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Premužić V, Prijić R, Jelaković M, Krznarić Ž, Čuković-Čavka S, Jelaković B. White coat hypertension is another clinical characteristic of patients with inflammatory bowel disease: A cross-sectional study. Medicine (Baltimore) 2022; 101:e29722. [PMID: 36343048 PMCID: PMC9646610 DOI: 10.1097/md.0000000000029722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
In this cross-sectional study, our aim was to analyze association of ambulatory blood pressure monitoring (ABPM) values with pulse wave velocity (PWV) in inflammatory bowel disease (IBD) patients as well as the prevalence and characteristics of white coat hypertension (WCH) in this group of patients with chronic inflammation and high prevalence of anxiety. We enrolled 120 consecutive IBD patients (77 Crohn´s disease; 43 ulcerative colitis) who were not treated with antihypertensive drugs without cardiovascular, cerebrovascular and renal morbidity. Office blood pressure, ABPM, and PWV were measured with Omrom M6, SpaceLab 90207, and Arteriograph, respectively. The prevalence of true normotension, sustained hypertension and WCH was analyzed in IBD patients. WCH was found in 27.5% patients. IBD-WCH patients had significantly lower prevalence of traditional risk factors than general WCH subjects. PWV and augmentation index (AIx) values were higher in WCH than in true normotensive patients. When adjusted for age and duration of IBD, only PWV was a positive predictor of WCH, and patients with higher PWV and longer disease duration had OR´s for WCH of 0.69 and 2.50, respectively. IBD patients had significantly higher prevalence of WCH and higher PWV values than healthy control patients. WCH is highly prevalent in IBD patients but IBD-WCH patients have lower frequency of traditional cardiovascular risk factors than general WCH population. Our results suggest that WCH could be considered as another clinical characteristic of IBD which is associated with increased arterial stiffness and those patients should be monitored more closely.
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Affiliation(s)
- Vedran Premužić
- Department of Nephrology, Hypertension, Dialysis and Transplantation, ESH Excellence Center, University Hospital Center Zagreb, Zagreb, Croatia
- School of Medicine University of Zagreb, Zagreb, Croatia
- * Correspondence: Vedran Premužić, Department of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, Kišpatićeva 12, Zagreb 10000, Croatia (e-mail: )
| | - Radovan Prijić
- Department of Gastroenterology University Hospital Center Zagreb, Zagreb, Croatia
| | - Mislav Jelaković
- Department of Gastroenterology University Hospital Center Zagreb, Zagreb, Croatia
| | - Željko Krznarić
- School of Medicine University of Zagreb, Zagreb, Croatia
- Department of Gastroenterology University Hospital Center Zagreb, Zagreb, Croatia
| | - Silvija Čuković-Čavka
- School of Medicine University of Zagreb, Zagreb, Croatia
- Department of Gastroenterology University Hospital Center Zagreb, Zagreb, Croatia
| | - Bojan Jelaković
- Department of Nephrology, Hypertension, Dialysis and Transplantation, ESH Excellence Center, University Hospital Center Zagreb, Zagreb, Croatia
- School of Medicine University of Zagreb, Zagreb, Croatia
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Central systolic blood pressure relates inversely to nitric oxide synthesis in young black adults: the African-PREDICT study. J Hum Hypertens 2021; 35:985-993. [PMID: 33273698 DOI: 10.1038/s41371-020-00453-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/27/2020] [Accepted: 11/16/2020] [Indexed: 02/03/2023]
Abstract
Lower nitric oxide (NO) bioavailabilty associates with hypertension in patients and elderly populations. With hypertension known to develop earlier in black populations, we compared both plasma and urinary NO-related markers and their associations with central systolic blood pressure (cSBP) and arterial stiffness in healthy young black and white adults. We included healthy black and white men and women (n = 1110; 20-30 years) and measured cSBP and pulse wave velocity (PWV), along with both plasma and urinary arginine, homoarginine, asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), as well as urinary ornithine/citrulline, nitrite and nitrate. In addition, the urinary nitrate-to-nitrite ratio (UNOxR) was calculated. The black men and women had higher cSBP and higher plasma arginine and ADMA, but lower urinary nitrate and UNOxR (all p ≤ 0.003) than their white counterparts. In single and forward stepwise multiple regression analyses, we found an inverse association of cSBP (adj. R2 = 0.124; β = -0.134; p = 0.006) and plasma homoarginine in black men. Central SBP associated inversely with UNOxR in black women only (adj. R2 = 0.171; β = -0.130; p = 0.029). In the white women, cSBP associated positively with urinary ADMA (adj. R2 = 0.372; β = 0.162; p = 0.015). PWV associated inversely with plasma ADMA (adj. R2 = 0.253; β = -0.163; p = 0.024) in the white women only. The lower NO synthesis and the higher cSBP in our black cohort support the notion of a potential increased risk for future large artery stiffness and hypertension development in later life.
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Kostov K, Blazhev A. Circulating Levels of Endothelin-1 and Big Endothelin-1 in Patients with Essential Hypertension. PATHOPHYSIOLOGY 2021; 28:489-495. [PMID: 35366246 PMCID: PMC8830463 DOI: 10.3390/pathophysiology28040031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/15/2021] [Accepted: 10/21/2021] [Indexed: 11/20/2022] Open
Abstract
The role of endothelin-1 (ET-1) in the pathogenesis of hypertension (HTN) is not clearly established. There is evidence that its circulating levels are elevated in some forms of experimental and human HTN, but this was not a consistent finding. Based on these controversial data, we tested serum levels of ET-1 and Big ET-1 (the precursor of ET-1) in patients with essential HTN, comparing the results with those of healthy normotensive controls. The levels of ET-1 and Big ET-1 were measured by ELISA. Our results in patients with essential HTN showed that the mean levels of ET-1 (5.01 ± 2.1 pg/mL) were significantly higher (F = 6.34, p = 0.0144) than the mean levels in the control group (3.2 ± 1.0 pg/mL). The levels of Big ET-1 in patients with essential HTN (0.377 ± 0.1 pmol/L) were similar to those in the control group (0.378 ± 0.07 pmol/L) and did not differ significantly (F = 0.00, p = 0.9531). These data suggest that ET-1, but not Big ET-1, may play an important role in the pathogenesis of primary HTN.
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Affiliation(s)
- Krasimir Kostov
- Department of Pathophysiology, Medical University-Pleven, 1 Kliment Ohridski Str., 5800 Pleven, Bulgaria
- Correspondence: ; Tel.: +359-889-257-459
| | - Alexander Blazhev
- Department of Biology, Medical University-Pleven, 1 Kliment Ohridski Str., 5800 Pleven, Bulgaria;
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Gavriilaki E, Eftychidis I, Papassotiriou I. Update on endothelial dysfunction in COVID-19: severe disease, long COVID-19 and pediatric characteristics. J LAB MED 2021. [DOI: 10.1515/labmed-2021-0134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Abstract
Objectives
To review current literature on the role of endothelial dysfunction in coronavirus disease-2019 (COVID-19) infection in terms of pathophysiology, laboratory features and markers, clinical phenotype in adults and children, as well as long COVID-19.
Content
We conducted a thorough assessment of the literature and critically analyzed current data, mostly utilizing the PubMed and Medline search engines to find original studies published in the previous decade.
Summary and Outlook
Accumulating evidence suggests that endothelial dysfunction may be a common denominator of severe COVID-19 in adults and children, as well as long COVID-19, implicating mutual pathophysiological pathways. This narrative review summarizes the up-to-date knowledge of endothelial dysfunction caused by COVID-19, including novel aspects of long COVID-19 and pediatric disease. This knowledge is important in order not only to understand the multisystemic attack of COVID-19, but also to improve patient management and prognosis.
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Affiliation(s)
- Eleni Gavriilaki
- Hematology Department – BMT Unit , G. Papanikolaou Hospital , Thessaloniki , Greece
| | - Ioannis Eftychidis
- Hematology Department – BMT Unit , G. Papanikolaou Hospital , Thessaloniki , Greece
| | - Ioannis Papassotiriou
- Department of Clinical Biochemistry , “Aghia Sophia” Children’s Hospital , Athens , Greece
- IFCC Emerging Technologies Division , Emerging Technologies in Pediatric Laboratory Medicine (C-ETPLM) , Milan , Italy
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Ntlahla EE, Mfengu MM, Engwa GA, Nkeh-Chungag BN, Sewani-Rusike CR. Gut permeability is associated with hypertension and measures of obesity but not with Endothelial Dysfunction in South African youth. Afr Health Sci 2021; 21:1172-1184. [PMID: 35222580 PMCID: PMC8843265 DOI: 10.4314/ahs.v21i3.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Though gut permeability has shown to be associated with measures of obesity and hypertension, its relationship with endothelial dysfunction, an early predictor for cardiovascular diseases remains unknown. Objective This study assessed the relationship between hypertension, measures of obesity, gut permeability and endothelial dysfunction. Methods A cross-sectional quantitative study which enrolled 151 South African youths was conducted. Anthropometric and blood pressure measurements were performed. Zonulin, a marker for gut permeability; adiponectin, an anti-inflammatory molecule, as well as asymmetric dimethylarginine (ADMA) and Nitric oxide (NO) which are markers for endothelialfunction were assayed. Results Approximately eighteen percent (17.88%) of the participants were hypertensive while 40.4% were pre-hypertensive. Adiponectin significantly increased in hypertensive subjects and negatively correlated (p<0.05) with measures of obesity but was not associated with gut permeability and endothelial dysfunction. Increased body mass index (BMI) and visceral fat (VF) predicted reduced adiponectin (inflammation). Zonulin was significantly higher (p<0.05) in hypertensive subjects and positively associated (p<0.05) with systolic blood pressure (SBP) in females. A positive relationship (p<0.05) was observed between zonulin and measurements of obesity. Moreover, zonulin negatively associated (p<0.05) with ADMA but positively associated (p<0.05) with NO in males. Increased VF and waist circumference predicted gut permeability. Conclusion Gut permeability was associated with hypertension and measures of obesity but not with markers of endothelial dysfunction in a South African youth population.
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Affiliation(s)
- Ezona E Ntlahla
- Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University PBX1, 5117, Mthatha, South Africa
| | - Mvuyisi Mo Mfengu
- Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University PBX1, 5117, Mthatha, South Africa
| | - Godwill A Engwa
- Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University PBX1, 5117, Mthatha, South Africa
| | - Benedicta N Nkeh-Chungag
- Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University PBX1, 5117, Mthatha, South Africa
| | - Constance R Sewani-Rusike
- Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University PBX1, 5117, Mthatha, South Africa
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A study of endothelial and platelet microvesicles across different hypertension phenotypes. J Hum Hypertens 2021; 36:561-569. [PMID: 33837293 DOI: 10.1038/s41371-021-00531-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/05/2021] [Accepted: 03/22/2021] [Indexed: 01/01/2023]
Abstract
Rather than being mere biomarkers reflecting generalized vascular injury, endothelial- (EMVs) and platelet-derived (PMVs) microvesicles have emerged as potent regulators of intercellular communication with significant biologic effects in vascular homeostasis and several pathophysiological responses including inflammation and thrombosis. So far, studies in hypertension are scarce, whereas no studies exist in masked hypertension (MH). We measured EMVs and PMVs in untreated, newly diagnosed hypertensives (HTs) and MHs compared to normotensive controls (NTs), and associated them with various cardiovascular risk factors. Sustained hypertension (SHT) and MH were defined according to standard blood pressure (BP) criteria. All HTs were free of cardiovascular disease and medications. Microvesicles' quantitation and detection were performed by flow cytometry by using cell-specific antibodies and corresponding isotypes (anti-CD105 and anti-CD144 for EMVs, anti-CD42a for PMVs, and Annexin V-fluorescein isothiocyanate for all microvesicles). In this study, we included 59 HTs (44 SHTs and 15 MHs) and 27 NTs. HTs had significantly elevated EMVs (p = 0.004), but not PMVs compared to NTs. MHs had significantly elevated EMVs compared to NTs (p = 0.012) but not compared to SHTs. Furthermore, EMVs significantly correlated with ambulatory (r = 0.214-0.284), central BP (r = 0.247-0.262), and total vascular resistance (r = 0.327-0.361). EMVs are increased not only in SHTs but also in MHs, a hypertension phenotype with a cardiovascular risk close to SHT. EMVs have emerged as active contributors to thromboinflammation and vascular damage and may explain, in part, the adverse cardiovascular profile of SHTs and MHs.
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Sang M, Fu Y, Wei C, Yang J, Qiu X, Ma J, Qin C, Wu F, Zhou X, Yang T, Sun M. Comparison of biomarkers of endothelial dysfunction and microvascular endothelial function in patients with primary aldosteronism and essential hypertension. J Renin Angiotensin Aldosterone Syst 2021; 22:1470320321999491. [PMID: 33678006 PMCID: PMC8164554 DOI: 10.1177/1470320321999491] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: Studies have shown that primary aldosteronism (PA) has a higher risk of
cardiovascular events than essential hypertension (EH). Endothelial
dysfunction is an independent predictor of cardiovascular events. Whether PA
and EH differ in the endothelial dysfunction is uncertain. Our study was
designed to investigate the levels of biomarkers of endothelial dysfunction
(Asymmetric dimethylarginine, ADMA; E-selectin, and Plasminogen activator
inhibitor-1, PAI-1) and assess the microvascular endothelial function in
patients with PA and EH, respectively. Methods: The biomarkers of endothelial dysfunction were measured by enzyme-linked
immunosorbent assay (ELISA). Microvascular endothelial function was
evaluated by Pulse amplitude tonometry (PAT). Results: Thirty-one subjects with EH and 36 subjects with PA including 22 with
aldosterone-producing adenoma (APA) and 14 with idiopathic
hyperaldosteronism (IHA) were enrolled in our study. The ADMA levels among
the three groups were different (APA 47.83 (27.50, 87.74) ng/ml vs EH 25.08
(22.44, 39.79) ng/ml vs IHA 26.00 (22.23, 33.75) ng/ml;
p = 0.04), however, when the APA group was
compared with EH and IHA group, there was no statistical significance (47.83
(27.50, 87.74) ng/ml vs 25.08 (22.44, 39.79) ng/ml for EH,
p = 0.11; 47.83 (27.50, 87.74) ng/ml vs
IHA 26.00 (33.75) ng/ml, p = 0.07). The
results of ADMA levels are presented as Median (p25, p75). Whereas, levels
of PAI-1 and E-selectin, microvascular endothelial function were not
significantly different between PA and EH subjects. Conclusions: Our study shows no significant differences between PA and EH in terms of
biomarkers of endothelial dysfunction and microvascular endothelial
function. The microvascular endothelial function of PA and EH patients is
comparable.
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Affiliation(s)
- Miaomiao Sang
- Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yu Fu
- Department of Nuclear Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chenmin Wei
- Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jing Yang
- School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xueting Qiu
- Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jingqing Ma
- School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chao Qin
- Department of Urology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Feiyan Wu
- Department of Endocrinology, The Second People's Hospital of Wuxi, Wuxi, Jiangsu, China
| | - Xueling Zhou
- Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Tao Yang
- Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Min Sun
- Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
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Wu Y, Zhang G, Hu R, Du J. Risk of Target Organ Damage in Patients with Masked Hypertension versus Sustained Hypertension: A Meta-analysis. CARDIOVASCULAR INNOVATIONS AND APPLICATIONS 2021. [DOI: 10.15212/cvia.2019.1261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objective: To compare the risk of target organ damage in masked hypertension (MH) and sustained hypertension (SH).Methods: A systematic review and meta-analysis was performed. A search of PubMed, Embase, and the Cochrane Library of relevant case-control studies was
performed from inception to December 2019, and articles on MH and SH selected according to the inclusion criteria were analyzed. The primary end point was target organ damage in the heart. The secondary end points were target organ damage in the kidneys and blood vessels.Results:
Seventeen studies that met the screening criteria were included in the meta-analysis. Compared with the SH group, in the MH group carotid intima-media thickness (IMT) and E/A ratio were significantly greater and the prevalence of left ventricular remodeling and the pulse wave velocity were
significantly lower. Other indicators in the heart, kidneys, and blood vessels were not statistically different between the two groups. IMT: P=0.01, E/A ratio: P=0.01, prevalence of left ventricular remodeling: P=0.02, pulse wave velocity: P=0.01.Conclusion: Our study has shown
that MH may have almost the same degree of target organ damage as SH, so clinicians may need to consider target organ damage.
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Affiliation(s)
- Yue Wu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Guoyue Zhang
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Rong Hu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Jianlin Du
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
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Du Z, Wang J, Lu Y, Ma X, Wen R, Lin J, Zhou C, Song Z, Li J, Tu P, Jiang Y. The cardiac protection of Baoyuan decoction via gut-heart axis metabolic pathway. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2020; 79:153322. [PMID: 32920286 DOI: 10.1016/j.phymed.2020.153322] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/30/2020] [Accepted: 08/04/2020] [Indexed: 05/09/2023]
Abstract
BACKGROUND Gut-heart axis has emerged as a novel concept to provide new insights into the complex mechanisms of heart failure (HF) and offer new therapeutic targets. Cardiac hypertrophy (CH) is one of the etiological agents contributing to the development of HF. Baoyuan Decoction (BYD), a traditional Chinese medicine (TCM) formula, exhibits unambiguous effects on treating CH and preventing HF. Previously, we have reported that BYD-targeted endogenous metabolites are potentially linked to gut microbiota metabolism, but the contribution of gut microbiota and metabolic interaction to the cardioprotective efficacy of BYD remains to be elucidated. PURPOSE To investigate whether the gut microbiota plays a key role in anti-CH effects of BYD. STUDY DESIGN A comprehensive strategy via incorporating pharmacodynamics, microbiomics, metabolomics, and microflora suppression model was adopted to investigate the links between the microbiota-host metabolic interaction and BYD efficacy in CH rats. METHOD Firstly, the efficacy evaluation of BYD in treating chronic isoproterenol (ISO)-induced CH rats was performed by using multiple pharmacodynamic approaches. Then, the fecal metabolomics and 16S rRNA sequencing techniques were used to obtain the microbial and metabolic features of BYD against CH. After that, the potential gut-heart axis-based mechanism of BYD against CH was predicted by bioinformatic network analysis and validated by multiple molecular biology approaches. Finally, the antibiotics (AB)-induced gut microbiota suppression was employed to investigate whether the anti-CH effects of BYD is associated with the gut microflora. RESULTS The fecal microbial communities and metabolic compositions were significantly altered in ISO-induced CH rats, while BYD effectively ameliorated the CH-associated gut microbiota dysbiosis, especially of Firmicutes and Bacteroidetes, and time-dependently alleviated the disturbance of fecal metabolome and reversed the changes of key CH and gut microbiota-related metabolites, such as short/medium chain fatty acids, primary/secondary bile acids, and amino acids. The mechanism study showed that the anti-CH effect of BYD was related to inhibition of the derivatives of arginine and tryptophan and their downstream pro-hypertrophic, pro-inflammatory, and pro-oxidant signaling pathways. The following microflora suppression test showed that BYD-mediated myocardial protection was decreased either in pharmacodynamics or in metabolic modulation. CONCLUSION This study demonstrates that the protection of BYD against CH is partially gut microbiota dependent, and the regulatory effects of gut metabolism-related tryptophan and arginine derivatives is an important cardioprotection mechanism of BYD.
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Affiliation(s)
- Zhiyong Du
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
| | - Jinlong Wang
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
| | - Yingyuan Lu
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
| | - Xiaoli Ma
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
| | - Ran Wen
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
| | - Jihong Lin
- Waters Technologies Ltd., Shanghai 201203, China
| | - Chao Zhou
- Waters Technologies Ltd., Shanghai 201203, China
| | - Zonghua Song
- Chinese Pharmacopoeia Commission, Beijing 100061, China
| | - Jun Li
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
| | - Pengfei Tu
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
| | - Yong Jiang
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China.
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Abstract
Purpose of Review To review current literature on endothelial dysfunction with previous coronaviruses, and present available data on the role of endothelial dysfunction in coronavirus disease-2019 (COVID-19) infection in terms of pathophysiology and clinical phenotype Recent Findings Recent evidence suggests that signs and symptoms of severe COVID-19 infection resemble the clinical phenotype of endothelial dysfunction, implicating mutual pathophysiological pathways. Dysfunction of endothelial cells is believed to mediate a variety of viral infections, including those caused by previous coronaviruses. Experience from previous coronaviruses has triggered hypotheses on the role of endothelial dysfunction in the pathophysiology of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which are currently being tested in preclinical and clinical studies. Summary Endothelial dysfunction is the common denominator of multiple clinical aspects of severe COVID-19 infection that have been problematic for treating physicians. Given the global impact of this pandemic, better understanding of the pathophysiology could significantly affect management of patients.
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Verratti V, Ferrante C, Soranna D, Zambon A, Bhandari S, Orlando G, Brunetti L, Parati G. Effect of high-altitude trekking on blood pressure and on asymmetric dimethylarginine and isoprostane production: Results from a Mount Ararat expedition. J Clin Hypertens (Greenwich) 2020; 22:1494-1503. [PMID: 32762147 DOI: 10.1111/jch.13961] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 04/30/2020] [Accepted: 05/10/2020] [Indexed: 12/18/2022]
Abstract
The study aimed at exploring the mechanisms behind blood pressure and heart rate changes upon acute altitude exposure utilizing urinary excretion of biochemical factors involved in cardiovascular regulation. The study was conducted on 12 lowlander native male mountain climbers, living at sea level, exposed to altitudes ranging from 1800 to 5147 m above sea level over 4 days, during their ascent to Mount Ararat (Turkey). Blood pressure (measured by oscillometric method), heart rate, and blood oxygen saturation (SpO2 ) were recorded at rest (on awakening before food intake), in hypoxic conditions at 4200 m and at sea level before and after the altitude expedition. In the same study conditions (ie before-during-after the expedition), first-voided urinary samples were collected and assayed for 8-iso-prostaglandin F2α (8-iso-PGF2α ) and asymmetric dimethylarginine (ADMA) determination. Heart rate, and systolic and diastolic blood pressures were higher (P < .05) at high altitude than at the sea level. Furthermore, both urinary 8-iso-PGF2α and ADMA were significantly elevated (P < .01) at high altitude and returned to normal levels soon after returning to sea level. A 4-day exposure to high-altitude hypoxia induced a temporary increase in blood pressure and heart rate, confirming previous findings. Blood pressure increase at high altitude was associated with significantly enhanced production of biochemical mediators such as 8-iso-PGF2α, catecholamines, and ADMA, although we could not demonstrate a direct link between these parallel significant changes probably due to the forcefully limited sample size of our study, carried out in challenging environmental conditions at very high altitude.
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Affiliation(s)
- Vittore Verratti
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Claudio Ferrante
- Department of Pharmacy, "G. d'Annunzio" University, Chieti-Pescara, Italy
| | - Davide Soranna
- Department of Cardiovascular Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Antonella Zambon
- Department of statistic and quantitative method, University of Milano-Bicocca, Milan, Italy
| | - Suwas Bhandari
- Department of Critical Care and Internal Medicine, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Giustino Orlando
- Department of Pharmacy, "G. d'Annunzio" University, Chieti-Pescara, Italy
| | - Luigi Brunetti
- Department of Pharmacy, "G. d'Annunzio" University, Chieti-Pescara, Italy
| | - Gianfranco Parati
- Department of Cardiovascular Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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Abstract
PURPOSE OF REVIEW To review the data on the role of endothelial dysfunction and the impact of hypertension as a potent mediator of cardiovascular disease in patients with rheumatoid arthritis (RA). RECENT FINDINGS RA represents the most common autoimmune rheumatic disorder and is characterized by chronic systemic inflammation predisposing to cardiovascular complications. Cardiovascular mortality is increased among patients with RA and represents the leading cause of death. Although the exact prevalence is debated, hypertension is increased in RA. Hypertension acts synergistically with chronic inflammation and accounts, at least partially, for the increased cardiovascular morbidity in this group of patients. Endothelial dysfunction is considered a primary process in the pathogenesis of hypertension and cardiovascular diseases and contributes significantly to the development and progression of the associated micro- and macrovascular complications. Even though several studies in patients with RA have shown the presence of endothelial dysfunction with traditional methods, novel biochemical and vascular methods for the evaluation of endothelial dysfunction have been scarcely applied. In addition, it remains unclear whether and to which extent endothelial dysfunction in RA is present regardless of concomitant hypertension, even in well-controlled patients. Hypertension, endothelial dysfunction, and chronic systemic inflammation appear as a mutually reinforcing triad aggravating cardiovascular risk in patients with RA. Detection of endothelial dysfunction in patients with RA in the early stages further aiming at the development of novel therapeutic targets might contribute to prevention of cardiovascular complications and remains under investigation.
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Impact of Intensive Lifestyle Treatment (Diet Plus Exercise) on Endothelial and Vascular Function, Arterial Stiffness and Blood Pressure in Stage 1 Hypertension: Results of the HINTreat Randomized Controlled Trial. Nutrients 2020; 12:nu12051326. [PMID: 32392715 PMCID: PMC7284619 DOI: 10.3390/nu12051326] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/02/2020] [Accepted: 05/04/2020] [Indexed: 12/12/2022] Open
Abstract
Lifestyle modification is an important component of essential hypertension (EH) therapy. The aim of the Hypertension Intensive Nutrition Treatment (HINTreat) parallel, randomized controlled trial was to examine the effect of a 6-month intensive lifestyle treatment (ILT) (diet plus exercise with monthly visits) compared to the usual care. A total of 76 adults with stage 1 EH were randomized (38 in each group). Dietary analysis, anthropometry, physical activity, biochemical and urine profile, blood pressure (BP), asymmetric dimethylarginine (ADMA), central hemodynamics, β-stiffness index and carotid intima media-thickness were evaluated. The dietary inflammatory index (DII) was calculated for each participant from the intake of 29 nutrients/food components. At the end of the trial, participants in the ILT group reduced their 24h urinary Na excretion (p ≤ 0.001), daytime systolic BP (p ≤ 0.048) and mean carotid β-stiffness index (p ≤ 0.005) and ameliorated their lipidemic profile compared to the standard care. Univariate analysis for the total sample showed a strong association between DII and ADMA levels (β = 0.089, p ≤ 0.01). ILT is effective in improving the inflammatory components of the diet and selected cardiometabolic parameters, including arterial stiffness.
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Touyz RM, Rios FJ, Alves-Lopes R, Neves KB, Camargo LL, Montezano AC. Oxidative Stress: A Unifying Paradigm in Hypertension. Can J Cardiol 2020; 36:659-670. [PMID: 32389339 PMCID: PMC7225748 DOI: 10.1016/j.cjca.2020.02.081] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/19/2020] [Accepted: 02/19/2020] [Indexed: 02/07/2023] Open
Abstract
The etiology of hypertension involves complex interactions among genetic, environmental, and pathophysiologic factors that influence many regulatory systems. Hypertension is characteristically associated with vascular dysfunction, cardiovascular remodelling, renal dysfunction, and stimulation of the sympathetic nervous system. Emerging evidence indicates that the immune system is also important and that activated immune cells migrate and accumulate in tissues promoting inflammation, fibrosis, and target-organ damage. Common to these processes is oxidative stress, defined as an imbalance between oxidants and antioxidants in favour of the oxidants that leads to a disruption of oxidation-reduction (redox) signalling and control and molecular damage. Physiologically, reactive oxygen species (ROS) act as signalling molecules and influence cell function through highly regulated redox-sensitive signal transduction. In hypertension, oxidative stress promotes posttranslational modification (oxidation and phosphorylation) of proteins and aberrant signalling with consequent cell and tissue damage. Many enzymatic systems generate ROS, but NADPH oxidases (Nox) are the major sources in cells of the heart, vessels, kidneys, and immune system. Expression and activity of Nox are increased in hypertension and are the major systems responsible for oxidative stress in cardiovascular disease. Here we provide a unifying concept where oxidative stress is a common mediator underlying pathophysiologic processes in hypertension. We focus on some novel concepts whereby ROS influence vascular function, aldosterone/mineralocorticoid actions, and immunoinflammation, all important processes contributing to the development of hypertension.
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Affiliation(s)
- Rhian M Touyz
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland, United Kingdom.
| | - Francisco J Rios
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Rhéure Alves-Lopes
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Karla B Neves
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Livia L Camargo
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Augusto C Montezano
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland, United Kingdom
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Antza C, Vazakidis P, Doundoulakis I, Bouras E, Haidich A, Stabouli S, Kotsis V. Masked and white coat hypertension, the double trouble of large arteries: A systematic review and meta‐analysis. J Clin Hypertens (Greenwich) 2020; 22:802-811. [DOI: 10.1111/jch.13876] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/25/2020] [Accepted: 03/05/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Christina Antza
- Third Department of Internal Medicine Hypertension‐24h ABPM ESH Center of Excellence Papageorgiou Hospital Aristotle University of Thessaloniki Thessaloniki Greece
| | | | - Ioannis Doundoulakis
- Third Department of Internal Medicine Hypertension‐24h ABPM ESH Center of Excellence Papageorgiou Hospital Aristotle University of Thessaloniki Thessaloniki Greece
- Department of Cardiology 424 General Military Hospital Thessaloniki Greece
| | - Emmanouil Bouras
- Department of Hygiene Social‐Preventive Medicine & Medical Statistics School of Medicine Aristotle University of Thessaloniki Thessaloniki Greece
| | - Anna‐Bettina Haidich
- Department of Hygiene Social‐Preventive Medicine & Medical Statistics School of Medicine Aristotle University of Thessaloniki Thessaloniki Greece
| | - Stella Stabouli
- First Department of Pediatrics Aristotle University ThessalonikiHippokratio Hospital Thessaloniki Greece
| | - Vasilios Kotsis
- Third Department of Internal Medicine Hypertension‐24h ABPM ESH Center of Excellence Papageorgiou Hospital Aristotle University of Thessaloniki Thessaloniki Greece
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16
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Asymmetric dimethylarginine is not a marker of arterial damage in children with glomerular kidney diseases. Cent Eur J Immunol 2020; 44:370-379. [PMID: 32140048 PMCID: PMC7050061 DOI: 10.5114/ceji.2019.92788] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 10/03/2019] [Indexed: 02/07/2023] Open
Abstract
Introduction Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, correlates with cardiovascular risk especially in patients with chronic kidney disease. The aim of our study was to establish significance of ADMA as a biomarker of arterial damage in children with glomerulopathies. Material and methods In 80 children with glomerulopathies (mean age, 11.33 ±4.25 years; 42 with idiopathic nephrotic syndrome [INS], 38 with IgA or Henoch-Schoenlein nephropathy [IgAN/HSN]), we analyzed serum ADMA [nmol/ml], peripheral and central blood pressure, arterial stiffness (augmentation index – AIx75HR, pulse wave velocity – PWV), common carotid artery intima media thickness (cIMT), and selected clinical and biochemical parameters. Results In the study group, mean ADMA concentration was 1.66 ±1.19 [nmol/ml] and did not differ between INS and IgAN/HSN patients. We found no significant correlations between concentration of ADMA, cIMT [mm]/Z-score, PWV [m/s]/Z-score, and AIx75HR [%] in the whole group and in INS and IgAN/HSN patients. In the whole group of 80 children, ADMA correlated (p < 0.05) with BMI Z-score (r = –0.24), uric acid (r = –0.23), HDL-cholesterol (r = –0.25), and central mean arterial pressure (r = –0.25), in children with INS also with total protein (r = 0.37), albumin (r = 0.36), and total cholesterol (r = –0.40, p = 0.028). In multivariate analysis, serum albumin was the strongest determinant of ADMA in the whole group (β = 0.536, 95% CI: 0.013-1.060, p = 0.045). Conclusions 1. In children with glomerulonephritis, measurement of asymmetric dimethylarginine cannot replace well established and validated methods of assessment of subclinical arterial damage. 2. In children with glomerular kidney diseases, ADMA concentration is related primarily to serum albumin concentration.
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Gkaliagkousi E, Gavriilaki E, Vasileiadis I, Nikolaidou B, Yiannaki E, Lazaridis A, Triantafyllou A, Anyfanti P, Markala D, Zarifis I, Douma S. Endothelial Microvesicles Circulating in Peripheral and Coronary Circulation Are Associated With Central Blood Pressure in Coronary Artery Disease. Am J Hypertens 2019; 32:1199-1205. [PMID: 31350539 DOI: 10.1093/ajh/hpz116] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Endothelial microvesicles (EMVs) have emerged as markers of endothelial injury. However, little is known about their levels in the coronary circulation of acute coronary syndrome (ACS) and stable coronary artery disease (CAD). We hypothesized that ACS patients exhibit a more pronounced increase of EMVs both in the peripheral and coronary circulation when compared with CAD. We also investigated possible associations of EMVs with markers preclinical target organ damage. METHODS We enrolled consecutive eligible patients undergoing coronary angiography. Blood samples were collected from the stem of the left coronary artery and the femoral artery. ΕMVs were measured by a standardized flow cytometry protocol. Central systolic blood pressure (cSBP) was measured invasively and patients' history was recorded. RESULTS CAD patients exhibited increased levels of EMVs compared with controls. When patients with ACS and stable CAD were compared, the former had significantly increased EMVs in both coronary and peripheral circulation. Importantly, both ACS and CAD patients exhibited increased levels of EMVs in the coronary circulation compared with periphery. In addition, EMVs were associated with cSBP. CONCLUSIONS EMVs emerge as novel markers of ongoing underlying vascular damage, further augmenting the vicious cycle of inflammation and thrombosis mainly in ACS but also in stable CAD.
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Affiliation(s)
- Eugenia Gkaliagkousi
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Gavriilaki
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Barbara Nikolaidou
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efthalia Yiannaki
- Hematology Laboratory, Theagenion Cancer Center, Thessaloniki, Greece
| | - Antonios Lazaridis
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Areti Triantafyllou
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiota Anyfanti
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Markala
- Hematology Laboratory, Theagenion Cancer Center, Thessaloniki, Greece
| | - Ioannis Zarifis
- Cardiology Department, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Stella Douma
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Antza C, Doundoulakis I, Stabouli S, Tziomalos K, Kotsis V. Masked hypertensives: A disguised arterial stiffness population. J Clin Hypertens (Greenwich) 2019; 21:1473-1480. [DOI: 10.1111/jch.13692] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/28/2019] [Accepted: 07/08/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Christina Antza
- 3rd Department of Internal Medicine Hypertension‐24h Ambulatory Blood Pressure Monitoring Center Papageorgiou Hospital Aristotle University Thessaloniki Greece
| | - Ioannis Doundoulakis
- 3rd Department of Internal Medicine Hypertension‐24h Ambulatory Blood Pressure Monitoring Center Papageorgiou Hospital Aristotle University Thessaloniki Greece
| | - Stella Stabouli
- 1st Department of Pediatrics Hippokration Hospital Aristotle University Thessaloniki Greece
| | - Konstantinos Tziomalos
- 1st Propedeutic Department of Internal Medicine Medical School AHEPA Hospital Aristotle University of Thessaloniki Thessaloniki Greece
| | - Vasilios Kotsis
- 3rd Department of Internal Medicine Hypertension‐24h Ambulatory Blood Pressure Monitoring Center Papageorgiou Hospital Aristotle University Thessaloniki Greece
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Gavriilaki E, Gkaliagkousi E, Sakellari I, Anyfanti P, Douma S, Anagnostopoulos A. Early Prediction of Cardiovascular Risk after Hematopoietic Cell Transplantation: Are We There Yet? Biol Blood Marrow Transplant 2019; 25:e310-e316. [PMID: 31310812 DOI: 10.1016/j.bbmt.2019.07.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/03/2019] [Accepted: 07/10/2019] [Indexed: 12/14/2022]
Abstract
Cardiovascular (CV) events have emerged as a major cause of morbidity and mortality among hematopoietic cell transplantation (HCT) survivors. Accumulating evidence supports the presence of increased CV risk in HCT recipients. Most studies have focused mainly on traditional CV risk factors, such as the metabolic syndrome and hypertension. However, detection of these factors suggests the development of irreversible overt clinical atherosclerosis. Therefore, earlier prediction of CV risk is needed to prevent CV morbidity and mortality in these patients. In the field of CV research, endothelial dysfunction is considered an early event in the pathophysiology of CV risk factors, and a number of markers have been proposed for its assessment. In addition, markers of subclinical target organ damage have been introduced to implement CV risk prediction and early preventive or intensive therapeutic interventions. Furthermore, a number of CV models have been suggested aiming for optimal stratification of patients. Preliminary studies have indicated excess CV risk using these early markers in HCT recipients. However, their role in the pathophysiology and clinical practice in HCT survivors remains largely understudied. Taking into account the need for increased awareness from treating physicians in this evolving setting, we conducted a state-of-the-art review aiming to summarize current knowledge on endothelial dysfunction, subclinical target organ damage, and CV risk prediction in HCT survivors.
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Affiliation(s)
- Eleni Gavriilaki
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece.
| | - Eugenia Gkaliagkousi
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioanna Sakellari
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Panagiota Anyfanti
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stella Douma
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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20
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El-Saka MH, Madi NM, Ibrahim RR, Alghazaly GM, Elshwaikh S, El-Bermawy M. The ameliorative effect of angiotensin 1-7 on experimentally induced-preeclampsia in rats: Targeting the role of peroxisome proliferator-activated receptors gamma expression & asymmetric dimethylarginine. Arch Biochem Biophys 2019; 671:123-129. [PMID: 31295432 DOI: 10.1016/j.abb.2019.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/02/2019] [Accepted: 07/07/2019] [Indexed: 01/10/2023]
Abstract
This study was designed to explore the effect of angiotensin 1-7 (Ang 1-7) on experimentally induced-preeclampsia in Wistar rats targeting the role of peroxisome proliferator-activated receptors gamma expression (PPARs-γ) & asymmetric dimethylarginine (ADMA). 30 female Wistar rats were divided into three groups: Normal pregnant (NP), preeclampsia (PE), and preeclampsia treated with Ang 1-7 (PE + Ang 1-7) groups. Reduced uterine perfusion pressure (RUPP) model was induced on GD14. On GD18, protein in urine, urine volume and urinary sodium excretion were determined. On GD19, the systolic blood pressure (SBP) was measured, and the gene expression of PPARs-γ were determined. The serum samples were separated for determination of Ang 1-7, ADMA, soluble fms-like tyrosine kinase (sFlt-1), vascular endothelial growth factor (VEGF), nitric oxide (NO) products, endothelial nitric oxide synthase (eNOS) activity, interleukin-6 (IL-6), interleukin-10 (IL-10), malondialdehyde (MDA), and total anti-oxidant capacity (T-AOC). Compared to NP group, SBP, urine protein, serum levels of ADMA, sFlt-1, IL-6 and MDA significantly increased, while expression of PPARs-γ, serum levels of Ang 1-7, VEGF, NO products, eNOS, IL-10 and T-AOC significantly decreased in PE group, while treatment of Ang 1-7 significantly ameliorated all these studied parameters as compared to PE group. We concluded that Ang 1-7 attenuated the symptoms of preeclampsia, which might be via increasing the expression of PPARs-γ and reduction of ADMA levels which could explain its anti-hypertensive, anti-angiogenic, anti-inflammatory and antioxidant effects.
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Affiliation(s)
- Mervat H El-Saka
- The Department of Physiology, Faculty of Medicine, Tanta University, Egypt.
| | - Nermin M Madi
- The Department of Physiology, Faculty of Medicine, Tanta University, Egypt
| | - Rowida Raafat Ibrahim
- The Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Tanta University, Egypt
| | | | - Shereef Elshwaikh
- The Department of Gynecology and Obstetric, Faculty of Medicine, Tanta University, Egypt
| | - Manal El-Bermawy
- The Department of Anatomy, Faculty of Medicine, Tanta University, Egypt
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