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Bolignano D, Greco M, D’Agostino M, Cianfrone P, Tripodi L, Misiti R, Zicarelli M, Ganino L, Foti DP, Andreucci M, Coppolino G. Urinary Marinobufagenin in Patients with Non-Advanced Chronic Kidney Disease: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1392. [PMID: 37629682 PMCID: PMC10456778 DOI: 10.3390/medicina59081392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/24/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: The global prevalence of chronic kidney disease (CKD) is on the rise, posing important challenges for healthcare systems. Thus, the search for new factors potentially involved in the pathogenesis, progression and complications of early CKD remains urgent. Marinobufagenin (MBG) is a natriuretic endogenous cardiotonic steroid, and increased circulating levels of it may accelerate kidney damage. In this study, we explored the possible clinical significance of measuring urinary marinobufagenin (uMBG) in patients with non-advanced CKD. Materials and Methods: One hundred and eight adult CKD patients (mean age 71.6 ± 10 years, 70.4% male; mean eGFR 40.54 ± 17 mL/min/1.73 m2) were enrolled in this cross-sectional study. uMBG was measured together with a series of clinical, anthropometric, laboratory and instrumental analyses. Twenty-five healthy matched subjects served as controls for the uMBG measurement. Results: The uMBG values were lower in the patients with CKD as compared to those of the controls (0.37 [IQR: 0.25-0.45] vs. 0.64 [0.46-0.78] nmol/L. p = 0.004), and a significant trend in eGFR levels was noticed across the decreasing uMBG tertiles (p = 0.03). Regarding the correlation analyses, the uMBG values remained robustly associated with the eGFR in multivariate models employing either uMBG or eGFR as the dependent variable (β = 0.248; p = 0.01 and β = 0.139; p = 0.04, respectively). Besides the eGFR, the independent predictors of uMBG values in this population were the use of statins (β = -0.326; p = 0.001), the presence of diabetes (β = 0.243; p = 0.009) and urine sodium (β = 0.204; p = 0.01). Conclusions: Reduced uMBG excretion may reflect impaired renal clearance, which may contribute to the detrimental effects attributed to this hormone due to systemic accumulation. Future studies are needed to clarify the biological mechanisms placing uMBG at the crossroad of sodium intake and the presence of diabetes in CKD-suffering individuals and to verify whether a statin treatment may somewhat limit the detrimental effects of MBG in the presence of impaired renal function.
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Affiliation(s)
- Davide Bolignano
- Nephrology and Dialysis Unit, Magna-Graecia University Hospital, 88100 Catanzaro, Italy (L.T.)
- Department of Medical and Surgical Sciences, Magna-Graecia University, 88100 Catanzaro, Italy
| | - Marta Greco
- Clinical Pathology Lab., Magna-Graecia University Hospital, 88100 Catanzaro, Italy
- Department of Health Sciences, Magna-Graecia University, 88100 Catanzaro, Italy
| | - Mario D’Agostino
- Nephrology and Dialysis Unit, Magna-Graecia University Hospital, 88100 Catanzaro, Italy (L.T.)
| | - Paola Cianfrone
- Nephrology and Dialysis Unit, Magna-Graecia University Hospital, 88100 Catanzaro, Italy (L.T.)
| | - Loredana Tripodi
- Nephrology and Dialysis Unit, Magna-Graecia University Hospital, 88100 Catanzaro, Italy (L.T.)
| | - Roberta Misiti
- Clinical Pathology Lab., Magna-Graecia University Hospital, 88100 Catanzaro, Italy
| | - Mariateresa Zicarelli
- Department of Medical and Surgical Sciences, Magna-Graecia University, 88100 Catanzaro, Italy
| | - Ludovica Ganino
- Clinical Pathology Lab., Magna-Graecia University Hospital, 88100 Catanzaro, Italy
| | - Daniela Patrizia Foti
- Clinical Pathology Lab., Magna-Graecia University Hospital, 88100 Catanzaro, Italy
- Department of Experimental and Clinical Medicine, Magna-Graecia University, 88100 Catanzaro, Italy
| | - Michele Andreucci
- Nephrology and Dialysis Unit, Magna-Graecia University Hospital, 88100 Catanzaro, Italy (L.T.)
- Department of Health Sciences, Magna-Graecia University, 88100 Catanzaro, Italy
| | - Giuseppe Coppolino
- Nephrology and Dialysis Unit, Magna-Graecia University Hospital, 88100 Catanzaro, Italy (L.T.)
- Department of Health Sciences, Magna-Graecia University, 88100 Catanzaro, Italy
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Carullo N, Fabiano G, D'Agostino M, Zicarelli MT, Musolino M, Presta P, Michael A, Andreucci M, Bolignano D, Coppolino G. New Insights on the Role of Marinobufagenin from Bench to Bedside in Cardiovascular and Kidney Diseases. Int J Mol Sci 2023; 24:11186. [PMID: 37446363 DOI: 10.3390/ijms241311186] [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: 03/15/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
Marinobufagenin (MBG) is a member of the bufadienolide family of compounds, which are natural cardiac glycosides found in a variety of animal species, including man, which have different physiological and biochemical functions but have a common action on the inhibition of the adenosine triphosphatase sodium-potassium pump (Na+/K+-ATPase). MBG acts as an endogenous cardiotonic steroid, and in the last decade, its role as a pathogenic factor in various human diseases has emerged. In this paper, we have collated major evidence regarding the biological characteristics and functions of MBG and its implications in human pathology. This review focused on MBG involvement in chronic kidney disease, including end-stage renal disease, cardiovascular diseases, sex and gender medicine, and its actions on the nervous and immune systems. The role of MBG in pathogenesis and the development of a wide range of pathological conditions indicate that this endogenous peptide could be used in the future as a diagnostic biomarker and/or therapeutic target, opening important avenues of scientific research.
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Affiliation(s)
- Nazareno Carullo
- Renal Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Giuseppe Fabiano
- Renal Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Mario D'Agostino
- Renal Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | | | - Michela Musolino
- Renal Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Pierangela Presta
- Renal Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Ashour Michael
- Renal Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Michele Andreucci
- Renal Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Davide Bolignano
- Renal Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Giuseppe Coppolino
- Renal Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
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3
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Bolignano D, Greco M, Presta P, Caglioti A, Carullo N, Zicarelli M, Foti DP, Dragone F, Andreucci M, Coppolino G. Marinobufagenin, Left Ventricular Hypertrophy and Residual Renal Function in Kidney Transplant Recipients. J Clin Med 2023; 12:jcm12093072. [PMID: 37176512 PMCID: PMC10179363 DOI: 10.3390/jcm12093072] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/10/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Left ventricular hypertrophy (LVH), which is a pervasive complication of end-stage kidney disease (ESKD), persists in some uremic individuals even after kidney transplantation (Ktx), contributing to worsening CV outcomes. Marinobufagenin (MBG), an endogenous steroid cardiotonic hormone endowed with natriuretic and vasoconstrictive properties, is an acknowledged trigger of uremic cardiomyopathy. However, its clinical significance in the setting of Ktx remains undefined. METHODS In a cohort of chronic Ktx recipients (n = 40), we assessed circulating MBG together with a thorough clinical and echocardiographic examination. Forty matched haemodialysis (HD) patients and thirty healthy subjects served as controls for MBG measurements. Patients were then prospectively followed up to 12 months and the occurrence of an established cardio-renal endpoint (death, CV events, renal events, graft rejection) was recorded. RESULTS Median MBG plasma levels were lower in Ktx as compared with HD patients (p = 0.02), but higher as compared with healthy controls (p = 0.0005). Urinary sodium (β = 0.423; p = 0.01) and eGFR (β = -0.324; p = 0.02) were the sole independent predictors of MBG in this cohort, while a strong correlation with left ventricular mass index (LVMi), found in univariate analyses (R = 0.543; p = 0.0007), gained significance only in multivariate models not including eGFR. Logistic regression analyses indicated MBG as a significant predictor of the combined endpoint (OR 2.38 [1.10-5.12] per each 1 nmoL/L increase; p = 0.01), as well as eGFR, LVMi, serum phosphate and proteinuria. CONCLUSIONS Ktx recipients display altered MBG levels which are influenced by sodium balance, renal impairment and the severity of LVH. Thus, MBG might represent an important missing link between reduced graft function and pathological cardiac remodelling and may hold important prognostic value for improving cardio-renal risk assessment.
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Affiliation(s)
- Davide Bolignano
- Nephrology and Dialysis Unit, University "Magna-Graecia" of Catanzaro, 88100 Catanzaro, Italy
- Department of Medical and Surgical Sciences, University "Magna-Graecia" of Catanzaro, 88100 Catanzaro, Italy
| | - Marta Greco
- Clinical Pathology Lab, University "Magna-Graecia" of Catanzaro, 88100 Catanzaro, Italy
- Department of Health Sciences, University "Magna-Graecia" of Catanzaro, 88100 Catanzaro, Italy
| | - Pierangela Presta
- Nephrology and Dialysis Unit, University "Magna-Graecia" of Catanzaro, 88100 Catanzaro, Italy
| | - Alfredo Caglioti
- Nephrology and Dialysis Unit, University "Magna-Graecia" of Catanzaro, 88100 Catanzaro, Italy
| | - Nazareno Carullo
- Nephrology and Dialysis Unit, University "Magna-Graecia" of Catanzaro, 88100 Catanzaro, Italy
| | - Mariateresa Zicarelli
- Nephrology and Dialysis Unit, University "Magna-Graecia" of Catanzaro, 88100 Catanzaro, Italy
| | - Daniela Patrizia Foti
- Clinical Pathology Lab, University "Magna-Graecia" of Catanzaro, 88100 Catanzaro, Italy
- Department of Clinical and Experimental Medicine, University "Magna-Graecia" of Catanzaro, 88100 Catanzaro, Italy
| | - Francesco Dragone
- Clinical Pathology Lab, University "Magna-Graecia" of Catanzaro, 88100 Catanzaro, Italy
| | - Michele Andreucci
- Nephrology and Dialysis Unit, University "Magna-Graecia" of Catanzaro, 88100 Catanzaro, Italy
- Department of Health Sciences, University "Magna-Graecia" of Catanzaro, 88100 Catanzaro, Italy
| | - Giuseppe Coppolino
- Nephrology and Dialysis Unit, University "Magna-Graecia" of Catanzaro, 88100 Catanzaro, Italy
- Department of Health Sciences, University "Magna-Graecia" of Catanzaro, 88100 Catanzaro, Italy
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4
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Bolignano D, De Rosa S, Greco M, Presta P, Patella G, Crugliano G, Sabatino J, Strangio A, Romano LR, Comi A, Cianfrone P, Andreucci M, Dragone F, Indolfi C, Foti DP, Coppolino G. Marinobufagenin, left ventricular geometry and cardiac dysfunction in end-stage kidney disease patients. Int Urol Nephrol 2022; 54:2581-2589. [PMID: 35274285 DOI: 10.1007/s11255-022-03161-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Left ventricular hypertrophy (LVH) is remarkably prevalent among end-stage kidney disease (ESKD) on chronic dialysis and has a strong prognostic value for adverse outcomes. In experimental models, the endogenous cardiotonic steroid Marinobufagenin (MBG) promotes cardiac hypertrophy and accelerates uremic cardiomyopathy. In this study, we investigated the possible relationships between MBG, LV geometry and cardiac dysfunction in a clinical setting of ESKD. METHODS Plasmatic MBG was measured in 46 prevalent ESKD patients (n = 30 HD, n = 16 PD) together with a thorough laboratory, clinical, bioimpedance and echocardiography assessment. Different patterns of LV geometry were defined by left ventricular mass index (LVMi) and ventricular morphology. Diastolic dysfunction was diagnosed by the ASE/EACVI criteria. RESULTS MBG levels were significantly higher in ESKD patients than in healthy controls (p = 0.001) and more elevated in PD than in HD (p = 0.02). At multivariate analyses, E/e' (β = 0.38; p = 0.009) and LVMi (β = 0.42; p = 0.02) remained the sole independent predictors of MBG. A statistically significant trend in MBG levels (p = 0.01) was noticed across different patterns of LV geometry, with the highest values found in eccentric LVH. MBG levels were higher in the presence of diastolic dysfunction (p = 0.01) and this substance displayed a remarkable diagnostic capacity in distinguish patients with normal LV geometry, LV hypertrophy and, particularly, eccentric LVH (AUC 0.888; p < 0.0001) and diastolic dysfunction (AUC 0.79; p = 0.001). CONCLUSIONS Deranged plasma MBG levels in ESKD patients on chronic dialysis reflect alterations in LV structure and function. MBG may, thus, candidate as a novel biomarker for improving cardiac assessment in this high-risk population.
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Affiliation(s)
- Davide Bolignano
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy. .,Department of Medical and Surgical Sciences-Renal Unit, Magna Graecia University of Catanzaro, Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy.
| | - Salvatore De Rosa
- Department of Medical and Surgical Sciences-Renal Unit, Magna Graecia University of Catanzaro, Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy.,Cardiovascular Research Center, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Marta Greco
- Clinical Pathology Lab, Magna Graecia University of Catanzaro, Catanzaro, Italy.,Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Pierangela Presta
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Gemma Patella
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Giuseppina Crugliano
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Jolanda Sabatino
- Department of Medical and Surgical Sciences-Renal Unit, Magna Graecia University of Catanzaro, Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy.,Cardiovascular Research Center, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Antonio Strangio
- Department of Medical and Surgical Sciences-Renal Unit, Magna Graecia University of Catanzaro, Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy
| | - Letizia Rosa Romano
- Department of Medical and Surgical Sciences-Renal Unit, Magna Graecia University of Catanzaro, Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy
| | - Alessandro Comi
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Paola Cianfrone
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Michele Andreucci
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy.,Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Francesco Dragone
- Clinical Pathology Lab, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Ciro Indolfi
- Department of Medical and Surgical Sciences-Renal Unit, Magna Graecia University of Catanzaro, Campus Salvatore Venuta, Viale Europa, 88100, Catanzaro, Italy.,Cardiovascular Research Center, Magna Graecia University of Catanzaro, Catanzaro, Italy.,Mediterranea Cardiocentro, Naples, Italy
| | - Daniela Patrizia Foti
- Clinical Pathology Lab, Magna Graecia University of Catanzaro, Catanzaro, Italy.,Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Giuseppe Coppolino
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy.,Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
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5
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Słabiak-Błaż N, Piecha G. Endogenous Mammalian Cardiotonic Steroids-A New Cardiovascular Risk Factor?-A Mini-Review. Life (Basel) 2021; 11:life11080727. [PMID: 34440471 PMCID: PMC8398695 DOI: 10.3390/life11080727] [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: 07/06/2021] [Revised: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 12/19/2022] Open
Abstract
The role of endogenous mammalian cardiotonic steroids (CTS) in the physiology and pathophysiology of the cardiovascular system and the kidneys has interested researchers for more than 20 years. Cardiotonic steroids extracted from toads or plants, such as digitalis, have been used to treat heart disease since ancient times. CTS, also called endogenous digitalis-like factors, take part in the regulation of blood pressure and sodium homeostasis through their effects on the transport enzyme called sodium–potassium adenosine triphosphatase (Na/K-ATPase) in renal and cardiovascular tissue. In recent years, there has been increasing evidence showing deleterious effects of CTS on the structure and function of the heart, vasculature and kidneys. Understanding the role of CTS may be useful in the development of potential new therapeutic strategies.
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Łabno-Kirszniok K, Kujawa-Szewieczek A, Wiecek A, Piecha G. The Effects of Short-Term Changes in Sodium Intake on Plasma Marinobufagenin Levels in Patients with Primary Salt-Sensitive and Salt-Insensitive Hypertension. Nutrients 2021; 13:nu13051502. [PMID: 33946894 PMCID: PMC8147121 DOI: 10.3390/nu13051502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 11/25/2022] Open
Abstract
Increased marinobufagenin (MBG) synthesis has been suggested in response to high dietary salt intake. The aim of this study was to determine the effects of short-term changes in sodium intake on plasma MBG levels in patients with primary salt-sensitive and salt-insensitive hypertension. In total, 51 patients with primary hypertension were evaluated during acute sodium restriction and sodium loading. Plasma or serum concentrations of MBG, natriuretic pro-peptides, aldosterone, sodium, potassium, as well as hematocrit (Hct) value, plasma renin activity (PRA) and urinary sodium and potassium excretion were measured. Ambulatory blood pressure monitoring (ABPM) and echocardiography were performed at baseline. In salt-sensitive patients with primary hypertension plasma MBG correlated positively with diastolic blood pressure (ABPM) and serum NT-proANP concentration at baseline and with serum NT-proANP concentration after dietary sodium restriction. In this subgroup plasma MBG concentration decreased during sodium restriction, and a parallel increase of PRA was observed. Acute salt loading further decreased plasma MBG concentration in salt-sensitive subjects in contrast to salt insensitive patients. No correlation was found between plasma MBG concentration and left ventricular mass index. In conclusion, in salt-sensitive hypertensive patients plasma MBG concentration correlates with 24-h diastolic blood pressure and dietary sodium restriction reduces plasma MBG levels. Decreased MBG secretion in response to acute salt loading may play an important role in the pathogenesis of salt sensitivity.
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Affiliation(s)
| | | | | | - Grzegorz Piecha
- Correspondence: ; Tel.: +48-322-591-429; Fax: +48-322-553-726
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7
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Strauss M, Smith W, Fedorova OV, Schutte AE. The Na +K +-ATPase Inhibitor Marinobufagenin and Early Cardiovascular Risk in Humans: a Review of Recent Evidence. Curr Hypertens Rep 2019; 21:38. [PMID: 30980225 PMCID: PMC6590998 DOI: 10.1007/s11906-019-0942-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW This review synthesizes recent findings in humans pertaining to the relationships between marinobufagenin (MBG), a steroidal Na+/K+-ATPase inhibitor and salt-sensitivity biomarker, and early cardiovascular risk markers. RECENT FINDINGS Twenty-four-hour urinary MBG strongly associates with habitual salt intake in young healthy adults (aged 20-30 years). Furthermore, in young healthy adults free of detected cardiovascular disease, MBG associates with increased large artery stiffness and left ventricular mass independent of blood pressure. These findings in human studies corroborate mechanistic data from rat studies whereby stimulation of MBG by a high salt intake or MBG infusion increased vascular fibrosis and cardiac hypertrophy. Twenty-four-hour urinary MBG may be a potential biomarker of early cardiovascular risk. Adverse associations between MBG-which increases with salt consumption-and early cardiovascular risk markers support the global efforts to reduce population-wide salt intake in an effort to prevent and control the burden of non-communicable diseases.
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Affiliation(s)
- Michél Strauss
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X1290, Potchefstroom, 2520, South Africa
| | - Wayne Smith
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X1290, Potchefstroom, 2520, South Africa
- MRC Research Unit: Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Olga V Fedorova
- Laboratory of Cardiovascular Science, National Institute on Aging, NIH, Baltimore, MD, USA
| | - Aletta E Schutte
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X1290, Potchefstroom, 2520, South Africa.
- MRC Research Unit: Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
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8
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Paczula A, Wiecek A, Piecha G. Cardiotonic Steroids-A Possible Link Between High-Salt Diet and Organ Damage. Int J Mol Sci 2019; 20:ijms20030590. [PMID: 30704040 PMCID: PMC6386955 DOI: 10.3390/ijms20030590] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 01/24/2019] [Accepted: 01/28/2019] [Indexed: 02/07/2023] Open
Abstract
High dietary salt intake has been listed among the top ten risk factors for disability-adjusted life years. We discuss the role of endogenous cardiotonic steroids in mediating the dietary salt-induced hypertension and organ damage.
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Affiliation(s)
- Aneta Paczula
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20-24, 40-027 Katowice, Poland.
| | - Andrzej Wiecek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20-24, 40-027 Katowice, Poland.
| | - Grzegorz Piecha
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20-24, 40-027 Katowice, Poland.
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Strauss M, Smith W, Wei W, Fedorova OV, Schutte AE. Autonomic activity and its relationship with the endogenous cardiotonic steroid marinobufagenin: the African-PREDICT study. Nutr Neurosci 2019; 23:849-859. [PMID: 30614779 DOI: 10.1080/1028415x.2018.1564985] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Aim: Marinobufagenin (MBG), a cardiotonic steroid and a natriuretic hormone, is elevated in response to high salt diet consumption. In animal models salt intake stimulates adrenocortical MBG secretion via increased angiotensin II, sympathetic activity and aldosterone. No evidence in humans exists to suggest the involvement of the angiotensinergic-sympatho-excitatory pathway in MBG production. We investigated whether MBG is related to indices of autonomic activity in men and women. Methods: This cross-sectional study included 680 black and white, men and women from the African-PREDICT study (aged 20-30 years). Continuous 24 hr ECG recordings were used to obtain low and high frequency (LF, HF) heart rate variability (HRV). We measured 24 hr urinary MBG excretion and serum aldosterone. Results: We found a positive association of MBG excretion with estimated salt intake (P < 0.001) and aldosterone (P < 0.001) in women and men. In women only, a positive relationship was evident between MBG excretion and LF HRV in multivariate adjusted regression analyses (Adj. R 2 = 0.33; β = 0.11; P = 0.030). In men, MBG excretion associated positively with HF HRV in similar regression analyses (R 2 = 0.36; β = 0.12; P = 0.034). Sex-specific results were corroborated only in blacks, namely, a positive association of MBG excretion with LF HRV in black women (R 2 = 0.38; β = 0.13; P = 0.036), and negative association with HF HRV in black men (R 2 = 0.40; β = 0.18; P = 0.045). No relationships were evident in white women (P = 0.58) or men (P = 0.27). Conclusion: Our findings in this human cohort support suggested mechanisms whereby MBG is elevated as a result of increased salt intake, including autonomic activity, previously demonstrated in Dahl salt-sensitive hypertension.
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Affiliation(s)
- Michél Strauss
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Wayne Smith
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,MRC Research Unit: Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Wen Wei
- Laboratory of Cardiovascular Science, National Institute on Aging, NIH, Baltimore, MD, USA
| | - Olga V Fedorova
- Laboratory of Cardiovascular Science, National Institute on Aging, NIH, Baltimore, MD, USA
| | - Aletta E Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,MRC Research Unit: Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
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