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Kaniraja G, Karthikeyan M, Dhinesh Kumar M, Ananthappan P, Arunsunai Kumar K, Shanmugaiah V, Sivasamy Vasantha V, Karunakaran C. Cytochrome c electrochemical detection utilizing molecularly imprinted poly(3, 4-ethylenedioxythiophene) on a disposable screen printed carbon electrode. Anal Biochem 2024; 692:115557. [PMID: 38718955 DOI: 10.1016/j.ab.2024.115557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/04/2024] [Accepted: 05/06/2024] [Indexed: 05/14/2024]
Abstract
Cytochrome c (cyt c) has been found to play a function in apoptosis in cell-free models. This work presents the creation of molecularly imprinted conducting poly(3, 4-ethylenedioxythiopene) (MIPEDOT) on the surface of a screen printed carbon electrode (SPCE) for cyt c. Cyt c was imprinted by electropolymerization due to the presence of an EDOT monomer hydrophobic functional group on SPCE, using CV to obtain highly selective materials with excellent molecular recognition ability. MIPEDOT was characterized by CV, EIS, and DPV using ferricyanide/ferrocyanide as a redox probe. Further, the characterization of the sensor was accomplished using SEM for surface morphological confirmation. Using CV, the peak current measured at the potential of +1 to -1 V (vs. Ag/AgCl) is linear in the cyt c concentration range from 1 to 1200 pM, showing a remarkably low detection limit of 0.5 pM (sensitivity:0.080 μA pM). Moreover, the applicability of the approach was successfully confirmed with the detection of cyt c in biological samples (human plasma). Similarly, our research has proven a low-cost, simple, and efficient sensing platform for cyt c detection, rendering it a viable tool for the future improvement of reliable and exact non-encroaching cell death detection.
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Affiliation(s)
- Ganesan Kaniraja
- Department of Chemistry, Virudhunagar Hindu Nadars' Senthikumara Nadar College (Autonomous & Affiliated to Madurai Kamaraj University), Virudhunagar, 626 001, Tamil Nadu, India
| | - Murugesan Karthikeyan
- Department of Chemistry, Virudhunagar Hindu Nadars' Senthikumara Nadar College (Autonomous & Affiliated to Madurai Kamaraj University), Virudhunagar, 626 001, Tamil Nadu, India
| | - Marimuthu Dhinesh Kumar
- Department of Chemistry, Virudhunagar Hindu Nadars' Senthikumara Nadar College (Autonomous & Affiliated to Madurai Kamaraj University), Virudhunagar, 626 001, Tamil Nadu, India
| | - Periyasamy Ananthappan
- Department of Natural Products Chemistry, School of Chemistry, Madurai Kamaraj University, Madurai, 625 021, Tamil Nadu, India
| | - Karuppiah Arunsunai Kumar
- Department of Chemistry, Virudhunagar Hindu Nadars' Senthikumara Nadar College (Autonomous & Affiliated to Madurai Kamaraj University), Virudhunagar, 626 001, Tamil Nadu, India
| | - Vellasamy Shanmugaiah
- Department of Microbial Technology, School of Biological Science, Madurai Kamaraj University, Madurai, 625 021, Tamil Nadu, India
| | - Vairathevar Sivasamy Vasantha
- Department of Natural Products Chemistry, School of Chemistry, Madurai Kamaraj University, Madurai, 625 021, Tamil Nadu, India
| | - Chandran Karunakaran
- Department of Chemistry, Virudhunagar Hindu Nadars' Senthikumara Nadar College (Autonomous & Affiliated to Madurai Kamaraj University), Virudhunagar, 626 001, Tamil Nadu, India.
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Torp MK, Stensløkken KO, Vaage J. When Our Best Friend Becomes Our Worst Enemy: The Mitochondrion in Trauma, Surgery, and Critical Illness. J Intensive Care Med 2024:8850666241237715. [PMID: 38505947 DOI: 10.1177/08850666241237715] [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: 03/21/2024]
Abstract
Common for major surgery, multitrauma, sepsis, and critical illness, is a whole-body inflammation. Tissue injury is able to trigger a generalized inflammatory reaction. Cell death causes release of endogenous structures termed damage associated molecular patterns (DAMPs) that initiate a sterile inflammation. Mitochondria are evolutionary endosymbionts originating from bacteria, containing molecular patterns similar to bacteria. These molecular patterns are termed mitochondrial DAMPs (mDAMPs). Mitochondrial debris released into the extracellular space or into the circulation is immunogenic and damaging secondary to activation of the innate immune system. In the circulation, released mDAMPS are either free or exist in extracellular vesicles, being able to act on every organ and cell in the body. However, the role of mDAMPs in trauma and critical care is not fully clarified. There is a complete lack of knowledge how they may be counteracted in patients. Among mDAMPs are mitochondrial DNA, cardiolipin, N-formyl peptides, cytochrome C, adenosine triphosphate, reactive oxygen species, succinate, and mitochondrial transcription factor A. In this overview, we present the different mDAMPs, their function, release, targets, and inflammatory potential. In light of present knowledge, the role of mDAMPs in the pathophysiology of major surgery and trauma as well as sepsis, and critical care is discussed.
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Affiliation(s)
- May-Kristin Torp
- Section of Physiology, Department of Molecular Medicine, Institute of Basic Medical Science, University of Oslo, Oslo, Norway
- Department of Research, Østfold Hospital Trust, Grålum, Norway
| | - Kåre-Olav Stensløkken
- Section of Physiology, Department of Molecular Medicine, Institute of Basic Medical Science, University of Oslo, Oslo, Norway
| | - Jarle Vaage
- Section of Physiology, Department of Molecular Medicine, Institute of Basic Medical Science, University of Oslo, Oslo, Norway
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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3
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Lamichhane S, Timalsina R, Schultz C, Fescenko I, Ambal K, Liou SH, Lai RY, Laraoui A. Nitrogen-Vacancy Magnetic Relaxometry of Nanoclustered Cytochrome C Proteins. NANO LETTERS 2024; 24:873-880. [PMID: 38207217 DOI: 10.1021/acs.nanolett.3c03843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Nitrogen-vacancy (NV) magnetometry offers an alternative tool to detect paramagnetic centers in cells with a favorable combination of magnetic sensitivity and spatial resolution. Here, we employ NV magnetic relaxometry to detect cytochrome C (Cyt-C) nanoclusters. Cyt-C is a water-soluble protein that plays a vital role in the electron transport chain of mitochondria. Under ambient conditions, the heme group in Cyt-C remains in the Fe3+ state, which is paramagnetic. We vary the concentration of Cyt-C from 6 to 54 μM and observe a reduction of the NV spin-lattice relaxation time (T1) from 1.2 ms to 150 μs, which is attributed to the spin noise originating from the Fe3+ spins. NV T1 imaging of Cyt-C drop-casted on a nanostructured diamond chip allows us to detect the relaxation rates from the adsorbed Fe3+ within Cyt-C.
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Affiliation(s)
- Suvechhya Lamichhane
- Department of Physics and Astronomy and the Nebraska Center for Materials and Nanoscience, University of Nebraska-Lincoln, Lincoln, Nebraska 68588, United States
| | - Rupak Timalsina
- Department of Mechanical & Materials Engineering, University of Nebraska-Lincoln, Lincoln, Nebraska 68588, United States
| | - Cody Schultz
- Department of Chemistry, University of Nebraska-Lincoln, Lincoln, Nebraska 68588, United States
| | - Ilja Fescenko
- Laser Center, University of Latvia, Riga, LV-1004, Latvia
| | - Kapildeb Ambal
- Department of Mathematics, Statistics, and Physics, Wichita State University, Wichita, Kansas 67260, United States
| | - Sy-Hwang Liou
- Department of Physics and Astronomy and the Nebraska Center for Materials and Nanoscience, University of Nebraska-Lincoln, Lincoln, Nebraska 68588, United States
| | - Rebecca Y Lai
- Department of Chemistry, University of Nebraska-Lincoln, Lincoln, Nebraska 68588, United States
| | - Abdelghani Laraoui
- Department of Physics and Astronomy and the Nebraska Center for Materials and Nanoscience, University of Nebraska-Lincoln, Lincoln, Nebraska 68588, United States
- Department of Mechanical & Materials Engineering, University of Nebraska-Lincoln, Lincoln, Nebraska 68588, United States
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4
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Li JY, Sun XA, Wang X, Yang NH, Xie HY, Guo HJ, Lu L, Xie X, Zhou L, Liu J, Zhang W, Lu LM. PGAM5 exacerbates acute renal injury by initiating mitochondria-dependent apoptosis by facilitating mitochondrial cytochrome c release. Acta Pharmacol Sin 2024; 45:125-136. [PMID: 37684381 PMCID: PMC10770374 DOI: 10.1038/s41401-023-01151-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 08/03/2023] [Indexed: 09/10/2023] Open
Abstract
Acute kidney injury (AKI) is a worldwide public health problem characterized by the massive loss of tubular cells. However, the precise mechanism for initiating tubular cell death has not been fully elucidated. Here, we reported that phosphoglycerate mutase 5 (PGAM5) was upregulated in renal tubular epithelial cells during ischaemia/reperfusion or cisplatin-induced AKI in mice. PGAM5 knockout significantly alleviated the activation of the mitochondria-dependent apoptosis pathway and tubular apoptosis. Apoptosis inhibitors alleviated the activation of the mitochondria-dependent apoptosis pathway. Mechanistically, as a protein phosphatase, PGAM5 could dephosphorylate Bax and facilitate Bax translocation to the mitochondrial membrane. The translocation of Bax to mitochondria increased membrane permeability, decreased mitochondrial membrane potential and facilitated the release of mitochondrial cytochrome c (Cyt c) into the cytoplasm. Knockdown of Bax attenuated PGAM5 overexpression-induced Cyt c release and tubular cell apoptosis. Our results demonstrated that the increase in PGAM5-mediated Bax dephosphorylation and mitochondrial translocation was implicated in the development of AKI by initiating mitochondrial Cyt c release and activating the mitochondria-dependent apoptosis pathway. Targeting this axis might be beneficial for alleviating AKI.
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Affiliation(s)
- Jing-Yao Li
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
- Division of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Xi-Ang Sun
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
| | - Xin Wang
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
| | - Ning-Hao Yang
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
| | - Hong-Yan Xie
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
| | - Heng-Jiang Guo
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
| | - Li Lu
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Dali University, Dali, Yunnan, 671013, China
| | - Xin Xie
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
| | - Li Zhou
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
| | - Jun Liu
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
| | - Wei Zhang
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China.
| | - Li-Min Lu
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China.
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.
- Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Children's Hospital of Fudan University, Shanghai, 201102, China.
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Yu Y, Zhou M, Long X, Yin S, Hu G, Yang X, Jian W, Yu R. Study on the mechanism of action of colchicine in the treatment of coronary artery disease based on network pharmacology and molecular docking technology. Front Pharmacol 2023; 14:1147360. [PMID: 37405052 PMCID: PMC10315633 DOI: 10.3389/fphar.2023.1147360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/07/2023] [Indexed: 07/06/2023] Open
Abstract
Objective: This is the first study to explore the mechanism of colchicine in treating coronary artery disease using network pharmacology and molecular docking technology, aiming to predict the key targets and main approaches of colchicine in treating coronary artery disease. It is expected to provide new ideas for research on disease mechanism and drug development. Methods: Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), Swiss Target Prediction and PharmMapper databases were used to obtain drug targets. GeneCards, Online Mendelian Inheritance in Man (OMIM), Therapeutic Target Database (TTD), DrugBank and DisGeNET databases were utilized to gain disease targets. The intersection of the two was taken to access the intersection targets of colchicine for the treatment of coronary artery disease. The Sting database was employed to analyze the protein-protein interaction network. Gene Ontology (GO) functional enrichment analysis was performed using Webgestalt database. Reactom database was applied for Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Molecular docking was simulated using AutoDock 4.2.6 and PyMOL2.4 software. Results: A total of 70 intersecting targets of colchicine for the treatment of coronary artery disease were obtained, and there were interactions among 50 targets. GO functional enrichment analysis yielded 13 biological processes, 18 cellular components and 16 molecular functions. 549 signaling pathways were obtained by KEGG enrichment analysis. The molecular docking results of key targets were generally good. Conclusion: Colchicine may treat coronary artery disease through targets such as Cytochrome c (CYCS), Myeloperoxidase (MPO) and Histone deacetylase 1 (HDAC1). The mechanism of action may be related to the cellular response to chemical stimulus and p75NTR-mediated negative regulation of cell cycle by SC1, which is valuable for further research exploration. However, this research still needs to be verified by experiments. Future research will explore new drugs for treating coronary artery disease from these targets.
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Affiliation(s)
- Yunfeng Yu
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Manli Zhou
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Xi Long
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Shuang Yin
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Gang Hu
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Xinyu Yang
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Weixiong Jian
- College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
- Key Laboratory of Chinese Medicine Diagnostics in Hunan Province, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Rong Yu
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
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6
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Torp MK, Vaage J, Stensløkken KO. Mitochondria-derived damage-associated molecular patterns and inflammation in the ischemic-reperfused heart. Acta Physiol (Oxf) 2023; 237:e13920. [PMID: 36617670 DOI: 10.1111/apha.13920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/01/2022] [Accepted: 01/02/2023] [Indexed: 01/10/2023]
Abstract
Cardiac cell death after myocardial infarction release endogenous structures termed damage-associated molecular patterns (DAMPs) that trigger the innate immune system and initiate a sterile inflammation in the myocardium. Cardiomyocytes are energy demanding cells and 30% of their volume are mitochondria. Mitochondria are evolutionary endosymbionts originating from bacteria containing molecular patterns similar to bacteria, termed mitochondrial DAMPs (mDAMPs). Consequently, mitochondrial debris may be particularly immunogenic and damaging. However, the role of mDAMPs in myocardial infarction is not clarified. Identifying the most harmful mDAMPs and inhibiting their early inflammatory signaling may reduce infarct size and the risk of developing post-infarct heart failure. The focus of this review is the role of mDAMPs in the immediate pro-inflammatory phase after myocardial infarction before arrival of immune cells in the myocardium. We discuss different mDAMPs, their role in physiology and present knowledge regarding their role in the inflammatory response of acute myocardial infarction.
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Affiliation(s)
- May-Kristin Torp
- Division of Physiology, Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Jarle Vaage
- Division of Physiology, Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Kåre-Olav Stensløkken
- Division of Physiology, Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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7
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Choi CHJ, Barr W, Zaman S, Model C, Park A, Koenen M, Lin Z, Szwed SK, Marchildon F, Crane A, Carroll TS, Molina H, Cohen P. LRG1 is an adipokine that promotes insulin sensitivity and suppresses inflammation. eLife 2022; 11:e81559. [PMID: 36346018 PMCID: PMC9674348 DOI: 10.7554/elife.81559] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 11/06/2022] [Indexed: 11/11/2022] Open
Abstract
While dysregulation of adipocyte endocrine function plays a central role in obesity and its complications, the vast majority of adipokines remain uncharacterized. We employed bio-orthogonal non-canonical amino acid tagging (BONCAT) and mass spectrometry to comprehensively characterize the secretome of murine visceral and subcutaneous white and interscapular brown adip ocytes. Over 600 proteins were identified, the majority of which showed cell type-specific enrichment. We here describe a metabolic role for leucine-rich α-2 glycoprotein 1 (LRG1) as an obesity-regulated adipokine secreted by mature adipocytes. LRG1 overexpression significantly improved glucose homeostasis in diet-induced and genetically obese mice. This was associated with markedly reduced white adipose tissue macrophage accumulation and systemic inflammation. Mechanistically, we found LRG1 binds cytochrome c in circulation to dampen its pro-inflammatory effect. These data support a new role for LRG1 as an insulin sensitizer with therapeutic potential given its immunomodulatory function at the nexus of obesity, inflammation, and associated pathology.
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Affiliation(s)
- Chan Hee J Choi
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD ProgramNew YorkUnited States
- Laboratory of Molecular Metabolism, Rockefeller UniversityNew YorkUnited States
| | - William Barr
- Laboratory of Molecular Metabolism, Rockefeller UniversityNew YorkUnited States
| | - Samir Zaman
- Laboratory of Molecular Metabolism, Rockefeller UniversityNew YorkUnited States
| | - Corey Model
- Laboratory of Molecular Metabolism, Rockefeller UniversityNew YorkUnited States
| | - Annsea Park
- Department of Immunobiology, Yale UniversityNew HavenUnited States
| | - Mascha Koenen
- Laboratory of Molecular Metabolism, Rockefeller UniversityNew YorkUnited States
| | - Zeran Lin
- Laboratory of Molecular Metabolism, Rockefeller UniversityNew YorkUnited States
| | - Sarah K Szwed
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD ProgramNew YorkUnited States
- Laboratory of Molecular Metabolism, Rockefeller UniversityNew YorkUnited States
| | - Francois Marchildon
- Laboratory of Molecular Metabolism, Rockefeller UniversityNew YorkUnited States
| | - Audrey Crane
- Laboratory of Molecular Metabolism, Rockefeller UniversityNew YorkUnited States
| | - Thomas S Carroll
- Bioinformatics Resouce Center, Rockefeller UniversityNew YorkUnited States
| | - Henrik Molina
- Proteomics Resource Center, Rockefeller UniversityNew YorkUnited States
| | - Paul Cohen
- Laboratory of Molecular Metabolism, Rockefeller UniversityNew YorkUnited States
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Serebrovska ZO, Xi L, Tumanovska LV, Shysh AM, Goncharov SV, Khetsuriani M, Kozak TO, Pashevin DA, Dosenko VE, Virko SV, Kholin VA, Grib ON, Utko NA, Egorov E, Polischuk AO, Serebrovska TV. Response of Circulating Inflammatory Markers to Intermittent Hypoxia-Hyperoxia Training in Healthy Elderly People and Patients with Mild Cognitive Impairment. Life (Basel) 2022; 12:life12030432. [PMID: 35330183 PMCID: PMC8953753 DOI: 10.3390/life12030432] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 12/28/2022] Open
Abstract
Intermittent hypoxia-hyperoxia training (IHHT) is a non-pharmacological therapeutic modality for management of some chronic- and age-related pathologies, such as Alzheimer’s disease (AD). Our previous studies demonstrated significant improvement of cognitive function after IHHT in the patients with mild cognitive impairment (MCI). The present study further investigated the effects of IHHT on pro-inflammatory factors in healthy elderly individuals and patients with early signs of AD. Twenty-nine subjects (13 healthy subjects without signs of cognitive impairment syndrome and 16 patients diagnosed with MCI; age 52 to 76 years) were divided into four groups: Healthy+Sham (n = 7), Healthy+IHHT (n = 6), MCI+Sham (n = 6), and MCI+IHHT (n = 10). IHHT was carried out 5 days per week for 3 weeks (total 15 sessions), and each daily session included 4 cycles of 5-min hypoxia (12% FIO2) and 3-min hyperoxia (33% FIO2). Decline in cognitive function indices was observed initially in both MCI+Sham and MCI+IHHT groups. The sham training did not alter any of the parameters, whereas IHHT resulted in improvement in latency of cognitive evoked potentials, along with elevation in APP110, GDF15 expression, and MMP9 activity in both healthy subjects and those with MCI. Increased MMP2 activity, HMGB1, and P-selectin expression and decreased NETs formation and Aβ expression were also observed in the MCI+IHHT group. There was a negative correlation between MoCA score and the plasma GDF15 expression (R = −0.5799, p < 0.05) before the initiation of IHHT. The enhanced expression of GDF15 was also associated with longer latency of the event-related potentials P330 and N200 (R = 0.6263, p < 0.05 and R = 0.5715, p < 0.05, respectively). In conclusion, IHHT upregulated circulating levels of some inflammatory markers, which may represent potential triggers for cellular adaptive reprogramming, leading to therapeutic effects against cognitive dysfunction and neuropathological changes during progression of AD. Further investigation is needed to clarify if there is a causative relationship between the improved cognitive function and the elevated inflammatory markers following IHHT.
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Affiliation(s)
- Zoya O. Serebrovska
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, 01024 Kyiv, Ukraine; (L.V.T.); (A.M.S.); (S.V.G.); (M.K.); (T.O.K.); (D.A.P.); (V.E.D.); (A.O.P.); (T.V.S.)
- Correspondence: (Z.O.S.); (L.X.)
| | - Lei Xi
- Pauley Heart Center, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA 23298-0204, USA
- Correspondence: (Z.O.S.); (L.X.)
| | - Lesya V. Tumanovska
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, 01024 Kyiv, Ukraine; (L.V.T.); (A.M.S.); (S.V.G.); (M.K.); (T.O.K.); (D.A.P.); (V.E.D.); (A.O.P.); (T.V.S.)
| | - Angela M. Shysh
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, 01024 Kyiv, Ukraine; (L.V.T.); (A.M.S.); (S.V.G.); (M.K.); (T.O.K.); (D.A.P.); (V.E.D.); (A.O.P.); (T.V.S.)
| | - Sergii V. Goncharov
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, 01024 Kyiv, Ukraine; (L.V.T.); (A.M.S.); (S.V.G.); (M.K.); (T.O.K.); (D.A.P.); (V.E.D.); (A.O.P.); (T.V.S.)
| | - Michael Khetsuriani
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, 01024 Kyiv, Ukraine; (L.V.T.); (A.M.S.); (S.V.G.); (M.K.); (T.O.K.); (D.A.P.); (V.E.D.); (A.O.P.); (T.V.S.)
| | - Taisia O. Kozak
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, 01024 Kyiv, Ukraine; (L.V.T.); (A.M.S.); (S.V.G.); (M.K.); (T.O.K.); (D.A.P.); (V.E.D.); (A.O.P.); (T.V.S.)
| | - Denis A. Pashevin
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, 01024 Kyiv, Ukraine; (L.V.T.); (A.M.S.); (S.V.G.); (M.K.); (T.O.K.); (D.A.P.); (V.E.D.); (A.O.P.); (T.V.S.)
| | - Victor E. Dosenko
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, 01024 Kyiv, Ukraine; (L.V.T.); (A.M.S.); (S.V.G.); (M.K.); (T.O.K.); (D.A.P.); (V.E.D.); (A.O.P.); (T.V.S.)
| | - Sergii V. Virko
- Lashkariov Institute of Semiconductor Physics, National Academy of Sciences, 41 Nauki Ave., 03028 Kyiv, Ukraine;
| | - Viktor A. Kholin
- Department of Age Physiology and Pathology of Nervous System, Chebotarev Institute of Gerontology NAMS of Ukraine, 04114 Kyiv, Ukraine; (V.A.K.); (O.N.G.); (N.A.U.)
| | - Oksana N. Grib
- Department of Age Physiology and Pathology of Nervous System, Chebotarev Institute of Gerontology NAMS of Ukraine, 04114 Kyiv, Ukraine; (V.A.K.); (O.N.G.); (N.A.U.)
| | - Natalie A. Utko
- Department of Age Physiology and Pathology of Nervous System, Chebotarev Institute of Gerontology NAMS of Ukraine, 04114 Kyiv, Ukraine; (V.A.K.); (O.N.G.); (N.A.U.)
| | - Egor Egorov
- CELLGYM Technologies GmbH, 14193 Berlin, Germany;
| | - Anna O. Polischuk
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, 01024 Kyiv, Ukraine; (L.V.T.); (A.M.S.); (S.V.G.); (M.K.); (T.O.K.); (D.A.P.); (V.E.D.); (A.O.P.); (T.V.S.)
| | - Tetiana V. Serebrovska
- Department of General and Molecular Pathophysiology, Bogomoletz Institute of Physiology, 01024 Kyiv, Ukraine; (L.V.T.); (A.M.S.); (S.V.G.); (M.K.); (T.O.K.); (D.A.P.); (V.E.D.); (A.O.P.); (T.V.S.)
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9
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Koenig A, Buskiewicz-Koenig IA. Redox Activation of Mitochondrial DAMPs and the Metabolic Consequences for Development of Autoimmunity. Antioxid Redox Signal 2022; 36:441-461. [PMID: 35352943 PMCID: PMC8982130 DOI: 10.1089/ars.2021.0073] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Significance: Reactive oxygen species (ROS) are well known to promote innate immune responses during and in the absence of microbial infections. However, excessive or prolonged exposure to ROS provokes innate immune signaling dysfunction and contributes to the pathogenesis of many autoimmune diseases. The relatively high basal expression of pattern recognition receptors (PRRs) in innate immune cells renders them prone to activation in response to minor intrinsic or extrinsic ROS misbalances in the absence of pathogens. Critical Issues: A prominent source of ROS are mitochondria, which are also major inter-organelle hubs for innate immunity activation, since most PRRs and downstream receptor molecules are directly located either at mitochondria or at mitochondria-associated membranes. Due to their ancestral bacterial origin, mitochondria can also act as quasi-intrinsic self-microbes that mimic a pathogen invasion and become a source of danger-associated molecular patterns (DAMPs) that triggers innate immunity from within. Recent Advances: The release of mitochondrial DAMPs correlates with mitochondrial metabolism changes and increased generation of ROS, which can lead to the oxidative modification of DAMPs. Recent studies suggest that ROS-modified mitochondrial DAMPs possess increased, persistent immunogenicity. Future Directions: Herein, we discuss how mitochondrial DAMP release and oxidation activates PRRs, changes cellular metabolism, and causes innate immune response dysfunction by promoting systemic inflammation, thereby contributing to the onset or progression of autoimmune diseases. The future goal is to understand what the tipping point for DAMPs is to become oxidized, and whether this is a road without return. Antioxid. Redox Signal. 36, 441-461.
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Affiliation(s)
- Andreas Koenig
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, New York, USA
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10
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Kuschner CE, Kim N, Shoaib M, Choudhary RC, Nishikimi M, Yin T, Becker LB, Hoppel CL, Kim J. Understanding physiologic phospholipid maintenance in the context of brain mitochondrial phospholipid alterations after cardiac arrest. Mitochondrion 2021; 60:112-120. [PMID: 34384933 DOI: 10.1016/j.mito.2021.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/14/2021] [Accepted: 08/06/2021] [Indexed: 11/18/2022]
Abstract
Cardiac arrest (CA) induces whole-body ischemia resulting in mitochondrial dysfunction. We used isolated mitochondria to examine phospholipid alterations in the brain, heart, kidney, and liver post-CA. Our data shows that ischemia/reperfusion most significantly alters brain mitochondria phospholipids, predominately after resuscitation. Furthermore, the alterations do not appear to be a function of dysregulated importation of phospholipids, but caused by impaired intra-mitochondrial synthesis and/or remodeling of phospholipids. Our data demonstrates only brain mitochondria undergo significant alterations in phospholipids, providing a rationale for the high vulnerability of the brain to ischemia/reperfusion. Furthermore, analyzing this pathophysiologic state provides insight into physiologic mitochondrial phospholipid metabolism.
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Affiliation(s)
- Cyrus E Kuschner
- Laboratory for Critical Care Physiology, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Nancy Kim
- Laboratory for Critical Care Physiology, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Muhammad Shoaib
- Laboratory for Critical Care Physiology, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Rishabh C Choudhary
- Laboratory for Critical Care Physiology, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Mitsuaki Nishikimi
- Laboratory for Critical Care Physiology, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Tai Yin
- Laboratory for Critical Care Physiology, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Lance B Becker
- Laboratory for Critical Care Physiology, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Charles L Hoppel
- Center for Mitochondrial Diseases and Departments of Pharmacology and Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Junhwan Kim
- Laboratory for Critical Care Physiology, Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
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11
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Hayashida K, Takegawa R, Shoaib M, Aoki T, Choudhary RC, Kuschner CE, Nishikimi M, Miyara SJ, Rolston DM, Guevara S, Kim J, Shinozaki K, Molmenti EP, Becker LB. Mitochondrial transplantation therapy for ischemia reperfusion injury: a systematic review of animal and human studies. J Transl Med 2021; 19:214. [PMID: 34001191 PMCID: PMC8130169 DOI: 10.1186/s12967-021-02878-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/07/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Mitochondria are essential organelles that provide energy for cellular functions, participate in cellular signaling and growth, and facilitate cell death. Based on their multifactorial roles, mitochondria are also critical in the progression of critical illnesses. Transplantation of mitochondria has been reported as a potential promising approach to treat critical illnesses, particularly ischemia reperfusion injury (IRI). However, a systematic review of the relevant literature has not been conducted to date. Here, we systematically reviewed the animal and human studies relevant to IRI to summarize the evidence for mitochondrial transplantation. METHODS We searched MEDLINE, the Cochrane library, and Embase and performed a systematic review of mitochondrial transplantation for IRI in both preclinical and clinical studies. We developed a search strategy using a combination of keywords and Medical Subject Heading/Emtree terms. Studies including cell-mediated transfer of mitochondria as a transfer method were excluded. Data were extracted to a tailored template, and data synthesis was descriptive because the data were not suitable for meta-analysis. RESULTS Overall, we identified 20 animal studies and two human studies. Among animal studies, 14 (70%) studies focused on either brain or heart IRI. Both autograft and allograft mitochondrial transplantation were used in 17 (85%) animal studies. The designs of the animal studies were heterogeneous in terms of the route of administration, timing of transplantation, and dosage used. Twelve (60%) studies were performed in a blinded manner. All animal studies reported that mitochondrial transplantation markedly mitigated IRI in the target tissues, but there was variation in biological biomarkers and pathological changes. The human studies were conducted with a single-arm, unblinded design, in which autologous mitochondrial transplantation was applied to pediatric patients who required extracorporeal membrane oxygenation (ECMO) for IRI-associated myocardial dysfunction after cardiac surgery. CONCLUSION The evidence gathered from our systematic review supports the potential beneficial effects of mitochondrial transplantation after IRI, but its clinical translation remains limited. Further investigations are thus required to explore the mechanisms of action and patient outcomes in critical settings after mitochondrial transplantation. Systematic review registration The study was registered at UMIN under the registration number UMIN000043347.
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Affiliation(s)
- Kei Hayashida
- The Feinstein Institutes for Medical Research, Northwell Health System, 350 Community Drive, Manhasset, NY, USA. .,Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, 350 Community Dr, Manhasset, NY, 11030, USA.
| | - Ryosuke Takegawa
- The Feinstein Institutes for Medical Research, Northwell Health System, 350 Community Drive, Manhasset, NY, USA.,Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Muhammad Shoaib
- The Feinstein Institutes for Medical Research, Northwell Health System, 350 Community Drive, Manhasset, NY, USA.,Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, 350 Community Dr, Manhasset, NY, 11030, USA.,Zucker School of Medicine At Hofstra/Northwell, New York, NY, USA
| | - Tomoaki Aoki
- The Feinstein Institutes for Medical Research, Northwell Health System, 350 Community Drive, Manhasset, NY, USA.,Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Rishabh C Choudhary
- The Feinstein Institutes for Medical Research, Northwell Health System, 350 Community Drive, Manhasset, NY, USA.,Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Cyrus E Kuschner
- The Feinstein Institutes for Medical Research, Northwell Health System, 350 Community Drive, Manhasset, NY, USA.,Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, 350 Community Dr, Manhasset, NY, 11030, USA.,Zucker School of Medicine At Hofstra/Northwell, New York, NY, USA
| | - Mitsuaki Nishikimi
- The Feinstein Institutes for Medical Research, Northwell Health System, 350 Community Drive, Manhasset, NY, USA.,Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Santiago J Miyara
- The Feinstein Institutes for Medical Research, Northwell Health System, 350 Community Drive, Manhasset, NY, USA.,Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Daniel M Rolston
- Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, 350 Community Dr, Manhasset, NY, 11030, USA.,Zucker School of Medicine At Hofstra/Northwell, New York, NY, USA
| | - Sara Guevara
- Department of Surgery, Northwell Health, Manhasset, NY, USA
| | - Junhwan Kim
- The Feinstein Institutes for Medical Research, Northwell Health System, 350 Community Drive, Manhasset, NY, USA.,Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, 350 Community Dr, Manhasset, NY, 11030, USA.,Zucker School of Medicine At Hofstra/Northwell, New York, NY, USA
| | - Koichiro Shinozaki
- The Feinstein Institutes for Medical Research, Northwell Health System, 350 Community Drive, Manhasset, NY, USA.,Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, 350 Community Dr, Manhasset, NY, 11030, USA.,Zucker School of Medicine At Hofstra/Northwell, New York, NY, USA
| | - Ernesto P Molmenti
- Zucker School of Medicine At Hofstra/Northwell, New York, NY, USA.,Department of Surgery, Northwell Health, Manhasset, NY, USA
| | - Lance B Becker
- The Feinstein Institutes for Medical Research, Northwell Health System, 350 Community Drive, Manhasset, NY, USA.,Department of Emergency Medicine, North Shore University Hospital, Northwell Health System, 350 Community Dr, Manhasset, NY, 11030, USA.,Zucker School of Medicine At Hofstra/Northwell, New York, NY, USA
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12
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Niu K, Qin JL, Lu GF, Guo J, Williams JP, An JX. Dexmedetomidine Reverses Postoperative Spatial Memory Deficit by Targeting Surf1 and Cytochrome c. Neuroscience 2021; 466:148-161. [PMID: 33895343 DOI: 10.1016/j.neuroscience.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 04/11/2021] [Accepted: 04/13/2021] [Indexed: 10/21/2022]
Abstract
Anesthesia and surgery are associated with perioperative neurocognitive disorders (PND). Dexmedetomidine is known to improve PND in rats; however, little is known about the mechanisms. Male Sprague-Dawley rats were subjected to resection of the hepatic apex under propofol anesthesia to clinically mimic human abdominal surgery. The rats were divided into four groups: control group (C), anesthesia group (A), model group (M), and model + dex group (D). Cognitive function was evaluated with the Morris water maze (MWM). Neuronal morphology was observed with H&E staining, Nissl's staining and immunohistochemistry. Transcriptome analysis and quantitative real-time PCR were performed to investigate functional mitochondrial mRNA changes in the hippocampus. Protein levels were measured by Western blotting at 1, 3, and 7 days after surgery. Surgery-induced cognitive decline lasted for three days, but not seven days after surgery in the M group; however, rats in the D group were significantly improved by dexmedetomidine. No significant differences in the number of neurons were observed between the groups after surgery. Rats from the M group showed significantly greater expression levels of Iba-1 and GFAP compared with the C group and the D group. Rats in the M group demonstrated increased Surf1 and Cytochrome c expression on days 1 and 3, but not day 7; similar changes were not induced in rats in the D group. Dexmedetomidine appears to reverse surgery-induced behavior, mitigate the higher density of Iba-1 and GFAP, and downregulate the expression of Surf1 and Cytochrome c protein in the hippocampus of rats in a PND model.
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Affiliation(s)
- Kun Niu
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 100049, China; Department of Anesthesiology, Pain & Sleep Medicine, Aviation General Hospital of China Medical University & Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing 100012, China.
| | - Jia-Lin Qin
- Department of Anesthesiology, Pain & Sleep Medicine, Aviation General Hospital of China Medical University & Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing 100012, China.
| | - Guo-Fang Lu
- State Key Laboratory of Cancer Biology and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, China
| | - Jian Guo
- Department of Anesthesiology, Pain & Sleep Medicine, Aviation General Hospital of China Medical University & Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing 100012, China
| | - John P Williams
- Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburg 15213, PA, USA.
| | - Jian-Xiong An
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 100049, China; Department of Anesthesiology, Pain & Sleep Medicine, Aviation General Hospital of China Medical University & Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing 100012, China; School of Medical Science & Engineering, Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100191, China.
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13
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Aoki T, Okuma Y, Becker LB, Hayashida K, Shinozaki K. Methodological Issue of Mitochondrial Isolation in Acute-Injury Rat Model: Asphyxia Cardiac Arrest and Resuscitation. Front Med (Lausanne) 2021; 8:666735. [PMID: 33912580 PMCID: PMC8071985 DOI: 10.3389/fmed.2021.666735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/17/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Identification of the mechanisms underlying mitochondrial dysfunction is key to understanding the pathophysiology of acute injuries such as cardiac arrest (CA); however, effective methods for measurement of mitochondrial function associated with mitochondrial isolation have been debated for a long time. This study aimed to evaluate the dysregulation of mitochondrial respiratory function after CA while testing the sampling bias that might be induced by the mitochondrial isolation method. Materials and Methods: Adult rats were subjected to 10-min asphyxia-induced CA. 30 min after resuscitation, the brain and kidney mitochondria from animals in sham and CA groups were isolated (n = 8, each). The mitochondrial quantity, expressed as protein concentration (isolation yields), was determined, and the oxygen consumption rates were measured. ADP-dependent (state-3) and ADP-limited (state-4) respiration activities were compared between the groups. Mitochondrial quantity was evaluated based on citrate synthase (CS) activity and cytochrome c concentration, measured independent of the isolation yields. Results: The state-3 respiration activity and isolation yield in the CA group were significantly lower than those in the sham group (brain, p < 0.01; kidney, p < 0.001). The CS activity was significantly lower in the CA group as compared to that in the sham group (brain, p < 0.01; kidney, p < 0.01). Cytochrome c levels in the CA group showed a similar trend (brain, p = 0.08; kidney, p = 0.25). Conclusions: CA decreased mitochondrial respiration activity and the quantity of mitochondria isolated from the tissues. Owing to the nature of fragmented or damaged mitochondrial membranes caused by acute injury, there is a potential loss of disrupted mitochondria. Thus, it is plausible that the mitochondrial function in the acute-injury model may be underestimated as this loss is not considered.
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Affiliation(s)
- Tomoaki Aoki
- The Feinstein Institutes for Medical Research at Northwell, Manhasset, NY, United States
| | - Yu Okuma
- The Feinstein Institutes for Medical Research at Northwell, Manhasset, NY, United States.,Department of Neurological Surgery at Fukuyama City Hospital, Fukuyama, Japan
| | - Lance B Becker
- The Feinstein Institutes for Medical Research at Northwell, Manhasset, NY, United States.,Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Kei Hayashida
- The Feinstein Institutes for Medical Research at Northwell, Manhasset, NY, United States
| | - Koichiro Shinozaki
- The Feinstein Institutes for Medical Research at Northwell, Manhasset, NY, United States.,Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
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14
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Cosentino N, Campodonico J, Moltrasio M, Lucci C, Milazzo V, Rubino M, De Metrio M, Marana I, Grazi M, Bonomi A, Veglia F, Lauri G, Bartorelli AL, Marenzi G. Mitochondrial Biomarkers in Patients with ST-Elevation Myocardial Infarction and Their Potential Prognostic Implications: A Prospective Observational Study. J Clin Med 2021; 10:jcm10020275. [PMID: 33451159 PMCID: PMC7828727 DOI: 10.3390/jcm10020275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/05/2021] [Accepted: 01/08/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Mitochondrial biomarkers have been investigated in different critical settings, including ST-elevation myocardial infarction (STEMI). Whether they provide prognostic information in STEMI, complementary to troponins, has not been fully elucidated. We prospectively explored the in-hospital and long-term prognostic implications of cytochrome c and cell-free mitochondrial DNA (mtDNA) in STEMI patients undergoing primary percutaneous coronary intervention. Methods: We measured cytochrome c and mtDNA at admission in 466 patients. Patients were grouped according to mitochondrial biomarkers detection: group 1 (−/−; no biomarker detected; n = 28); group 2 (−/+; only one biomarker detected; n = 283); group 3 (+/+; both biomarkers detected; n = 155). A composite of in-hospital mortality, cardiogenic shock, and acute pulmonary edema was the primary endpoint. Four-year all-cause mortality was the secondary endpoint. Results: Progressively lower left ventricular ejection fractions (52 ± 8%, 49 ± 8%, 47 ± 9%; p = 0.006) and higher troponin I peaks (54 ± 44, 73 ± 66, 106 ± 81 ng/mL; p = 0.001) were found across the groups. An increase in primary (4%, 14%, 19%; p = 0.03) and secondary (10%, 15%, 23%; p = 0.02) endpoint rate was observed going from group 1 to group 3. The adjusted odds ratio increment of the primary endpoint from one group to the next was 1.65 (95% CI 1.04–2.61; p = 0.03), while the adjusted hazard ratio increment of the secondary endpoint was 1.55 (95% CI 1.12–2.52; p = 0.03). The addition of study group allocation to admission troponin I reclassified 12% and 22% of patients for the primary and secondary endpoint, respectively. Conclusions: Detection of mitochondrial biomarkers is common in STEMI and seems to be associated with in-hospital and long-term outcome independently of troponin.
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Affiliation(s)
- Nicola Cosentino
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (J.C.); (M.M.); (C.L.); (V.M.); (M.R.); (M.D.M.); (I.M.); (M.G.); (A.B.); (F.V.); (G.L.); (A.L.B.); (G.M.)
- Correspondence: ; Tel.: +39-0258-0021
| | - Jeness Campodonico
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (J.C.); (M.M.); (C.L.); (V.M.); (M.R.); (M.D.M.); (I.M.); (M.G.); (A.B.); (F.V.); (G.L.); (A.L.B.); (G.M.)
| | - Marco Moltrasio
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (J.C.); (M.M.); (C.L.); (V.M.); (M.R.); (M.D.M.); (I.M.); (M.G.); (A.B.); (F.V.); (G.L.); (A.L.B.); (G.M.)
| | - Claudia Lucci
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (J.C.); (M.M.); (C.L.); (V.M.); (M.R.); (M.D.M.); (I.M.); (M.G.); (A.B.); (F.V.); (G.L.); (A.L.B.); (G.M.)
| | - Valentina Milazzo
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (J.C.); (M.M.); (C.L.); (V.M.); (M.R.); (M.D.M.); (I.M.); (M.G.); (A.B.); (F.V.); (G.L.); (A.L.B.); (G.M.)
| | - Mara Rubino
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (J.C.); (M.M.); (C.L.); (V.M.); (M.R.); (M.D.M.); (I.M.); (M.G.); (A.B.); (F.V.); (G.L.); (A.L.B.); (G.M.)
| | - Monica De Metrio
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (J.C.); (M.M.); (C.L.); (V.M.); (M.R.); (M.D.M.); (I.M.); (M.G.); (A.B.); (F.V.); (G.L.); (A.L.B.); (G.M.)
| | - Ivana Marana
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (J.C.); (M.M.); (C.L.); (V.M.); (M.R.); (M.D.M.); (I.M.); (M.G.); (A.B.); (F.V.); (G.L.); (A.L.B.); (G.M.)
| | - Marco Grazi
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (J.C.); (M.M.); (C.L.); (V.M.); (M.R.); (M.D.M.); (I.M.); (M.G.); (A.B.); (F.V.); (G.L.); (A.L.B.); (G.M.)
| | - Alice Bonomi
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (J.C.); (M.M.); (C.L.); (V.M.); (M.R.); (M.D.M.); (I.M.); (M.G.); (A.B.); (F.V.); (G.L.); (A.L.B.); (G.M.)
| | - Fabrizio Veglia
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (J.C.); (M.M.); (C.L.); (V.M.); (M.R.); (M.D.M.); (I.M.); (M.G.); (A.B.); (F.V.); (G.L.); (A.L.B.); (G.M.)
| | - Gianfranco Lauri
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (J.C.); (M.M.); (C.L.); (V.M.); (M.R.); (M.D.M.); (I.M.); (M.G.); (A.B.); (F.V.); (G.L.); (A.L.B.); (G.M.)
| | - Antonio L. Bartorelli
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (J.C.); (M.M.); (C.L.); (V.M.); (M.R.); (M.D.M.); (I.M.); (M.G.); (A.B.); (F.V.); (G.L.); (A.L.B.); (G.M.)
- Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20122 Milan, Italy
| | - Giancarlo Marenzi
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (J.C.); (M.M.); (C.L.); (V.M.); (M.R.); (M.D.M.); (I.M.); (M.G.); (A.B.); (F.V.); (G.L.); (A.L.B.); (G.M.)
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15
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Shoaib M, Choudhary RC, Choi J, Kim N, Hayashida K, Yagi T, Yin T, Nishikimi M, Stevens JF, Becker LB, Kim J. Plasma metabolomics supports the use of long-duration cardiac arrest rodent model to study human disease by demonstrating similar metabolic alterations. Sci Rep 2020; 10:19707. [PMID: 33184308 PMCID: PMC7665036 DOI: 10.1038/s41598-020-76401-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/20/2020] [Indexed: 12/16/2022] Open
Abstract
Cardiac arrest (CA) is a leading cause of death and there is a necessity for animal models that accurately represent human injury severity. We evaluated a rat model of severe CA injury by comparing plasma metabolic alterations to human patients. Plasma was obtained from adult human control and CA patients post-resuscitation, and from male Sprague–Dawley rats at baseline and after 20 min CA followed by 30 min cardiopulmonary bypass resuscitation. An untargeted metabolomics evaluation using UPLC-QTOF-MS/MS was performed for plasma metabolome comparison. Here we show the metabolic commonality between humans and our severe injury rat model, highlighting significant metabolic dysfunction as seen by similar alterations in (1) TCA cycle metabolites, (2) tryptophan and kynurenic acid metabolites, and (3) acylcarnitine, fatty acid, and phospholipid metabolites. With substantial interspecies metabolic similarity in post-resuscitation plasma, our long duration CA rat model metabolically replicates human disease and is a suitable model for translational CA research.
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Affiliation(s)
- Muhammad Shoaib
- Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, 350 Community Dr, Manhasset, NY, 11030, USA.,Donald and Barbara Zucker School of Medicine At Hofstra/Northwell, Hempstead, NY, USA
| | - Rishabh C Choudhary
- Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Jaewoo Choi
- Linus Pauling Institute, Oregon State University, Corvallis, OR, USA.,Department of Pharmaceutical Sciences, Oregon State University, Corvallis, OR, USA
| | - Nancy Kim
- Donald and Barbara Zucker School of Medicine At Hofstra/Northwell, Hempstead, NY, USA
| | - Kei Hayashida
- Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Tsukasa Yagi
- Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Tai Yin
- Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Mitsuaki Nishikimi
- Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, 350 Community Dr, Manhasset, NY, 11030, USA
| | - Jan F Stevens
- Linus Pauling Institute, Oregon State University, Corvallis, OR, USA.,Department of Pharmaceutical Sciences, Oregon State University, Corvallis, OR, USA
| | - Lance B Becker
- Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, 350 Community Dr, Manhasset, NY, 11030, USA.,Donald and Barbara Zucker School of Medicine At Hofstra/Northwell, Hempstead, NY, USA.,Department of Emergency Medicine, Northwell Health, NY, USA
| | - Junhwan Kim
- Laboratory for Critical Care Physiology, Feinstein Institutes for Medical Research, 350 Community Dr, Manhasset, NY, 11030, USA. .,Donald and Barbara Zucker School of Medicine At Hofstra/Northwell, Hempstead, NY, USA. .,Department of Emergency Medicine, Northwell Health, NY, USA.
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16
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Cocchi MN, Salciccioli J, Yankama T, Chase M, Patel PV, Liu X, Mader TJ, Donnino MW. Predicting Outcome After Out-of-Hospital Cardiac Arrest: Lactate, Need for Vasopressors, and Cytochrome c. J Intensive Care Med 2019; 35:1483-1489. [PMID: 31466497 DOI: 10.1177/0885066619873315] [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] [Indexed: 12/14/2022]
Abstract
BACKGROUND Outcome prediction after out-of-hospital cardiac arrest (OHCA) is difficult. We hypothesized that lactate and need for vasopressors would predict outcome, and that addition of a mitochondrial biomarker would enhance performance of the tool. METHODS Prospective observational study of OHCA patients presenting to an academic medical center September 2008 to April 2016. We conducted univariate and multivariate logistic regressions. RESULTS Patients were divided based on 2 variables: vasopressor status and initial lactate (<5 mmol/L, 5-10, ≥10). Three hundred fifty-two patients were evaluated; 249 had a lactate within 3 hours and were included. Patients on vasopressors had higher mortality (74% vs 40%; P < .001). A stepwise increase in mortality is associated with increasing lactate (45% lactate <5, 66% 5-10, and 83% ≥10; P < 001). Multivariable models with lactate group and vasopressors as predictors demonstrated excellent discrimination (area under the receiver operating curve [AUC]: 0.73 [95% confidence interval, CI: 0.66-0.79]; adjusted for additional covariates: AUC: 0.81 [95% CI: 0.75-0.86]). Thirty-six patients had cytochrome c levels available; among these 36, when comparing models with and without cytochrome c, there was no difference (AUC: 0.88 [95% CI: 0.76-1.00] vs AUC: 0.85 [95% CI: 0.73-0.98], respectively; P = .30). CONCLUSION In this prospective validation, the combination of lactate and vasopressors in the immediate postarrest period is predictive of mortality. Cytochrome c offered minimal additional predictive power.
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Affiliation(s)
- Michael N Cocchi
- Department of Emergency Medicine, 1859Beth Israel Deaconess Medical Center, Boston, MA, USA.,Division of Critical Care, Department of Anesthesia Critical Care, 1859Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - Tuyen Yankama
- Department of Emergency Medicine, 1859Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Maureen Chase
- Department of Emergency Medicine, 1859Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Parth V Patel
- Department of Emergency Medicine, 1859Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Xiaowen Liu
- Department of Emergency Medicine, 1859Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Timothy J Mader
- Department of Emergency Medicine, Baystate Medical Center, Springfield, MA, USA
| | - Michael W Donnino
- Department of Emergency Medicine, 1859Beth Israel Deaconess Medical Center, Boston, MA, USA.,Division of Pulmonary Critical Care, Department of Medicine, 1859Beth Israel Deaconess Medical Center, Boston, MA, USA
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17
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Wenzel TJ, Bajwa E, Klegeris A. Cytochrome c can be released into extracellular space and modulate functions of human astrocytes in a toll-like receptor 4-dependent manner. Biochim Biophys Acta Gen Subj 2019; 1863:129400. [PMID: 31344401 DOI: 10.1016/j.bbagen.2019.07.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 06/23/2019] [Accepted: 07/18/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Chronic activation of glial cells contributes to neurodegenerative diseases. Cytochrome c (CytC) is a soluble mitochondrial protein that can act as a damage-associated molecular pattern (DAMP) when released into the extracellular space from damaged cells. CytC causes immune activation of microglia in a toll-like receptor (TLR) 4-dependent manner. The effects of extracellular CytC on astrocytes are unknown. Astrocytes, which are the most abundant glial cell type in the brain, express TLR 4 and secrete inflammatory mediators; therefore, we hypothesized that extracellular CytC can interact with the TLR 4 of astrocytes inducing their release of inflammatory molecules and cytotoxins. METHOD Experiments were conducted using primary human astrocytes, U118 MG human astrocytic cells, BV-2 murine microglia, and SH-SY5Y human neuronal cells. RESULTS Extracellularly applied CytC increased the secretion of interleukin (IL)-1β, granulocyte-macrophage colony stimulating factor (GM-CSF) and IL-12 p70 by cultured primary human astrocytes. Anti-TLR 4 antibodies blocked the CytC-induced secretion of IL-1β and GM-CSF by astrocytes. Supernatants from CytC-activated astrocytes were toxic to human SH-SY5Y neuronal cells. We also demonstrated CytC release from damaged glial cells by measuring CytC in the supernatants of BV-2 microglia after their exposure to cytotoxic concentrations of staurosporine, amyloid-β peptides (Aβ42) and tumor necrosis factor-α. CONCLUSION CytC can be released into the extracellular space from damaged glial cells causing immune activation of astrocytes in a TLR 4-dependent manner. GENERAL SIGNIFICANCE Astrocyte activation by CytC may contribute to neuroinflammation and neuronal death in neurodegenerative diseases. Astrocyte TLR 4 could be a potential therapeutic target in these diseases.
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Affiliation(s)
- Tyler J Wenzel
- Department of Biology, University of British Columbia Okanagan Campus, Kelowna, British Columbia V1V 1V7, Canada
| | - Ekta Bajwa
- Department of Biology, University of British Columbia Okanagan Campus, Kelowna, British Columbia V1V 1V7, Canada
| | - Andis Klegeris
- Department of Biology, University of British Columbia Okanagan Campus, Kelowna, British Columbia V1V 1V7, Canada.
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18
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K. B. A, Madhavan A, T. R. R, Thomas S, Nisha P. Short chain fatty acids enriched fermentation metabolites of soluble dietary fibre from Musa paradisiaca drives HT29 colon cancer cells to apoptosis. PLoS One 2019; 14:e0216604. [PMID: 31095579 PMCID: PMC6522120 DOI: 10.1371/journal.pone.0216604] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 04/24/2019] [Indexed: 12/15/2022] Open
Abstract
In this study, the prebiotic potential of soluble dietary fibre extracted from plantain inflorescence (PIF) was investigated. PIF demonstrated prebiotic potential by enhancing the growth of the probiotics under study and thereby hindered colon cancer development. The soluble dietary fibre from Musa paradisiaca inflorescence (PIF) was fermented using Lactobacillus casei and Bifidobacterium bifidum. The fermentation supernatants (LS and BS) were enriched with short chain fatty acids (SCFA) and were able to initiate apoptotic signalling in HT29 colon cancer cells leading to cell death. Both BS and LS exhibited cytotoxic effect; induced DNA damage and enhanced generation of reactive oxygen species in HT29 cells leading to apoptosis. The induction of apoptosis was facilitated by the reduction of membrane potential of mitochondria and ATP synthesis; enhanced delivery of cytochrome c and interference with the expression of pro/antiapoptotic proteins. BS, which exhibited better activity, was further analysed for the identification of differentially regulated proteins by performing two dimensional electrophoresis and MALDI-TOF mass spectrometry. Results emphasized on the fact that, the exposure to BSalteredthe HT29 proteins expression, particularly the upregulation of apoptosis- inducing factor-AIFM1 leading to apoptosis of HT29 cells.
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Affiliation(s)
- Arun K. B.
- Agro Processing and Technology Division, National Institute for Interdisciplinary Science and Technology (CSIR-NIIST), Thiruvananthapuram, Kerala, India
| | - Aravind Madhavan
- Microbial Processing and Technology Division, CSIR-NIIST, Thiruvananthapuram, Kerala, India
| | - Reshmitha T. R.
- Agro Processing and Technology Division, National Institute for Interdisciplinary Science and Technology (CSIR-NIIST), Thiruvananthapuram, Kerala, India
- Academy of Scientific and Innovative Research (AcSIR), New Delhi, India
| | - Sithara Thomas
- Agro Processing and Technology Division, National Institute for Interdisciplinary Science and Technology (CSIR-NIIST), Thiruvananthapuram, Kerala, India
- Academy of Scientific and Innovative Research (AcSIR), New Delhi, India
| | - P. Nisha
- Agro Processing and Technology Division, National Institute for Interdisciplinary Science and Technology (CSIR-NIIST), Thiruvananthapuram, Kerala, India
- Academy of Scientific and Innovative Research (AcSIR), New Delhi, India
- * E-mail:
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19
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Mitochondria-Derived Damage-Associated Molecular Patterns in Sepsis: From Bench to Bedside. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:6914849. [PMID: 31205588 PMCID: PMC6530230 DOI: 10.1155/2019/6914849] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 04/18/2019] [Indexed: 12/15/2022]
Abstract
Sepsis is one of the most serious health hazards. Current research suggests that the pathogenesis of sepsis is mediated by both pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMPs). Mitochondria are among the most important organelles in cells and determine their life and death. A variety of mitochondria-derived DAMPs (mtDAMPs) are similar to bacteria because mitochondria are derived from bacteria according to the mitochondrial endosymbiotic theory. Their activated signaling pathways extensively affect organ functions, the immune system, and metabolic functions in sepsis. In this review, we describe the essential roles of mtDAMPs in sepsis and discuss their research prospects and clinical importance.
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20
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Sodium-Hydrogen Exchanger Isoform-1 Inhibition: A Promising Pharmacological Intervention for Resuscitation from Cardiac Arrest. Molecules 2019; 24:molecules24091765. [PMID: 31067690 PMCID: PMC6538998 DOI: 10.3390/molecules24091765] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 04/23/2019] [Indexed: 01/14/2023] Open
Abstract
Out-of-hospital sudden cardiac arrest is a major public health problem with an overall survival of less than 5%. Upon cardiac arrest, cessation of coronary blood flow rapidly leads to intense myocardial ischemia and activation of the sarcolemmal Na+-H+ exchanger isoform-1 (NHE-1). NHE-1 activation drives Na+ into cardiomyocytes in exchange for H+ with its exchange rate intensified upon reperfusion during the resuscitation effort. Na+ accumulates in the cytosol driving Ca2+ entry through the Na+-Ca2+ exchanger, eventually causing cytosolic and mitochondrial Ca2+ overload and worsening myocardial injury by compromising mitochondrial bioenergetic function. We have reported clinically relevant myocardial effects elicited by NHE-1 inhibitors given during resuscitation in animal models of ventricular fibrillation (VF). These effects include: (a) preservation of left ventricular distensibility enabling hemodynamically more effective chest compressions, (b) return of cardiac activity with greater electrical stability reducing post-resuscitation episodes of VF, (c) less post-resuscitation myocardial dysfunction, and (d) attenuation of adverse myocardial effects of epinephrine; all contributing to improved survival in animal models. Mechanistically, NHE-1 inhibition reduces adverse effects stemming from Na+–driven cytosolic and mitochondrial Ca2+ overload. We believe the preclinical work herein discussed provides a persuasive rationale for examining the potential role of NHE-1 inhibitors for cardiac resuscitation in humans.
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21
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Cardiopulmonary resuscitation ameliorates myocardial mitochondrial dysfunction in a cardiac arrest rat model. Am J Emerg Med 2019; 38:65-72. [PMID: 31027936 DOI: 10.1016/j.ajem.2019.04.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 03/14/2019] [Accepted: 04/12/2019] [Indexed: 01/05/2023] Open
Abstract
PURPOSE Previous studies implicate that the mitochondrial injury may play an important role in the development of post-resuscitation myocardial dysfunction, however few of them are available regarding the ultrastructural alterations of myocardial mitochondria, mitochondrial energy producing and utilization ability in the stage of arrest time (no-low) and resuscitation time (low-flow). This study aimed to observe the dynamic changes of myocardial mitochondrial function and metabolic disorders during cardiac arrest (CA) and following cardiopulmonary resuscitation (CPR). METHODS A total of 30 healthy male Sprague-Dawley rats were randomized into three groups: 1) VF/CPR: Ventricular fibrillation (VF) was electrically induced, and 5 min of CPR was performed after 10 min of untreated VF; 2) Untreated VF: VF was induced and untreated for 15 min; and 3) Sham: Rats were identically prepared without VF/CPR. Amplitude spectrum area (AMSA) at VF 5, 10 and 15 min were calculated from ECG signals. The rats' hearts were quickly removed at the predetermined time of 15 min after beginning the procedure to gather measurements of myocardial mitochondrial function, high-energy phosphate stores, lactate, mitochondrial ultrastructure, and myocardial glycogen. RESULTS The mitochondrial respiratory control ratios significantly decreased after CA compared to sham group. CPR significantly increased respiratory control ratios compared with untreated VF animals. A significant decrease of myocardial glycogen was observed after CA, and a more rapid depletion of myocardial glycogen was observed in CPR animals. CPR significantly reduced the tissue lactate. The mitochondrial ultrastructure abnormalities in CPR animals were less severe than untreated VF animals. AMSA decayed during untreated VF; however, it was significantly greater in CPR group than the untreated VF group. In addition, AMSA was clearly positively correlated with ATP, but negatively correlated with myocardial glycogen. CONCLUSION Impairment of myocardial mitochondrial function and the incapability of utilizing glycogen were observed after CA. Furthermore, optimal CPR might, in part, preserved mitochondrial function and enhanced utilization of myocardial glycogen.
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22
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Sanz MN, Farine E, Niederberger P, Méndez-Carmona N, Wyss RK, Arnold M, Gulac P, Fiedler GM, Gressette M, Garnier A, Carrel TP, Tevaearai Stahel HT, Longnus SL. Cardioprotective reperfusion strategies differentially affect mitochondria: Studies in an isolated rat heart model of donation after circulatory death (DCD). Am J Transplant 2019; 19:331-344. [PMID: 30019521 DOI: 10.1111/ajt.15024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 06/22/2018] [Accepted: 07/05/2018] [Indexed: 01/25/2023]
Abstract
Donation after circulatory death (DCD) holds great promise for improving cardiac graft availability; however, concerns persist regarding injury following warm ischemia, after donor circulatory arrest, and subsequent reperfusion. Application of preischemic treatments is limited for ethical reasons; thus, cardioprotective strategies applied at graft procurement (reperfusion) are of particular importance in optimizing graft quality. Given the key role of mitochondria in cardiac ischemia-reperfusion injury, we hypothesize that 3 reperfusion strategies-mild hypothermia, mechanical postconditioning, and hypoxia, when briefly applied at reperfusion onset-provoke mitochondrial changes that may underlie their cardioprotective effects. Using an isolated, working rat heart model of DCD, we demonstrate that all 3 strategies improve oxygen-consumption-cardiac-work coupling and increase tissue adenosine triphosphate content, in parallel with increased functional recovery. These reperfusion strategies, however, differentially affect mitochondria; mild hypothermia also increases phosphocreatine content, while mechanical postconditioning stimulates mitochondrial complex I activity and reduces cytochrome c release (marker of mitochondrial damage), whereas hypoxia upregulates the expression of peroxisome proliferator-activated receptor-gamma coactivator (regulator of mitochondrial biogenesis). Characterization of the role of mitochondria in cardioprotective reperfusion strategies should aid in the identification of new, mitochondrial-based therapeutic targets and the development of effective reperfusion strategies that could ultimately facilitate DCD heart transplantation.
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Affiliation(s)
- Maria N Sanz
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, Bern, Switzerland.,Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Emilie Farine
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, Bern, Switzerland.,Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Petra Niederberger
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, Bern, Switzerland.,Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Natalia Méndez-Carmona
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, Bern, Switzerland.,Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Rahel K Wyss
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, Bern, Switzerland.,Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Maria Arnold
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, Bern, Switzerland.,Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Patrik Gulac
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, Bern, Switzerland.,Department for BioMedical Research, University of Bern, Bern, Switzerland.,Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Bratislava, Slovak Republic
| | - Georg M Fiedler
- Center of Laboratory Medicine, University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Mélanie Gressette
- UMR-S 1180, INSERM, Université Paris-Sud, Université Paris-Saclay, Châtenay-Malabry, France
| | - Anne Garnier
- UMR-S 1180, INSERM, Université Paris-Sud, Université Paris-Saclay, Châtenay-Malabry, France
| | - Thierry P Carrel
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, Bern, Switzerland.,Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Hendrik T Tevaearai Stahel
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, Bern, Switzerland.,Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Sarah L Longnus
- Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, Bern, Switzerland.,Department for BioMedical Research, University of Bern, Bern, Switzerland
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23
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Bajwa E, Pointer CB, Klegeris A. The Role of Mitochondrial Damage-Associated Molecular Patterns in Chronic Neuroinflammation. Mediators Inflamm 2019; 2019:4050796. [PMID: 31065234 PMCID: PMC6466851 DOI: 10.1155/2019/4050796] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 03/01/2019] [Accepted: 03/06/2019] [Indexed: 01/05/2023] Open
Abstract
Mitochondrial dysfunction has been established as a common feature of neurodegenerative disorders that contributes to disease pathology by causing impaired cellular energy production. Mitochondrial molecules released into the extracellular space following neuronal damage or death may also play a role in these diseases by acting as signaling molecules called damage-associated molecular patterns (DAMPs). Mitochondrial DAMPs have been shown to initiate proinflammatory immune responses from nonneuronal glial cells, including microglia and astrocytes; thereby, they have the potential to contribute to the chronic neuroinflammation present in these disorders accelerating the degeneration of neurons. In this review, we highlight the mitochondrial DAMPs cytochrome c (CytC), mitochondrial transcription factor A (TFAM), and cardiolipin and explore their potential role in the central nervous system disorders including Alzheimer's disease and Parkinson's disease, which are characterized by neurodegeneration and chronic neuroinflammation.
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Affiliation(s)
- Ekta Bajwa
- Department of Biology, University of British Columbia Okanagan Campus, Kelowna, BC, Canada
| | - Caitlin B. Pointer
- Department of Biology, University of British Columbia Okanagan Campus, Kelowna, BC, Canada
| | - Andis Klegeris
- Department of Biology, University of British Columbia Okanagan Campus, Kelowna, BC, Canada
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24
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Rapamycin attenuates mitochondrial injury and renal tubular cell apoptosis in experimental contrast-induced acute kidney injury in rats. Biosci Rep 2018; 38:BSR20180876. [PMID: 30341250 PMCID: PMC6246763 DOI: 10.1042/bsr20180876] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/30/2018] [Accepted: 10/11/2018] [Indexed: 11/17/2022] Open
Abstract
Reactive oxygen species (ROS) overproduction and renal tubular epithelial cell (TEC) apoptosis are key mechanisms of contrast-induced acute kidney injury (CI-AKI). Mitochondria are the main source of intracellular ROS. In the present study, the characteristics of mitophagy and the effects of rapamycin on contrast-induced abnormalities in oxidative stress, mitochondrial injury and mitophagy, TEC apoptosis and renal function were investigated in a CI-AKI rat model. Rats were divided into control group, CI-AKI group, and pretreatment groups (with rapamycin dose of 2 or 5 mg/kg). CI-AKI was induced by intraperitoneal injection of iohexol (12.25 g iodine/kg). Renal malondialdehyde (MDA) and catalase (CAT) were measured as oxidative markers. Light-chain 3 (LC3), P62, Beclin-1, PTEN-induced putative kinase (Pink1), and cytochrome c (Cyt c) expression were measured by Western blot. Mitochondrial membrane potential (ΔΨm) was determined by JC-1, colocalization of LC3-labeled autophagosomes with TOMM20-labeled mitochondria or LAMP2-labeled lysosomes was observed by fluorescence microscopy. Significantly increased serum creatinine (Scr), MDA and CAT, obvious mitochondrial injury including increase in cytosolic/mitochondrial Cyt c and decrease in ΔΨm, TEC apoptosis were induced by contrast administration. Contrast administration induced an increased expression of LC3II/I, Beclin-1, and Pink1 and decreased expression of P62. Rapamycin pretreatment induced overexpression of LC3II/I and Beclin-1. Moreover, LC3-labeled autophagosomes increasingly overlapped with TOMM20-labeled mitochondria and LAMP2-labeled lysosomes in CI-AKI, which was further enhanced by rapamycin administration. Contrast-induced Scr increase, oxidative stress, mitochondrial injury, TEC apoptosis, and necrosis were dose-dependently attenuated by rapamycin pretreatment. Rapamycin exerts renoprotective effects against CI-AKI by attenuating mitochondrial injury and oxidative stress, which might be associated with increasing mitophagy.
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25
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Chimenti MS, Sunzini F, Fiorucci L, Botti E, Fonti GL, Conigliaro P, Triggianese P, Costa L, Caso F, Giunta A, Esposito M, Bianchi L, Santucci R, Perricone R. Potential Role of Cytochrome c and Tryptase in Psoriasis and Psoriatic Arthritis Pathogenesis: Focus on Resistance to Apoptosis and Oxidative Stress. Front Immunol 2018; 9:2363. [PMID: 30429845 PMCID: PMC6220124 DOI: 10.3389/fimmu.2018.02363] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 09/24/2018] [Indexed: 02/06/2023] Open
Abstract
Psoriasis (PsO) is an autoimmune disease characterized by keratinocyte proliferation, chronic inflammation and mast cell activation. Up to 42% of patients with PsO may present psoriatic arthritis (PsA). PsO and PsA share common pathophysiological mechanisms: keratinocytes and fibroblast-like synoviocytes are resistant to apoptosis: this is one of the mechanism facilitating their hyperplasic growth, and at joint level, the destruction of articular cartilage, and bone erosion and/or proliferation. Several clinical studies regarding diseases characterized by impairment of cell death, either due to apoptosis or necrosis, reported cytochrome c release from the mitochondria into the extracellular space and finally into the circulation. The presence of elevated cytochrome c levels in serum has been demonstrated in diseases as inflammatory arthritis, myocardial infarction and stroke, and liver diseases. Cytochrome c is a signaling molecule essential for apoptotic cell death released from mitochondria to the cytosol allowing the interaction with protease, as the apoptosis protease activation factor, which lead to the activation of factor-1 and procaspase 9. It has been demonstrated that this efflux from the mitochondria is crucial to start the intracellular signaling responsible for apoptosis, then to the activation of the inflammatory process. Another inflammatory marker, the tryptase, a trypsin-like serine protease produced by mast cells, is released during inflammation, leading to the activation of several immune cells through proteinase-activated receptor-2. In this review, we aimed at discussing the role played by cytochrome c and tryptase in PsO and PsA pathogenesis. To this purpose, we searched pathogenetic mechanisms in PUBMED database and review on oxidative stress, cytochrome c and tryptase and their potential role during inflammation in PsO and PsA. To this regard, the cytochrome c release into the extracellular space and tryptase may have a role in skin and joint inflammation.
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Affiliation(s)
- Maria Sole Chimenti
- Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy
| | - Flavia Sunzini
- Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy
| | - Laura Fiorucci
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Giulia Lavinia Fonti
- Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy
| | - Paola Conigliaro
- Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy
| | - Paola Triggianese
- Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy
| | - Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | | | - Maria Esposito
- Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Luca Bianchi
- Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Roberto Santucci
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Roberto Perricone
- Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy
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Schindler SM, Frank MG, Annis JL, Maier SF, Klegeris A. Pattern recognition receptors mediate pro-inflammatory effects of extracellular mitochondrial transcription factor A (TFAM). Mol Cell Neurosci 2018; 89:71-79. [DOI: 10.1016/j.mcn.2018.04.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 04/09/2018] [Accepted: 04/13/2018] [Indexed: 12/11/2022] Open
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27
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Radhakrishnan J, Origenes R, Littlejohn G, Nikolich S, Choi E, Smite S, Lamoureux L, Baetiong A, Shah M, Gazmuri RJ. Plasma Cytochrome c Detection Using a Highly Sensitive Electrochemiluminescence Enzyme-Linked Immunosorbent Assay. Biomark Insights 2017; 12:1177271917746972. [PMID: 29276374 PMCID: PMC5731609 DOI: 10.1177/1177271917746972] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 10/29/2017] [Indexed: 11/17/2022] Open
Abstract
Background Cytochrome c is an intermembrane mitochondrial protein that is released to the bloodstream following mitochondrial injury. Methods and results We developed an electrochemiluminescence immunoassay to measure cytochrome c in human and rat plasma, which showed high sensitivity with broad dynamic range (2-1200 ng/mL in humans and 5-500 ng/mL in rat) and high assay reproducibility (inter-assay coefficient <6% in humans and <10% in rat). In patients after blunt trauma, plasma cytochrome c directly correlated with injury severity. In rats after cardiac resuscitation, plasma cytochrome c inversely correlated with survival and responsiveness to mitochondrial protective interventions. Conclusions The cytochrome c assays herein presented have high sensitivity, wide dynamic range, and high reproducibility well suited for biomarker of mitochondrial injury.
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Affiliation(s)
- Jeejabai Radhakrishnan
- Resuscitation Institute, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Rovi Origenes
- Advocate Lutheran General Hospital, Park Ridge, IL, USA
| | - Gina Littlejohn
- James R. & Helen D. Russell Institute for Research & Innovation, Park Ridge, IL, USA
| | | | - Eunjung Choi
- Resuscitation Institute, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Sharon Smite
- Resuscitation Institute, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Lorissa Lamoureux
- Resuscitation Institute, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Alvin Baetiong
- Resuscitation Institute, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Manoj Shah
- Advocate Lutheran General Hospital, Park Ridge, IL, USA
| | - Raúl J Gazmuri
- Resuscitation Institute, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.,Captain James A. Lovell Federal Health Care Centre, North Chicago, IL, USA
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28
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An Assay Using Localized Surface Plasmon Resonance and Gold Nanorods Functionalized with Aptamers to Sense the Cytochrome-c Released from Apoptotic Cancer Cells for Anti-Cancer Drug Effect Determination. MICROMACHINES 2017; 8:mi8110338. [PMID: 30400530 PMCID: PMC6190337 DOI: 10.3390/mi8110338] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 10/31/2017] [Accepted: 11/15/2017] [Indexed: 12/22/2022]
Abstract
To determine the degree of cancer cell killing after treatment with chemotherapeutic drugs, we have developed a sensitive platform using localized surface plasmon resonance (LSPR) and aptamers to detect the extracellular cytochrome-c (cyto-c), a mitochondrial protein released from cancer cells for the induction of apoptosis after treatment, to evaluate the effectiveness of cancer therapy. In this assay, a short single-stranded 76-mer DNA aptamer with a unique DNA sequence, which binds towards the cyto-c like an antibody with a high binding affinity and specificity, was conjugated to gold nanorods (AuNR) for LSPR sensing. Practically, cyto-c was first grabbed by a capturing antibody functionalized on the surface of micro-magnetic particles (MMPs). Subsequently, the AuNR-conjugated aptamer was added to form a complex sandwich structure with cyto-c (i.e., (MMP-Ab)-(cyto-c)-(AuNR-aptamer)) after washing away the non-target impurities, such as serum residues and intracellular contents, in a microfluidic chip. The sandwich complex led to formation of AuNR aggregates, which changed the LSPR signals in relation to the amount of cyto-c. With the LSPR signal enhancement effects from the AuNRs, the detection limit of cyto-c, sparked in human serum or culture medium, was found to be 0.1 ng/mL in our platform and the whole sensing process could be completed within two hours. Moreover, we have applied this assay to monitor the apoptosis in leukemia cancer cells induced by a potential anti-cancer agent phenylarsine oxide.
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Gouveia A, Bajwa E, Klegeris A. Extracellular cytochrome c as an intercellular signaling molecule regulating microglial functions. Biochim Biophys Acta Gen Subj 2017; 1861:2274-2281. [DOI: 10.1016/j.bbagen.2017.06.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 06/05/2017] [Accepted: 06/22/2017] [Indexed: 01/13/2023]
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Andersen LW, Liu X, Montissol S, Holmberg MJ, Fabian-Jessing BK, Donnino MW. Cytochrome c in patients undergoing coronary artery bypass grafting: A post hoc analysis of a randomized trial. J Crit Care 2017; 42:248-254. [PMID: 28802789 DOI: 10.1016/j.jcrc.2017.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 07/07/2017] [Accepted: 08/03/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To establish whether plasma cytochrome c is detectable in patients undergoing cardiac surgery, whether cytochrome c levels are associated with lactate/inflammatory markers/cellular oxygen consumption, and whether cytochrome c levels are associated with clinical outcomes. MATERIALS AND METHODS This was an observational sub-study of a randomized trial comparing thiamine to placebo in patients undergoing coronary artery bypass grafting. Patients had blood drawn before, after, and again 6h after surgery. Cytochrome c, inflammatory markers, and cellular oxygen consumption were measured. RESULTS 64 patients were included. Cytochrome c was detectable in 63 (98%) patients at baseline with a median cytochrome c level of 0.18ng/mL (quartiles: 0.13, 0.55). There was no difference from baseline level to post-surgical level (0.19ng/mL [0.09, 0.51], p=0.36) or between post-surgical level and 6-hour post-surgical level (0.17ng/mL [0.10, 0.57], p=0.61). There was no difference between the thiamine and placebo groups' change in cytochrome c levels from baseline to after surgery (p=0.22). Cytochrome c levels were not associated with lactate, inflammatory markers, cellular oxygen consumption, or clinical outcomes. CONCLUSIONS Cytochrome c levels did not increase after cardiac surgery and was not associated with the degree of inflammation or clinical outcomes.
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Affiliation(s)
- Lars W Andersen
- Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark.
| | - Xiaowen Liu
- Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Sophia Montissol
- Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Mathias J Holmberg
- Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark.
| | | | - Michael W Donnino
- Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Medicine, Division of Pulmonary and Critical Care, Beth Israel Deaconess Medical Center, Boston, MA, USA.
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Ayoub IM, Radhakrishnan J, Gazmuri RJ. In vivo opening of the mitochondrial permeability transition pore in a rat model of ventricular fibrillation and closed-chest resuscitation. Am J Transl Res 2017; 9:3345-3359. [PMID: 28804552 PMCID: PMC5553884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 08/11/2016] [Indexed: 06/07/2023]
Abstract
Opening of the mitochondrial permeability transition pore (mPTP) is considered central to reperfusion injury. Yet, most of our knowledge comes from observations in isolated mitochondria, cells, and organs. We used a rat model of ventricular fibrillation (VF) and closed-chest resuscitation to examine whether the mPTP opens in vivo and whether cyclosporine A (CsA) attenuates the associated myocardial injury. Two series of 26 and 18 rats each underwent 10 minutes of untreated VF before attempting resuscitation. In series-1, rats received 50 µCi of tritium-labeled 2-deoxyglucose ([3H]DOG) harvesting their hearts at baseline (n=5), during VF (n=5), during resuscitation (n=6), and at post-resuscitation 60 minutes (n=5) and 240 minutes (n=5). mPTP opening was estimated measuring the ratio of mitochondria to left ventricular intracellular [3H]. In series-2, rats received 10 mg/kg of CsA or vehicle before resuscitation, measuring mitochondrial NAD+ content to indirectly assess mPTP opening. In Series-1, the mPTP opening ratio vs baseline (10.4 ± 1.9) increased during VF (16.8 ± 2.4, NS), closed-chest resuscitation (20.8 ± 6.3, P<0.05), and at post-resuscitation 60 minutes (20.9 ± 4.7, P<0.05) and 240 minutes (25.7 ± 11.0, P<0.01). In series 2, CsA failed to attenuate reductions in mitochondrial NAD+ and did not affect plasma cytochrome c, plasma cardiac troponin I, myocardial function, and survival. We report for the first time in an intact rat model of VF that mPTP opens during closed-chest resuscitation consistent with previous observations in mitochondria, cells, and organs of mPTP opening upon reperfusion. CsA, at the dose of 10 mg/kg neither prevented mPTP opening nor attenuated post-resuscitation myocardial injury.
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Affiliation(s)
- Iyad M Ayoub
- Resuscitation Institute at Rosalind Franklin University of Medicine and ScienceNorth Chicago, Illinois, USA
| | - Jeejabai Radhakrishnan
- Resuscitation Institute at Rosalind Franklin University of Medicine and ScienceNorth Chicago, Illinois, USA
| | - Raúl J Gazmuri
- Resuscitation Institute at Rosalind Franklin University of Medicine and ScienceNorth Chicago, Illinois, USA
- Critical Care Medicine, Captain James A Lovell Federal Health Care CenterNorth Chicago, Illinois, USA
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High Versus Low Blood-Pressure Target in Experimental Ischemic Prolonged Cardiac Arrest Treated with Extra Corporeal Life Support. Shock 2017; 47:759-764. [DOI: 10.1097/shk.0000000000000793] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Donnino MW, Liu X, Andersen LW, Rittenberger JC, Abella BS, Gaieski DF, Ornato JP, Gazmuri RJ, Grossestreuer AV, Cocchi MN, Abbate A, Uber A, Clore J, Peberdy MA, Callaway CW. Characterization of mitochondrial injury after cardiac arrest (COMICA). Resuscitation 2017; 113:56-62. [PMID: 28126408 DOI: 10.1016/j.resuscitation.2016.12.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 12/16/2016] [Accepted: 12/24/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Mitochondrial injury post-cardiac arrest has been described in pre-clinical settings but the extent to which this injury occurs in humans remains largely unknown. We hypothesized that increased levels of mitochondrial biomarkers would be associated with mortality and neurological morbidity in post-cardiac arrest subjects. METHODS We performed a prospective multicenter study of post-cardiac arrest subjects. Inclusion criteria were comatose adults who suffered an out-of-hospital cardiac arrest. Mitochondrial biomarkers were measured at 0, 12, 24, 36 and 48h after return of spontaneous circulation as well as in healthy controls. RESULTS Out of 111 subjects enrolled, 102 had evaluable samples at 0h. Cardiac arrest subjects had higher baseline cytochrome c levels compared to controls (2.18ng/mL [0.74, 7.74] vs. 0.16ng/mL [0.03, 0.91], p<0.001), and subjects who died had higher 0h cytochrome c levels compared to survivors (3.66ng/mL [1.40, 14.9] vs. 1.27ng/mL [0.16, 2.37], p<0.001). There were significantly higher Ribonuclease P (RNaseP) (3.3 [1.2, 5.7] vs. 1.2 [0.8, 1.2], p<0.001) and Beta-2microglobulin (B2M) (12.0 [1.0, 22.9], vs. 0.6 [0.6, 1.3], p<0.001) levels in cardiac arrest subjects at baseline compared to the control subjects. There were no differences between survivors and non-survivors for mitochondrial DNA, nuclear DNA, or cell free DNA. CONCLUSIONS Cytochrome c was increased in post- cardiac arrest subjects compared to controls, and in post-cardiac arrest non-survivors compared to survivors. Nuclear DNA and cell free DNA was increased in plasma of post-cardiac arrest subjects. There were no differences in mitochondrial DNA, nuclear DNA, or cell free DNA between survivors and non-survivors. Mitochondrial injury markers showed mixed results in the post-cardiac arrest period. Future research needs to investigate these differences.
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Affiliation(s)
- Michael W Donnino
- Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, MA, United States; Beth Israel Deaconess Medical Center, Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Boston, MA, United States.
| | - Xiaowen Liu
- Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, MA, United States
| | - Lars W Andersen
- Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, MA, United States; Aarhus University Hospital, Research Center for Emergency Medicine, Aarhus, Denmark; Aarhus University Hospital, Department of Anesthesiology,, Aarhus, Denmark
| | | | - Benjamin S Abella
- University of Pennsylvania, Center for Resuscitation Science, Philadelphia, PA, United States
| | - David F Gaieski
- Thomas Jefferson University Hospital, Department of Emergency Medicine, Philadelphia, PA, United States
| | - Joseph P Ornato
- Virginia Commonwealth University, Department of Emergency Medicine, Richmond, VA, United States
| | - Raúl J Gazmuri
- Rosalind Franklin University of Medicine and Science, Resuscitation Institute and Division of Critical Care Medicine, North Chicago, IL, United States
| | - Anne V Grossestreuer
- Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, MA, United States
| | - Michael N Cocchi
- Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, MA, United States; Beth Israel Deaconess Medical Center, Department of Anesthesia Critical Care, Division of Critical Care, Boston, MA, United States
| | - Antonio Abbate
- Virginia Commonwealth University, Department of Internal Medicine, Richmond, VA, United States
| | - Amy Uber
- Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, MA, United States
| | - John Clore
- Virginia Commonwealth University, Department of Internal Medicine, Richmond, VA, United States
| | - Mary Anne Peberdy
- Virginia Commonwealth University, Department of Internal Medicine and Emergency Medicine, Richmond, VA, United States
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Abstract
PURPOSE Cytochrome c is an essential component of the electron transport chain, and circulating cytochrome c might be an indicator of mitochondrial injury. The objective of this study was to determine whether cytochrome c levels are elevated in septic patients, whether there is an association between cytochrome c levels and lactate/inflammatory markers, and whether elevated levels of cytochrome c are associated with poor outcomes. METHODS This was a single-center, prospective, observational, pilot study within a randomized, placebo-controlled trial. We enrolled adult patients in septic shock and with an elevated lactate (>3 mmol/L). Blood was collected at enrollment and at 12 and 24 h thereafter. Cytochrome c was measured in plasma using an electrochemiluminescence immunoassay. RESULTS We included 77 patients. Plasma cytochrome c levels were significantly higher in septic patients than in healthy controls (0.70 ng/mL [quartiles: 0.06, 1.99] vs. 0.19 ng/mL [quartiles: 0.03, 1.32], P = 0.008). Cytochrome c levels at enrollment were positively correlated with lactate levels (r(s) = 0.40, P < 0.001) but not with inflammatory markers. Patients who died before hospital discharge had significantly higher cytochrome c levels than survivors (0.99 ng/mL [quartiles: 0.36, 4.09] vs. 0.58 ng/mL [quartiles: 0.03, 1.64], P = 0.01). When analyzed over time, the difference between survivors and nonsurvivors remained significant (P < 0.001). CONCLUSIONS Cytochrome c levels are higher in septic patients than in controls. In unadjusted analysis, septic nonsurvivors had higher cytochrome c levels than survivors.
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Marenzi G, Cosentino N, Boeddinghaus J, Trinei M, Giorgio M, Milazzo V, Moltrasio M, Cardinale D, Sandri MT, Veglia F, Bonomi A, Kaech M, Twerenbold R, Nestelberger T, Reichlin T, Wildi K, Shrestha S, Kohzuharov N, Sabti Z, Cipolla CM, Mueller C, Bartorelli AL. Diagnostic and Prognostic Utility of Circulating Cytochrome c in Acute Myocardial Infarction. Circ Res 2016; 119:1339-1346. [PMID: 27799252 PMCID: PMC5627527 DOI: 10.1161/circresaha.116.309792] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 10/20/2016] [Accepted: 10/25/2016] [Indexed: 01/09/2023]
Abstract
Supplemental Digital Content is available in the text. Rationale: In contrast to cardiomyocyte necrosis, which can be quantified by cardiac troponin, functional cardiomyocyte impairment, including mitochondrial dysfunction, has escaped clinical recognition in acute myocardial infarction (AMI) patients. Objective: To investigate the diagnostic accuracy for AMI and prognostic prediction of in-hospital mortality of cytochrome c. Methods and Results: We prospectively assessed cytochrome c serum levels at hospital presentation in 2 cohorts: a diagnostic cohort of patients presenting with suspected AMI and a prognostic cohort of definite AMI patients. Diagnostic accuracy for AMI was the primary diagnostic end point, and prognostic prediction of in-hospital mortality was the primary prognostic end point. Serum cytochrome c had no diagnostic utility for AMI (area under the receiver-operating characteristics curve 0.51; 95% confidence intervals 0.44–0.58; P=0.76). Among 753 AMI patients in the prognostic cohort, cytochrome c was detectable in 280 (37%) patients. These patients had higher in-hospital mortality than patients with nondetectable cytochrome c (6% versus 1%; P<0.001). This result was mainly driven by the high mortality rate observed in ST-segment–elevation AMI patients with detectable cytochrome c, as compared with those with nondetectable cytochrome c (11% versus 1%; P<0.001). At multivariable analysis, cytochrome c remained a significant independent predictor of in-hospital mortality (odds ratio 3.0; 95% confidence interval 1.9–5.7; P<0.001), even after adjustment for major clinical confounders (odds ratio 4.01; 95% confidence interval 1.20–13.38; P=0.02). Conclusions: Cytochrome c serum concentrations do not have diagnostic but substantial prognostic utility in AMI.
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Affiliation(s)
- Giancarlo Marenzi
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.).
| | - Nicola Cosentino
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Jasper Boeddinghaus
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Mirella Trinei
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Marco Giorgio
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Valentina Milazzo
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Marco Moltrasio
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Daniela Cardinale
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Maria Teresa Sandri
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Fabrizio Veglia
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Alice Bonomi
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Max Kaech
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Raphael Twerenbold
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Thomas Nestelberger
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Tobias Reichlin
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Karin Wildi
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Samyut Shrestha
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Nikola Kohzuharov
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Zaid Sabti
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Carlo M Cipolla
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Christian Mueller
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
| | - Antonio L Bartorelli
- From the Centro Cardiologico Monzino, I.R.C.C.S., University of Milan, Italy (G.M., N.C., V.M., M.M., M.T.S., F.V., A.B., A.L.B.); European Institute of Oncology, Milan, Italy (M.T., M.G., D.C., M.T.S., C.M.C.); and Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Switzerland (J.B., M.K., R.T., T.N., T.R., K.W., S.S., N.K., Z.S., C.M.)
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Lamoureux L, Radhakrishnan J, Mason TG, Kraut JA, Gazmuri RJ. Adverse postresuscitation myocardial effects elicited by buffer-induced alkalemia ameliorated by NHE-1 inhibition in a rat model of ventricular fibrillation. J Appl Physiol (1985) 2016; 121:1160-1168. [PMID: 27633736 DOI: 10.1152/japplphysiol.00336.2016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 09/12/2016] [Indexed: 11/22/2022] Open
Abstract
Major myocardial abnormalities occur during cardiac arrest and resuscitation including intracellular acidosis-partly caused by CO2 accumulation-and activation of the Na+-H+ exchanger isoform-1 (NHE-1). We hypothesized that a favorable interaction may result from NHE-1 inhibition during cardiac resuscitation followed by administration of a CO2-consuming buffer upon return of spontaneous circulation (ROSC). Ventricular fibrillation was electrically induced in 24 male rats and left untreated for 8 min followed by defibrillation after 8 min of cardiopulmonary resuscitation (CPR). Rats were randomized 1:1:1 to the NHE-1 inhibitor zoniporide or vehicle during CPR and disodium carbonate/sodium bicarbonate buffer or normal saline (30 ml/kg) after ROSC. Survival at 240 min declined from 100% with Zoniporide/Saline to 50% with Zoniporide/Buffer and 25% with Vehicle/Buffer (P = 0.004), explained by worsening postresuscitation myocardial dysfunction. Marked alkalemia occurred after buffer administration along with lactatemia that was maximal after Vehicle/Buffer, attenuated by Zoniporide/Buffer, and minimal with Zoniporide/Saline [13.3 ± 4.8 (SD), 9.2 ± 4.6, and 2.7 ± 1.0 mmol/l; P ≤ 0.001]. We attributed the intense postresuscitation lactatemia to enhanced glycolysis consequent to severe buffer-induced alkalemia transmitted intracellularly by an active NHE-1. We attributed the worsened postresuscitation myocardial dysfunction also to severe alkalemia intensifying Na+ entry via NHE-1 with consequent Ca2+ overload injuring mitochondria, evidenced by increased plasma cytochrome c Both buffer-induced effects were ameliorated by zoniporide. Accordingly, buffer-induced alkalemia after ROSC worsened myocardial function and survival, likely through enhancing NHE-1 activity. Zoniporide attenuated these effects and uncovered a complex postresuscitation acid-base physiology whereby blood pH drives NHE-1 activity and compromises mitochondrial function and integrity along with myocardial function and survival.
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Affiliation(s)
- Lorissa Lamoureux
- Resuscitation Institute at Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Jeejabai Radhakrishnan
- Resuscitation Institute at Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Thomas G Mason
- Department of Chemistry, University of California, Los Angeles, Los Angeles, California
| | - Jeffrey A Kraut
- Medical and Research Services, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.,Membrane Biology Laboratory, University of California, Los Angeles, Los Angeles, California; and.,Division of Nephrology, Veterans Affairs Greater Los Angeles Healthcare System and David Geffen School of Medicine, Los Angeles, California
| | - Raúl J Gazmuri
- Resuscitation Institute at Rosalind Franklin University of Medicine and Science, North Chicago, Illinois; .,Section of Critical Care Medicine, Captain James A. Lovell Federal Health Care Center, North Chicago, Illinois
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Eleftheriadis T, Pissas G, Liakopoulos V, Stefanidis I. Cytochrome c as a Potentially Clinical Useful Marker of Mitochondrial and Cellular Damage. Front Immunol 2016; 7:279. [PMID: 27489552 PMCID: PMC4951490 DOI: 10.3389/fimmu.2016.00279] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 07/11/2016] [Indexed: 11/24/2022] Open
Abstract
Mitochondria are evolutionary endosymbionts derived from bacteria. Thus, they bear molecules, such as mitochondrial DNA (mtDNA) that contains CpG DNA repeats and N-formyl peptides (FPs), found in bacteria. Upon cell necrosis or apoptosis, these molecules are released into the interstitial space and the circulation and recognized by the immune cells through the same receptors that recognize pathogen-associated molecular patterns, leading to inflammation. Other mitochondrial molecules are not of bacterial origin, but they may serve as danger-associated molecular patterns (DAMPs) when due to cell injury are translocated into inappropriate compartments. There they are recognized by pattern recognition receptors of the immune cells. Cytochrome c is such a molecule. In this review, experimental and clinical data are presented that confirms cytochrome c release into the extracellular space in pathological conditions characterized by cell death. This indicates that serum cytochrome c, which can be easily measured, may be a clinically useful marker for diagnosing and assessing the severity of such pathological entities. Reasonably, detection of high cytochrome c level into the circulation means release of various other molecules that serves as DAMPs when found extracellularly, the mtDNA and FPs included. Finally, because the release of this universally found compound into the extracellular space makes cytochrome c an ideal molecule to play the role of a DAMP per se, the available experimental and clinical data that support such a role are provided.
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Affiliation(s)
| | - Georgios Pissas
- Department of Nephrology, Medical School, University of Thessaly , Larissa , Greece
| | | | - Ioannis Stefanidis
- Department of Nephrology, Medical School, University of Thessaly , Larissa , Greece
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Moser MAJ, Arcand S, Lin HB, Wojnarowicz C, Sawicka J, Banerjee T, Luo Y, Beck GR, Luke PP, Sawicki G. Protection of the Transplant Kidney from Preservation Injury by Inhibition of Matrix Metalloproteinases. PLoS One 2016; 11:e0157508. [PMID: 27327879 PMCID: PMC4915675 DOI: 10.1371/journal.pone.0157508] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 05/30/2016] [Indexed: 11/30/2022] Open
Abstract
Background Matrix metalloproteinases (MMPs), particularly MMP-2 and MMP-9, play an important role in ischemic injury to the heart, yet it is not known if these MMPs are involved in the injury that occurs to the transplant kidney. We therefore studied the pharmacologic protection of transplant kidneys during machine cold perfusion. Methods Human kidney perfusates were analyzed for the presence of injury markers such as cytochrome c oxidase, lactate dehydrogenase, and neutrophil-gelatinase associated lipocalin (NGAL), and MMP-2 and MMP-9 were measured. The effects of MMP inhibitors MMP-2 siRNA and doxycycline were studied in an animal model of donation after circulatory determination of death (DCDD). Results Markers of injury were present in all analyzed perfusates, with higher levels seen in perfusates from human kidneys donated after controlled DCDD compared to brain death and in perfusate from kidneys with delayed graft function. When rat kidneys were perfused at 4°C for 22 hours with the addition of MMP inhibitors, this resulted in markedly reduced levels of MMP-2, MMP-9 and analyzed injury markers. Conclusions Based on our study, MMPs are involved in preservation injury and the supplementation of preservation solution with MMP inhibitors is a potential novel strategy in protecting the transplant kidney from preservation injury.
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Affiliation(s)
- Michael A. J. Moser
- Department of Surgery and Saskatchewan Renal Transplant Program, Saskatoon, Saskatchewan
- * E-mail: (GS); (MM)
| | - Steve Arcand
- Department of Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Han-Bin Lin
- Department of Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Chris Wojnarowicz
- Prairie Diagnostic Services, Department of Veterinary Pathology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Jolanta Sawicka
- Department of Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Tamalina Banerjee
- Department of Laboratory Medicine and Pathology, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada
| | - Yigang Luo
- Department of Surgery and Saskatchewan Renal Transplant Program, Saskatoon, Saskatchewan
| | - Gavin R. Beck
- Department of Surgery and Saskatchewan Renal Transplant Program, Saskatoon, Saskatchewan
| | - Patrick P. Luke
- Multi Organ Transplant Program, London Health Sciences Centre, London, Ontario, Canada
| | - Grzegorz Sawicki
- Department of Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Department of Clinical Chemistry, Medical University of Wroclaw, Wroclaw, Poland
- * E-mail: (GS); (MM)
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Abstract
Cancer is a disease characterized by a very little apoptosis, ie, genetically programmed cell death. Aberrations in apoptotic pathways are central to tumorigenesis, tumor progression, and overall tumor growth and regression in response to chemotherapy. It is now increasingly accepted that chemotherapeutic drug efficacy is partially related to its ability to induce apoptosis. Apoptosis, therefore, represents not only a vital target in cancer therapy but also a unique biomarker opportunity that has thus far been largely unexploited. In response to therapy, tumor cells undergo apoptosis and release their cellular components in the circulation. As such, these materials may serve as biomarkers to assess response. Apoptosis markers in breast cancer include circulating soluble FasL, granzyme B, and cytochrome c that increase following chemotherapy. Unfortunately, there is a paucity of information in the literature with respect to this approach. As such, large-scale prospective studies are clearly needed to validate this approach and more fully elucidate clinical usefulness.
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Zhloba A, Subbotina T, Alekseevskaya E, Moiseeva O, Gavrilyuk N, Irtyuga O. The level of circulating PGC1a in cardiovascular disease. ACTA ACUST UNITED AC 2016; 62:198-205. [DOI: 10.18097/pbmc20166202198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The level of peroxisome proliferator-activated receptor gamma coactivator-1alpha (PGC1a) in human blood plasma was investigated. Samples of healthy individuals (n=34) and patients with cardiovascular diseases (n=110), including aortic aneurysm (n=69), aortic stenosis (n=25) and patients without aortic pathologies were analyzed. In patients the PGC1a concentration was higher than that in healthy persons, and tended to decrease with age. Elevated concentrations of lactic acid, total homocysteine and asymmetric dimethylarginine in the blood of patients suggested a parallel development of endothelial and secondary mitochondrial dysfunction. However, concentrations of lactic and pyruvic acids exceeding reference limit were associated with the decrease in the PGC1a level
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Affiliation(s)
- A.A. Zhloba
- Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia; Federal Almazov Medical Research Center, Saint Petersburg, Russia
| | - T.F. Subbotina
- Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia; Federal Almazov Medical Research Center, Saint Petersburg, Russia
| | - E.S. Alekseevskaya
- Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia; Federal Almazov Medical Research Center, Saint Petersburg, Russia
| | - O.M. Moiseeva
- Federal Almazov Medical Research Center, Saint Petersburg, Russia
| | - N.D. Gavrilyuk
- Federal Almazov Medical Research Center, Saint Petersburg, Russia
| | - O.B. Irtyuga
- Federal Almazov Medical Research Center, Saint Petersburg, Russia
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Assessment of muscle tissue oxygen saturation after out-of-hospital cardiac arrest. J Crit Care 2015; 30:1184-9. [DOI: 10.1016/j.jcrc.2015.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 06/01/2015] [Accepted: 07/12/2015] [Indexed: 11/21/2022]
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Identifying the role of cytochrome c in post-resuscitation pathophysiology. Am J Emerg Med 2015; 33:1826-30. [PMID: 26494628 DOI: 10.1016/j.ajem.2015.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 09/06/2015] [Accepted: 09/17/2015] [Indexed: 12/19/2022] Open
Abstract
Cytochrome c, an electron carrier that normally resides in the mitochondrial intermembrane space, may translocate to the cytosol under ischemic and hypoxic conditions and contribute to mitochondrial permeability transition pore opening. In addition, reperfusion of brain tissue following ischemia initiates a cell death cascade that includes cytochrome c-mediated induction of apoptosis. Further studies are needed to determine the contribution of cytochrome c in the regulation of cell death, as well as its value as an in vivo prognostic marker after cardiac arrest and resuscitation.
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Donnino MW, Mortensen SJ, Andersen LW, Chase M, Berg KM, Balkema J, Radhakrishnan J, Gazmuri RJ, Liu X, Cocchi MN. Ubiquinol (reduced Coenzyme Q10) in patients with severe sepsis or septic shock: a randomized, double-blind, placebo-controlled, pilot trial. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2015; 19:275. [PMID: 26130237 PMCID: PMC4520066 DOI: 10.1186/s13054-015-0989-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 06/15/2015] [Indexed: 12/29/2022]
Abstract
Introduction We previously found decreased levels of Coenzyme Q10 (CoQ10) in patients with septic shock. The objective of the current study was to assess whether the provision of exogenous ubiquinol (the reduced form of CoQ10) could increase plasma CoQ10 levels and improve mitochondrial function. Methods We performed a randomized, double-blind, pilot trial at a single, tertiary care hospital. Adults (age ≥18 years) with severe sepsis or septic shock between November 2012 and January 2014 were included. Patients received 200 mg enteral ubiquinol or placebo twice a day for up to seven days. Blood draws were obtained at baseline (0 h), 12, 24, 48, and 72 h. The primary outcome of the study was change in plasma CoQ10 parameters (total CoQ10 levels, CoQ10 levels relative to cholesterol levels, and levels of oxidized and reduced CoQ10). Secondary outcomes included assessment of: 1) vascular endothelial biomarkers, 2) inflammatory biomarkers, 3) biomarkers related to mitochondrial injury including cytochrome c levels, and 4) clinical outcomes. CoQ10 levels and biomarkers were compared between groups using repeated measures models. Results We enrolled 38 patients: 19 in the CoQ10 group and 19 in the placebo group. The mean patient age was 62 ± 16 years and 47 % were female. Baseline characteristics and CoQ10 levels were similar for both groups. There was a significant increase in total CoQ10 levels, CoQ10 levels relative to cholesterol levels, and levels of oxidized and reduced CoQ10 in the ubiquinol group compared to the placebo group. We found no difference between the two groups in any of the secondary outcomes. Conclusions In this pilot trial we showed that plasma CoQ10 levels could be increased in patients with severe sepsis or septic shock, with the administration of oral ubiquinol. Further research is needed to address whether ubiquinol administration can result in improved clinical outcomes in this patient population. Trial registration Clinicaltrials.gov identifier NCT01948063. Registered on 18 February 2013.
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Affiliation(s)
- Michael W Donnino
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road West CC-2, Boston, MA, 02215, USA. .,Department of Medicine, Division of Pulmonary and Critical Care, Beth Israel Deaconess Medical Center, One Deaconess Road West CC-2, Boston, MA, USA.
| | - Sharri J Mortensen
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road West CC-2, Boston, MA, 02215, USA. .,Research Center for Emergency Medicine, Aarhus University Hospital, Norrebrogade 44, Aarhus, 8000, Denmark.
| | - Lars W Andersen
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road West CC-2, Boston, MA, 02215, USA. .,Department of Anesthesiology, Aarhus University Hospital, Norrebrogade 44, Aarhus, 8000, Denmark.
| | - Maureen Chase
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road West CC-2, Boston, MA, 02215, USA.
| | - Katherine M Berg
- Department of Medicine, Division of Pulmonary and Critical Care, Beth Israel Deaconess Medical Center, One Deaconess Road West CC-2, Boston, MA, USA.
| | - Julia Balkema
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road West CC-2, Boston, MA, 02215, USA.
| | - Jeejabai Radhakrishnan
- Resuscitation Institute at Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL, 60064, USA.
| | - Raúl J Gazmuri
- Resuscitation Institute at Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL, 60064, USA.
| | - Xiaowen Liu
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road West CC-2, Boston, MA, 02215, USA.
| | - Michael N Cocchi
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road West CC-2, Boston, MA, 02215, USA. .,Department of Anesthesia Critical Care, Division of Critical Care, Beth Israel Deaconess Medical Center, One Deaconess Road West CC-2, Boston, MA, USA.
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Lamoureux L, Radhakrishnan J, Gazmuri RJ. A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique. J Vis Exp 2015:52413. [PMID: 25938619 PMCID: PMC4541594 DOI: 10.3791/52413] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
A rat model of electrically-induced ventricular fibrillation followed by cardiac resuscitation using a closed chest technique that incorporates the basic components of cardiopulmonary resuscitation in humans is herein described. The model was developed in 1988 and has been used in approximately 70 peer-reviewed publications examining a myriad of resuscitation aspects including its physiology and pathophysiology, determinants of resuscitability, pharmacologic interventions, and even the effects of cell therapies. The model featured in this presentation includes: (1) vascular catheterization to measure aortic and right atrial pressures, to measure cardiac output by thermodilution, and to electrically induce ventricular fibrillation; and (2) tracheal intubation for positive pressure ventilation with oxygen enriched gas and assessment of the end-tidal CO2. A typical sequence of intervention entails: (1) electrical induction of ventricular fibrillation, (2) chest compression using a mechanical piston device concomitantly with positive pressure ventilation delivering oxygen-enriched gas, (3) electrical shocks to terminate ventricular fibrillation and reestablish cardiac activity, (4) assessment of post-resuscitation hemodynamic and metabolic function, and (5) assessment of survival and recovery of organ function. A robust inventory of measurements is available that includes - but is not limited to - hemodynamic, metabolic, and tissue measurements. The model has been highly effective in developing new resuscitation concepts and examining novel therapeutic interventions before their testing in larger and translationally more relevant animal models of cardiac arrest and resuscitation.
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Affiliation(s)
- Lorissa Lamoureux
- Resuscitation Institute, Rosalind Franklin University of Medicine and Science
| | | | - Raúl J Gazmuri
- Resuscitation Institute, Rosalind Franklin University of Medicine and Science;
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Cour M, Abrial M, Jahandiez V, Loufouat J, Belaïdi E, Gharib A, Varennes A, Monneret G, Thibault H, Ovize M, Argaud L. Ubiquitous protective effects of cyclosporine A in preventing cardiac arrest-induced multiple organ failure. J Appl Physiol (1985) 2014; 117:930-6. [PMID: 25213634 DOI: 10.1152/japplphysiol.00495.2014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Opening of the mitochondrial permeability transition pore (mPTP) appears to be a pivotal event in myocardial ischemia-reperfusion (I/R) injury. Resuscitated cardiac arrest (CA) leads to the post-CA syndrome that encompasses, not only myocardial dysfunction, but also brain injury, failure of other organs (kidney, liver, or lung), and systemic response to I/R. We aimed to determine whether cyclosporine A (CsA) might prevent multiple organ failure following CA through a ubiquitous mPTP inhibition in each distant vital organ. Anesthetized New Zealand White rabbits were subjected to 15 min of CA and 120 min of reperfusion. At the onset of resuscitation, the rabbits received CsA, its non-immunosuppressive derivative NIM811, or vehicle (controls). Survival, hemodynamics, brain damage, organ injuries, and systemic I/R response were analyzed. Fresh mitochondria were isolated from the brain, heart, kidney, liver, and lung to assess both oxidative phosphorylation and permeability transition. CsA analogs significantly improved short-term survival and prevented multiple organ failure, including brain damage and myocardial dysfunction (P < 0.05 vs. controls). Susceptibility of mPTP opening was significantly increased in heart, brain, kidney, and liver mitochondria isolated from controls, while mitochondrial respiration was impaired (P < 0.05 vs. sham). CsA analogs prevented these mitochondrial dysfunctions (P < 0.05 vs. controls). These results suggest that CsA and NIM811 can prevent the post-CA syndrome through a ubiquitous mitochondrial protective effect at the level of each major distant organ.
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Affiliation(s)
- Martin Cour
- Hospices Civils de Lyon, Groupement Hospitalier Edouard Herriot, Service de Réanimation Médicale, Lyon, France; Faculté de Médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France; INSERM UMR 1060, CarMeN, Lyon, France
| | | | - Vincent Jahandiez
- Hospices Civils de Lyon, Groupement Hospitalier Edouard Herriot, Service de Réanimation Médicale, Lyon, France; Faculté de Médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France; INSERM UMR 1060, CarMeN, Lyon, France
| | | | | | | | - Annie Varennes
- Laboratoire de Biochimie, Hospices Civils de Lyon, Groupement Hospitalier Edouard Herriot, Lyon, France
| | - Guillaume Monneret
- Laboratoire d'Immunologie Clinique, Hospices Civils de Lyon, Groupement Hospitalier Edouard Herriot, Lyon, France; and
| | - Hélène Thibault
- INSERM UMR 1060, CarMeN, Lyon, France; Explorations Fonctionnelles Cardiovasculaires & Centre d'Investigations Cliniques de Lyon, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France
| | - Michel Ovize
- INSERM UMR 1060, CarMeN, Lyon, France; Explorations Fonctionnelles Cardiovasculaires & Centre d'Investigations Cliniques de Lyon, Hospices Civils de Lyon, Groupement Hospitalier Est, Lyon, France
| | - Laurent Argaud
- Hospices Civils de Lyon, Groupement Hospitalier Edouard Herriot, Service de Réanimation Médicale, Lyon, France; Faculté de Médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France; INSERM UMR 1060, CarMeN, Lyon, France;
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Donnino MW, Andersen LW, Giberson T, Gaieski D, Abella B, Peberdy MA, Rittenberger JC, Callaway CW, Ornato J, Clore J, Grossestreuer A, Salciccioli J, Cocchi M. Initial lactate and lactate change in post-cardiac arrest: a multicenter validation study. Crit Care Med 2014; 42:1804-11. [PMID: 24776606 PMCID: PMC4154535 DOI: 10.1097/ccm.0000000000000332] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Rate of lactate change is associated with in-hospital mortality in post-cardiac arrest patients. This association has not been validated in a prospective multicenter study. The objective of the current study was to determine the association between percent lactate change and outcomes in post-cardiac arrest patients. DESIGN Four-center prospective observational study conducted from June 2011 to March 2012. SETTING The National Post-Arrest Research Consortium is a clinical research network conducting research in post-cardiac arrest care. The network consists of four urban tertiary care teaching hospitals. PATIENTS Inclusion criteria consisted of adult out-of-hospital non-traumatic cardiac arrest patients who were comatose after return of spontaneous circulation. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The primary outcome was survival to hospital discharge, and secondary outcome was good neurologic outcome. We compared the absolute lactate levels and the differences in the percent lactate change over 24 hours between survivors and nonsurvivors and between subjects with good and bad neurologic outcomes. One hundred patients were analyzed. The median age was 63 years (interquartile range, 50-75) and 40% were female. Ninety-seven percent received therapeutic hypothermia, and overall survival was 46%. Survivors and patients with good neurologic outcome had lower lactate levels at 0, 12, and 24 hours (p< 0.01). In adjusted models, percent lactate decrease at 12 hours was greater in survivors (odds ratio, 2.2; 95% CI, 1.1-6.2) and in those with good neurologic outcome (odds ratio, 2.2; 95% CI, 1.1-4.4). CONCLUSION Lower lactate levels at 0, 12, and 24 hours and greater percent decrease in lactate over the first 12 hours post cardiac arrest are associated with survival and good neurologic outcome.
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Affiliation(s)
- Michael W. Donnino
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Medicine, Division of Critical Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Lars W. Andersen
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Research Center for Emergency Medicine, Aarhus University, Aarhus, Denmark
| | - Tyler Giberson
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - David Gaieski
- Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Benjamin Abella
- Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mary Anne Peberdy
- Department of Emergency Medicine, Virginia Commonwealth University Health System, Richmond, Virginia
| | - Jon C. Rittenberger
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Clifton W. Callaway
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Joseph Ornato
- Department of Emergency Medicine, Virginia Commonwealth University Health System, Richmond, Virginia
| | - John Clore
- Department of Emergency Medicine, Virginia Commonwealth University Health System, Richmond, Virginia
| | - Anne Grossestreuer
- Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Justin Salciccioli
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Michael Cocchi
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Anesthesia Critical Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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Murnin MR, Sonder P, Janssens GN, Henry CL, Polderman KH, Rittenberger JC, Dezfulian C. Determinants of heat generation in patients treated with therapeutic hypothermia following cardiac arrest. J Am Heart Assoc 2014; 3:e000580. [PMID: 24780205 PMCID: PMC4309044 DOI: 10.1161/jaha.113.000580] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Therapeutic hypothermia (TH) is recommended to reduce ischemic brain injury after cardiac arrest. The variables that predict heat generation by patients receiving TH are uncertain, as is how this heat generation relates to neurologic outcome. We hypothesized that patient characteristics, medication use, inflammation, and organ injury would be associated with heat generation. We further hypothesized that neurologic outcome would be most strongly associated with heat generation. Methods and Results Surface and intravascular cooling devices were used to provide TH in 57 consecutive cardiac arrest patients. Device water temperatures during the maintenance (33°C) phase were collected. Patient heat generation was quantified as the “heat index” (HI), which was the inverse average water temperature over a minimum of 2 hours of maintenance hypothermia. Variables measuring reduced ischemic injury and improved baseline health were significantly associated with HI. After controlling for presenting rhythm, a higher HI was independently associated with favorable disposition (OR=2.2; 95% CI 1.2 to 4.1; P=0.014) and favorable Cerebral Performance Category (OR=1.8; 95% CI 1.0 to 3.1; P=0.035). Higher HI predicted favorable disposition (receiver‐operator area under the curve 0.71, P=0.029). HI was linearly correlated with arteriovenous CO2 (r=0.69; P=0.041) but not O2 (r=0.13; P=0.741) gradients. Conclusions In cardiac arrest patients receiving TH, greater heat generation is associated with better baseline health, reduced ischemic injury, and improved neurologic function, which results in higher metabolism. HI can control for confounding effects of patient heat generation in future clinical trials of rapid TH and offers early prognostic information.
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Affiliation(s)
- Matthew R Murnin
- Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Impaired cerebral mitochondrial oxidative phosphorylation function in a rat model of ventricular fibrillation and cardiopulmonary resuscitation. BIOMED RESEARCH INTERNATIONAL 2014; 2014:192769. [PMID: 24696844 PMCID: PMC3947758 DOI: 10.1155/2014/192769] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 01/04/2014] [Indexed: 01/18/2023]
Abstract
Postcardiac arrest brain injury significantly contributes to mortality and morbidity in patients suffering from cardiac arrest (CA). Evidence that shows that mitochondrial dysfunction appears to be a key factor in tissue damage after ischemia/reperfusion is accumulating. However, limited data are available regarding the cerebral mitochondrial dysfunction during CA and cardiopulmonary resuscitation (CPR) and its relationship to the alterations of high-energy phosphate. Here, we sought to identify alterations of mitochondrial morphology and oxidative phosphorylation function as well as high-energy phosphates during CA and CPR in a rat model of ventricular fibrillation (VF). We found that impairment of mitochondrial respiration and partial depletion of adenosine triphosphate (ATP) and phosphocreatine (PCr) developed in the cerebral cortex and hippocampus following a prolonged cardiac arrest. Optimal CPR might ameliorate the deranged phosphorus metabolism and preserve mitochondrial function. No obvious ultrastructural abnormalities of mitochondria have been found during CA. We conclude that CA causes cerebral mitochondrial dysfunction along with decay of high-energy phosphates, which would be mitigated with CPR. This study may broaden our understanding of the pathogenic processes underlying global cerebral ischemic injury and provide a potential therapeutic strategy that aimed at preserving cerebral mitochondrial function during CA.
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Gazmuri RJ. Targeting Mitochondria During CPR. Resuscitation 2014. [DOI: 10.1007/978-88-470-5507-0_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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