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Dong Y, Wang J, Yang C, Bao J, Liu X, Chen H, Zhang X, Shi W, Zhang L, Qi Q, Li Y, Wang S, Ma R, Cong B, Zhang G. Phosphorylated CPI-17 and MLC2 as Biomarkers of Coronary Artery Spasm-Induced Sudden Cardiac Death. Int J Mol Sci 2024; 25:2941. [PMID: 38474189 PMCID: PMC10932290 DOI: 10.3390/ijms25052941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/19/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
Coronary artery spasm (CAS) plays an important role in the pathogeneses of various ischemic heart diseases and has gradually become a common cause of life-threatening arrhythmia. The specific molecular mechanism of CAS has not been fully elucidated, nor are there any specific diagnostic markers for the condition. Therefore, this study aimed to examine the specific molecular mechanism underlying CAS, and screen for potential diagnostic markers. To this end, we successfully constructed a rat CAS model and achieved in vitro culture of a human coronary-artery smooth-muscle cell (hCASMC) contraction model. Possible molecular mechanisms by which protein kinase C (PKC) regulated CAS through the C kinase-potentiated protein phosphatase 1 inhibitor of 17 kDa (CPI-17)/myosin II regulatory light chain (MLC2) pathway were studied in vivo and in vitro to screen for potential molecular markers of CAS. We performed hematoxylin and eosin staining, myocardial zymogram, and transmission electron microscopy to determine myocardial and coronary artery injury in CAS rats. Then, using immunohistochemical staining, immunofluorescence staining, and Western blotting, we further demonstrated a potential molecular mechanism by which PKC regulated CAS via the CPI-17/MLC2 pathway. The results showed that membrane translocation of PKCα occurred in the coronary arteries of CAS rats. CPI-17/MLC2 signaling was observably activated in coronary arteries undergoing CAS. In addition, in vitro treatment of hCASMCs with angiotensin II (Ang II) increased PKCα membrane translocation while consistently activating CPI-17/MLC2 signaling. Conversely, GF-109203X and calphostin C, specific inhibitors of PKC, inactivated CPI-17/MLC2 signaling. We also collected the coronary artery tissues from deceased subjects suspected to have died of CAS and measured their levels of phosphorylated CPI-17 (p-CPI-17) and MLC2 (p-MLC2). Immunohistochemical staining was positive for p-CPI-17 and p-MLC2 in the tissues of these subjects. These findings suggest that PKCα induced CAS through the CPI-17/MLC2 pathway; therefore, p-CPI-17 and p-MLC2 could be used as potential markers for CAS. Our data provide novel evidence that therapeutic strategies against PKC or CPI-17/MLC2 signaling might be promising in the treatment of CAS.
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Affiliation(s)
- Yiming Dong
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China; (Y.D.); (J.W.); (C.Y.); (J.B.); (X.L.); (H.C.); (X.Z.); (W.S.); (L.Z.); (Q.Q.); (Y.L.); (S.W.); (R.M.); (B.C.)
| | - Jianfeng Wang
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China; (Y.D.); (J.W.); (C.Y.); (J.B.); (X.L.); (H.C.); (X.Z.); (W.S.); (L.Z.); (Q.Q.); (Y.L.); (S.W.); (R.M.); (B.C.)
| | - Chenteng Yang
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China; (Y.D.); (J.W.); (C.Y.); (J.B.); (X.L.); (H.C.); (X.Z.); (W.S.); (L.Z.); (Q.Q.); (Y.L.); (S.W.); (R.M.); (B.C.)
| | - Junxia Bao
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China; (Y.D.); (J.W.); (C.Y.); (J.B.); (X.L.); (H.C.); (X.Z.); (W.S.); (L.Z.); (Q.Q.); (Y.L.); (S.W.); (R.M.); (B.C.)
| | - Xia Liu
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China; (Y.D.); (J.W.); (C.Y.); (J.B.); (X.L.); (H.C.); (X.Z.); (W.S.); (L.Z.); (Q.Q.); (Y.L.); (S.W.); (R.M.); (B.C.)
| | - Hao Chen
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China; (Y.D.); (J.W.); (C.Y.); (J.B.); (X.L.); (H.C.); (X.Z.); (W.S.); (L.Z.); (Q.Q.); (Y.L.); (S.W.); (R.M.); (B.C.)
| | - Xiaojing Zhang
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China; (Y.D.); (J.W.); (C.Y.); (J.B.); (X.L.); (H.C.); (X.Z.); (W.S.); (L.Z.); (Q.Q.); (Y.L.); (S.W.); (R.M.); (B.C.)
| | - Weibo Shi
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China; (Y.D.); (J.W.); (C.Y.); (J.B.); (X.L.); (H.C.); (X.Z.); (W.S.); (L.Z.); (Q.Q.); (Y.L.); (S.W.); (R.M.); (B.C.)
| | - Lihua Zhang
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China; (Y.D.); (J.W.); (C.Y.); (J.B.); (X.L.); (H.C.); (X.Z.); (W.S.); (L.Z.); (Q.Q.); (Y.L.); (S.W.); (R.M.); (B.C.)
| | - Qian Qi
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China; (Y.D.); (J.W.); (C.Y.); (J.B.); (X.L.); (H.C.); (X.Z.); (W.S.); (L.Z.); (Q.Q.); (Y.L.); (S.W.); (R.M.); (B.C.)
| | - Yingmin Li
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China; (Y.D.); (J.W.); (C.Y.); (J.B.); (X.L.); (H.C.); (X.Z.); (W.S.); (L.Z.); (Q.Q.); (Y.L.); (S.W.); (R.M.); (B.C.)
| | - Songjun Wang
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China; (Y.D.); (J.W.); (C.Y.); (J.B.); (X.L.); (H.C.); (X.Z.); (W.S.); (L.Z.); (Q.Q.); (Y.L.); (S.W.); (R.M.); (B.C.)
| | - Rufei Ma
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China; (Y.D.); (J.W.); (C.Y.); (J.B.); (X.L.); (H.C.); (X.Z.); (W.S.); (L.Z.); (Q.Q.); (Y.L.); (S.W.); (R.M.); (B.C.)
| | - Bin Cong
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China; (Y.D.); (J.W.); (C.Y.); (J.B.); (X.L.); (H.C.); (X.Z.); (W.S.); (L.Z.); (Q.Q.); (Y.L.); (S.W.); (R.M.); (B.C.)
| | - Guozhong Zhang
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang 050017, China; (Y.D.); (J.W.); (C.Y.); (J.B.); (X.L.); (H.C.); (X.Z.); (W.S.); (L.Z.); (Q.Q.); (Y.L.); (S.W.); (R.M.); (B.C.)
- Hebei Province Laboratory of Experimental Animal, Shijiazhuang 050017, China
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Nishimiya K, Takahashi J, Oyama K, Matsumoto Y, Yasuda S, Shimokawa H. Mechanisms of Coronary Artery Spasm. Eur Cardiol 2023; 18:e39. [PMID: 37456775 PMCID: PMC10345984 DOI: 10.15420/ecr.2022.55] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 03/22/2023] [Indexed: 07/18/2023] Open
Abstract
Recent clinical trials have highlighted that percutaneous coronary intervention in patients with stable angina provides limited additional benefits on top of optimal medical therapy. This has led to much more attention being paid to coronary vasomotion abnormalities regardless of obstructive or non-obstructive arterial segments. Coronary vasomotion is regulated by multiple mechanisms that include the endothelium, vascular smooth muscle cells (VSMCs), myocardial metabolic demand, autonomic nervous system and inflammation. Over the years, several animal models have been developed to explore the central mechanism of coronary artery spasm. This review summarises the landmark studies on the mechanisms of coronary vasospasm demonstrating the central role of Rho-kinase as a molecular switch of VSMC hypercontraction and the important role of coronary adventitial inflammation for Rho-kinase upregulation in VSMCs.
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Affiliation(s)
- Kensuke Nishimiya
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan
| | - Kazuma Oyama
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan
| | - Yasuharu Matsumoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan
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Sinha A, Rahman H, Perera D. Vasospastic Angina: A Contemporary Review of its Pathophysiology, Diagnosis and Management. Heart Int 2022; 16:99-104. [PMID: 36741101 PMCID: PMC9872780 DOI: 10.17925/hi.2022.16.2.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/30/2022] [Indexed: 12/25/2022] Open
Abstract
Nearly 40% of patients presenting to the catheter laboratory with angina have non-obstructed coronary arteries (ANOCA), an umbrella term that encompasses distinct pathophysiological entities, such as coronary artery spasm. Coronary artery spasm leads to sudden reversible coronary flow attenuation, which clinically manifests as vasospastic angina (VSA). VSA is associated with poor quality of life and an increased risk of major adverse cardiac events. However, the pathophysiological mechanisms underlying this phenomenon are incompletely understood, which has resulted in limited therapeutic options for patients afflicted with this condition. The past decade has seen a surge in new research being conducted in the field of ANOCA and VSA. This review article provides a comprehensive summary of the underlying pathophysiological mechanisms of VSA and the current therapeutic options. We also appraise the current diagnostic approach in patients with suspected VSA.
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Affiliation(s)
- Aish Sinha
- The British Heart Foundation Centre of Excellence and the National Institute for Health and Care Research Biomedical Research Centre at the School of Cardiovascular Medicine and Sciences, King's College London, London, UK
| | - Haseeb Rahman
- The British Heart Foundation Centre of Excellence and the National Institute for Health and Care Research Biomedical Research Centre at the School of Cardiovascular Medicine and Sciences, King's College London, London, UK
| | - Divaka Perera
- The British Heart Foundation Centre of Excellence and the National Institute for Health and Care Research Biomedical Research Centre at the School of Cardiovascular Medicine and Sciences, King's College London, London, UK
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Boorman S, Douglas H, Driessen B, Gillespie MJ, Schaer TP. Fatal Ovarian Hemorrhage Associated With Anticoagulation Therapy in a Yucatan Mini-Pig Following Venous Stent Implantation. Front Vet Sci 2020; 7:18. [PMID: 32083102 PMCID: PMC7002391 DOI: 10.3389/fvets.2020.00018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 01/10/2020] [Indexed: 01/10/2023] Open
Abstract
Swine models are commonly utilized in endovascular research for development of intravascular interventions and medical device development. As part of a pilot study for a venous vascular stent device, a 5-year-old female Yucatan mini-pig underwent bilateral external iliac vein stent placement under general anesthesia. To reduce thrombotic complications by reduction of thrombus formation on wires, sheaths, and catheters, the pig was heparinized with a total of 300 IU/kg of heparin, establishing an activated clotting time (ACT) of 436 s. The ACT had returned to below 200 s by the end of the procedure. To prevent postoperative thrombosis, the pig received an anticoagulation therapy protocol consisting of enoxaparin, clopidogrel, and aspirin. There were no complications during the immediate postoperative period. However, the pig died 4 days after surgery. Necropsy established the cause of death as abdominal exsanguination due to severe, acute, intra-ovarian hemorrhage, most likely related to ovulation. Life-threatening ovarian hemorrhage is occasionally seen in women with congenital or acquired bleeding disorders; to our knowledge this is the first report of fatal ovarian hemorrhage in an animal enrolled in a pre-clinical research trial.
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Affiliation(s)
- Sophie Boorman
- Department of Clinical Sciences, College of Veterinary Medicine, JT Vaughan Large Animal Teaching Hospital, Auburn University, Auburn, AL, United States
| | - Hope Douglas
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Bernd Driessen
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Matthew J Gillespie
- Department of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Thomas P Schaer
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Kodaira M, Tabei R, Kuno T, Numasawa Y. Catastrophic catheter-induced coronary artery vasospasm successfully rescued using intravascular ultrasound imaging guidance. BMJ Case Rep 2017; 2017:bcr-2017-222607. [PMID: 29222206 DOI: 10.1136/bcr-2017-222607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 46-year-old man underwent coronary angiography for stable angina. He developed inferior ST-segment myocardial infarction during the angiography. Intravascular ultrasound (IVUS) findings suggested coronary vasospasm. Intracoronary administration of isosorbide dinitrate restored the coronary flow. This case illustrates the essential role IVUS imaging played in establishing the diagnosis of catheter-induced coronary vasospasm.
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Affiliation(s)
- Masaki Kodaira
- Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan
| | - Ryota Tabei
- Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan
| | - Toshiki Kuno
- Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan
| | - Yohei Numasawa
- Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan
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Selli C, Tosun M. Effects of cyclopiazonic acid and dexamethasone on serotonin-induced calcium responses in vascular smooth muscle cells. J Physiol Biochem 2016; 72:245-53. [PMID: 26944908 PMCID: PMC4873523 DOI: 10.1007/s13105-016-0474-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/20/2016] [Indexed: 01/24/2023]
Abstract
We previously observed that sarcoendoplasmic reticulum Ca(2+) ATPase (SERCA) blockade by cyclopiazonic acid (CPA) significantly potentiates serotonin (5-hydroxytryptamine (5-HT))-induced vascular contractions. Furthermore, 5-HT receptor antagonist methysergide partially inhibited CPA-potentiated 5-HT contractions. In the present study, we further investigated whether SERCA inhibition potentiates 5-HT-induced Ca(2+) responses along with attenuating the receptor antagonism by store-operated Ca(2+) (SOC) entry and protein kinase C (PKC)-mediated mechanisms. The effects of dexamethasone that was previously shown to induce SOC entry and enhance 5-HT responses were also tested. For this purpose, intracellular Ca(2+) levels were monitored in A7r5 embryonic rat vascular smooth muscle cells by spectrofluorometry using the fluorescent indicator fura-2. The results showed that CPA, although not dexamethasone, significantly potentiated 5-HT-induced Ca(2+) elevations. Ketanserin partially decreased 5-HT-induced and CPA-potentiated Ca(2+) elevations whereas both PKC inhibitor D-sphingosine and SOC entry blocker 2-aminoethoxydiphenyl borate (2-APB) abolished the remaining responses. The data suggests that diminished antagonistic effect on 5-HT-induced Ca(2+) elevations in the presence of SERCA inhibition is induced by SOC entry and PKC activation.
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Affiliation(s)
- Cigdem Selli
- Department of Pharmacology, Faculty of Pharmacy, Ege University, 35040, Izmir, Turkey. .,Applied Bioinformatics of Cancer, Edinburgh Cancer Research Centre, Institute of Genetics and Molecular Medicine, Edinburgh, EH4 2XU, UK.
| | - Metiner Tosun
- Department of Pharmacology, Faculty of Pharmacy, Ege University, 35040, Izmir, Turkey
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Shimokawa H. 2014 Williams Harvey Lecture: importance of coronary vasomotion abnormalities-from bench to bedside. Eur Heart J 2014; 35:3180-93. [PMID: 25354517 DOI: 10.1093/eurheartj/ehu427] [Citation(s) in RCA: 156] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Coronary vasomotion abnormalities play important roles in the pathogenesis of ischaemic heart disease, in which endothelial dysfunction and coronary artery spasm are substantially involved. Endothelial vasodilator functions are heterogeneous depending on the vessel size, with relatively greater role of nitric oxide (NO) in conduit arteries and predominant role of endothelium-derived hyperpolarizing factor (EDHF) in resistance arteries, where endothelium-derived hydrogen peroxide serves as an important EDHF. The functions of NO synthases in the endothelium are also heterogeneous with multiple mechanisms involved, accounting for the diverse functions of the endothelium in vasomotor as well as metabolic modulations. Cardiovascular abnormalities and metabolic phenotypes become evident when all three NO synthases are deleted, suggesting the importance of both NO and EDHF. Coronary artery spasm plays important roles in the pathogenesis of a wide range of ischaemic heart disease. The central mechanism of the spasm is hypercontraction of vascular smooth muscle cells (VSMCs), but not endothelial dysfunction, where activation of Rho-kinase, a molecular switch of VSMC contraction, plays a major role through inhibition of myosin light-chain phosphatase. The Rho-kinase pathway is also involved in the pathogenesis of a wide range of cardiovascular diseases and new Rho-kinase inhibitors are under development for various indications. The registry study by the Japanese Coronary Spasm Association has demonstrated many important aspects of vasospastic angina. The ongoing international registry study of vasospastic angina in six nations should elucidate the unknown aspects of the disorder. Coronary vasomotion abnormalities appear to be an important therapeutic target in cardiovascular medicine.
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Affiliation(s)
- Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
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Raffai G, Khang G, Vanhoutte PM. Vanillin and vanillin analogs relax porcine coronary and basilar arteries by inhibiting L-type Ca2+ channels. J Pharmacol Exp Ther 2014; 352:14-22. [PMID: 25344384 DOI: 10.1124/jpet.114.217935] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Vanillin (VA) and vanillyl alcohol (VAA), components of natural vanilla, and ethyl vanillin (EtVA; synthetic analog) are used as flavoring agents and/or as additives by the food, cosmetic, or pharmaceutic industries. VA, VAA, and EtVA possess antioxidant and anti-inflammatory properties, but their vascular effects have not been determined. Therefore, we compared in isolated porcine coronary and basilar arteries the changes in isometric tension caused by VA, VAA, and EtVA. VA and its analogs caused concentration-dependent relaxations of both preparations during contractions from U46619 (9,11-dideoxy-11α,9α-epoxymethanoprostaglandin F2α, a thromboxane A2 receptor agonist), and of coronary arteries contracted with KCl or endothelin-1. The order of potency was VAA < VA < EtVA. The relaxations were not inhibited by endothelium removal, by inhibitors of NO synthases (N(ω)-nitro-l-arginine methyl ester hydrochloride), cyclooxygenases (indomethacin), soluble guanylyl cyclase (1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one [ODQ]), KCa (1-[(2-chlorophenyl)diphenylmethyl]-1H-pyrazole [TRAM-34], 6,12,19,20,25,26-hexahydro-5,27:13,18:21,24-trietheno-11,7-metheno-7H-dibenzo[b,n][1,5,12,16]tetraazacyclotricosine-5,13-diium ditrifluoroacetate hydrate [UCL-1684], or iberiotoxin), by KATP (glibenclamide), by Kir (BaCl2), by transient receptor potential receptor vanilloid 3 (TRPV3) channels (ruthenium red), or by antioxidants (catalase, apocynin, tempol, N-acetylcysteine, tiron). VA and its analogs inhibited contractions induced by Ca(2+) reintroduction in coronary arteries, and by an opener of L-type Ca(2+)-channels (methyl 2,6-dimethyl-5-nitro-4-[2-(trifluoromethyl)phenyl]-1,4-dihydropyridine-3-carboxylate [Bay K8644]) in coronary and basilar arteries. They inhibited contractions of coronary rings induced by the protein kinase C activator phorbol 12,13-dibutyrate to the same extent as the removal of extracellular Ca(2+) or incubation with nifedipine. Thus, in porcine arteries, relaxation from VA (and its analogs) is due to inhibition of L-type Ca(2+) channels. Hence, these compounds could be used to relieve coronary or cerebral vasospasms due to exaggerated Ca(2+) influx, but therapeutic efficacy would require exposures that far exceed the current levels obtained by the use of vanillin additives.
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Affiliation(s)
- Gábor Raffai
- Department of BIN Fusion Technology, Department of Polymer Nano Science & Technology, Chonbuk National University, Jeonju, South Korea (G.R., G.K., P.M.V.); and Key State Laboratory of Pharmaceutical Biotechnologies and Department of Pharmacology and Pharmacy, University of Hong Kong, Hong Kong SAR, People's Republic of China (P.M.V.)
| | - Gilson Khang
- Department of BIN Fusion Technology, Department of Polymer Nano Science & Technology, Chonbuk National University, Jeonju, South Korea (G.R., G.K., P.M.V.); and Key State Laboratory of Pharmaceutical Biotechnologies and Department of Pharmacology and Pharmacy, University of Hong Kong, Hong Kong SAR, People's Republic of China (P.M.V.)
| | - Paul M Vanhoutte
- Department of BIN Fusion Technology, Department of Polymer Nano Science & Technology, Chonbuk National University, Jeonju, South Korea (G.R., G.K., P.M.V.); and Key State Laboratory of Pharmaceutical Biotechnologies and Department of Pharmacology and Pharmacy, University of Hong Kong, Hong Kong SAR, People's Republic of China (P.M.V.)
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Bahloul M, Chaari A, Dammak H, Samet M, Chtara K, Chelly H, Ben Hamida C, Kallel H, Bouaziz M. Pulmonary edema following scorpion envenomation: Mechanisms, clinical manifestations, diagnosis and treatment. Int J Cardiol 2013; 162:86-91. [DOI: 10.1016/j.ijcard.2011.10.013] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Revised: 08/03/2011] [Accepted: 10/15/2011] [Indexed: 10/15/2022]
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Bahloul M, Chaari A, Dammak H, Bouaziz M. "Pulmonary edema induced by scorpion venom: evidence of cardiogenic nature". Int J Cardiol 2012; 158:292-3. [PMID: 22609008 DOI: 10.1016/j.ijcard.2012.04.083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Accepted: 04/14/2012] [Indexed: 10/28/2022]
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Wiesbauer F, Schlager O, Domanovits H, Wildner B, Maurer G, Muellner M, Blessberger H, Schillinger M. Perioperative beta-blockers for preventing surgery-related mortality and morbidity: a systematic review and meta-analysis. Anesth Analg 2007; 104:27-41. [PMID: 17179240 DOI: 10.1213/01.ane.0000247805.00342.21] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Perioperative beta-blockers are suggested to reduce cardiovascular mortality, myocardial-ischemia/infarction, and supraventricular arrhythmias after surgery. We reviewed the evidence regarding the effectiveness of perioperative beta-blockers for improving patient outcomes after cardiac and noncardiac surgery. METHODS Eleven large databases were searched from the time of their inception until October 2005. Various online-resources were consulted for the identification of unpublished trials and conference abstracts. We included randomized, controlled trials comparing perioperative beta-blockers with either placebo or the standard-of-care. Of the 3680 retrieved titles, 69 met inclusion criteria for analysis. Odds ratios (OR) assuming random effects were computed in the absence of significant clinical heterogeneity. RESULTS Beta-blockers reduced the frequency of ventricular tachyarrhythmias [OR (cardiac surgery): 0.28, 95% CI 0.13-0.57; OR (noncardiac surgery): 0.56, 95% CI 0.21-1.45], atrial fibrillation/flutter [OR (cardiac surgery): 0.37, 95% CI 0.28-0.48], other supraventricular arrhythmias [OR (cardiac surgery): 0.25, 95% CI 0.18-0.35; OR (noncardiac surgery): 0.43, 95% CI 0.14-1.37], and myocardial ischemia [OR (cardiac surgery): 0.49, 95% CI 0.17-1.4; OR (noncardiac surgery): 0.38, 95% CI 0.21-0.69]. Length of hospitalization was not reduced [weighted mean difference (cardiac surgery): -0.35 days, 95% CI -0.77-0.07; weighted mean difference (noncardiac surgery): -5.59 days, 95% CI -12.22-1.04] and, in contrast to previous reports, beta-blockers did not reduce mortality [OR (cardiac surgery): 0.55, 95% CI 0.17-1.83; OR (noncardiac surgery): 0.78, 95% CI 0.33-1.87], and they had no influence on the occurrence of perioperative myocardial infarction [OR (cardiac surgery): 0.89, 95% CI 0.53-1.5; OR (noncardiac surgery): 0.59; 0.25-1.39]. CONCLUSIONS Beta-blockers reduced perioperative arrhythmias and myocardial ischemia, but they had no effect on myocardial infarction, mortality, or length of hospitalization.
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Affiliation(s)
- Franz Wiesbauer
- Department of Cardiology, Vienna General Hospital, Medical University, Vienna, Austria.
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12
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Budzyn K, Paull M, Marley PD, Sobey CG. Segmental differences in the roles of rho-kinase and protein kinase C in mediating vasoconstriction. J Pharmacol Exp Ther 2006; 317:791-6. [PMID: 16452393 DOI: 10.1124/jpet.105.100040] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Rho-kinase and protein kinase C (PKC) have each been reported to mediate vasoconstriction via calcium sensitization. However, the relative contributions of these two kinases to vascular contraction, and whether their roles vary between large and small arteries, are largely unknown. We therefore assessed the relative roles of rho-kinase and PKC in mediating vasoconstriction in arteries from three segments of the aortic and mesenteric vasculature. We studied contractile responses of rat isolated thoracic aorta (diameter approximately 2 mm), superior mesenteric artery (SMA; approximately 1.5 mm), and second order branches of the superior mesenteric artery (BMA; approximately 300 mum). The roles of rho-kinase and PKC in mediating contractile responses to phenylephrine, 9,11-dideoxy-9,11-methanoepoxy prostaglandin F(2alpha) (U46619), and KCl were assessed by using the rho-kinase inhibitor R-[+]-trans-N-[4-pyridyl]-4-[1-aminoethyl]-cycloheaxanecarboxamide (Y-27632) (1 and 10 muM) and the PKC inhibitor 3-[1-[3-(amidinothio)propyl-1H-indol-3-yl]-3-(1-methyl-1H-indol-3-yl) maleimide (Ro 31-8220) (5 muM). Contractile responses of aorta and SMA were reduced by either 1 or 10 muM Y-27632 (P < 0.05), whereas responses of BMA were reduced by 10 muM (P < 0.05) but not 1 muM Y-27632. In contrast, Ro 31-8220 partly reduced contractile responses in aorta and SMA (P < 0.05), but it abolished responses of BMA (P < 0.05). Cotreatment with Y-27632 and Ro 31-8220 markedly attenuated contractile responses to phenylephrine and KCl in all vessels, but it had only a moderate inhibitory effect on responses to U46619 in aorta and SMA. Thus, contractile responses of the larger arteries can involve both rho-kinase and PKC to varying degrees. Conversely, contractile responses of small mesenteric resistance arteries seem to be mediated exclusively by PKC, with no apparent role for rho-kinase.
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Affiliation(s)
- Klaudia Budzyn
- Department of Pharmacology, University of Melbourne, Parkville, Victoria, Australia
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13
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Bahloul M, Kallel H, Rekik N, Ben Hamida C, Chelly H, Bouaziz M. [Cardiovascular dysfunction following severe scorpion envenomation. Mechanisms and physiopathology]. Presse Med 2005; 34:115-20. [PMID: 15687982 DOI: 10.1016/s0755-4982(05)88241-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The seriousness of scorpion envenomation results essentially from left cardiac function with pulmonary oedema and/or a state of shock. Adrenergic myocarditis, toxic myocarditis and myocardial ischemia are the 3 mechanisms that explain the cardiac dysfunction. Myocardial ischemia is not only due to the release of catecolamines but also the effect of the cytokines and/or neuropeptide Y on the coronary vessels. The cardiac damage can be due or enhanced by the depressive effect of the cytokines on the myocardial cells. The frequently observed hyperglycaemia only enhances the state of the already damaged myocardium.
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Affiliation(s)
- Mabrouk Bahloul
- Service de réanimation médicale, CHU Habib Bourguiba, Sfax, Tunisie.
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14
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Bahloul M, Ben Hamida C, Chtourou K, Ksibi H, Dammak H, Kallel H, Chaari A, Chelly H, Guermazi F, Rekik N, Bouaziz M. Evidence of myocardial ischaemia in severe scorpion envenomation. Myocardial perfusion scintigraphy study. Intensive Care Med 2003; 30:461-7. [PMID: 14673518 DOI: 10.1007/s00134-003-2082-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2002] [Accepted: 10/28/2003] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To explore the myocardial perfusion by thallium-201 scintigraphy for patients with evidence of myocardial damage after scorpion envenomation. DESIGN Prospective study over 1-year period. SETTING Medical intensive care unit of a university hospital (Sfax, Tunisia). PATIENTS We have prospectively included six patients admitted for scorpion envenomation over a period of 1 year in the 22-bed intensive care unit (ICU) of our university hospital. The evidence of myocardial damage was confirmed by electrocardiography and echocardiography in all patients. Myocardial perfusion scintigraphy ((201)Tl scintigraphy) coupled with radionuclide ventriculography ((99m)Tc) was performed for all patients, occurring 32 h on average (range 12-72 h) after the sting. RESULTS Radionuclide ventriculography was abnormal in all cases; the abnormalities observed were similar to those observed by echocardiography. Moreover (201)Tl scintigraphy showed evidence of myocardial hypoperfusion in all cases. The myocardial hypoperfusion grade and localisation were more marked in the abnormal localisation shown by echocardiography and electrocardiography, compared to the normal wall. Repeated studies, obtained only in two patients within 6 and 15 days, respectively, showed considerable, but not complete, improvement of wall motion and myocardial perfusion. Segments with improved perfusion showed greatly improved regional wall motion. CONCLUSION This study confirms the evidence of myocardial hypoperfusion after severe scorpion envenomation.
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Affiliation(s)
- Mabrouk Bahloul
- Service de Réanimation médicale, CHU Habib Bourguiba, Route el Ain Km 1, 3029 Sfax, Tunisia
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15
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MESH Headings
- Alemtuzumab
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal/toxicity
- Antibodies, Monoclonal, Humanized
- Antibodies, Neoplasm/therapeutic use
- Antibodies, Neoplasm/toxicity
- Humans
- Lymphoma, T-Cell, Peripheral/complications
- Lymphoma, T-Cell, Peripheral/drug therapy
- Male
- Middle Aged
- Myocardial Infarction/chemically induced
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16
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Selemidis S, Cocks TM. Endothelium-dependent hyperpolarization as a remote anti-atherogenic mechanism. Trends Pharmacol Sci 2002; 23:213-20. [PMID: 12007998 DOI: 10.1016/s0165-6147(02)01998-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Endothelial cell injury and the loss of cytoprotective mechanisms that involve nitric oxide, prostacyclin and endothelium-dependent hyperpolarization (EDH) are thought to underlie atherosclerosis, although how these mechanisms are anti-atherogenic is unclear. This is particularly so because thrombus formation, one of the major initiators of the disease, usually occurs at discrete luminal sites; thus, only small numbers of endothelial cells can be recruited to initiate anti-inflammatory responses. However, we, and others, have demonstrated that locally generated EDH spreads to endothelial cells and smooth muscle cells throughout a vessel to cause remote vasodilatation. In this article, we propose that, in addition to a widespread inhibitory signalling mechanism, EDH produced by the endothelium also initiates remote anti-inflammatory actions that prevent large blood vessels developing atherosclerosis.
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Affiliation(s)
- Stavros Selemidis
- Dept of Pharmacology, The University of Melbourne, Victoria 3010, Australia
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17
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Woodsome TP, Eto M, Everett A, Brautigan DL, Kitazawa T. Expression of CPI-17 and myosin phosphatase correlates with Ca(2+) sensitivity of protein kinase C-induced contraction in rabbit smooth muscle. J Physiol 2001; 535:553-64. [PMID: 11533144 PMCID: PMC2278797 DOI: 10.1111/j.1469-7793.2001.t01-1-00553.x] [Citation(s) in RCA: 190] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2000] [Accepted: 05/10/2001] [Indexed: 12/24/2022] Open
Abstract
1. Various smooth muscles have unique contractile characteristics, such as the degree of Ca(2+) sensitivity induced by physiological and pharmacological agents. Here we evaluated six different rabbit smooth muscle tissues for protein kinase C (PKC)-induced Ca(2+) sensitization. We also examined the expression levels of myosin light chain phosphatase (MLCP), the MLCP inhibitor phosphoprotein CPI-17, and the thin filament regulator h-calponin. 2. Immunohistochemical and Western blot analyses indicated that CPI-17 was found primarily in smooth muscle, although expression varied among different tissues. Vascular muscles contained more CPI-17 than visceral muscles, with further distinction existing between tonic and phasic subtypes. For example, the tonic femoral artery possessed approximately 8 times the cellular CPI-17 concentration of the phasic vas deferens. 3. In contrast to CPI-17 expression patterns, phasic muscles contained more MLCP myosin-targeting subunit than tonic tissues. Calponin expression was not statistically different. 4. Addition of phorbol ester to alpha-toxin-permeabilized smooth muscle caused an increase in contraction and phosphorylation of both CPI-17 and myosin light chain (MLC) at submaximal [Ca(2+)]i. These responses were several-fold greater in femoral artery as compared to vas deferens. 5. We conclude that the expression ratio of CPI-17 to MLCP correlates with the Ca(2+) sensitivities of contraction induced by a PKC activator. PKC stimulation of arterial smooth muscle with a high CPI-17 and low MLCP expression generated greater force and MLC phosphorylation than stimulation of visceral muscle with a relatively low CPI-17 and high MLCP content. This implicates CPI-17 inhibition of MLCP as an important component in modulating vascular muscle tone.
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Affiliation(s)
- T P Woodsome
- Department of Physiology and Biophysics, Georgetown University Medical Center, Washington, DC 20007, USA
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18
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Kuga T, Shimokawa H, Hirakawa Y, Kadokami Y, Arai Y, Fukumoto Y, Kuwata K, Kozai T, Egashira K, Takeshita A. Increased expression of L-type calcium channels in vascular smooth muscle cells at spastic site in a porcine model of coronary artery spasm. J Cardiovasc Pharmacol 2000; 35:822-8. [PMID: 10813387 DOI: 10.1097/00005344-200005000-00021] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Coronary artery spasm is caused primarily by increased contractility of vascular smooth muscle. Excessive Ca2+ entry into vascular smooth muscle cells (VSMCs) may be one of the key mechanisms for the spasm, but no study has ever directly examined the possible alterations of Ca2+ channels in the spastic coronary artery. Here we show that L-type Ca2+ channels are excessively expressed at the spastic site of the coronary artery. In a porcine model of coronary spasm with balloon injury, both receptor-mediated stimulation of L-type Ca2+ channels by serotonin and direct stimulation of the channels by Bay K 8644 (a dihydropyridine Ca2+ channel agonist) repeatedly induced coronary spasm in vivo, which was abolished by pretreatment with nifedipine, a dihydropyridine Ca2+ channel antagonist. In a single VSMC freshly dispersed from coronary arteries in vitro, patch-clamp experiments showed that current density of L-type Ca2+ channel current was significantly increased in VSMCs from the spastic site compared with that from the control site even when the channels were maximally stimulated by Bay K 8644. There was no difference in the sensitivity of the channels to Bay K 8644. These results indicate that functionally available L-type Ca2+ channels are excessively expressed at the spastic site of the coronary artery in our porcine model, suggesting that increased expression of L-type Ca2+ channels and concomitant increase in Ca2+ entry into VSMCs through the channels may contribute, at least in part, to the pathogenesis of coronary artery spasm.
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Affiliation(s)
- T Kuga
- Department of Cardiovascular Medicine, Kyushu University, Graduate School of Medical Sciences, Fukuoka, Japan
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19
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Miyata K, Shimokawa H, Higo T, Yamawaki T, Katsumata N, Kandabashi T, Tanaka E, Takamura Y, Yogo K, Egashira K, Takeshita A. Sarpogrelate, a selective 5-HT2A serotonergic receptor antagonist, inhibits serotonin-induced coronary artery spasm in a porcine model. J Cardiovasc Pharmacol 2000; 35:294-301. [PMID: 10672864 DOI: 10.1097/00005344-200002000-00018] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Serotonin is one of the most important vasoactive substances and has been implicated in the pathogenesis of coronary artery spasm and of acute coronary syndrome. We have recently demonstrated that local and long-term treatment with interleukin-1beta(IL-1beta) causes coronary arteriosclerotic changes and hyperconstrictive responses to serotonin in pigs in vivo. However, it remains to be examined which serotonergic (5-HT) receptor subtype mediates coronary spasm and whether alterations in serotonergic receptors are involved in the abnormality. In this study, we examined the inhibitory effect of sarpogrelate, a selective 5-HT2A serotonergic receptor antagonist, on the serotonin-induced coronary spasm as well as the possible alterations of serotonergic receptors in our porcine model. A segment of the porcine coronary artery was carefully dissected and aseptically wrapped with cotton mesh absorbing IL-1beta-bound microbeads from the adventitia. Two weeks after the procedure, angiographic study was performed, followed by binding assay for 5-HT1B and 5-HT2A serotonergic receptors and reverse transcription-polymerase chain reaction (RT-PCR) analysis for mRNA of those receptors. Angiographic study showed coronary vasospastic responses to serotonin at the IL-1beta-treated site. Sarpogrelate dose-dependently inhibited the serotonin-induced coronary spasm, but it did not affect the prostaglandin F2alpha-induced vasoconstriction. Radiolabeled receptor-binding assay showed that receptor affinity or receptor number of the 5-HT1B, or 5-HT2A receptors did not differ significantly between the spastic and the control sites. Furthermore, RT-PCR analysis showed that the expression of neither 5-HT2A nor 5-HT1B receptor mRNA was significantly altered at the spastic site. These results indicate that serotonin-induced coronary spasm is mediated primarily by 5-HT2A receptor in our porcine model, although the 5-HT2A receptor was not up-regulated, suggesting that alteration in the signal-transduction pathway for vascular smooth muscle contraction beyond the 5-HT2A receptor plays a primary role in the pathogenesis of coronary spasm in our porcine model.
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Affiliation(s)
- K Miyata
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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20
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Shimokawa H. Cellular and molecular mechanisms of coronary artery spasm: lessons from animal models. JAPANESE CIRCULATION JOURNAL 2000; 64:1-12. [PMID: 10651199 DOI: 10.1253/jcj.64.1] [Citation(s) in RCA: 144] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Coronary artery spasm plays an important role in the pathogenesis of a wide variety of ischemic heart diseases, especially in the Japanese population. Because coronary artery spasm can be induced by a variety of stimuli with different mechanisms of action, the occurrence of the spasm appears to be due to the local hyperreactivity of the coronary artery rather than to an enhanced stimulation with a single mechanism of action. Several lines of evidence indicate that coronary artery spasm is caused primarily by smooth muscle hypercontraction whereas the contribution of endothelial dysfunction may be minimal. In order to elucidate the cellular and molecular mechanisms of the spasm, porcine models of the spasm were developed. In the first model with balloon injury and high-cholesterol feeding, a close topological correlation between the early atherosclerotic lesions and the spastic sites was noted, whereas in the second model with an inflammatory cytokine the potential importance of coronary inflammatory changes, especially at the adventitia, was noted. Subsequent studies in vivo and in vitro demonstrated that protein kinase C (PKC) and Rho-kinase are substantially involved in the intracellular mechanism of the spasm, resulting in increases in the mono- and diphosphorylations of myosin light chain (MLC). Furthermore, molecular biological analyses demonstrated that Rho-kinase is upregulated at the spastic site (at all levels, including mRNA, protein, and activity), resulting in the inhibition of MLC phosphatase through the phosphorylation of its myosin binding subunit and thereby causing the increase in MLC phosphorylations. Preliminary results also suggest that the long-term inhibition of Rho-kinase is effective in inhibiting the development of arteriosclerotic vascular lesions in several porcine models. Thus, Rho-kinase could be regarded as a novel therapeutic target for coronary arteriosclerosis in general and coronary artery spasm in particular.
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Affiliation(s)
- H Shimokawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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21
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Beltrame JF, Sasayama S, Maseri A. Racial heterogeneity in coronary artery vasomotor reactivity: differences between Japanese and Caucasian patients. J Am Coll Cardiol 1999; 33:1442-52. [PMID: 10334407 DOI: 10.1016/s0735-1097(99)00073-x] [Citation(s) in RCA: 253] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Japanese investigators have provided a substantial contribution in the understanding of coronary vasomotor reactivity. On occasions, their findings have been at variance with those undertaken on caucasian patients, raising speculation that vasomotor differences between races may exist. In a comparative review of the published literature, we evaluated the vasoreactive differences among Japanese and caucasian patients with variant angina or myocardial infarction. In variant angina, Japanese patients appear to have diffusely hyperreactive coronary arteries compared with caucasian people, manifested by their segmental rather than focal spasm, hyperreactive nonspastic vessels and multivessel spasm. These differences may reflect the increased basal tone among Japanese variant angina patients and may relate to controversial differences in endothelial nitric oxide production or autonomic nervous system activity. Provocative vasomotor studies of Japanese patients with a recent myocardial infarction report a higher incidence of inducible spasm than caucasian studies, an observation recently supported by a controlled study. Furthermore, the hyperreactivity was diffuse, occurring in both non-infarct- and infarct-related vessels. These observations support the existence of racial coronary vasomotor reactivity differences but require confirmation in further prospectively conducted studies.
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Affiliation(s)
- J F Beltrame
- Cardiology Unit, The North Western Adelaide Health Service, University of Adelaide, Australia
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22
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Eickelberg O, Roth M, Block LH. Effects of amlodipine on gene expression and extracellular matrix formation in human vascular smooth muscle cells and fibroblasts: implications for vascular protection. Int J Cardiol 1997; 62 Suppl 2:S31-7. [PMID: 9488193 DOI: 10.1016/s0167-5273(97)00239-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Vascular smooth muscle cells (VSMC) are involved in the pathogenesis of hypertension and coronary artery disease. Amlodipine, a calcium channel blocker of the dihydropyridine type, is widely used in the therapy of these diseases, and has been shown to reduce the progression of the underlying pathophysiological mechanisms, such as atherosclerosis and restenosis. Research on the impact of calcium channel blockers on cell behavior has revealed an antiproliferative effect on VSMC. Cell proliferation is tightly controlled by permanent interaction of cells with their surrounding microenvironment, the extracellular matrix (ECM). The ECM is subjected to a continuous turnover and implicated in (i) stabilization and compartmentalization of tissue architecture and (ii) local binding and preservation of growth factors and cytokines. These growth factors and cytokines can be released during degradation of the ECM, and can function as local inflammatory factors without de novo synthesis. In this context, we assessed the effects of amlodipine on the composition of the ECM and related factors. We investigated the effects of amlodipine on (i) the regulation of cellular cholesterol metabolism, (ii) the activation of genes encoding for inflammatory factors, (iii) gene expression and turnover of ECM compounds, and (iv) the activity of matrix-degrading enzymes. Most of these effects of calcium channel blockers require direct induction of gene expression. In this respect, we demonstrate that amlodipine increases expression of the cytokine interleukin-6 by directly activating the respective gene promoter in human VSMC.
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Affiliation(s)
- O Eickelberg
- Department of Internal Medicine and Research, University Hospital Basel, Switzerland
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23
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Kozai T, Shimokawa H, Fukumoto Y, Kobayashi S, Owada MK, Kadokami T, Ito A, Kuwata K, Egashira K, Shiraishi T, Kanaide H, Takeshita A. Tyrosine kinase inhibitor markedly suppresses the development of coronary lesions induced by long-term treatment with platelet-derived growth factor in pigs in vivo. J Cardiovasc Pharmacol 1997; 29:536-45. [PMID: 9156365 DOI: 10.1097/00005344-199704000-00016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Platelet-derived growth factor (PDGF) plays an important role in the development of coronary atherosclerosis. However, it remains to be examined what morphologic and functional changes are induced in vivo by the long-term treatment with PDGF itself or what pharmacologic interventions could suppress those changes in vivo. Our study was designed to address these points. We examined the effects of long-term treatment with PDGF on the porcine coronary artery in vivo. Under aseptic conditions, the proximal segments of the left porcine coronary artery were gently wrapped with cotton mesh absorbing sepharose beads either with or without recombinant human PDGF-AA or -BB. Two weeks after the operation, coronary hyperconstrictions to intracoronary serotonin or histamine were noted at the sites treated with PDGF-AA or -BB. Histologically, neointimal formation and geometric remodeling (reduction of the total vessel area) were noted at the PDGF-treated sites. These functional and histologic changes of the coronary artery induced by PDGF were markedly inhibited by cotreatment with ST 638, a specific inhibitor of tyrosine kinases. A Western blot analysis showed that ST 638 markedly suppressed the PDGF-induced tyrosine phosphorylations in the coronary segment. These results indicate that long-term treatment with PDGF induces neointimal formation, geometric remodeling, and vasospastic responses in vivo, for all of which, activation of tyrosine kinases is substantially involved.
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Affiliation(s)
- T Kozai
- Research Institute of Angiocardiology, Kyushu University School of Medicine, Fukuoka, Japan
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Fukumoto Y, Shimokawa H, Ito A, Kadokami T, Yonemitsu Y, Aikawa M, Owada MK, Egashira K, Sueishi K, Nagai R, Yazaki Y, Takeshita A. Inflammatory cytokines cause coronary arteriosclerosis-like changes and alterations in the smooth-muscle phenotypes in pigs. J Cardiovasc Pharmacol 1997; 29:222-31. [PMID: 9057072 DOI: 10.1097/00005344-199702000-00011] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We recently developed a porcine model in which chronic, local treatment with interleukin-1 beta (IL-1 beta) causes coronary arteriosclerosis-like changes and hyperconstrictive responses. This study was designed to examine whether or not other major inflammatory cytokines [tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 alpha (IL-1 alpha) might also cause similar coronary responses and whether those responses are associated with alterations in the smooth-muscle phenotypes. A segment of the porcine coronary artery was aseptically wrapped with cotton mesh, absorbing IL-1 beta, TNF-alpha, and IL-1 alpha. Two weeks after the operation, coronary arteriography showed the development of mild stenotic lesions at the cytokine-treated sites, where hyperconstrictive responses were repeatedly induced by intracoronary serotonin or histamine. Histologically mild intimal thickening was noted at those cytokine-treated sites. Immunostaining and immunoblotting demonstrated that all three myosin heavy chain isoforms, SM1, SM2 (smooth-muscle type), and SMemb (nonmuscle type), were noted in the normal coronary segments, whereas in the segments treated with inflammatory cytokines, SM1 and SM2 were markedly reduced, and only SMemb was noted. These results indicate that inflammatory cytokines all have a similar ability to induce coronary arteriosclerosis-like changes and hyperconstrictive responses, which are associated with alterations in smooth-muscle phenotypes toward dedifferentiation.
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Affiliation(s)
- Y Fukumoto
- Research Institute of Angiocardiology, Kyushu University School of Medicine, Fukuoka, Japan
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