ACE2-to-ACE ratio of 11.7 ± 0.5 in BFR vs 9.1 ± 0.9 in control (P < 0.05). Cell supernatants have threefold increase in the ACE2-to-ACE ratio following BFR compared with control (P < 0.001). Collectively, these findings provide strong evidence for the upregulation of ACE2 by acute regional hypoxia in vivo. Hypoxic exercise regimens appear to be promising means of enhancing vascular regenerative capacity.NEW & NOTEWORTHY Although many studies have explored the mechanisms of skeletal muscle growth and adaptation with hypoxia exercise interventions, less attention has been given to the potential for vascular adaptation and regenerative capacity. This study shows for the first time an acute upregulation of the angiotensin-converting enzyme 2 and increase in CD34+ vasculogenic cells following an acute bout of blood flow restriction with low-intensity exercise. These rapid changes collectively promote skeletal muscle angiogenesis. Therefore, this study supports the potential of hypoxic exercise interventions with low intensity for vascular and muscle health.
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Affiliation(s)
- Shrinidh Joshi
- Department of Pharmaceutical Sciences, College of Health Professions, North Dakota State University, Fargo, North Dakota
| | - Sean Mahoney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, North Dakota
| | - Jesmin Jahan
- Department of Pharmaceutical Sciences, College of Health Professions, North Dakota State University, Fargo, North Dakota
| | - Logan Pitts
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, North Dakota
| | - Kyle J Hackney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, North Dakota
| | - Yagna Pr Jarajapu
- Department of Pharmaceutical Sciences, College of Health Professions, North Dakota State University, Fargo, North Dakota
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Effect of cold provocation on vessel density in eyes with primary open angle glaucoma: An optical coherence tomography angiography study. Sci Rep 2019; 9:9384. [PMID: 31253843 PMCID: PMC6599001 DOI: 10.1038/s41598-019-45386-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 05/29/2019] [Indexed: 11/08/2022] Open
Abstract
The cold pressor test (CPT) induces a cardiovascular response, which may affect ocular blood flow and neuronal function. This study assessed whether optical coherence tomography angiography (OCT-A) can be used to evaluate CPT-induced changes in healthy eyes and in eyes with primary open-angle glaucoma (POAG). Twenty-two healthy subjects and 23 subjects with POAG and retinal fibre layer defects in only one hemifield were included in this study. The CPT was performed by submerging a subject’s hand in cold water (0–4 °C) for 1 minute. The results showed that baseline peripapillary and macular vessel density (VD) measurements were significantly lower in subjects with POAG than in controls (all P < 0.05). Post-CPT VD measurements did not significantly differ from baseline in either healthy or glaucomatous eyes. Additionally, CPT-induced changes in VD did not differ among normal eyes, damaged and undamaged glaucomatous hemifields. Changes in VD were also not significantly influenced by self-reported history of cold extremities. In conclusion, the CPT does not induce significant VD changes, as measured by OCT-A, in the peripapillary or macular areas of either healthy eyes or eyes with POAG. The VD, an all-or-nothing flow measure, may not be sensitive enough for evaluating cold-induced ocular haemodynamic changes.
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Felice F, Francini A, Domenici V, Cifelli M, Belardinelli E, Sebastiani L, Cantini C, Di Stefano R. Effects of Extra Virgin Olive Oil and Apples Enriched-Dark Chocolate on Endothelial Progenitor Cells in Patients with Cardiovascular Risk Factors: A Randomized Cross-Over Trial. Antioxidants (Basel) 2019; 8:antiox8040088. [PMID: 30987385 PMCID: PMC6523981 DOI: 10.3390/antiox8040088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/29/2019] [Accepted: 04/01/2019] [Indexed: 12/12/2022] Open
Abstract
Background: Endothelial dysfunction has been associated to cardiovascular outcomes in patients with cardiovascular risk factors. Circulating endothelial progenitor cells (EPCs) play an important physiological role for their reparative potential of vascular integrity, but are numerically reduced and functionally impaired in patients with cardiovascular risks. This study assesses the effects of Extra Virgin Olive Oil (EVOO) and apple-enriched dark chocolate intake on the blood levels of EPCs. Methods: Thirty volunteers with cardiovascular risk factors, enrolled in a randomised, crossover, four-weeks trial, received a solid dark chocolate bar (40 g/day) containing 10% EVOO or 2.5% dry apples. Urine samples were analyzed for endogenous metabolites. Circulating EPCs levels, clinical data and anthropometric examinations were collected. Results: 26 volunteers (M/F:14/12, 51 ± 9 years of age) completed the study. Comparison of pre-post intervention revealed a significant increase in EPCs levels associated with EVOO-dark chocolate consumption. Most biochemical parameters were not significantly modified by both chocolates. Conclusions: This study shows that a daily consumption of a non fattening dose of dark chocolate enriched with EVOO improves blood levels of EPCs, a well known surrogate biologic marker for endothelial function.
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Affiliation(s)
- Francesca Felice
- Cardiovascular Research Laboratory, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56100 Pisa, Italy.
| | - Alessandra Francini
- BioLabs, Institute of Life Sciences, Scuola Superiore Sant'Anna, 56127 Pisa, Italy.
| | - Valentina Domenici
- Department of Chemistry and Industrial Chemistry, University of Pisa, 56100 Pisa, Italy.
| | - Mario Cifelli
- Department of Chemistry and Industrial Chemistry, University of Pisa, 56100 Pisa, Italy.
| | - Ester Belardinelli
- Cardiovascular Research Laboratory, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56100 Pisa, Italy.
| | - Luca Sebastiani
- BioLabs, Institute of Life Sciences, Scuola Superiore Sant'Anna, 56127 Pisa, Italy.
| | - Claudio Cantini
- Trees and Timber Institute, IVALSA-CNR, Sesto Fiorentino, 50019 Florence, Italy.
| | - Rossella Di Stefano
- Cardiovascular Research Laboratory, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56100 Pisa, Italy.
- Interdepartmental Research Center "Nutraceuticals and Food for Health", University of Pisa, 56100 Pisa, Italy.
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Wareham LK, Buys ES, Sappington RM. The nitric oxide-guanylate cyclase pathway and glaucoma. Nitric Oxide 2018; 77:75-87. [PMID: 29723581 DOI: 10.1016/j.niox.2018.04.010] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/18/2018] [Accepted: 04/23/2018] [Indexed: 01/12/2023]
Abstract
Glaucoma is a prevalent optic neuropathy characterized by the progressive dysfunction and loss of retinal ganglion cells (RGCs) and their optic nerve axons, which leads to irreversible visual field loss. Multiple risk factors for the disease have been identified, but elevated intraocular pressure (IOP) remains the primary risk factor amenable to treatment. Reducing IOP however does not always prevent glaucomatous neurodegeneration, and many patients progress with the disease despite having IOP in the normal range. There is increasing evidence that nitric oxide (NO) is a direct regulator of IOP and that dysfunction of the NO-Guanylate Cyclase (GC) pathway is associated with glaucoma incidence. NO has shown promise as a novel therapeutic with targeted effects that: 1) lower IOP; 2) increase ocular blood flow; and 3) confer neuroprotection. The various effects of NO in the eye appear to be mediated through the activation of the GC- guanosine 3:5'-cyclic monophosphate (cGMP) pathway and its effect on downstream targets, such as protein kinases and Ca2+ channels. Although NO-donor compounds are promising as therapeutics for IOP regulation, they may not be ideal to harness the neuroprotective potential of NO signaling. Here we review evidence that supports direct targeting of GC as a novel pleiotrophic treatment for the disease, without the need for direct NO application. The identification and targeting of other factors that contribute to glaucoma would be beneficial to patients, particularly those that do not respond well to IOP-dependent interventions.
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Affiliation(s)
- Lauren K Wareham
- Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | | | - Rebecca M Sappington
- Department of Ophthalmology and Visual Sciences, Vanderbilt University School of Medicine, Nashville, TN 37232, USA; Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA.
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Samietz S, Jürgens C, Ittermann T, Holtfreter B, Pink C, Schipf S, Biffar R, Völzke H, Kocher T, Tost F. Cross-sectional association between oral health and retinal microcirculation. J Clin Periodontol 2018; 45:404-412. [DOI: 10.1111/jcpe.12872] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Stefanie Samietz
- Department of Prosthodontics, Gerostomatology and Biomaterials; Center for Oral Health; University Medicine Greifswald; Greifswald Germany
| | - Clemens Jürgens
- Institute for Community Medicine; University Medicine Greifswald; Greifswald Germany
| | - Till Ittermann
- Institute for Community Medicine; University Medicine Greifswald; Greifswald Germany
| | - Birte Holtfreter
- Unit of Periodontology; Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics; Center for Oral Health; University Medicine Greifswald; Greifswald Germany
| | - Christiane Pink
- Unit of Periodontology; Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics; Center for Oral Health; University Medicine Greifswald; Greifswald Germany
| | - Sabine Schipf
- Institute for Community Medicine; University Medicine Greifswald; Greifswald Germany
| | - Reiner Biffar
- Department of Prosthodontics, Gerostomatology and Biomaterials; Center for Oral Health; University Medicine Greifswald; Greifswald Germany
| | - Henry Völzke
- Institute for Community Medicine; University Medicine Greifswald; Greifswald Germany
| | - Thomas Kocher
- Unit of Periodontology; Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics; Center for Oral Health; University Medicine Greifswald; Greifswald Germany
| | - Frank Tost
- Department of Ophthalmology; University Medicine Greifswald; Greifswald Germany
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The acute impact of high-dose lipid-lowering treatment on endothelial progenitor cells in patients with coronary artery disease-The REMEDY-EPC early substudy. PLoS One 2017; 12:e0172800. [PMID: 28394933 PMCID: PMC5386268 DOI: 10.1371/journal.pone.0172800] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/09/2017] [Indexed: 01/11/2023] Open
Abstract
RATIONALE AND OBJECTIVE Endothelial progenitor cells (EPCs) play a role in vascular repair, while circulating endothelial cells (CECs) are biomarkers of vascular damage and regeneration. Statins may promote EPC/CEC mobilization in the peripheral blood. We evaluated whether pre-procedural exposure to different lipid-lowering drugs (statins±ezetimibe) can acutely increase levels/activity of EPCs/CECs in patients with stable coronary artery disease (CAD). METHODS In a planned sub-analysis of the Rosuvastatin For REduction Of Myocardial DamagE During Coronary AngioplastY (REMEDY) trial, 38 patients with stable CAD on chronic low-dose statin therapy were randomized, in a double-blind, placebo-controlled design, into 4 groups before PCI: i. placebo (n = 11); ii. atorvastatin (80 mg+40 mg, n = 9); iii. rosuvastatin (40 mg twice, n = 9); and iv. rosuvastatin (5 mg) and ezetimibe (10 mg) twice, (n = 9). At baseline and 24 h after treatment-before PCI-, patients underwent blinded analyses of EPCs [colony forming units-endothelial cells (CFU-ECs), endothelial colony-forming cells (ECFCs) and tubulization activity] and CECs in peripheral blood. RESULTS We found no significant treatment effects on parameters investigated such as number of CECs [Median (IQR): i. 0(0), ii. 4.5(27), iii. 1.9(2.3), iv. 1.9(2.3)], CFU-ECs [Median (IQR): i. 27(11), ii. 19(31), iii. 47(36), iv. 30(98)], and ECFCs [Median (IQR): i. 86(84), ii. 7(84), iii. 8/(42.5), iv. 5(2)], as well as tubulization activity [total tubuli (well), Median (IQR): i. 19(7), ii. 5(4), iii. 25(13), iv. 15(24)]. CONCLUSIONS In this study, we found no evidence of acute changes in levels or activity of EPCs and CECs after high-dose lipid-lowering therapy in stable CAD patients.
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Albuminuria Is Associated with Open-Angle Glaucoma in Nondiabetic Korean Subjects: A Cross-Sectional Study. PLoS One 2016; 11:e0168682. [PMID: 28006020 PMCID: PMC5179114 DOI: 10.1371/journal.pone.0168682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 12/05/2016] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE Systemic vascular dysfunction has been suggested to contribute to glaucomatous damage. Albuminuria is a surrogate marker of endothelial injury, including vessels. However, their relationship is not well understood. This study aimed to investigate the association between albuminuria and the prevalence of open-angle glaucoma (OAG) in nondiabetic subjects. METHODS We conducted a cross-sectional study of 4186 nondiabetic participants aged 19 years or older from the 2011-2012 Korea National Health and Nutrition Examination Survey. OAG was defined based on the criteria of the International Society for Geographic and Epidemiologic Ophthalmology. Urinary albumin excretion was assessed by the urinary albumin-to-creatinine ratio (UACR). A multivariate logistic regression analysis was performed to evaluate the relationship between albuminuria and OAG. RESULTS Among the subjects, 124 had OAG. The weighted prevalences of microalbuminuria (UACR of 30-299 mg/g creatinine [Cr]) and macroalbuminuria (UACR ≥ 300 mg/g Cr) were 3.2 ± 0.3% and 0.4 ± 0.1%, respectively. The percentages of OAG increased in accordance with increasing UACR tertiles. Compared with subjects in the lower UACR tertile, those in the upper tertile showed an increased prevalence of OAG (odds ratio, 1.963; 95% confidence interval 1.072-3.595, P = 0.029) after adjusting for demographic factors, laboratory parameters, kidney function, and intraocular pressure. Furthermore, even after excluding 155 subjects with microalbuminuria and 19 subjects with macroalbuminuria, a positive association persisted between the upper UACR tertile (low-grade albuminuria) and an increased prevalence of OAG (odds ratio, 2.170; 95% confidence interval, 1.174-4.010, P = 0.014). CONCLUSION Albuminuria, even low-grade, was significantly associated with OAG in nondiabetic subjects. This result implies the role of vascular endothelial dysfunction in the pathogenic mechanism of OAG and suggests that careful monitoring of OAG is required in nondiabetic subjects with albuminuria.
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Pasquale LR, Hyman L, Wiggs JL, Rosner BA, Joshipura K, McEvoy M, McPherson ZE, Danias J, Kang JH. Prospective Study of Oral Health and Risk of Primary Open-Angle Glaucoma in Men: Data from the Health Professionals Follow-up Study. Ophthalmology 2016; 123:2318-2327. [PMID: 27554035 PMCID: PMC5077693 DOI: 10.1016/j.ophtha.2016.07.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/16/2016] [Accepted: 07/11/2016] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Tooth loss or periodontal disease is associated with systemic endothelial dysfunction, which has been implicated in primary open-angle glaucoma (POAG). The relationship between oral health and POAG has received limited attention. Thus, we evaluated the association between oral health history and risk of POAG and POAG subtypes. DESIGN Prospective cohort study. PARTICIPANTS Health Professionals Follow-up Study participants (40 536 men) followed biennially from 1986 to 2012. At each 2-year risk period, eligible participants were aged 40+ years, were free of POAG, and reported eye examinations. METHODS By using validated questions, we updated participants' status on number of natural teeth, teeth lost, periodontal disease with bone loss, and root canal treatments. MAIN OUTCOME MEASURES During follow-up, 485 incident cases of POAG were confirmed with medical records and classified into subtypes defined by intraocular pressure (IOP; ≥ or <22 mmHg) or visual field (VF) loss pattern at diagnosis (peripheral loss only or early paracentral loss). Multivariable relative risks (MVRRs) and 95% confidence intervals (CIs) were estimated. RESULTS Number of natural teeth, periodontal disease, and root canal treatment were not associated with POAG. However, compared with no report of tooth loss, a report of losing teeth within the past 2 years was associated with a 1.45-fold increased risk of POAG (95% CI, 1.06-1.97); in particular, a report within the past 2 years of both losing teeth and having a prevalent diagnosis of periodontal disease was associated with a 1.85-fold increased risk of POAG (95% CI, 1.07-3.18). The associations with recent tooth loss were not significantly different for the POAG subtypes (P for heterogeneity ≥0.36), although associations were strongest in relation to the POAG subtypes with IOP <22 mmHg (MVRR, 1.93; 95% CI, 1.09-3.43) and early paracentral VF loss (MVRR, 2.27; 95% CI, 1.32-3.88). CONCLUSIONS Although the number of natural teeth was not associated with risk of POAG, recent tooth loss was associated with an increased risk of POAG. Because these findings may be due to chance, they need confirmation in larger studies.
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Affiliation(s)
- Louis R Pasquale
- Glaucoma Service, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Leslie Hyman
- Division of Epidemiology, Department of Preventive Medicine, Stony Brook University, Stony Brook, New York
| | - Janey L Wiggs
- Glaucoma Service, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts
| | - Bernard A Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Kaumudi Joshipura
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; Center for Clinical Research and Health Promotion, University of Puerto Rico-MSC, San Juan, Puerto Rico
| | - Mark McEvoy
- The School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Zachary E McPherson
- The School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - John Danias
- Glaucoma Service, Department of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, New York
| | - Jae H Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts.
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Microvascular endothelial function and severity of primary open angle glaucoma. Eye (Lond) 2016; 30:1579-1587. [PMID: 27540832 DOI: 10.1038/eye.2016.185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 06/26/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeThe role of microvascular endothelial dysfunction on severity of primary open angle glaucoma (POAG) was investigated in this study.Patients and methodsA prospective cohort study was conducted. One hundred and fourteen ethnically Malay patients (114 eyes) with POAG treated at the eye clinic of Hospital University Sains Malaysia between April 2012 and December 2014 were recruited. Patients aged between 40 and 80 years with two consecutive reliable and reproducible Humphrey visual field 24-2 analyses were selected. Patients who were diagnosed with any other type of glaucoma, previous glaucoma-filtering surgery, or other surgeries except uncomplicated cataract and pterygium surgery were excluded. Humphrey visual field analysis 24-2 was used to stratify the severity of glaucoma using Advanced Glaucoma Intervention Study (AGIS) score at the time of recruitment. Microvascular endothelial function was assessed using Laser Doppler fluximetry and iontophoresis. Iontophoresis process with acetylcholine (ACh) and sodium nitroprusside (SNP) was used to measure microvascular endothelium-dependent and -independent vasodilatation, respectively.ResultsBased on the AGIS score, 55 patients showed mild glaucoma, with 29 moderate and 30 severe. There was statistically significant difference in microvascular endothelial function (ACh% and AChmax) between mild and moderate POAG cases (P=0.023) and between mild and severe POAG cases (P<0.001). There was negative correlation between microvascular endothelial function and severity of POAG (r=-0.457, P<0.001).ConclusionMicrovascular endothelial dysfunction may have a role in influencing the severity of POAG in Malay patients.
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Pasquale LR, Hanyuda A, Ren A, Giovingo M, Greenstein SH, Cousins C, Patrianakos T, Tanna AP, Wanderling C, Norkett W, Wiggs JL, Green K, Kang JH, Knepper PA. Nailfold Capillary Abnormalities in Primary Open-Angle Glaucoma: A Multisite Study. Invest Ophthalmol Vis Sci 2016; 56:7021-8. [PMID: 26523386 DOI: 10.1167/iovs.15-17860] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE There is considerable evidence for systemic vascular dysfunction in primary open-angle glaucoma (POAG). We performed nailfold capillary video microscopy to observe directly the nature of nonocular microvasculature abnormalities in POAG. METHODS We enrolled 199 POAG patients and 124 control subjects from four sites. We used JH-1004 capillaroscopes to perform nailfold capillary video microscopy on the fourth and fifth digits of each subject's nondominant hand. Videos were evaluated for hemorrhages, dilated capillary loops > 50 μm, and avascular zones > 100 μm by graders masked to case status. Multivariable odds ratios (ORs) and 95% confidence intervals (CIs) for POAG were obtained by means of logistic regression analyses that were applied to data from all cases and controls. Corresponding estimates of moderate or severe POAG versus mild POAG (based on the Hodapp-Anderson-Parrish scale) were obtained among cases only. RESULTS After controlling for demographic factors, family history of glaucoma, systemic diseases, and use of anticoagulation and antiplatelet therapy, for each 100 nailfold capillaries assessed, all types of microvascular abnormalities were significantly associated with POAG. Specifically, the presence of any dilated capillaries (OR = 2.9; 95% CI, 1.6-5.6), avascular zones (OR = 4.4; 95% CI, 1.7-11.3) and hemorrhages (OR = 12.2; 95% CI, 5.9-25.1) were associated with POAG. Among cases, the frequency of microvascular abnormalities was not associated with glaucoma severity (P ≥ 0.43). CONCLUSIONS These data provided support for nonocular capillary bed abnormalities in POAG. Comparable vascular abnormalities in the optic nerve may render it susceptible to glaucomatous damage.
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Affiliation(s)
- Louis R Pasquale
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States 2Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Akiko Hanyuda
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Ai Ren
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Michael Giovingo
- Department of Ophthalmology, John H. Stroger Jr Hospital of Cook County, Chicago, Illinois, United States
| | - Scott H Greenstein
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Clara Cousins
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Thomas Patrianakos
- Department of Ophthalmology, John H. Stroger Jr Hospital of Cook County, Chicago, Illinois, United States
| | - Angelo P Tanna
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
| | - Christopher Wanderling
- Department of Ophthalmology and Visual Sciences, University of Illinois College of Medicine at Chicago, Chicago, Illinois, United States
| | - William Norkett
- Department of Ophthalmology and Visual Sciences, University of Illinois College of Medicine at Chicago, Chicago, Illinois, United States
| | - Janey L Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Kelsey Green
- Department of Ophthalmology and Visual Sciences, University of Illinois College of Medicine at Chicago, Chicago, Illinois, United States
| | - Jae H Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - Paul A Knepper
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States 6Department of Ophthalmology and Visual Sciences, University of Illinois College of Medicine at Chicago, Chicago, Illinois, United States
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Abstract
PURPOSE OF REVIEW The purpose of this review is to discuss whether vascular dysfunction and autonomic dysfunction are related to primary open-angle glaucoma stratified by the intraocular pressure (IOP) level. RECENT FINDINGS Patients with primary open angle glaucoma (POAG) across the spectrum of IOP exhibit a variety of ocular and nonocular vascular abnormalities. Interestingly, common genetic variation in nitric oxide synthase 3 (NOS3) and the caveolin 1/caveolin 2 (CAV1/CAV2) genomic regions, which code for proteins involved in setting vascular tone, are associated with POAG. These markers seem to stratify with POAG subtypes stratified by sex or pattern of initial visual field loss and not by IOP level. Overall, it is clear that there is also cardiovascular autonomic dysfunction in high-tension glaucoma and normal-tension glaucoma but it is unclear if this dysfunction is more common in normal-tension glaucoma compared with high-tension glaucoma. SUMMARY Overall, POAG is likely a heterogeneous disease but stratifying cases by IOP level associated with initial optic nerve damage may be less useful than using other endophenotype approaches. Embracing the evidence suggesting systemic endothelial and autonomic dysfunction are operative in POAG will help us move beyond an IOP-centric view of the disease and facilitate 'tearing down the wall' that divides treating physicians and a better understanding of POAG pathogenesis.
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Affiliation(s)
- Louis R. Pasquale
- Mass Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114
- Division of Network Medicine, Brigham and Women’s Hospital, 221 Longwood Avenue, Boston, MA 02115, Phone: 617-573-3674
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Impaired systemic vascular endothelial function in patients with non-arteritic anterior ischaemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol 2015; 254:977-81. [DOI: 10.1007/s00417-015-3212-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 10/14/2015] [Accepted: 10/27/2015] [Indexed: 10/22/2022] Open
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Lanuti P, Rotta G, Almici C, Avvisati G, Budillon A, Doretto P, Malara N, Marini M, Neva A, Simeone P, Di Gennaro E, Leone A, Falda A, Tozzoli R, Gregorj C, Di Cerbo M, Trunzo V, Mollace V, Marchisio M, Miscia S. Endothelial progenitor cells, defined by the simultaneous surface expression of VEGFR2 and CD133, are not detectable in healthy peripheral and cord blood. Cytometry A 2015; 89:259-70. [DOI: 10.1002/cyto.a.22730] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 05/18/2015] [Accepted: 07/16/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Paola Lanuti
- Department of Medicine and Aging Science; School of Medicine and Health Science, University “G. d'Annunzio” of Chieti-Pescara; Chieti 66013 Italy
- Center for Ageing Sciences (Ce.S.I.), “Università G. d'Annunzio” Foundation; Chieti 66013 Italy
| | | | - Camillo Almici
- Department of Transfusion Medicine; Laboratory for Stem Cells Manipulation and Cryopreservation, AO Spedali Civili di Brescia; Brescia 25123 Italy
| | - Giuseppe Avvisati
- Department of Hematology; Stem Cell Transplantation, Transfusion Medicine and Cellular Therapy, Campus Bio-Medico University Hospital; Rome 00128 Italy
| | - Alfredo Budillon
- Experimental Pharmacology Unit, Istituto Nazionale Tumori Fondazione G. Pascale-IRCCS; Naples 80131 Italy
| | - Paolo Doretto
- Department of Laboratory Medicine; Clinical Pathology Laboratory, “S. Maria Degli Angeli” Hospital; Pordenone 33170 Italy
| | - Natalia Malara
- Department of Health Science; Interregional Research Center for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro; Catanzaro 88100 Italy
- Department of Experimental and Clinical Medicine; BioNEM Lab, University “Magna Graecia” of Catanzaro, Catanzaro 88100; Italy
| | - Mirella Marini
- Department of Transfusion Medicine; Laboratory for Stem Cells Manipulation and Cryopreservation, AO Spedali Civili di Brescia; Brescia 25123 Italy
| | - Arabella Neva
- Department of Transfusion Medicine; Laboratory for Stem Cells Manipulation and Cryopreservation, AO Spedali Civili di Brescia; Brescia 25123 Italy
| | - Pasquale Simeone
- Department of Medicine and Aging Science; School of Medicine and Health Science, University “G. d'Annunzio” of Chieti-Pescara; Chieti 66013 Italy
- Center for Ageing Sciences (Ce.S.I.), “Università G. d'Annunzio” Foundation; Chieti 66013 Italy
| | - Elena Di Gennaro
- Experimental Pharmacology Unit, Istituto Nazionale Tumori Fondazione G. Pascale-IRCCS; Naples 80131 Italy
| | - Alessandra Leone
- Experimental Pharmacology Unit, Istituto Nazionale Tumori Fondazione G. Pascale-IRCCS; Naples 80131 Italy
| | - Alessandra Falda
- Department of Laboratory Medicine; Clinical Pathology Laboratory, “S. Maria Degli Angeli” Hospital; Pordenone 33170 Italy
| | - Renato Tozzoli
- Department of Laboratory Medicine; Clinical Pathology Laboratory, “S. Maria Degli Angeli” Hospital; Pordenone 33170 Italy
| | - Chiara Gregorj
- Department of Hematology; Stem Cell Transplantation, Transfusion Medicine and Cellular Therapy, Campus Bio-Medico University Hospital; Rome 00128 Italy
| | - Melania Di Cerbo
- Department of Hematology; Stem Cell Transplantation, Transfusion Medicine and Cellular Therapy, Campus Bio-Medico University Hospital; Rome 00128 Italy
| | - Valentina Trunzo
- Department of Health Science; Interregional Research Center for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro; Catanzaro 88100 Italy
| | - Vincenzo Mollace
- Department of Health Science; Interregional Research Center for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro; Catanzaro 88100 Italy
| | - Marco Marchisio
- Department of Medicine and Aging Science; School of Medicine and Health Science, University “G. d'Annunzio” of Chieti-Pescara; Chieti 66013 Italy
- Center for Ageing Sciences (Ce.S.I.), “Università G. d'Annunzio” Foundation; Chieti 66013 Italy
| | - Sebastiano Miscia
- Department of Medicine and Aging Science; School of Medicine and Health Science, University “G. d'Annunzio” of Chieti-Pescara; Chieti 66013 Italy
- Center for Ageing Sciences (Ce.S.I.), “Università G. d'Annunzio” Foundation; Chieti 66013 Italy
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Wierzbowska J, Wojtkiewicz S, Zbieć A, Wierzbowski R, Liebert A, Maniewski R. Prolonged postocclusive hyperemia response in patients with normal-tension glaucoma. Med Sci Monit 2014; 20:2607-16. [PMID: 25502623 PMCID: PMC4266367 DOI: 10.12659/msm.891069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background It is believed that endothelial dysfunction may be a link between systemic and ocular dysregulation in glaucoma. The aim of this study was to evaluate peripheral vascular reactive hyperemia in response to occlusion test and to correlate peripheral vascular findings with retrobulbar hemodynamics parameters in patients with normal-tension glaucoma. Material/Methods Forty-eight patients with normal-tension glaucoma (mean age 58.1 years, 38 women) and 40 control subjects (mean age 54.1 years, 36 women) were subjected to a brachial arterial occlusion test and color Doppler imaging (LOGIQ 9, GE Medical Systems) of the retrobulbar arteries. Finger hyperemia was assessed by using a 2-channel laser Doppler flowmeter (MBF-3D, Moor Instruments, Ltd.). Time parameters (time to peak flow, half-time of hyperemia, time of recovery) and amplitude parameters (maximum hyperemia response, biological zero) of the post-occlusive reactive hyperemia signal pattern as well as velocities and resistance index of the ophthalmic, central retinal, and short posterior ciliary arteries were evaluated and compared between study groups. Results In glaucoma patients, time to peak flow and half-time of hyperemia were significantly longer (21.4 vs. 12.0 s, p=0.02 and 74.1 vs. 44.2 s, p=0.03, respectively) and biological zero was significantly lower (2.4 vs. 3.2, p=0.01) comparing with healthy subjects. In glaucoma patients, peak-systolic and end-diastolic velocities of central retinal artery were significantly lower (12.8 vs.14.1, p=0.03 and 3.9 vs. 4.7, p=0.01, respectively) and resistance index of this artery was significantly higher (0.69 vs. 0.67, p=0.03) compared to controls. In the glaucoma group, maximum hyperemic response was negatively correlated with the resistance index of temporal short posterior ciliary arteries (r=−0.4, p=0.01), whereas in the control group half-time of hyperemia was negatively correlated with end-diastolic velocity of the central retinal artery (r=−0.3, p=0.03). Conclusions Arterial occlusion test elicited a prolonged systemic hyperemia response in patients with glaucoma as compared with healthy subjects. Retrobulbar blood flow alterations in glaucoma patients may be related to systemic vascular dysregulation.
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Affiliation(s)
- Joanna Wierzbowska
- Department of Ophthalmology, Military Institute of Medicine, Warsaw, Poland
| | - Stanisław Wojtkiewicz
- Nałęcz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Anna Zbieć
- Nałęcz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Robert Wierzbowski
- Department of Cardiology, Military Institute of Medicine, Warsaw, Poland
| | - Adam Liebert
- Nałęcz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Roman Maniewski
- Nałęcz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
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Systemic endothelial function in primary open-angle glaucoma. J Ophthalmol 2014; 2014:529082. [PMID: 25031870 PMCID: PMC4086348 DOI: 10.1155/2014/529082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 05/20/2014] [Accepted: 05/21/2014] [Indexed: 11/23/2022] Open
Abstract
Objective. We aimed to assess peripheral vascular endothelial function in
open-angle glaucoma (POAG) by measuring flow-mediated dilatation (FMD). Materials and Methods. The study included 20 cases with POAG (group 1, mean age 58.68 ± 13.3 years) and 30 healthy individuals (group 2, mean age 58.68 ± 13.6 years). In all cases, responses of endothelial function were assessed by a cardiologist through measurement of FMD following brachial artery occlusion. Results. Mean percent of FMD, an indicator of endothelial function, was found to be 11.9 ± 4.2% in group 1 and 12.3 ± 4.4% in group 2 (P = 0.86). Conclusion. No impairment in systemic vascular function of cases with POAG suggests that POAG could be a local disorder rather than being a component of systemic disease.
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Yao B, Zhao Q, Yan H, Chen F, Liu L. Correlation between the Reduced Circulating Endothelial Progenitor Cell Counts and Elevated Intraocular Pressure-Induced Retinal Ganglion Cell Apoptosis. Curr Eye Res 2014; 40:516-25. [DOI: 10.3109/02713683.2014.935442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abegão Pinto L, Vandewalle E, De Clerck E, Marques-Neves C, Stalmans I. Lack of spontaneous venous pulsation: possible risk indicator in normal tension glaucoma? Acta Ophthalmol 2013; 91:514-20. [PMID: 22776135 DOI: 10.1111/j.1755-3768.2012.02472.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Recently, the absence of spontaneous venous pulsation (SVP) has been suggested as a vascular risk factor for primary open-angle glaucoma (POAG). As the mechanism behind this phenomenon is still unknown, the authors have studied this vascular component using colour Doppler imaging (CDI). METHODS A total of 236 patients were divided into three diagnostic groups: healthy controls (81), POAG (86) and normal tension glaucoma (NTG; 69). All subjects were submitted to CDI studies of the retrobulbar circulation, intraocular pressure measurements and assessment of SVP existence. Mann-Whitney, chi-square contingency tables and Spearman correlations were used to explore differences and correlations between variables in the diagnostic groups. RESULTS Eighty-two percent of healthy controls had SVP (66/81), while a smaller numbers were registered in both glaucoma groups: POAG - 50% (43/86); NTG - 51% (35/69). In NTG patients, but not in POAG patients, the prevalence of the SVP phenomenon decreases with increased glaucoma damage (p = 0.04; p = 0.55, respectively). Overall glaucoma patients from both groups had lower central retinal vein (CRV) velocities than the healthy controls (p < 0.05). NTG patients with SVP had less severe visual field defects (mean defect -6.92 versus -11.1, p < 0.05), higher [correction added after online publication 21 September 2012; the word 'higher' has been inserted to replace the word 'lower'] peak systolic and mean flow velocities in the central retinal artery (p < 0.01; p < 0.05, respectively) as well as higher [correction added after online publication 21 September 2012; the word higher has been inserted to replace the word lower] maximal velocities and RI of the CRV (p < 0.02; p < 0.05, respectively). CONCLUSIONS Glaucoma patients have a decrease in CRV velocities. SVP is less prevalent in glaucoma patients than in healthy individuals. This phenomenon apparently reflects different hemodynamic patterns in the central retinal vessels. This variable may be of particular importance in NTG patients, where it may be associated with more advanced functional damage.
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Affiliation(s)
- Luís Abegão Pinto
- Department of Ophthalmology, Centro Hospitalar de Lisboa Central, Portugal
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Flammer J, Konieczka K, Flammer AJ. The primary vascular dysregulation syndrome: implications for eye diseases. EPMA J 2013; 4:14. [PMID: 23742177 PMCID: PMC3693953 DOI: 10.1186/1878-5085-4-14] [Citation(s) in RCA: 196] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 04/26/2013] [Indexed: 01/08/2023]
Abstract
Vascular dysregulation refers to the regulation of blood flow that is not adapted to the needs of the respective tissue. We distinguish primary vascular dysregulation (PVD, formerly called vasospastic syndrome) and secondary vascular dysregulation (SVD). Subjects with PVD tend to have cold extremities, low blood pressure, reduced feeling of thirst, altered drug sensitivity, increased pain sensitivity, prolonged sleep onset time, altered gene expression in the lymphocytes, signs of oxidative stress, slightly increased endothelin-1 plasma level, low body mass index and often diffuse and fluctuating visual field defects. Coldness, emotional or mechanical stress and starving can provoke symptoms. Virtually all organs, particularly the eye, can be involved. In subjects with PVD, retinal vessels are stiffer and more irregular, and both neurovascular coupling and autoregulation capacity are reduced while retinal venous pressure is often increased. Subjects with PVD have increased risk for normal-tension glaucoma, optic nerve compartment syndrome, central serous choroidopathy, Susac syndrome, retinal artery and vein occlusions and anterior ischaemic neuropathy without atherosclerosis. Further characteristics are their weaker blood–brain and blood-retinal barriers and the higher prevalence of optic disc haemorrhages and activated astrocytes. Subjects with PVD tend to suffer more often from tinnitus, muscle cramps, migraine with aura and silent myocardial ischaemic and are at greater risk for altitude sickness. While the main cause of vascular dysregulation is vascular endotheliopathy, dysfunction of the autonomic nervous system is also involved. In contrast, SVD occurs in the context of other diseases such as multiple sclerosis, retrobulbar neuritis, rheumatoid arthritis, fibromyalgia and giant cell arteritis. Taking into consideration the high prevalence of PVD in the population and potentially linked pathologies, in the current article, the authors provide recommendations on how to effectively promote the field in order to create innovative diagnostic tools to predict the pathology and develop more efficient treatment approaches tailored to the person.
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Affiliation(s)
- Josef Flammer
- Department of Ophthalmology, University of Basel, Mittlere Strasse 91, Basel CH-4031, Switzerland.
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Gugleta K, Waldmann N, Polunina A, Kochkorov A, Katamay R, Flammer J, Orgul S. Retinal neurovascular coupling in patients with glaucoma and ocular hypertension and its association with the level of glaucomatous damage. Graefes Arch Clin Exp Ophthalmol 2013; 251:1577-85. [PMID: 23417339 DOI: 10.1007/s00417-013-2276-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 01/01/2013] [Accepted: 01/22/2013] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To analyze neurovascular coupling in the retina of untreated primary open-angle glaucoma (POAG) and ocular hypertension (OHT) patients. PATIENTS AND METHODS Maximal vessel dilation in response to flicker light was analyzed with Retinal Vessel Analyzer (RVA) in temporal superior/inferior arterioles and veins in 51 POAG patients, 46 OHT and 59 control subjects. RVA parameters were compared between groups, between contralateral POAG eyes, and correlated to intraocular pressure, visual field mean defect and retinal nerve fiber layer thickness. RESULTS POAG eyes demonstrated generally smaller response of all vessels to flicker light than the other two groups (ANOVA p=0.026; mean arterial flicker response in percent of baseline, averaged superior and inferior was 3.48 ± 2.22 % for controls , 2.35 ± 2.06 % for POAG patients , and 2.97 ± 2.35 % for OHT patients; corresponding values for venules were 3.88 ± 1.98 %, 2.89 ± 1.72 %, 3.45 ± 2.77 %). There was no difference in flicker response between the eye with more and less advanced damage in each patient of the POAG group (ANOVA p=0.79). Correlation of flicker response to intraocular pressure (IOP) was borderline at best, correlations to the level of glaucomatous damage were not significant. Correlation of flicker response of superior and inferior vessels of the same eye was significant for the arteries (Pearson r=0.23, p=0.004), as well as venules (r=0.52, p<0.001). CONCLUSION General vessel response to flicker light was decreased in POAG patients, compared to normal controls and OHT patients. In contrast to significant correlation between the two contralateral eyes of the flicker response itself, only its borderline correlation to IOP was seen. There was no correlation to the level of damage, altogether indicating a systemic dysregulation phenomenon. GRANTS: Swiss National Foundation Grant 3200B0-113685, Velux Stiftung Grant, Freie Akademische Gesellschaft (FAG) Grant, Pfizer Inc. Grant CLINICAL TRIAL REGISTRATION REFERENCE NUMBER: ClinicalTrials.gov NCT00430209.
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Affiliation(s)
- K Gugleta
- Department of Ophthalmology, University Hospital Basel, University Basel, Mittlerestrasse 91, CH-4031, Basel, Switzerland.
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Tanano I, Nagaoka T, Sogawa K, Tani T, Omae T, Nakabayashi S, Ishibazawa A, Yoshida A. Impaired systemic vascular endothelial function in patients with branch retinal vein occlusion. Curr Eye Res 2012; 38:114-8. [PMID: 23167764 DOI: 10.3109/02713683.2012.738460] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To evaluate systemic endothelial function in patients with branch retinal vein occlusion (BRVO). METHODS Twenty-seven patients with BRVO (BRVO group, 8 men, 19 women; mean age, 65.4 ± 1.3), 10 patients with systemic hypertension and no other systemic or ocular disease (hypertension group, 6 men, 4 women; mean age, 70.4 ± 2.2), and 10 healthy volunteers (healthy group, 3 men, 7 women; mean age, 63.8 ± 2.1) were enrolled. We excluded patients with diabetes mellitus and current smokers. Using high-resolution ultrasonographic imaging, we evaluated the brachial artery (mm) to evaluate the flow-mediated vasodilation (FMD) by measuring the diameter of the brachial artery during reperfusion after arterial occlusion. RESULTS There were no significant differences among the three groups in age (p = 0.98), sex (p = 0.21), or the baseline diameter of the brachial artery (p = 0.11). The group-averaged FMD value decreased significantly in the BRVO group (4.6 ± 0.4%) compared to the hypertension group (8.0 ± 0.8%, p < 0.01) and the healthy group (6.9 ± 0.6%, p < 0.05). Multiple logistic regression analysis identified lower FMD as an independent risk factor for BRVO. CONCLUSIONS The results suggested that BRVO is associated with generalized endothelial dysfunction and that impaired systemic endothelial function may be associated with BRVO.
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Affiliation(s)
- Ichiro Tanano
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan
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Yorgun H, Tokgözoğlu L, Canpolat U, Gürses KM, Bozdağ G, Yapıcı Z, Sahiner L, Kaya EB, Kabakçı G, Oto A, Tuncer M, Aytemir K. The cardiovascular effects of premature ovarian failure. Int J Cardiol 2012; 168:506-10. [PMID: 23073277 DOI: 10.1016/j.ijcard.2012.09.197] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 09/26/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Previous studies have shown that cardiovascular risk is increased in premature ovarian failure (POF). To determine the effects of POF on different parameters of cardiovascular health, we investigated the relationship between POF and circulating endothelial progenitor cells (EPC), endothelial function, carotid intima media thickness (CIMT) and left ventricular diastolic function. METHODS We compared 23 female POF patients (mean age; 37.8 ± 10.8 years) with 20 gender and age-matched healthy controls. Circulating CD133(+)/34(+) and CD34(+)/KDR(+) EPCs were determined by using flow-cytometry. Ultrasound assessment of endothelial function by brachial artery flow-mediated dilatation (FMD) and CIMT was made. Left ventricular systolic and diastolic function was assessed by standard 2D and M-mode echocardiography and tissue Doppler velocities. RESULTS Brachial artery FMD was significantly impaired in patients with POF compared with CG (6.3 ± 1.9% vs 10.4 ± 3.7%, p<0.05). Furthermore, circulating EPCs were lower among patients with POF compared to controls for CD133(+)/34(+) and CD34(+)/KDR(+) cells (p<0.05). There was a significant correlation between serum estradiol levels and EPC number (CD 133+/34+) (r=0.329, p<0.05). POF patients had increased CIMT compared to controls (0.67 ± 0.17 vs 0.43 ± 0.10, p<0.05). When diastolic functions were assessed, patients with POF had lower Epeak, Apeak and mitral CP and higher DT and IVRT (p<0.05, respectively). CONCLUSION Our findings indicate that endothelial function as well as circulating EPCs, CIMT and diastolic function are significantly affected in young women with POF which may have an adverse long-term effect on cardiovascular prognosis.
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Affiliation(s)
- Hikmet Yorgun
- Department of Cardiology, Hacettepe University, Ankara, Turkey
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Relationship among endothelial response to hyperemia, bone marrow-derived progenitor cells, and parathyroid hormone in renal transplantation. Transplantation 2012; 93:835-41. [PMID: 22343335 DOI: 10.1097/tp.0b013e318247a75d] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Endothelial dysfunction may contribute to modulate cardiovascular complications in renal transplant recipients (RTRs), and a relationship between endothelial dysfunction and parathyroid hormone (PTH) levels in RTRs has been demonstrated. We evaluated the relationship between endothelial response to hyperemia and circulating progenitor cells (CPCs) and endothelial progenitor cells (EPCs) PTH, and genetic parameters in RTRs. METHODS In 120 RTRs and in healthy subjects without (n=107, group A) and with cardiovascular risk factors (n=109, group B), we evaluated endothelial response to hyperemia through digital tonometry (peripheral arterial tonometry) detected by reactive hyperemia index (RHI) and EPCs and CPCs by flow cytometry. RESULTS In RTRs, RHI median value was lower than in group A (P=0.05). EPC number was significantly lower in RTRs than in groups A and B (P<0.0001), whereas PTH median value was significantly higher (P<0.0001). In RTRs, RHI values were significantly lower according to the presence of three or more risk factors (P=0.04) and positively correlated with EPCs (P=0.04) but not with PTH (P=0.2). In patients who underwent dialysis for more than 5 years, lower RHI values (P=0.08), EPC number (P=0.5), and higher PTH concentrations (P=0.09) than in patients with less than 1 year dialysis time were observed. No relationship between eNOS gene -786T>C, 894G>T, and 4a/4b polymorphisms and RHI, EPC, and CPC number was found. CONCLUSIONS This study shows an altered endothelial response, associated with reduced EPCs, and increased PTH in RTRs; the evaluation of endothelial status in RTRs may contribute to better assess the risk profile of these patients.
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Fadini GP, Losordo D, Dimmeler S. Critical reevaluation of endothelial progenitor cell phenotypes for therapeutic and diagnostic use. Circ Res 2012; 110:624-37. [PMID: 22343557 DOI: 10.1161/circresaha.111.243386] [Citation(s) in RCA: 515] [Impact Index Per Article: 42.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Diverse subsets of endothelial progenitor cells (EPCs) are used for the treatment of ischemic diseases in clinical trials, and circulating EPCs levels are considered as biomarkers for coronary and peripheral artery disease. However, despite significant steps forward in defining their potential for both therapeutic and diagnostic purposes, further progress has been mired by unresolved questions around the definition and the mechanism of action of EPCs. Diverse culturing methods and detection of various combinations of different surface antigens were used to enrich and identify EPCs. These attempts were particularly challenged by the close relationship and overlapping markers of the endothelial and hematopoietic lineages. This article will critically review the most commonly used protocols to define EPCs by culture assays or by fluorescence-activated cell sorter in the context of their therapeutic or diagnostic use. We also delineate new research avenues to move forward our knowledge on EPC biology.
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Affiliation(s)
- Gian Paolo Fadini
- Institute of Cardiovascular Regeneration, Centre for Molecular Medicine, University of Frankfurt, Theodor-Stern-Kai 7, Frankfurt, Germany
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Cellini M, Strobbe E, Gizzi C, Balducci N, Toschi PG, Campos EC. Endothelin-1 plasma levels and vascular endothelial dysfunction in primary open angle glaucoma. Life Sci 2012; 91:699-702. [PMID: 22406080 DOI: 10.1016/j.lfs.2012.02.013] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Revised: 02/10/2012] [Accepted: 02/13/2012] [Indexed: 10/28/2022]
Abstract
AIMS To assess the relationship between endothelial dysfunction, endothelin 1 (ET-1) plasma levels and subclinical inflammation in primary open angle glaucoma (POAG) patients. MAIN METHODS We enrolled 40 POAG patients with progressive visual field damage, although well controlled intraocular pressure (IOP) and compared to age and sex matched healthxy subjects. Each patient underwent an ophthalmological examination, a standard achromatic perimetry (SAP), blood sampling to assess ET-1 plasma levels, an objective assessment of cellularity within the anterior chamber (FLARE) and measurement of flow mediated dilation (FMD) with high resolution 2-dimensional ultrasonographic imaging of the brachial artery. KEY FINDINGS At baseline, POAG patients, compared to healthy controls, showed an increase of ET-1 plasma levels: 2.83 ± 0.28 pg/ml vs. 1.75 ± 0.25 pg/ml (p<0.001), lower FMD values 4.46 ± 1.28% vs. 13.18 ± 2.80% (p<0.001) and increased FLARE values 9.98 ± 0.97 photons/ms vs. 5.87 ± 0.64 photons/ms (p<0.001). A follow up after 1 year revealed a further increase of ET-1 plasma levels (to 3.68 ± 0.60; p<0.001) and decrease of FMD (3.52 ± 1.28; p>0.001). SIGNIFICANCE The increase of ET-1 in POAG patients is related to vascular dysfunction (r=0.942; p=0.001) and vascular dysfunction is related to sub-clinical intraocular inflammation (r=0.968; p=0.001). Thus ET-1 and vascular dysfunction related to sub-clinical inflammation may play a key role in determining a progressive visual field damage in POAG patients who present a well-controlled IOP.
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Affiliation(s)
- Mauro Cellini
- Department of Specialistic Surgery and Anesthesiology Science-Ophthalmology, Service, University of Bologna, Italy.
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Cellular biomarkers of endothelial health: microparticles, endothelial progenitor cells, and circulating endothelial cells. ACTA ACUST UNITED AC 2012; 6:85-99. [PMID: 22321962 DOI: 10.1016/j.jash.2011.11.003] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 11/17/2011] [Accepted: 11/22/2011] [Indexed: 12/13/2022]
Abstract
Endothelial dysfunction, the shift from a healthy endothelium to a damaged pro-coagulative, pro-inflammatory, and pro-vasoconstrictive phenotype, is an early event in many chronic diseases that frequently precedes cardiovascular complications. Functional assessment of the endothelium can identify endothelial damage and predict cardiovascular risk; however, this assessment provides little information as to the mechanisms underlying development of endothelial dysfunction. Changes in plasma asymmetric dimethyl arginine levels, markers of lipid peroxidation, circulating levels of inflammatory mediators, indices of coagulation and cellular surrogates such as microparticles, circulating endothelial cells, and endothelial progenitor cells may reflect alterations in endothelial status and as such have been defined as "biomarkers" of endothelial function. Biomarkers may be chemical or cellular. This review examines some markers of endothelial dysfunction, with a particular focus on cellular biomarkers of endothelial dysfunction and their diagnostic potential.
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Chung SD, Hu CC, Ho JD, Keller JJ, Wang TJ, Lin HC. Open-angle glaucoma and the risk of erectile dysfunction: a population-based case-control study. Ophthalmology 2011; 119:289-93. [PMID: 22036631 DOI: 10.1016/j.ophtha.2011.08.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 08/05/2011] [Accepted: 08/05/2011] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Open-angle glaucoma (OAG) is associated with systemic metabolic and cardiovascular disorders, and both share common risk factors with erectile dysfunction (ED). However, few studies have investigated the association of ED with OAG. This study aimed to estimate the association of ED with prior OAG by using a nationwide, population-based data with a retrospective case-control cohort design in Taiwan. DESIGN Age-matched case-control study. PARTICIPANTS AND CONTROLS We identified 4605 patients with ED as the cases and randomly selected 23 025 subjects as the controls (5 controls to 1 case). METHODS We used conditional logistic regression analysis to estimate the odds ratio and 95% confidence interval of having previously been diagnosed with OAG according to the presence/absence of ED after adjusting for patient's monthly income, geographical location, hypertension, diabetes, coronary heart disease, hyperlipidemia, obesity, and alcohol abuse. MAIN OUTCOME MEASURES We identified OAG cases not only based on an International Classification of Diseases, Ninth Revision, Clinical Modification code, but also by the prescription of topical antiglaucoma medication. RESULTS In total, prior OAG was found among 137 subjects (0.5 %); 53 individuals (1.1% of the ED patients) from the cases and 84 individuals (0.4% of patients without ED) from the controls. Conditional logistic regression analysis demonstrated that, after adjusting for potential confounders, patients with ED were more likely to have prior OAG than controls (odds ratio, 2.85; 95% confidence interval, 2.10-4.07). CONCLUSIONS This study identifies a novel association between ED and prior OAG.
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Affiliation(s)
- Shiu-Dong Chung
- Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, Ban Ciao, Taipei, Taiwan
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Mandraffino G, Sardo MA, Riggio S, Loddo S, Imbalzano E, Alibrandi A, Saitta C, Cinquegrani M, Mormina EM, Saitta A. Circulating progenitor cells are increased in newly diagnosed untreated hypertensive patients with arterial stiffening but normal carotid intima-media thickness. Hypertens Res 2011; 34:876-83. [PMID: 21593737 DOI: 10.1038/hr.2011.56] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Circulating progenitor cells (CPCs), including endothelial progenitor cells (EPCs), have a key role in endothelium repair. Cellular NADPH oxidase (Nox) enzymes, including Nox-containing gp91phox, represent a source of reactive oxygen species (ROS); ROS trigger protective signals but may also have detrimental effects. Cellular defenses against ROS include the enzymes manganese superoxide dismutase (MnSOD), catalase (CAT) and glutathione peroxidase type-1 (GPx-1). We investigated the relationships of CPCs with cellular gp91phox, MnSOD, CAT, GPx-1 and ROS levels and with carotid intima-media thickness (cIMT) and stiffness in hypertensives without additional risk factors for cardiovascular disease. CPCs from 53 newly diagnosed, untreated hypertensives and from 29 controls were isolated and identified by flow cytometry. gp91phox, MnSOD, CAT, and GPx-1 mRNA and protein expression and ROS generation were evaluated in enriched samples of CD34(+) cells; cIMT and stiffness were assessed. Hypertensives showed higher arterial stiffness (P < 0.001) but no difference in cIMT with respect to controls. ROS generation was slightly increased (P=0.04), whereas gp91phox, MnSOD, CAT and GPx-1 were significantly higher (P < 0.001) with respect to controls, as was CPC number (P < 0.001), but EPCs were no different. CPC and EPC numbers correlated with gp91phox, ROS and fibrinogen (P < 0.001); moreover, gp91phox, MnSOD, CAT and GPx-1 were correlated with CPC number. In early phases of arterial hypertension, before the development of wall thickening and even in the presence of arterial mechanical impairment, CPC number may be increased to maintain an adequate number of EPCs in peripheral blood.
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Affiliation(s)
- Giuseppe Mandraffino
- Department of Internal Medicine and Medical Therapy, University of Messina, Messina, Italy
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Ramcharan KS, Lip GYH, Stonelake PS, Blann AD. The endotheliome: a new concept in vascular biology. Thromb Res 2010; 128:1-7. [PMID: 21168189 DOI: 10.1016/j.thromres.2010.11.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Revised: 11/16/2010] [Accepted: 11/19/2010] [Indexed: 10/18/2022]
Abstract
As the importance of the endothelium is becoming increasingly recognised, additional tools are needed to assess its functions. Separate studies have looked at different aspects of vascular biology primarily focusing on the central role of the endothelium, i.e. secretion/release of molecules in the plasma, physiological action on other cells, and the presence of endothelial cells themselves in the circulation. Targeting and protecting the endothelium is a promising therapeutic strategy for modifying a number of disease processes but 'ideal' methods to monitor this treatment, like many other tools for assessing endothelial activity, remain elusive. We suggest that a broader view of the endothelium is important, and with it the concept of the assessment of overall vascular function, which fuses different aspects of endothelial activity into a unifying concept. In the present document we review the current understanding of endothelial biology and the methods of its assessment, and hypothesise that a more multifactorial approach to the endothelium will be a crucial determinant of outcomes and treatment strategies for different diseases. This we describe as the 'endotheliome'.
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Affiliation(s)
- Khedar S Ramcharan
- Haemostasis, Thrombosis and Vascular Biology Unit, University of Birmingham Centre for Cardiovascular Science, City Hospital, Dudley Road, Birmingham B18 7QH, UK
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Li X, Tse HF, Yiu KH, Li LSW, Jin L. Effect of periodontal treatment on circulating CD34(+) cells and peripheral vascular endothelial function: a randomized controlled trial. J Clin Periodontol 2010; 38:148-56. [PMID: 21133981 DOI: 10.1111/j.1600-051x.2010.01651.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM periodontal disease is associated with endothelial dysfunction and increased circulating progenitor cell (CPC) count. This study sought to investigate the effect of periodontal treatment on CPC count and vascular endothelial function. MATERIALS AND METHODS a single-blind, randomized controlled trial was conducted in 50 otherwise healthy subjects with moderate-to-severe chronic periodontitis. They were randomly assigned into Treatment group (n=25), in whom periodontal treatment was conducted immediately, and Control group (n=25), in whom periodontal treatment was postponed until the completion of this 3-month study. CPCs and peripheral endothelial function were evaluated at baseline and 3-month follow-up using flow cytometry and peripheral arterial tonometry, respectively. RESULTS based on the intention-to-treat analysis, periodontal treatment exhibited neutral effects on endothelial function [treatment effect: 0.03, 95% confidence interval (CI): -0.29 to 0.35, p=0.85]. However, circulating CD34(+) cells count significantly decreased in the Treatment group compared with the controls (treatment effect: -29.85 cells/μl, 95% CI: -52.62 to -7.08, p=0.011). The reduction of circulating CD34(+) count was positively correlated with the decrease in sites% with bleeding on probing or periodontal pockets 4 mm. CONCLUSIONS this study suggests that treatment of periodontitis has neutral effects on peripheral endothelial function but significantly decreases circulating CD34(+) cell count.
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Affiliation(s)
- Xiao Li
- Faculty of Dentistry, Periodontology Department of Medicine, Division of Cardiology, Queen Mary Hospital Department of Medicine, Tung Wah Hospital, The University of Hong Kong, Hong Kong SAR, China
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Mandraffino G, Sardo MA, Riggio S, D'Ascola A, Loddo S, Alibrandi A, Saitta C, Imbalzano E, Mandraffino R, Venza M, Mormina EM, David A, Saitta A. Smoke exposure and circulating progenitor cells: evidence for modulation of antioxidant enzymes and cell count. Clin Biochem 2010; 43:1436-42. [PMID: 20888331 DOI: 10.1016/j.clinbiochem.2010.09.023] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 09/21/2010] [Accepted: 09/22/2010] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cigarette smoking is involved in vascular inflammation and impairment of circulating progenitor cells (CPCs), including endothelial progenitor cells (EPCs). The study aim was to evaluate the redox balance of these cells in relation to smoking exposure. METHODS Circulating cells from 36 healthy smokers and 26 controls were isolated and identified by flow cytometry. ROS generation, mRNA and protein cell expression, and enzymatic activity of MnSOD, catalase, and GPx-1 were evaluated. RESULTS Smokers showed higher levels of CRP and fibrinogen and lower levels of HDL-C. ROS and MnSOD were higher (p<0.001), while catalase and GPx-1 were lower (p<0.001) as was EPC number (p<0.001) in smokers. CPC and EPC correlated with HDL-C, CRP, ROS and enzyme expression and activity. CONCLUSIONS Our data suggest that smoking exposure involves antioxidant enzymes in CPCs and EPCs and that the inflammatory response in smokers plays an important role in impairing cells and their antioxidant functions.
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Affiliation(s)
- Giuseppe Mandraffino
- Department of Internal Medicine and Medical Therapy, University of Messina, Messina, Italy
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Cheng S, Cohen KS, Shaw SY, Larson MG, Hwang SJ, McCabe EL, Martin RP, Klein RJ, Hashmi B, Hoffmann U, Fox CS, Vasan RS, O'Donnell CJ, Wang TJ. Association of colony-forming units with coronary artery and abdominal aortic calcification. Circulation 2010; 122:1176-82. [PMID: 20823386 DOI: 10.1161/circulationaha.109.931279] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Certain bone marrow-derived cell populations, called endothelial progenitor cells, have been reported to possess angiogenic activity. Experimental data suggest that depletion of these angiogenic cell populations may promote atherogenesis, but limited data are available on their relation to subclinical atherosclerotic cardiovascular disease in humans. METHODS AND RESULTS We studied 889 participants of the Framingham Heart Study who were free of clinically apparent cardiovascular disease (mean age, 65 years; 55% women). Participants underwent endothelial progenitor cell phenotyping with an early-outgrowth colony-forming unit assay and cell surface markers. Participants also underwent noncontrast multidetector computed tomography to assess the presence of subclinical atherosclerosis, as reflected by the burden of coronary artery calcification and abdominal aortic calcification. Across decreasing tertiles of colony-forming units, there was a progressive increase in median coronary artery calcification and abdominal aortic calcification scores. In multivariable analyses adjusting for traditional cardiovascular risk factors, each 1-SD increase in colony-forming units was associated with a ≈16% decrease in coronary artery calcification (P=0.02) and 17% decrease in abdominal aortic calcification (P=0.03). In contrast, neither CD34(+)/KDR(+) nor CD34(+) variation was associated with significant differences in coronary or aortic calcification. CONCLUSIONS In this large, community-based sample of men and women, lower colony-forming unit number was associated with a higher burden of subclinical atherosclerosis in the coronary arteries and aorta. Decreased angiogenic potential could contribute to the development of atherosclerosis in humans.
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Affiliation(s)
- Susan Cheng
- Cardiology Division, GRB-800, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
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Jarajapu YPR, Grant MB. The promise of cell-based therapies for diabetic complications: challenges and solutions. Circ Res 2010; 106:854-69. [PMID: 20299675 DOI: 10.1161/circresaha.109.213140] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The discovery of endothelial progenitor cells (EPCs) in human peripheral blood advanced the field of cell-based therapeutics for many pathological conditions. Despite the lack of agreement about the existence and characteristics of EPCs, autologous EPC populations represent a novel treatment option for complications requiring therapeutic revascularization and vascular repair. Patients with diabetic complications represent a population of patients that may benefit from cellular therapy yet their broadly dysfunctional cells may limit the feasibility of this approach. Diabetic EPCs have decreased migratory prowess and reduced proliferative capacity and an altered cytokine/growth factor secretory profile that can accelerate deleterious repair mechanisms rather than support proper vascular repair. Furthermore, the diabetic environment poses additional challenges for the autologous transplantation of cells. The present review is focused on correcting diabetic EPC dysfunction and the challenges involved in the application of cell-based therapies for treatment of diabetic vascular complications. In addition, ex vivo and in vivo functional manipulation(s) of EPCs to overcome these hurdles are discussed.
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Affiliation(s)
- Yagna P R Jarajapu
- Pharmacology and Therapeutics, College of Medicine, University of Florida, PO Box 100267, Gainesville, FL 32610-0267, USA
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