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Kunamalla A, Ng J, Parini V, Yoo S, McGee KA, Tomson TT, Gordon D, Thorp EB, Lomasney J, Zhang Q, Shah S, Browne S, Knight BP, Passman R, Goldberger JJ, Aistrup G, Arora R. Constitutive Expression of a Dominant-Negative TGF-β Type II Receptor in the Posterior Left Atrium Leads to Beneficial Remodeling of Atrial Fibrillation Substrate. Circ Res 2016; 119:69-82. [PMID: 27217399 DOI: 10.1161/circresaha.115.307878] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 05/23/2016] [Indexed: 11/16/2022]
Abstract
RATIONALE Fibrosis is an important structural contributor to formation of atrial fibrillation (AF) substrate in heart failure. Transforming growth factor-β (TGF-β) signaling is thought to be intricately involved in creation of atrial fibrosis. OBJECTIVE We hypothesized that gene-based expression of dominant-negative type II TGF-β receptor (TGF-β-RII-DN) in the posterior left atrium in a canine heart failure model will sufficiently attenuate fibrosis-induced changes in atrial conduction and restitution to decrease AF. Because AF electrograms are thought to reflect AF substrate, we further hypothesized that TGF-β-RII-DN would lead to increased fractionation and decreased organization of AF electrograms. METHODS AND RESULTS Twenty-one dogs underwent injection+electroporation in the posterior left atrium of plasmid expressing a dominant-negative TGF-β type II receptor (pUBc-TGFβ-DN-RII; n=9) or control vector (pUBc-LacZ; n=12), followed by 3 to 4 weeks of right ventricular tachypacing (240 bpm). Compared with controls, dogs treated with pUBC-TGFβ-DN-RII demonstrated an attenuated increase in conduction inhomogeneity, flattening of restitution slope and decreased duration of induced AF, with AF electrograms being more fractionated and less organized in pUBc-TGFβ-DN-RII versus pUBc-LacZ dogs. Tissue analysis revealed a significant decrease in replacement/interstitial fibrosis, p-SMAD2/3 and p-ERK1/2. CONCLUSIONS Targeted gene-based reduction of TGF-β signaling in the posterior left atrium-with resulting decrease in replacement fibrosis-led to beneficial remodeling of both conduction and restitution characteristics of the posterior left atrium, translating into a decrease in AF and increased complexity of AF electrograms. In addition to providing mechanistic insights, this data may have important diagnostic and therapeutic implications for AF.
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Affiliation(s)
- Aaron Kunamalla
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Jason Ng
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Vamsi Parini
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Shin Yoo
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Kate A McGee
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Todd T Tomson
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - David Gordon
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Edward B Thorp
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Jon Lomasney
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Qiang Zhang
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Sanjiv Shah
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Suzanne Browne
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Bradley P Knight
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Rod Passman
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Jeffrey J Goldberger
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Gary Aistrup
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Rishi Arora
- From the Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL.
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Kalk P, Sharkovska Y, Kashina E, von Websky K, Relle K, Pfab T, Alter M, Guillaume P, Provost D, Hoffmann K, Fischer Y, Hocher B. Endothelin-Converting Enzyme/Neutral Endopeptidase Inhibitor SLV338 Prevents Hypertensive Cardiac Remodeling in a Blood Pressure–Independent Manner. Hypertension 2011; 57:755-63. [DOI: 10.1161/hypertensionaha.110.163972] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hypertensive heart disease is a major contributor to cardiovascular mortality. Endothelin is a potent vasoconstrictive and profibrotic mediator produced by the endothelin-converting enzyme (ECE), whereas natriuretic peptides, degraded by the neutral endopeptidase (NEP), have diuretic, vasodilatory, and antifibrotic properties. Thus, combined ECE/NEP inhibition may halt hypertensive cardiac remodeling. This study examined effects of SLV338, a novel ECE/NEP inhibitor, on cardiac protection in experimental renovascular hypertension (2-kidney, 1-clip [2K1C]). Male rats were allocated to 5 groups: sham-operated rats, untreated animals with 2K1C, 2K1C animals treated with oral SLV338 (30 and 100 mg/kg per day), and 2K1C animals treated with oral losartan (20 mg/kg per day). Treatment duration was 12 weeks. Blood pressure was assessed every 4 weeks. At study end, hearts were taken for histology/computer-aided histomorphometry/immunohistochemistry. Pharmacological properties of SLV338 are described. SLV338 is a dual ECE/NEP inhibitor, as demonstrated both in vitro and in vivo. In the 2K1C study, losartan lowered blood pressure by ≤46 mm Hg, whereas both dosages of SLV338 had no effect. However, SLV338 (both dosages) completely normalized cardiac interstitial fibrosis, perivascular fibrosis, myocyte diameter, and media:lumen ratio of cardiac arteries, as did losartan. Cardiac transforming growth factor-β1 expression was significantly enhanced in untreated 2K1C rats versus controls, whereas treatment with SLV338 and losartan prevented this effect. Taken together, dual ECE/NEP inhibitor SLV338 prevents cardiac remodeling to the same extent as losartan, but in a blood pressure–independent manner, in a rat model of renovascular hypertension. This effect is at least partially mediated via suppression of cardiac transforming growth factor-β1 expression.
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Affiliation(s)
- Philipp Kalk
- From the Department of Nephrology (P.K., T.P., M.A.), Charité, Campus Benjamin Franklin, Berlin, Germany; Center for Cardiovascular Research/Institute of Pharmacology (P.K., Y.S., E.K., K.v.W., K.R., T.P., M.A., B.H.), Charité, Campus Mitte, Berlin, Germany; Institute for Nutritional Science (Y.S., K.v.W., K.R., B.H.), University of Potsdam, Potsdam, Germany; Porsolt and Partners Pharmacology (P.G., D.P.), Le Genest-Saint-Isle, France; Abbott Products GmbH (K.H., Y.F.), Hannover, Germany; and
| | - Yuliya Sharkovska
- From the Department of Nephrology (P.K., T.P., M.A.), Charité, Campus Benjamin Franklin, Berlin, Germany; Center for Cardiovascular Research/Institute of Pharmacology (P.K., Y.S., E.K., K.v.W., K.R., T.P., M.A., B.H.), Charité, Campus Mitte, Berlin, Germany; Institute for Nutritional Science (Y.S., K.v.W., K.R., B.H.), University of Potsdam, Potsdam, Germany; Porsolt and Partners Pharmacology (P.G., D.P.), Le Genest-Saint-Isle, France; Abbott Products GmbH (K.H., Y.F.), Hannover, Germany; and
| | - Elena Kashina
- From the Department of Nephrology (P.K., T.P., M.A.), Charité, Campus Benjamin Franklin, Berlin, Germany; Center for Cardiovascular Research/Institute of Pharmacology (P.K., Y.S., E.K., K.v.W., K.R., T.P., M.A., B.H.), Charité, Campus Mitte, Berlin, Germany; Institute for Nutritional Science (Y.S., K.v.W., K.R., B.H.), University of Potsdam, Potsdam, Germany; Porsolt and Partners Pharmacology (P.G., D.P.), Le Genest-Saint-Isle, France; Abbott Products GmbH (K.H., Y.F.), Hannover, Germany; and
| | - Karoline von Websky
- From the Department of Nephrology (P.K., T.P., M.A.), Charité, Campus Benjamin Franklin, Berlin, Germany; Center for Cardiovascular Research/Institute of Pharmacology (P.K., Y.S., E.K., K.v.W., K.R., T.P., M.A., B.H.), Charité, Campus Mitte, Berlin, Germany; Institute for Nutritional Science (Y.S., K.v.W., K.R., B.H.), University of Potsdam, Potsdam, Germany; Porsolt and Partners Pharmacology (P.G., D.P.), Le Genest-Saint-Isle, France; Abbott Products GmbH (K.H., Y.F.), Hannover, Germany; and
| | - Katharina Relle
- From the Department of Nephrology (P.K., T.P., M.A.), Charité, Campus Benjamin Franklin, Berlin, Germany; Center for Cardiovascular Research/Institute of Pharmacology (P.K., Y.S., E.K., K.v.W., K.R., T.P., M.A., B.H.), Charité, Campus Mitte, Berlin, Germany; Institute for Nutritional Science (Y.S., K.v.W., K.R., B.H.), University of Potsdam, Potsdam, Germany; Porsolt and Partners Pharmacology (P.G., D.P.), Le Genest-Saint-Isle, France; Abbott Products GmbH (K.H., Y.F.), Hannover, Germany; and
| | - Thiemo Pfab
- From the Department of Nephrology (P.K., T.P., M.A.), Charité, Campus Benjamin Franklin, Berlin, Germany; Center for Cardiovascular Research/Institute of Pharmacology (P.K., Y.S., E.K., K.v.W., K.R., T.P., M.A., B.H.), Charité, Campus Mitte, Berlin, Germany; Institute for Nutritional Science (Y.S., K.v.W., K.R., B.H.), University of Potsdam, Potsdam, Germany; Porsolt and Partners Pharmacology (P.G., D.P.), Le Genest-Saint-Isle, France; Abbott Products GmbH (K.H., Y.F.), Hannover, Germany; and
| | - Markus Alter
- From the Department of Nephrology (P.K., T.P., M.A.), Charité, Campus Benjamin Franklin, Berlin, Germany; Center for Cardiovascular Research/Institute of Pharmacology (P.K., Y.S., E.K., K.v.W., K.R., T.P., M.A., B.H.), Charité, Campus Mitte, Berlin, Germany; Institute for Nutritional Science (Y.S., K.v.W., K.R., B.H.), University of Potsdam, Potsdam, Germany; Porsolt and Partners Pharmacology (P.G., D.P.), Le Genest-Saint-Isle, France; Abbott Products GmbH (K.H., Y.F.), Hannover, Germany; and
| | - Philippe Guillaume
- From the Department of Nephrology (P.K., T.P., M.A.), Charité, Campus Benjamin Franklin, Berlin, Germany; Center for Cardiovascular Research/Institute of Pharmacology (P.K., Y.S., E.K., K.v.W., K.R., T.P., M.A., B.H.), Charité, Campus Mitte, Berlin, Germany; Institute for Nutritional Science (Y.S., K.v.W., K.R., B.H.), University of Potsdam, Potsdam, Germany; Porsolt and Partners Pharmacology (P.G., D.P.), Le Genest-Saint-Isle, France; Abbott Products GmbH (K.H., Y.F.), Hannover, Germany; and
| | - Daniel Provost
- From the Department of Nephrology (P.K., T.P., M.A.), Charité, Campus Benjamin Franklin, Berlin, Germany; Center for Cardiovascular Research/Institute of Pharmacology (P.K., Y.S., E.K., K.v.W., K.R., T.P., M.A., B.H.), Charité, Campus Mitte, Berlin, Germany; Institute for Nutritional Science (Y.S., K.v.W., K.R., B.H.), University of Potsdam, Potsdam, Germany; Porsolt and Partners Pharmacology (P.G., D.P.), Le Genest-Saint-Isle, France; Abbott Products GmbH (K.H., Y.F.), Hannover, Germany; and
| | - Katrin Hoffmann
- From the Department of Nephrology (P.K., T.P., M.A.), Charité, Campus Benjamin Franklin, Berlin, Germany; Center for Cardiovascular Research/Institute of Pharmacology (P.K., Y.S., E.K., K.v.W., K.R., T.P., M.A., B.H.), Charité, Campus Mitte, Berlin, Germany; Institute for Nutritional Science (Y.S., K.v.W., K.R., B.H.), University of Potsdam, Potsdam, Germany; Porsolt and Partners Pharmacology (P.G., D.P.), Le Genest-Saint-Isle, France; Abbott Products GmbH (K.H., Y.F.), Hannover, Germany; and
| | - Yvan Fischer
- From the Department of Nephrology (P.K., T.P., M.A.), Charité, Campus Benjamin Franklin, Berlin, Germany; Center for Cardiovascular Research/Institute of Pharmacology (P.K., Y.S., E.K., K.v.W., K.R., T.P., M.A., B.H.), Charité, Campus Mitte, Berlin, Germany; Institute for Nutritional Science (Y.S., K.v.W., K.R., B.H.), University of Potsdam, Potsdam, Germany; Porsolt and Partners Pharmacology (P.G., D.P.), Le Genest-Saint-Isle, France; Abbott Products GmbH (K.H., Y.F.), Hannover, Germany; and
| | - Berthold Hocher
- From the Department of Nephrology (P.K., T.P., M.A.), Charité, Campus Benjamin Franklin, Berlin, Germany; Center for Cardiovascular Research/Institute of Pharmacology (P.K., Y.S., E.K., K.v.W., K.R., T.P., M.A., B.H.), Charité, Campus Mitte, Berlin, Germany; Institute for Nutritional Science (Y.S., K.v.W., K.R., B.H.), University of Potsdam, Potsdam, Germany; Porsolt and Partners Pharmacology (P.G., D.P.), Le Genest-Saint-Isle, France; Abbott Products GmbH (K.H., Y.F.), Hannover, Germany; and
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