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Durmuş G, Karataş MB, Gökalp M, Eren S, Cebeci AC, Nural A, Hatipoğlu E, Osken A, Karaca M, Zengin A. Increased Serum CRP-Albumin Ratio is Independently Associated With In-Stent Restenosis After Carotid Artery Stenting. Angiology 2024:33197241273331. [PMID: 39155812 DOI: 10.1177/00033197241273331] [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: 08/20/2024]
Abstract
Atherosclerotic stenosis of the carotid artery contributes significantly to ischemic strokes. This study investigates the correlation between the C-reactive protein (CRP) to albumin ratio (CAR) and in-stent restenosis (ISR) in patients (n = 529) undergoing carotid artery stenting. Patients were categorized based on ISR occurrence. Cox regression analyses were performed to identify independent predictors of ISR. The ISR rate was 10.3%. Laboratory analysis revealed higher levels of uric acid, CRP, and CAR in the ISR group. Cox regression identified CAR as an independent predictor of ISR (Hazard ratio (HR): 1.13, 95% CI: 1.03-1.24, P = .01), along with diabetes and smoking. A CAR cut-off of 0.28 predicted ISR with 93% sensitivity and 89% specificity (Area under the curve (AUC): 0.945, 95% CI: 0.923-0.963, P < .001). This study establishes a significant association between CAR and ISR in carotid artery stenting patients. The inflammatory response, indicated by CAR, emerges as a crucial factor in ISR development. The study contributes valuable insights into predicting and preventing ISR, emphasizing the potential of CAR as a prognostic biomarker. This easily accessible and cost-effective biomarker could enhance ISR prediction and guide preventive strategies for high-risk patients.
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Affiliation(s)
- Gündüz Durmuş
- Department of Cardiology, Istanbul Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Cardiology, Istanbul, Turkey
| | - Mehmet Baran Karataş
- Department of Cardiology, Istanbul Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Cardiology, Istanbul, Turkey
| | - Murat Gökalp
- Department of Cardiology, Istanbul Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Cardiology, Istanbul, Turkey
| | - Semih Eren
- Department of Cardiology, Istanbul Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Cardiology, Istanbul, Turkey
| | - Ahmet Ceyhun Cebeci
- Department of Cardiology, Istanbul Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Cardiology, Istanbul, Turkey
| | - Ali Nural
- Department of Cardiology, Istanbul Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Cardiology, Istanbul, Turkey
| | - Elif Hatipoğlu
- Department of Cardiology, Istanbul Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Cardiology, Istanbul, Turkey
| | - Altuğ Osken
- Department of Cardiology, Istanbul Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Cardiology, Istanbul, Turkey
| | - Mehmet Karaca
- Department of Cardiology, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Ahmet Zengin
- Department of Cardiology, Istanbul Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Cardiology, Istanbul, Turkey
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Catană MG, Popențiu IA, Văleanu M, Roman-Filip C, Mihăilă RG. IL-1 Beta-A Biomarker for Ischemic Stroke Prognosis and Atherosclerotic Lesions of the Internal Carotid Artery. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1790. [PMID: 37893508 PMCID: PMC10608497 DOI: 10.3390/medicina59101790] [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: 08/26/2023] [Revised: 09/26/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Stroke is a leading cause of mortality and morbidity worldwide. Treatment of this pathology is still under development and its risk factors remain to be determined. Therefore, we aim to determine the role of interleukin-1 beta in atherosclerotic lesions of the internal carotid artery as a risk factor for stroke and the role of this biomarker in stroke prognosis. Materials and Methods: This study enrolled 56 patients diagnosed with ischemic stroke in the anterior vascular territory (AVT) and posterior vascular territory (PVT). All the patients had venous blood collected at admission and 7 days after the onset of the cerebral ischemia in order to determine the plasma concentration of interleukin-1 beta. At the same time, an extracranial carotid ultrasound was performed. Results: The interleukin-1 beta collected at admission was positively correlated with the NIHSS at admission (Pearson index 0.424), and both measurements were correlated with carotid stenosis (Spearmen correlation index of 0.529 and 0.653, respectively). Conclusions: Interleukin-1 beta could be a reliable biomarker for stroke prognosis and the development of atherosclerotic lesions of the internal carotid.
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Affiliation(s)
- Maria-Gabriela Catană
- Faculty of Medicine, Lucian Blaga University of Sibiu, Izvorului Street, 550169 Sibiu, Romania
- Neurology Department, Emergency County Clinical Hospital Sibiu, Corneliu Coposu bvd, 550245 Sibiu, Romania
| | - Ioan-Adrian Popențiu
- Faculty of Medicine, Lucian Blaga University of Sibiu, Izvorului Street, 550169 Sibiu, Romania
- Department of General Surgery, “Alexandru Augustin” Military Emergency Hospital, Victoriei bvd, 550024 Sibiu, Romania
| | - Mădălina Văleanu
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, 7 Horea Street, 400174 Cluj-Napoca, Romania
| | - Corina Roman-Filip
- Faculty of Medicine, Lucian Blaga University of Sibiu, Izvorului Street, 550169 Sibiu, Romania
- Neurology Department, Emergency County Clinical Hospital Sibiu, Corneliu Coposu bvd, 550245 Sibiu, Romania
| | - Romeo-Gabriel Mihăilă
- Faculty of Medicine, Lucian Blaga University of Sibiu, Izvorului Street, 550169 Sibiu, Romania
- Hematology Department, Emergency County Clinical Hospital Sibiu, Sibiu Corneliu Coposu bvd, 550245 Sibiu, Romania
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Khan H, Shaikh F, Syed MH, Mamdani M, Saposnik G, Qadura M. Current Biomarkers for Carotid Artery Stenosis: A Comprehensive Review of the Literature. Metabolites 2023; 13:919. [PMID: 37623863 PMCID: PMC10456624 DOI: 10.3390/metabo13080919] [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: 06/30/2023] [Revised: 07/28/2023] [Accepted: 08/03/2023] [Indexed: 08/26/2023] Open
Abstract
Carotid artery stenosis (CAS), an atherosclerotic disease of the carotid artery, is one of the leading causes of transient ischemic attacks (TIA) and cerebrovascular attacks (CVA). The atherogenic process of CAS affects a wide range of physiological processes, such as inflammation, endothelial cell function, smooth muscle cell migration and many more. The current gold-standard test for CAS is Doppler ultrasound; however, there is yet to be determined a strong, clinically validated biomarker in the blood that can diagnose patients with CAS and/or predict adverse outcomes in such patients. In this comprehensive literature review, we evaluated all of the current research on plasma and serum proteins that are current contenders for biomarkers for CAS. In this literature review, 36 proteins found as potential biomarkers for CAS were categorized in to the following nine categories based on protein function: (1) Inflammation and Immunity, (2) Lipid Metabolism, (3) Haemostasis, (4) Cardiovascular Markers, (5) Markers of Kidney Function, (6) Bone Health, (7) Cellular Structure, (8) Growth Factors, and (9) Hormones. This literature review is the most up-to-date and current comprehensive review of research on biomarkers of CAS, and the only review that demonstrated the several pathways that contribute to the initiation and progression of the disease. With this review, future studies can determine if any new markers, or a panel of the proteins explored in this study, may be contenders as diagnostic or prognostic markers for CAS.
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Affiliation(s)
- Hamzah Khan
- Division of Vascular Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada; (H.K.); (F.S.); (M.H.S.)
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada; (M.M.); (G.S.)
| | - Farah Shaikh
- Division of Vascular Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada; (H.K.); (F.S.); (M.H.S.)
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada; (M.M.); (G.S.)
| | - Muzammil H. Syed
- Division of Vascular Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada; (H.K.); (F.S.); (M.H.S.)
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada; (M.M.); (G.S.)
| | - Muhammad Mamdani
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada; (M.M.); (G.S.)
- Temerty Centre for Artificial Intelligence Research and Education in Medicine (T-CAIREM), University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Gustavo Saposnik
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada; (M.M.); (G.S.)
- Division of Neurology, Department of Medicine, St. Michael’s Hospital, University of Toronto, 55 Queen St E, Toronto, ON M5C 1R6, Canada
| | - Mohammad Qadura
- Division of Vascular Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada; (H.K.); (F.S.); (M.H.S.)
- Division of Neurology, Department of Medicine, St. Michael’s Hospital, University of Toronto, 55 Queen St E, Toronto, ON M5C 1R6, Canada
- Department of Surgery, University of Toronto, Toronto, ON M5T 1P5, Canada
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Akpınar CK, Kocaturk O, Aykac O, Acar BA, Dogan H, Onalan A, Acar T, Uysal Kocabas Z, Topaktas B, Gurkas E, Ozdemir AO. Can C-reactive protein/albumin ratio be a prognostic factor in acute stroke patients undergoing mechanical thrombectomy? Clin Neurol Neurosurg 2023; 231:107856. [PMID: 37413825 DOI: 10.1016/j.clineuro.2023.107856] [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: 04/05/2023] [Revised: 06/12/2023] [Accepted: 06/24/2023] [Indexed: 07/08/2023]
Abstract
INTRODUCTION C-reactive protein (CRP) and albumin are markers synthesized by the liver and may reflect inflammatory responses. CRP/Albumin ratio (CAR) serves better to reflect the inflammatory state and therefore the prognosis. Worse prognosis is reported in previous studies when CAR rate on admission is high in patients with stroke, aneurysmal subarachnoid hemorrhage, malignancy or patients followed in intensive care units. We aimed to investigate the relation of CAR with prognosis in mechanical thrombectomy performed acute stroke patients. MATERIALS AND METHODS Stroke patients admitted to five different stroke centers between January 2021 and August 2022 undergoing mechanical thrombectomy were included and retrospectively analyzed. The CAR ratio was calculated as the ratio of CRP to albumin level in the venous blood samples. Primary outcome was the relation between CAR and functional outcome at 90 days determined by modified Rankin Scale (mRS). RESULTS This study included 558 patients with a mean age of 66,5 ± 12.5 years (age range:18-89 years) best cutoff value of the CAR was 3.36, with 74.2 % sensitivity and 60.7 % specificity (Area under the curve: 0.774; 95 %CI: 0.693-0.794). There was no significant correlation between CAR rate and age, CAR rate and NIHSS on admission, and also between CAR rate and symptom recanalization (p > 0.05). CAR ratio in the mRS 3-6 group was statistically significantly higher (p < 0.001). In the multivariate analyses, CAR showed an association with 90-day mortality (odds ratio, 1.049; 95 % CI, 1.032-1.066) CONCLUSION: In acute ischemic stroke patients treated with mechanical thrombectomy, CAR may be one of the factors affecting poor clinical outcome and/or mortality in patients undergoing mechanical thrombectomy. Upcoming similar studies in this patient group may better clarify the prognostic role of CAR.
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Affiliation(s)
- Cetin Kursad Akpınar
- Samsun University, Samsun Training and Research Hospital, Department of Neurology, Interventional Neurology, Samsun, Turkey
| | - Ozcan Kocaturk
- Balıkesir Atatürk City Hospital, Department of Neurology, Interventional Neurology, Balıkesir, Turkey
| | - Ozlem Aykac
- Eskisehir Osmangazi University, Medical Faculty, Department of Neurology, Neurocritical Care, Interventional Neurology, Eskisehir, Turkey
| | | | - Hasan Dogan
- Samsun University, Samsun Training and Research Hospital, Department of Neurology, Interventional Neurology, Samsun, Turkey.
| | - Aysenur Onalan
- Health Sciences University, Dr. Lutfi Kirdar City Hospital, Department of Neurology, Interventional Neurology, İstanbul, Turkey
| | - Turkan Acar
- Sakarya University, Faculty of Medicine, Department of Neurology, Sakarya, Turkey
| | - Zehra Uysal Kocabas
- Eskisehir Osmangazi University, Medical Faculty, Department of Neurology, Neurocritical Care, Interventional Neurology, Eskisehir, Turkey
| | | | - Erdem Gurkas
- Health Sciences University, Dr. Lutfi Kirdar City Hospital, Department of Neurology, Interventional Neurology, İstanbul, Turkey
| | - Atilla Ozcan Ozdemir
- Eskisehir Osmangazi University, Medical Faculty, Department of Neurology, Neurocritical Care, Interventional Neurology, Eskisehir, Turkey
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Wang G, Chen Z, Song Y, Wu H, Chen M, Lai S, Wu X. Xueshuantong injection alleviates cerebral microcirculation disorder in middle cerebral artery occlusion/reperfusion rats by suppressing inflammation via JNK mediated JAK2/STAT3 and NF-κB signaling pathways. JOURNAL OF ETHNOPHARMACOLOGY 2022; 298:115592. [PMID: 35931304 DOI: 10.1016/j.jep.2022.115592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/17/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE In the long history of traditional Chinese medicine, Panax notoginseng has been used as a key herb for the treatment of blood diseases. Brain microvessels support adequate blood circulation to maintain normal physiological function, therefore, brain microcirculation disorder is an important therapeutic target for various brain diseases. However, the role of Xueshuantong (XST) injection composed of saponins from P. Notoginseng (PNS) in the amelioration of cerebral microcirculation disorder is unclear. AIMS OF THE STUDY Cerebral microcirculation disorder and inflammation play a vital role in stroke. Capillary endothelial cells and adjacent tight junctions are fundamental to the structure and function of cerebrovascule. XST injection has been used clinically in the treatment of stroke, but no studies have reported its indication in cerebral microcirculation disorder. This study is to explore the action and mechanism of XST injection in the alleviation of cerebral microcirculation disorder in middle cerebral artery occlusion/reperfusion (MCAO/R) rats. MATERIALS AND METHODS MCAO/R rats and LPS-induced bEnd.3 cells were employed for the investigation of effect and mechanism of XST injection. Brain damages were evaluated by neurobehavioral assessment, 2, 3, 5-triphenyltetrazolium chloride (TTC) staining, hematoxylin and eosin staining (H&E), and Nissl staining. Morphology and density changes of cerebral microvessels were monitored by immunohistochemistry. Cell permeability was detected by measurement of trans-endothelial electrical resistance (TEER) and sodium fluorescein (NaF) leakage. The mRNA and protein expressions of inflammatory cytokines, tight junction proteins, adhesion molecules, Janus kinase 2 (JAK2), signal transducer and activator of transcription-3 (STAT3), inhibitor of NF-κB (IκB), nuclear factor-κB (NF-κB) and c-jun N-terminal kinase (JNK) in brain microvessels and lipopolysaccharide (LPS)-induced bEnd.3 cells were measured by real-time PCR and Western blot, respectively. RESULTS XST injection at 48 mg/kg significantly improved the neurological damage, inflammatory infiltration, and microvessel morphology, and increased microvessel density in brain of MCAO/R rats. The endothelial permeability was significantly mitigated by XST injection in LPS-induced bEnd.3 cells. Meanwhile, the tight junction proteins such as zona occludens 1 (ZO-1) and occludin were elevated remarkably in brain microvessel of MCAO/R rats and LPS-induced bEnd.3 cells. Moreover, the expression of inflammatory mediators including interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, inducible nitric oxide synthase (iNOS), cycloocygenases 2 (COX-2), vascular cellular adhesion molecule-1 (VCAM-1), matrix metalloproteinase (MMP)-2, and MMP-9 were inhibited by XST injection. In addition, XST injection suppressed the phosphorylation of JAK2, STAT3, IκB, NF-κB and JNK, which could be abolished by anisomycin, the JNK agonist. CONCLUSION XST injection improved cerebral microvescular structure damage and dysfunction in MCAO/R rats through inhibiting inflammation activated by JNK mediated JAK2/STAT3 and NF-κB signaling pathways. The novel findings may provide theoretical basis for the clinical application in the treatment of cerebral microcirculation disorder.
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Affiliation(s)
- Gaorui Wang
- Shanghai Key Laboratory of Compound Chinese Medicines, The Ministry of Education (MOE) Key Laboratory for Standardization of Chinese Medicines, The State Administration of TCM (SATCM) Key Laboratory for New Resources and Quality Evaluation of Chinese Medicine, Institute of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Ziyu Chen
- Shanghai Key Laboratory of Compound Chinese Medicines, The Ministry of Education (MOE) Key Laboratory for Standardization of Chinese Medicines, The State Administration of TCM (SATCM) Key Laboratory for New Resources and Quality Evaluation of Chinese Medicine, Institute of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Yingying Song
- Shanghai Key Laboratory of Compound Chinese Medicines, The Ministry of Education (MOE) Key Laboratory for Standardization of Chinese Medicines, The State Administration of TCM (SATCM) Key Laboratory for New Resources and Quality Evaluation of Chinese Medicine, Institute of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Hui Wu
- Shanghai Key Laboratory of Compound Chinese Medicines, The Ministry of Education (MOE) Key Laboratory for Standardization of Chinese Medicines, The State Administration of TCM (SATCM) Key Laboratory for New Resources and Quality Evaluation of Chinese Medicine, Institute of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Ming Chen
- Guangxi Key Laboratory of Comprehensive Utilization Technology of Pseudo-ginseng, Wu Zhou, China.
| | - Shusheng Lai
- Guangxi Key Laboratory of Comprehensive Utilization Technology of Pseudo-ginseng, Wu Zhou, China.
| | - Xiaojun Wu
- Shanghai Key Laboratory of Compound Chinese Medicines, The Ministry of Education (MOE) Key Laboratory for Standardization of Chinese Medicines, The State Administration of TCM (SATCM) Key Laboratory for New Resources and Quality Evaluation of Chinese Medicine, Institute of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Storax Protected Primary Cortical Neurons from Oxygen-Glucose Deprivation/Reoxygenation Injury via Inhibiting the TLR4/TRAF6/NF-κB Signaling Pathway. Brain Res 2022; 1792:148021. [PMID: 35878660 DOI: 10.1016/j.brainres.2022.148021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/14/2022] [Accepted: 07/18/2022] [Indexed: 12/24/2022]
Abstract
Storax is a traditional Chinese herb that is widely applied in stroke treatment. However, its neuroprotective effects and mechanisms are yet to be fully elucidated. This study aimed to elucidate the neuroprotective effects and underlying mechanisms of storax on oxygen-glucose deprivation/reoxygenation (OGD/R) in injured cortical neurons. The cortical neurons of Wistar rats were primarily cultured in vitro. TheTUNELmethod and CM-H2DCFDA probe were used to detect cell apoptosis and reactive oxygen species (ROS) expression. Enzyme-linked immunosorbent assay, reverse transcription-polymerase chain reaction, and Western blot were used to detect the expression of inflammatory cytokines and proteins of the TLR4/TRAF6/NF-κB signaling pathway. Immunofluorescence was used to measure NF-κB nuclear translocation. Transfection of TLR4 siRNA was used to detect the potential anti-inflammatory mechanisms of storax. The present results have shown that storax protected primary cortical neurons from OGD/R-induced injury by suppressing ROS generation and cell apoptosis; alleviating HMGB-1, TNF-α, IL-1β, and ICAM-1 expression; and promoting IL-10 expression. In addition, storax inhibited the activation of TLR4, TRAF6, IκBα, IKKβ, and NF-κBp65 caused by OGD/R. It is suggested that storax prevents OGD/R-induced primary cortical neuron injury by inhibiting the TLR4/TRAF6/NF-κB signaling pathway.
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Youwakim J, Girouard H. Inflammation: A Mediator Between Hypertension and Neurodegenerative Diseases. Am J Hypertens 2021; 34:1014-1030. [PMID: 34136907 DOI: 10.1093/ajh/hpab094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 05/03/2021] [Accepted: 06/15/2021] [Indexed: 12/14/2022] Open
Abstract
Hypertension is the most prevalent and modifiable risk factor for stroke, vascular cognitive impairment, and Alzheimer's disease. However, the mechanistic link between hypertension and neurodegenerative diseases remains to be understood. Recent evidence indicates that inflammation is a common pathophysiological trait for both hypertension and neurodegenerative diseases. Low-grade chronic inflammation at the systemic and central nervous system levels is now recognized to contribute to the physiopathology of hypertension. This review speculates that inflammation represents a mediator between hypertension and neurodegenerative diseases, either by a decrease in cerebral blood flow or a disruption of the blood-brain barrier which will, in turn, let inflammatory cells and neurotoxic molecules enter the brain parenchyma. This may impact brain functions including cognition and contribute to neurodegenerative diseases. This review will thus discuss the relationship between hypertension, systemic inflammation, cerebrovascular functions, neuroinflammation, and brain dysfunctions. The potential clinical future of immunotherapies against hypertension and associated cerebrovascular risks will also be presented.
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Affiliation(s)
- Jessica Youwakim
- Département de Pharmacologie et Physiologie, Université de Montréal, Montreal, QC, Canada
- Centre interdisciplinaire de recherche sur le cerveau et l’apprentissage (CIRCA); Montreal, QC, Canada
- Groupe de Recherche sur le Système Nerveux Central, Montreal, QC, Canada
| | - Hélène Girouard
- Département de Pharmacologie et Physiologie, Université de Montréal, Montreal, QC, Canada
- Centre interdisciplinaire de recherche sur le cerveau et l’apprentissage (CIRCA); Montreal, QC, Canada
- Groupe de Recherche sur le Système Nerveux Central, Montreal, QC, Canada
- Centre de recherche de l’Institut Universitaire de Gériaterie de Montréal, Montreal, QC, Canada
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Yildirim T, Kiris T, Avci E, Yildirim SE, Argan O, Safak Ö, Aktas Z, Toklu O, Esin FK. Increased Serum CRP-Albumin Ratio Is Independently Associated With Severity of Carotid Artery Stenosis. Angiology 2020; 71:740-746. [PMID: 32527139 DOI: 10.1177/0003319720926761] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Carotid artery stenosis (CAS), mainly caused by carotid atherosclerosis, is related to ischemic stroke. We investigated whether C-reactive protein (CRP) to albumin ratio (CAR) was associated with increased severity of carotid stenosis in patients undergoing carotid angiography. A total of 269 patients who were undergoing carotid angiography were included in this study. The patients were divided into 2 groups with respect to the severe CAS: group 1 (stenosis < 70%, n = 189) or group II (stenosis ≥ 70%, n = 80). C-reactive protein to albumin ratio was higher in group II compared to group I (0.56 ± 0.25 vs 0.14 ± 0.01, P < .001). The CAR (odds ratio [OR]: 1.051, 95%CI: 1.027-1.076, P < .001), neutrophil to lymphocyte ratio (NLR), and total cholesterol levels were independent predictors of severe CAS. The area under the receiver operating characteristic curve (area under the curve) for the CAR to predict severe CAS was 0.798 (95% CI: 0.741-0.854, P < .001). C-reactive to protein albumin ratio was an independent risk factor of severe CAS. Therefore, CAR might be considered a potential index in the severity of carotid artery disease.
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Affiliation(s)
- Tarik Yildirim
- Department of Cardiology, Balikesir University Medical School, Balikesir, Turkey
| | - Tuncay Kiris
- Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Eyüp Avci
- Department of Cardiology, Balikesir University Medical School, Balikesir, Turkey
| | | | - Onur Argan
- Department of Cardiology, Balikesir University Medical School, Balikesir, Turkey
| | - Özgen Safak
- Department of Cardiology, Balikesir University Medical School, Balikesir, Turkey
| | - Zihni Aktas
- Department of Cardiology, Balikesir Atatürk City Hospital, Balikesir, Turkey
| | - Oguzhan Toklu
- Department of Cardiology, Private Lokman Hekim Esnaf Hospital, Fethiye, Muğla, Turkey
| | - Fatma Kayaalı Esin
- Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
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Cao L, Guo Y, Zhu Z. Effects of hyperhomocysteinemia on ischemic cerebral small vessel disease and analysis of inflammatory mechanisms. Int J Neurosci 2020; 131:362-369. [PMID: 32233703 DOI: 10.1080/00207454.2020.1744597] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: Hyperhomocysteinemia is closely related to, but is not a confirmed risk factor of, cerebral small vessel disease (CSVD). This study aimed to determine whether hyperhomo-cysteinemia is correlated significantly with CSVD.Materials and methods: This cross-sectional study compared the homocysteine (Hcy) levels of patients with and without CSVD. High-sensitivity C-reactive protein (hs-CRP) levels were compared according to white matter lesion (WML) severity, which was classified using the Fazekas system. Risk factors for ischemic CSVD were analyzed through multivariate unconditional logistic regression analysis.Results: Hcy levels were significantly higher in patients with lacunar infarction (LI) than in controls (p=.0438), in patients with Fazekas 2-3 than in patients with Fazekas 0-1 WMLs (p=.0192), in patients with Fazekas 4-6 than in patients with Fazekas 2-3 WMLs (p=.0207), and in patients with LI than in patients without LI (p=.0043). hs-CRP levels were significantly higher in patients with LI than in patients without LI (p=.0068) and in patients with Fazekas 4-6 than in patients with Fazekas 0-1 WMLs (p=.0031). Three multivariate unconditional logistic regression analyses showed that hyperhomocysteinemia is a risk factor for LI (p=.006; odds ratio [OR], 27.668), severe WML (p=.028; OR, 1.984), and high hs-CRP level (p=.016; OR, 3.956).Conclusions: The assessment of Hcy levels is important for ischemic CSVD. Hyperhomocysteinemia is a risk factor for LI and severe WML. Further, hyperhomocysteinemia is associated with high hs-CRP levels, and this may involve an inflammatory mechanism; however, further studies are needed in this regard.
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Affiliation(s)
- Liming Cao
- Department of Neurology, The 3rd Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Yi Guo
- Department of Neurology, Shenzhen People's Hospital, Shenzhen, China
| | - Zhishan Zhu
- Department of Neurology, The 3rd Affiliated Hospital of Shenzhen University, Shenzhen, China
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Brain perivascular macrophages contribute to the development of hypertension in stroke-prone spontaneously hypertensive rats via sympathetic activation. Hypertens Res 2019; 43:99-110. [PMID: 31541222 DOI: 10.1038/s41440-019-0333-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 11/09/2022]
Abstract
Hypertension is associated with systemic inflammation. The activation of the sympathetic nervous system is critically involved in the pathogenesis of hypertension. Brain perivascular macrophages (PVMs) can be affected by circulating inflammatory cytokines, and the contribution of brain PVMs to sympathoexcitation has been demonstrated in a heart failure model. We thus investigated whether brain PVMs contribute to the development of hypertension through sympathoexcitation. Stroke-prone spontaneously hypertensive rats (SHRSP) developed hypertension over an 8-week period from 4 to 12 weeks of age. The number of brain PVMs and plasma interleukin-1β levels significantly increased at the ages of 8 and 12 weeks in SHRSP compared with normotensive Wistar-Kyoto rats (WKY). To determine the contribution of brain PVMs to blood pressure elevation, we intracerebroventricularly injected liposome-encapsulated clodronate, which eliminates macrophages by inducing apoptosis, into 8-week-old rats; we then assessed its effects in 10-week-old rats. Clodronate treatment attenuated the increase in mean blood pressure in SHRSP but not in WKY. Clodronate treatment reduced the depressor effect of hexamethonium, an index of sympathetic activity; it also reduced neuronal activity in sympathetic regulatory nuclei such as the hypothalamic paraventricular nucleus and rostral ventrolateral medulla and reduced the expression of cyclooxygenase-2 and prostaglandin E2, a downstream pathway in activated macrophages, in SHRSP but not in WKY. Furthermore, clodronate treatment attenuated the increase in blood pressure and renal sympathetic nerve activity in response to an acute intravenous injection of interleukin-1β in WKY. In conclusion, brain PVMs contribute to the development of hypertension via sympathetic activation. PVMs may be activated by increased levels of circulating interleukin-1β.
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Cao L, Guo Y, Zhu Z. Study of the Inflammatory Mechanisms in Hyperhomocysteinemia on Large-Artery Atherosclerosis Based on Hypersensitive C-Reactive Protein-A Study from Southern China. J Stroke Cerebrovasc Dis 2019; 28:1816-1823. [PMID: 31080137 DOI: 10.1016/j.jstrokecerebrovasdis.2019.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/10/2019] [Accepted: 04/17/2019] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To study the inflammatory mechanism of hyperhomocysteinemia on large-artery atherosclerosis based on hypersensitive C-reactive protein in patients. METHODS In all, 153 inpatients and 1357 physical examinees were selected. The levels of homocysteine were compared between the carotid/intracranial artery stenosis group and the nonstenosis group, between the carotid artery unstable plaque group and the nonplaque group, and between the intima-media thickness (IMT) greater than or equal to 1 group and the normal IMT group. The hypersensitive C-reactive protein levels were compared between the lacunar infarction (LI) group and the nonstroke control group and between the unstable plaque group and the nonplaque group. RESULTS Homocysteine level was significantly higher in the carotid/intracranial artery stenosis group than in the nonstenosis group, in the LI group than in the inpatient nonstroke group, and in the IMT greater than or equal to 1 group than in the normal IMT group. The hypersensitive C-reactive protein level was significantly higher in the LI group than in the nonstroke group and in the unstable plaque group than in the nonplaque group. CONCLUSIONS Hyperhomocysteinemia may aggravate the development of IMT, carotid atherosclerotic plaque instability, and carotid/intracranial artery stenosis by increasing inflammation, ultimately leading to the occurrence of LI. Hyperhomocysteinemia-induced inflammation mechanism warrants further study.
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Affiliation(s)
- Liming Cao
- Department of neurology, The First Affiliated Hospital of Jinan University, Guang zhou, China; Department of Neurology, The 3rd Affiliated Hospital of Shenzhen University, Shenzhen City, China.
| | - Yi Guo
- Department of Neurology, Shenzhen People's Hospital, Shenzhen City, China
| | - Zhishan Zhu
- Department of Neurology, The 3rd Affiliated Hospital of Shenzhen University, Shenzhen City, China
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12
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Sun HJ, Ren XS, Xiong XQ, Chen YZ, Zhao MX, Wang JJ, Zhou YB, Han Y, Chen Q, Li YH, Kang YM, Zhu GQ. NLRP3 inflammasome activation contributes to VSMC phenotypic transformation and proliferation in hypertension. Cell Death Dis 2017; 8:e3074. [PMID: 28981106 PMCID: PMC5680591 DOI: 10.1038/cddis.2017.470] [Citation(s) in RCA: 180] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 08/17/2017] [Accepted: 08/22/2017] [Indexed: 01/12/2023]
Abstract
Inflammation is involved in pathogenesis of hypertension. NLRP3 inflammasome activation is a powerful mediator of inflammatory response via caspase-1 activation. The present study was designed to determine the roles and mechanisms of NLRP3 inflammasome in phenotypic modulation and proliferation of vascular smooth muscle cells (VSMCs) in hypertension. Experiments were conducted in spontaneously hypertensive rats (SHR) and primary aortic VSMCs. NLRP3 inflammasome activation was observed in the media of aorta in SHR and in the VSMCs from SHR. Knockdown of NLRP3 inhibited inflammasome activation, VSMC phenotypic transformation and proliferation in SHR-derived VSMCs. Increased NFκB activation, histone acetylation and histone acetyltransferase expression were observed in SHR-derived VSMCs and in media of aorta in SHR. Chromatin immunoprecipitation analysis revealed the increased histone acetylation, p65-NFκB and Pol II occupancy at the NLRP3 promoter in vivo and in vitro. Inhibition of NFκB with BAY11-7082 or inhibition of histone acetyltransferase with curcumin prevented the NLRP3 inflammasome activation, VSMC phenotype switching and proliferation in VSMCs from SHR. Moreover, curcumin repressed NFκB activation. Silencing of NLRP3 gene ameliorated hypertension, vascular remodeling, NLRP3 inflammasome activation and phenotype switching in the aorta of SHR. These results indicate that NLRP3 inflammasome activation response to histone acetylation and NFκB activation contributes to VSMC phenotype switching and proliferation and vascular remodeling in hypertension.
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Affiliation(s)
- Hai-Jian Sun
- Department of Physiology, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Nanjing Medical University, Nanjing, Jiangsu 210029, China.,Department of Basic Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Xing-Sheng Ren
- Department of Physiology, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Xiao-Qing Xiong
- Department of Physiology, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yun-Zhi Chen
- Department of Physiology, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Ming-Xia Zhao
- Department of Physiology, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Jue-Jin Wang
- Department of Physiology, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Ye-Bo Zhou
- Department of Physiology, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Ying Han
- Department of Physiology, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Qi Chen
- Department of Pathophysiology, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yue-Hua Li
- Department of Pathophysiology, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yu-Ming Kang
- Department of Physiology and Pathophysiology, Cardiovascular Research Center, Xi'an Jiaotong University School of Medicine, Xi'an, Shanxi 710061, China
| | - Guo-Qing Zhu
- Department of Physiology, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Nanjing Medical University, Nanjing, Jiangsu 210029, China.,Department of Pathophysiology, Nanjing Medical University, Nanjing, Jiangsu 210029, China
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13
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Rodriguez-Iturbe B, Pons H, Johnson RJ. Role of the Immune System in Hypertension. Physiol Rev 2017; 97:1127-1164. [PMID: 28566539 PMCID: PMC6151499 DOI: 10.1152/physrev.00031.2016] [Citation(s) in RCA: 255] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 03/02/2017] [Accepted: 03/02/2017] [Indexed: 02/07/2023] Open
Abstract
High blood pressure is present in more than one billion adults worldwide and is the most important modifiable risk factor of death resulting from cardiovascular disease. While many factors contribute to the pathogenesis of hypertension, a role of the immune system has been firmly established by a large number of investigations from many laboratories around the world. Immunosuppressive drugs and inhibition of individual cytokines prevent or ameliorate experimental hypertension, and studies in genetically-modified mouse strains have demonstrated that lymphocytes are necessary participants in the development of hypertension and in hypertensive organ injury. Furthermore, immune reactivity may be the driving force of hypertension in autoimmune diseases. Infiltration of immune cells, oxidative stress, and stimulation of the intrarenal angiotensin system are induced by activation of the innate and adaptive immunity. High blood pressure results from the combined effects of inflammation-induced impairment in the pressure natriuresis relationship, dysfunctional vascular relaxation, and overactivity of the sympathetic nervous system. Imbalances between proinflammatory effector responses and anti-inflammatory responses of regulatory T cells to a large extent determine the severity of inflammation. Experimental and human studies have uncovered autoantigens (isoketal-modified proteins and heat shock protein 70) of potential clinical relevance. Further investigations on the immune reactivity in hypertension may result in the identification of new strategies for the treatment of the disease.
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Affiliation(s)
- Bernardo Rodriguez-Iturbe
- Renal Service, Hospital Universitario, Universidad del Zulia, and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo, Venezuela; and Division of Renal Diseases and Hypertension, University of Colorado, Anschutz Campus, Aurora, Colorado
| | - Hector Pons
- Renal Service, Hospital Universitario, Universidad del Zulia, and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo, Venezuela; and Division of Renal Diseases and Hypertension, University of Colorado, Anschutz Campus, Aurora, Colorado
| | - Richard J Johnson
- Renal Service, Hospital Universitario, Universidad del Zulia, and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo, Venezuela; and Division of Renal Diseases and Hypertension, University of Colorado, Anschutz Campus, Aurora, Colorado
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14
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Sun C, Wang X, Zheng G, Fan S, Lu J, Zhang Z, Wu D, Shan Q, Hu B, Zheng Y. Protective effect of different flavonoids against endothelial senescence via NLRP3 inflammasome. J Funct Foods 2016. [DOI: 10.1016/j.jff.2016.08.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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15
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Yousuf S, Atif F, Sayeed I, Wang J, Stein DG. Neuroprotection by progesterone after transient cerebral ischemia in stroke-prone spontaneously hypertensive rats. Horm Behav 2016; 84:29-40. [PMID: 27283379 DOI: 10.1016/j.yhbeh.2016.06.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 04/11/2016] [Accepted: 06/04/2016] [Indexed: 11/26/2022]
Abstract
We investigated the neuroprotective effects of progesterone (P4) treatment in stroke-prone spontaneously hypertensive rats (SHRSPs) given 60-min transient middle cerebral artery occlusion (tMCAO). The treatment groups were: (1) Wistar-Kyoto (normotensive sham), (2) SHRSP (hypertensive sham), (3) tMCAO SHRSPs (SHRSP+tMCAO), and (4) SHRSP+tMCAO+P4. P4 (8mg/kg) was administered 1h after occlusion and then daily for 14days. We measured cerebral infarction volume, blood pressure and body weight. Behavioral outcomes were analyzed at post-stroke days 3, 9, and 14. To assess morphological protection we measured activation of microglia and astrocytes, oxidative stress, apoptosis, expression of vascular endothelial growth factor (VEGF), an angiogenic marker, and IL-1β, a marker of inflammation, on day 14 post-stroke. There was no effect of P4 on body weight or systolic blood pressure compared to the SHRSP+tMCAO group. However, grip strength and sensory neglect measures in the P4 group were improved compared to SHRSP+tMCAO. In addition, significantly larger infarct volumes were seen in the SHRSP+tMCAO group compared to SHRSP+tMCAO+P4. Increased markers of the injury cascade such as macrophages, activated astrocytes, superoxide anion and apoptotic cells observed in the SHRSP+tMCAO group were significantly decreased by P4. We conclude that, despite hypertensive comorbidity, P4 improves functional outcomes and attenuates stroke infarct in hypertensive rats by reducing superoxide anion expression and by decreasing inflammation and neuronal apoptosis.
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Affiliation(s)
- Seema Yousuf
- Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA 30322, USA.
| | - Fahim Atif
- Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA 30322, USA.
| | - Iqbal Sayeed
- Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA 30322, USA.
| | - Jun Wang
- Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA 30322, USA.
| | - Donald G Stein
- Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA 30322, USA.
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16
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Gomes de Morais N, Barreto da Costa T, Bezerra de Lira JM, da Cunha Gonçalves de Albuquerque S, Alves Pereira VR, de Paiva Cavalcanti M, Machado Barbosa de Castro CM. TLR and NLRP3 inflammasome expression deregulation in macrophages of adult rats subjected to neonatal malnutrition and infected with methicillin-resistant Staphylococcus aureus. Nutrition 2016; 33:174-180. [PMID: 27637169 DOI: 10.1016/j.nut.2016.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 05/26/2016] [Accepted: 06/02/2016] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Nutritional aggression in critical periods may lead to epigenetic changes that affect gene expression. The aim of this study was to assess the effect of neonatal malnutrition on the expression of toll-like receptor (TLR)-2, TLR-4, and NLRP3 receptors, caspase-1 enzyme, and interleukin (IL)-1 β production in macrophages infected with methicillin-resistant (MRSA) and methicillin-sensitive (MSSA) Staphylococcus aureus. METHODS Wistar rats (N = 24) were divided in two distinct groups: nourished (17% casein) and malnourished (8% casein). Four systems were established after the isolation of mononuclear cells: negative control, positive control, MRSA, and MSSA. The plates were incubated at 37°C for 24 h in humidified atmosphere and 5% carbon dioxide. Tests were performed after this period to analyze the expression of standard recognition receptors, caspase-1 enzyme, and the production of IL-1 β. Student's t test and analysis of variance were used in the statistical analysis; P < 0.05 was statistically significant. RESULTS Malnutrition reduced animal growth and the expression of TLR-2, TLR-4, and NLRP3 receptors, the caspase-1 enzyme, and the IL-1 β levels in macrophages infected with lipopolysaccharides in the present study. However, the interaction between the S. aureus and the macrophages promoted greater gene expression of receptors and enzymes. CONCLUSION The neonatal malnutrition model compromised the expression of standard recognition receptors, of the caspase-1 enzyme as well as the production of IL-1 β. However, the S. aureus and neonatal malnutrition combination led to intense transcription of such innate immunity components. Therefore, the deregulation in the expression of TLR and NLRP3 receptors and of the caspase-1 enzyme may induce extensive tissue injury and favor the permanence and spread of these bacteria, especially those that are methicillin resistant.
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Affiliation(s)
- Natália Gomes de Morais
- Laboratory of Immunopathology Keizo Asami, Federal University of Pernambuco, Pernambuco, Brazil.
| | | | | | | | - Valéria Rêgo Alves Pereira
- Laboratory of Immunogenetics, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Pernambuco, Brazil
| | - Milena de Paiva Cavalcanti
- Laboratory of Immunoparasitology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Pernambuco, Brazil
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17
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Zhang J, Rudemiller NP, Patel MB, Karlovich NS, Wu M, McDonough AA, Griffiths R, Sparks MA, Jeffs AD, Crowley SD. Interleukin-1 Receptor Activation Potentiates Salt Reabsorption in Angiotensin II-Induced Hypertension via the NKCC2 Co-transporter in the Nephron. Cell Metab 2016; 23:360-8. [PMID: 26712462 PMCID: PMC4749461 DOI: 10.1016/j.cmet.2015.11.013] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 10/26/2015] [Accepted: 11/17/2015] [Indexed: 01/13/2023]
Abstract
Hypertension is among the most prevalent and catastrophic chronic diseases worldwide. While the efficacy of renin angiotensin system (RAS) blockade in lowering blood pressure illustrates that the RAS is broadly activated in human hypertension, the frequent failure of RAS inhibition to prevent or reverse hypertensive organ damage highlights the need for novel therapies to combat RAS-dependent hypertension. We previously discovered elevated levels of the macrophage cytokine IL-1 in the kidney in a murine model of RAS-mediated hypertension. Here we report that IL-1 receptor (IL-1R1) deficiency or blockade limits blood pressure elevation in this model by mitigating sodium reabsorption via the NKCC2 co-transporter in the nephron. In this setting, IL-1R1 activation prevents intra-renal myeloid cells from maturing into Ly6C(+)Ly6G(-) macrophages that elaborate nitric oxide, a natriuretic hormone that suppresses NKCC2 activity. By revealing how the innate immune system regulates tubular sodium transport, these experiments should lead to new immunomodulatory anti-hypertensive therapies.
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Affiliation(s)
- Jiandong Zhang
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, NC 27710, USA
| | - Nathan P Rudemiller
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, NC 27710, USA
| | - Mehul B Patel
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, NC 27710, USA
| | - Norah S Karlovich
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, NC 27710, USA
| | - Min Wu
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, NC 27710, USA
| | - Alicia A McDonough
- Department of Cell and Neurobiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Robert Griffiths
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, NC 27710, USA
| | - Matthew A Sparks
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, NC 27710, USA
| | - Alexander D Jeffs
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, NC 27710, USA
| | - Steven D Crowley
- Division of Nephrology, Department of Medicine, Duke University and Durham VA Medical Centers, Durham, NC 27710, USA.
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18
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Da Costa TB, De Morais NG, De Lira JMB, De Almeida TM, Gonçalves-De-Albuquerque SDC, Pereira VRA, De Paiva Cavalcanti M, De Castro CMMB. Relation between neonatal malnutrition and gene expression: inflammasome function in infections caused by Candida Albicans. Eur J Nutr 2015; 56:693-704. [PMID: 26658898 DOI: 10.1007/s00394-015-1113-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 11/22/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate the effects of neonatal malnutrition followed by nutritional replacement on the signaling mechanisms developed by the inflammasome complex by analyzing the expression of the targeted TLR2, TLR4, NLRP3, caspase-1 and release of IL-1β and IL-18 by alveolar macrophages infected in vitro with Candida albicans. METHODS Male Wistar rats (n = 24), 90-120 days, were suckled by mothers whose diet during lactation contained 17 % protein in the nourish group and 8 % protein in the malnourished group. After weaning, both groups were fed a normal protein diet. Macrophages were obtained after tracheostomy, through the collection of bronchoalveolar lavage fluid. The quantification of the expression levels of targets (TLR2, TLR4, NLRP3 and caspase-1) was performed by real-time RT-PCR. Production of cytokines was performed by ELISA. RESULTS The malnourished animals during lactation showed reduced body weight from the fifth day of life, remaining until adulthood. Further, the model applied malnutrition induced a lower expression of TLR4 and caspase-1. The quantification of the TLR2 and NLRP3, as well as the release of IL-1β and IL-18, was not different between groups of animals nourished and malnourished. The system challenged with Candida albicans showed high expression levels of all targets in the study. CONCLUSIONS The tests demonstrate nutritional restriction during critical periods of development, although nutritional supplementation may compromise defense patterns in adulthood in a timely manner, preserving distinct signaling mechanism, so that the individual does not become widely vulnerable to infections by opportunistic pathogens.
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Affiliation(s)
- Thacianna Barreto Da Costa
- Department of Tropical Medicine, Federal University of Pernambuco, Recife, Brazil. .,Keizo Asami Laboratory of Immunopathology, Federal University of Pernambuco, Av. Prof. Moraes Rego, 1235, Cidade Universitária, Recife, Pernambuco, 50670-901, Brazil.
| | - Natália Gomes De Morais
- Department of Tropical Medicine, Federal University of Pernambuco, Recife, Brazil.,Keizo Asami Laboratory of Immunopathology, Federal University of Pernambuco, Av. Prof. Moraes Rego, 1235, Cidade Universitária, Recife, Pernambuco, 50670-901, Brazil
| | - Joana Maria Bezerra De Lira
- Keizo Asami Laboratory of Immunopathology, Federal University of Pernambuco, Av. Prof. Moraes Rego, 1235, Cidade Universitária, Recife, Pernambuco, 50670-901, Brazil
| | - Thays Miranda De Almeida
- Department of Immunology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Campus Federal University of Pernambuco, Recife, Brazil
| | | | - Valéria Rêgo Alves Pereira
- Department of Immunology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Campus Federal University of Pernambuco, Recife, Brazil
| | - Milena De Paiva Cavalcanti
- Department of Immunology, Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Campus Federal University of Pernambuco, Recife, Brazil
| | - Célia Maria Machado Barbosa De Castro
- Department of Tropical Medicine, Federal University of Pernambuco, Recife, Brazil.,Keizo Asami Laboratory of Immunopathology, Federal University of Pernambuco, Av. Prof. Moraes Rego, 1235, Cidade Universitária, Recife, Pernambuco, 50670-901, Brazil
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Horgan SJ, Watson CJ, Glezeva N, Collier P, Neary R, Tea IJ, Corrigan N, Ledwidge M, McDonald K, Baugh JA. Serum Amyloid P-Component Prevents Cardiac Remodeling in Hypertensive Heart Disease. J Cardiovasc Transl Res 2015; 8:554-66. [PMID: 26577946 DOI: 10.1007/s12265-015-9661-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 11/09/2015] [Indexed: 01/19/2023]
Abstract
The potential for serum amyloid P-component (SAP) to prevent cardiac remodeling and identify worsening diastolic dysfunction (DD) was investigated. The anti-fibrotic potential of SAP was tested in an animal model of hypertensive heart disease (spontaneously hypertensive rats treated with SAP [SHR - SAP] × 12 weeks). Biomarker analysis included a prospective study of 60 patients with asymptomatic progressive DD. Compared with vehicle-treated Wistar-Kyoto rats (WKY-V), the vehicle-treated SHRs (SHR-V) exhibited significant increases in left ventricular mass, perivascular collagen, cardiomyocyte size, and macrophage infiltration. SAP administration was associated with significantly lower left ventricular mass (p < 0.01), perivascular collagen (p < 0.01), and cardiomyocyte size (p < 0.01). Macrophage infiltration was significantly attenuated in the SHR-SAP group. Biomarker analysis showed significant decreases in SAP concentration over time in patients with progressive DD (p < 0.05). Our results indicate that SAP prevents cardiac remodeling by inhibiting recruitment of pro-fibrotic macrophages and that depleted SAP levels identify patients with advancing DD suggesting a role for SAP therapy.
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Affiliation(s)
- Stephen J Horgan
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine, University College Dublin, Belfield, Dublin, Ireland.,Chronic Cardiovascular Disease Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Chris J Watson
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine, University College Dublin, Belfield, Dublin, Ireland.,Chronic Cardiovascular Disease Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Nadia Glezeva
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine, University College Dublin, Belfield, Dublin, Ireland.,Chronic Cardiovascular Disease Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Pat Collier
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine, University College Dublin, Belfield, Dublin, Ireland.,Chronic Cardiovascular Disease Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.,Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Roisin Neary
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Isaac J Tea
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Niamh Corrigan
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Mark Ledwidge
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine, University College Dublin, Belfield, Dublin, Ireland.,Chronic Cardiovascular Disease Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Ken McDonald
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine, University College Dublin, Belfield, Dublin, Ireland.,Chronic Cardiovascular Disease Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - John A Baugh
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine, University College Dublin, Belfield, Dublin, Ireland.
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20
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Peltsch H, Khurana S, Byrne CJ, Nguyen P, Khaper N, Kumar A, Tai TC. Cardiac phenylethanolamine N-methyltransferase: localization and regulation of gene expression in the spontaneously hypertensive rat. Can J Physiol Pharmacol 2015; 94:363-72. [PMID: 26761434 DOI: 10.1139/cjpp-2015-0303] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Phenylethanolamine N-methyltransferase (PNMT) is the terminal enzyme in the catecholamine biosynthetic pathway responsible for adrenaline biosynthesis. Adrenaline is involved in the sympathetic control of blood pressure; it augments cardiac function by increasing stroke volume and cardiac output. Genetic mapping studies have linked the PNMT gene to hypertension. This study examined the expression of cardiac PNMT and changes in its transcriptional regulators in the spontaneously hypertensive (SHR) and wild type Wistar-Kyoto (WKY) rats. SHR exhibit elevated levels of corticosterone, and lower levels of the cytokine IL-1β, revealing systemic differences between SHR and WKY. PNMT mRNA was significantly increased in all chambers of the heart in the SHR, with the greatest increase in the right atrium. Transcriptional regulators of the PNMT promoter show elevated expression of Egr-1, Sp1, AP-2, and GR mRNA in all chambers of the SHR heart, while protein levels of Sp1, Egr-1, and GR were elevated only in the right atrium. Interestingly, only AP-2 protein-DNA binding was increased, suggesting it may be a key regulator of cardiac PNMT in SHR. This study provides the first insights into the molecular mechanisms involved in the dysregulation of cardiac PNMT in a genetic model of hypertension.
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Affiliation(s)
- Heather Peltsch
- a Department of Biology, Laurentian University, Sudbury, ON, Canada
| | - Sandhya Khurana
- e Medical Sciences Division, Northern Ontario School of Medicine, East Campus, 935 Ramsey Lake Road, Sudbury, ON P3E 2C6, Canada
| | - Collin J Byrne
- a Department of Biology, Laurentian University, Sudbury, ON, Canada
| | - Phong Nguyen
- a Department of Biology, Laurentian University, Sudbury, ON, Canada
| | - Neelam Khaper
- d Medical Sciences Division, Northern Ontario School of Medicine, Thunder Bay, ON, Canada
| | - Aseem Kumar
- b Department of Chemistry and Biochemistry, Laurentian University, Sudbury, ON, Canada.,c Biomolecular Sciences, Laurentian University, Sudbury, ON, Canada
| | - T C Tai
- a Department of Biology, Laurentian University, Sudbury, ON, Canada.,b Department of Chemistry and Biochemistry, Laurentian University, Sudbury, ON, Canada.,c Biomolecular Sciences, Laurentian University, Sudbury, ON, Canada.,e Medical Sciences Division, Northern Ontario School of Medicine, East Campus, 935 Ramsey Lake Road, Sudbury, ON P3E 2C6, Canada
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21
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Venkat P, Chopp M, Chen J. Models and mechanisms of vascular dementia. Exp Neurol 2015; 272:97-108. [PMID: 25987538 DOI: 10.1016/j.expneurol.2015.05.006] [Citation(s) in RCA: 199] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 05/04/2015] [Accepted: 05/08/2015] [Indexed: 02/02/2023]
Abstract
Vascular dementia (VaD) is the second leading form of dementia after Alzheimer's disease (AD) plaguing the elderly population. VaD is a progressive disease caused by reduced blood flow to the brain, and it affects cognitive abilities especially executive functioning. VaD is poorly understood and lacks suitable animal models, which constrain the progress on understanding the basis of the disease and developing treatments. This review article discusses VaD, its risk factors, induced cognitive disability, various animal (rodent) models of VaD, pathology, and mechanisms of VaD and treatment options.
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Affiliation(s)
- Poornima Venkat
- Neurology, Henry Ford Hospital, Detroit, MI, USA; Physics, Oakland University, Rochester, MI, USA.
| | - Michael Chopp
- Neurology, Henry Ford Hospital, Detroit, MI, USA; Physics, Oakland University, Rochester, MI, USA.
| | - Jieli Chen
- Neurology, Henry Ford Hospital, Detroit, MI, USA; Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Geriatrics Institute, Tianjin, China.
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22
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Abstract
Acute systemic inflammatory reaction superimposed on chronic low-grade inflammation accompanies acute ischemic stroke. Elevated blood levels of systemic inflammatory markers such as IL-6 or C-reactive protein are associated with an unfavorable functional outcome and increased mortality after stroke. Animal studies have demonstrated a causal relationship between systemic inflammation and ischemic brain damage. The mechanisms linking systemic inflammation with poor outcome include increased neutrophil infiltration of cerebral cortex, disruption of the blood-brain barrier, impaired tissue reperfusion, increased platelet activation and microvascular coagulation and complement-dependent brain injury. Non-selective (e.g., by statins) or selective (e.g., by inhibition of IL-6) attenuation of systemic inflammation, enhancement of systemic anti-inflammatory response (e.g., by infusion of IL-1 receptor antagonist), prevention of infections that exacerbate systemic inflammation or inhibition of neuronal pathways triggering inflammatory reaction are potential therapeutic targets in stroke patients. This review discusses the relationship between systemic inflammation, cerebral ischemia and prognosis in the context of therapeutic strategies.
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Affiliation(s)
- Tomasz Dziedzic
- Department of Neurology, Jagiellonian University Medical Collage, ul. Botaniczna 3, 31-503 Kraków, Poland
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23
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Chiba T, Yokotani K, Suzuki S, Itoh T, Umegaki K. Resveratrol Partially Suppresses Inflammatory Events but Does not Affect Stroke Onset in Stroke-Prone Spontaneously Hypertensive Rats. J Atheroscler Thromb 2015; 22:958-70. [DOI: 10.5551/jat.27789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Tsuyoshi Chiba
- Information Center, National Institute of Health and Nutrition
| | - Kaori Yokotani
- Information Center, National Institute of Health and Nutrition
| | - Sachina Suzuki
- Information Center, National Institute of Health and Nutrition
| | - Tatsuki Itoh
- Department of Food Science and Nutrition, Kinki University Faculty of Agriculture
| | - Keizo Umegaki
- Information Center, National Institute of Health and Nutrition
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24
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Chemokines and neurodegeneration in the early stage of experimental ischemic stroke. Mediators Inflamm 2013; 2013:727189. [PMID: 24324296 PMCID: PMC3844257 DOI: 10.1155/2013/727189] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 09/15/2013] [Accepted: 10/11/2013] [Indexed: 01/17/2023] Open
Abstract
Neurodegeneration is a hallmark of most of the central nervous system (CNS) disorders including stroke. Recently inflammation has been implicated in pathogenesis of neurodegeneration and neurodegenerative diseases. The aim of this study was analysis of expression of several inflammatory markers and its correlation with development of neurodegeneration during the early stage of experimental stroke. Ischemic stroke model was induced by stereotaxic intracerebral injection of vasoconstricting agent endothelin-1 (ET-1). It was observed that neurodegeneration appears very early in that model and correlates well with migration of inflammatory lymphocytes and macrophages to the brain. Although the expression of several studied chemotactic cytokines (chemokines) was significantly increased at the early phase of ET-1 induced stroke model, no clear correlation of this expression with neurodegeneration was observed. These data may indicate that chemokines do not induce neurodegeneration directly. Upregulated in the ischemic brain chemokines may be a potential target for future therapies reducing inflammatory cell migration to the brain in early stroke. Inhibition of inflammatory cell accumulation in the brain at the early stage of stroke may lead to amelioration of ischemic neurodegeneration.
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25
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Xiong X, Xu C, Zhang Y, Li X, Wang B, Wang F, Yang Q, Wang D, Wang X, Li S, Chen S, Zhao Y, Yin D, Huang Y, Zhu X, Wang L, Wang L, Chang L, Xu C, Li H, Ke T, Ren X, Wu Y, Zhang R, Wu T, Xia Y, Yang Y, Ma X, Tu X, Wang QK. BRG1 variant rs1122608 on chromosome 19p13.2 confers protection against stroke and regulates expression of pre-mRNA-splicing factor SFRS3. Hum Genet 2013; 133:499-508. [PMID: 24190014 DOI: 10.1007/s00439-013-1389-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Accepted: 10/26/2013] [Indexed: 01/31/2023]
Abstract
A single nucleotide polymorphism (SNP) rs1122608 on chromosome 19p13.2 and in the BRG1/SMARCA4 gene was previously associated with coronary artery disease (CAD). CAD and ischemic stroke are both associated with atherosclerosis. Thus, we tested the hypothesis that rs1122608 is associated with ischemic stroke. Further studies were used to identify the most likely mechanism by which rs1122608 regulates atherosclerosis. For case-control association studies, two independent Chinese Han GeneID cohorts were used, including a Central cohort with 1,075 cases and 2,685 controls and the Northern cohort with 1,208 cases and 824 controls. eQTL and real-time RT-PCR analyses were used to identify the potential candidate gene(s) affected by rs1122608. The minor allele T of SNP rs1122608 showed significant association with a decreased risk of ischemic stroke in the Central GeneID cohort (adjusted P adj = 2.1 × 10(-4), OR 0.61). The association was replicated in an independent Northern GeneID cohort (P adj = 6.00 × 10(-3), OR 0.69). The association became more significant in the combined population (P adj = 7.86 × 10(-5), OR 0.73). Allele T of SNP rs1122608 also showed significant association with a decreased total cholesterol level (P adj = 0.013). Allele T of rs1122608 was associated with an increased expression level of SFRS3 encoding an mRNA splicing regulator, but not with the expression of BRG1/SMARCA4 or LDLR (located 36 kb from rs1122608). Increased expression of SFSR3 may decrease IL-1β expression and secretion, resulting in reduced risk of atherosclerosis and stroke. This is the first study that demonstrates that rs1122608 confers protection against ischemic stroke and implicates splicing factor SFSR3 in the disease process.
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Affiliation(s)
- Xin Xiong
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology and Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology, Wuhan, China
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