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Wang L, Zhang Q, Zhang Y, Zheng G, Wang K, Wu Z, Zhang J, Jia W, Zhang G. Insufficiency of plasmatic arginine/homoarginine during the initial postoperative phase among patients with tumors affecting the medulla oblongata heightens the likelihood of neurogenic pulmonary oedema following surgery. Int J Surg 2024; 110:1475-1483. [PMID: 38079589 PMCID: PMC10942246 DOI: 10.1097/js9.0000000000000957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 11/20/2023] [Indexed: 03/16/2024]
Abstract
BACKGROUND This prospective clinical study aims to investigate the fluctuations of neurotransmitters in peripheral venous blood during the perioperative period and to identify independent predictors for postoperative neurogenic pulmonary oedema (NPE) in patients with medulla oblongata-involved tumours. MATERIALS AND METHODS Peripheral venous blood samples of the enroled patients at seven perioperative time points, as well as their medical records and radiologic data were collected. High-performance liquid chromatography-tandem mass spectrometry was utilized to detect the concentrations of 39 neurotransmitters in these samples. The study applied univariate and multivariate generalized estimating equation (GEE) logistic regression analyses to explore independent predictors of postoperative NPE, and one-way repeated-measures ANOVA to compare the concentrations of the same neurotransmitter at different perioperative time points. RESULTS The study included 36 patients with medulla oblongata-involved tumours from January to December 2019, and found that 13.9% of them experienced postoperative NPE. The absence of intraoperative use of sevoflurane ( P =0.008), decreased concentrations of arginine ( P =0.026) and homoarginine ( P =0.030), and prolonged postoperative tracheal extubation ( P <0.001) were identified as independent risk factors for postoperative NPE in medulla oblongata-involved tumour patients. Pairwise comparison analysis revealed that the perioperative decreases in arginine and homoarginine concentrations mainly occurred within the postoperative 8 h. CONCLUSION This study demonstrates that NPE is not uncommon in patients with medulla oblongata-involved tumours. The absence of intraoperative use of sevoflurane, decreased concentrations of plasmatic arginine and homoarginine, and prolonged postoperative tracheal extubation are independent predictors of postoperative NPE. These two neurotransmitters' concentrations dropped mainly within the early postoperative hours and could serve as potential early warning indicators of postoperative NPE in clinical practice.
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Affiliation(s)
- Liang Wang
- Department of Neurosurgery
- China National Clinical Research Center for Neurological Diseases
- Center of Brain Tumor, Beijing Institute for Brain Disorders
- Beijing Key Laboratory of Brain Tumor, Beijing, People’s Republic of China
| | - Qing Zhang
- Department of Neurosurgery
- China National Clinical Research Center for Neurological Diseases
- Center of Brain Tumor, Beijing Institute for Brain Disorders
- Beijing Key Laboratory of Brain Tumor, Beijing, People’s Republic of China
| | - Yuan Zhang
- Department of Neurosurgery
- China National Clinical Research Center for Neurological Diseases
- Center of Brain Tumor, Beijing Institute for Brain Disorders
- Beijing Key Laboratory of Brain Tumor, Beijing, People’s Republic of China
| | - Guanghui Zheng
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University
| | - Ke Wang
- Department of Neurosurgery
- China National Clinical Research Center for Neurological Diseases
- Center of Brain Tumor, Beijing Institute for Brain Disorders
- Beijing Key Laboratory of Brain Tumor, Beijing, People’s Republic of China
| | - Zhen Wu
- Department of Neurosurgery
- China National Clinical Research Center for Neurological Diseases
- Center of Brain Tumor, Beijing Institute for Brain Disorders
- Beijing Key Laboratory of Brain Tumor, Beijing, People’s Republic of China
| | - Junting Zhang
- Department of Neurosurgery
- China National Clinical Research Center for Neurological Diseases
- Center of Brain Tumor, Beijing Institute for Brain Disorders
- Beijing Key Laboratory of Brain Tumor, Beijing, People’s Republic of China
| | - Wang Jia
- Department of Neurosurgery
- China National Clinical Research Center for Neurological Diseases
- Center of Brain Tumor, Beijing Institute for Brain Disorders
- Beijing Key Laboratory of Brain Tumor, Beijing, People’s Republic of China
| | - Guojun Zhang
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University
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Isailă OM, Moroianu LA, Hostiuc S. Current Trends in Biohumoral Screening for the Risk of Sudden Cardiac Death: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:418. [PMID: 38541144 PMCID: PMC10972295 DOI: 10.3390/medicina60030418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/23/2024] [Accepted: 02/27/2024] [Indexed: 07/23/2024]
Abstract
Background and Objectives: Sudden cardiac death (SCD) represents a challenge to health systems globally and is met with increased frequency in the population. Over time, multiple screening methods have been proposed, including the analysis of various plasma biomarkers. This article aims to analyze for illustrative purposes the specialized literature in terms of current biomarkers and testing trends, in the case of cardiovascular diseases and implicitly sudden cardiac death. Materials and Methods: In this regard, we searched the PubMed database from 2010 to the present time using the keywords "sudden cardiac death" and "biomarkers". The inclusion criteria were clinical trials that analyzed the effectiveness of screening methods in terms of biomarkers used in stratifying the risk of cardiac distress and/or sudden cardiac death. We excluded reviews, meta-analyses, and studies looking at the effectiveness of treatments. Results: An extended approach was found, through studies that brought to the forefront both classical markers analyzed by new, more performant methods, markers for other pathologies that also determined cardiovascular impact, non-specific molecules with effects on the cardiovascular system, and state-of-the-art markers, such as microRNA. Some molecules were analyzed simultaneously in certain groups of patients. Conclusion: The observed current trend revealed the tendency to define the clinical-biological particularities of the person to be screened.
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Affiliation(s)
- Oana-Maria Isailă
- Department of Legal Medicine and Bioethics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Lavinia-Alexandra Moroianu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunarea de Jos University, 47 Domneasca Street, 800008 Galati, Romania;
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Schwieren L, Jensen M, Schulz R, Lezius S, Laxy E, Milatz M, Thomalla G, Böger R, Gerloff C, Magnus T, Schwedhelm E, Choe CU. Homoarginine Associates with Carotid Intima-Media Thickness and Atrial Fibrillation and Predicts Adverse Events after Stroke. Life (Basel) 2023; 13:1590. [PMID: 37511965 PMCID: PMC10381763 DOI: 10.3390/life13071590] [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: 06/06/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Homoarginine is associated with cardio- and cerebrovascular morbidity and mortality. However, the underlying pathomechanisms remain elusive. Here, we evaluated the association of homoarginine with adverse events (i.e., death, stroke, and myocardial infarction) and carotid intima-media thickness (cIMT) in stroke patients. In the prospective bioMARKers in STROKE (MARK-STROKE) cohort, patients with acute ischemic stroke or transient ischemic attack (TIA) were enrolled. Plasma homoarginine concentrations were analyzed and associated with clinical phenotypes in cross-sectional (374 patients) and prospective (273 patients) analyses. Adjustments for possible confounders were evaluated. A two-fold increase in homoarginine was inversely associated with the National Institutes of Health Stroke Scale (NIHSS) score at admission, cIMT, and prevalent atrial fibrillation (mean factor -0.68 [95% confidence interval (CI): -1.30, -0.07], -0.14 [95% CI: -0.22, -0.05]; and odds ratio 0.57 [95% CI: 0.33, 0.96], respectively). During the follow-up (median 284 [25th, 75th percentile: 198, 431] days), individuals with homoarginine levels in the highest tertile had fewer incident events compared with patients in the lowest homoarginine tertile independent of traditional risk factors (hazard ratio 0.22 [95% CI: 0.08, 0.63]). A lower prevalence of atrial fibrillation and a reduced cIMT pinpointed potential underlying pathomechanisms.
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Affiliation(s)
- Laura Schwieren
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
- Institute of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Märit Jensen
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Robert Schulz
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Susanne Lezius
- Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Elena Laxy
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Magalie Milatz
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Rainer Böger
- Institute of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Christian Gerloff
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Tim Magnus
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Edzard Schwedhelm
- Institute of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK e.V.) Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany
| | - Chi-Un Choe
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
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Reczkowicz J, Kortas J, Juhas U, Zychowska M, Borkowska A, Pilis K, Ziemann E, Sobol Z, Antosiewicz J. Eight-Day Fast and a Single Bout of Exercise: The Effect on Serum Methylarginines and Amino Acids in Men. Nutrients 2023; 15:2981. [PMID: 37447307 PMCID: PMC10346826 DOI: 10.3390/nu15132981] [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: 05/30/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Changes in serum concentration of methylarginines and amino acids after exercise are well documented, whereas the effects of exercise applied together with fasting are still debated and not thoroughly studied. Thus, we hypothesised that alterations in methylarginines such as ADMA, SDMA and L-NMMA might be responsible for decreased exercise performance after 8 days of fasting. Additionally, we propose that conditions in which the human body is exposed to prolonged fasting for more than a week elicit a distinctly different response to exercise than after overnight fasting. A group of 10 healthy men with previous fasting experience participated in the study. The exercise test was performed until exhaustion with a gradually increasing intensity before and after the 8-day fast. Blood samples were collected before and immediately after exercise. ADMA, SDMA, L-NMMA, dimethylamine and amino acids were analysed in serum samples by ID-LC-MS/MS. SDMA, L-NMMA and dimethylamine significantly decreased after 8 days of fasting, whereas ADMA did not change. BCAA, Phe, alanine and some other amino acids increased after fasting. Exercise-induced changes in amino acids were distinct after an 8-day fast compared to overnight fasting. A decrease in physical performance accompanied all of these alterations. In conclusion, our data indicate that neither methyl-arginine changes nor the Trp/BCAA ratio can explain exercise-induced fatigue after fasting. However, the observed decrease in hArg concentration suggests the limited synthesis of creatine, possibly contributing to reduced physical performance.
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Affiliation(s)
- Joanna Reczkowicz
- Department of Bioenergetics and Physiology of Exercise, Medical University of Gdansk, 80-210 Gdansk, Poland; (J.R.); (U.J.); (A.B.)
| | - Jakub Kortas
- Department of Health and Life Sciences, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland;
| | - Ulana Juhas
- Department of Bioenergetics and Physiology of Exercise, Medical University of Gdansk, 80-210 Gdansk, Poland; (J.R.); (U.J.); (A.B.)
| | - Malgorzata Zychowska
- Department of Biological Foundation of Physical Culture, Faculty of Health Science and Physical Culture, Kazimierz Wielki University, 85-064 Bydgoszcz, Poland;
| | - Andzelika Borkowska
- Department of Bioenergetics and Physiology of Exercise, Medical University of Gdansk, 80-210 Gdansk, Poland; (J.R.); (U.J.); (A.B.)
| | - Karol Pilis
- Department of Health Sciences, Jan Długosz University in Czestochowa, 42-200 Czestochowa, Poland;
| | - Ewa Ziemann
- Department of Athletics, Strength and Conditioning, Poznan University of Physical Education, 61-871 Poznan, Poland;
| | - Zuzanna Sobol
- Masdiag Sp. z o.o., 33 Stefana Żeromskiego St., 01-882 Warsaw, Poland;
| | - Jedrzej Antosiewicz
- Department of Bioenergetics and Physiology of Exercise, Medical University of Gdansk, 80-210 Gdansk, Poland; (J.R.); (U.J.); (A.B.)
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Lee TF, Tommasi S, Bersten A, Heilbronn LK, Sotgia S, Zinellu A, Carru C, Mangoni AA, Burt MG. Does hyperglycemia affect arginine metabolites in critically ill patients? A prospective cohort and in vitro study. Diabetol Metab Syndr 2023; 15:68. [PMID: 37005603 PMCID: PMC10067243 DOI: 10.1186/s13098-023-01035-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/22/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND Changes in the arginine metabolites asymmetric dimethyl-L-arginine (ADMA) and L-homoarginine and acute blood glucose concentrations have been shown to cause endothelial dysfunction and be independently associated with mortality in Intensive Care Unit (ICU) patients. The aim of this study was to investigate whether hyperglycemia potentially modulates these arginine metabolite concentrations to provide a mechanism that may link hyperglycemia and mortality in this patient group. METHODS A clinical and in vitro study were undertaken. Glucose, glycosylated hemoglobin-A1c (HbA1c) and the stress hyperglycemia ratio (SHR) (to quantify absolute, chronic and relative hyperglycemia respectively) were measured in 1155 acutely unwell adult patients admitted to a mixed medical-surgical ICU. SHR was calculated by dividing the admission glucose by the estimated average glucose over the last 3 months, which was derived from HbA1c. ADMA and L-homoarginine were measured in a plasma sample collected at admission to ICU by liquid chromatography tandem mass spectrometry. The activity of dimethylarginine-dimethylaminohydrolase 1 (DDAH1), the main enzyme regulating ADMA concentrations, was assessed at varying glucose concentrations in vitro by quantifying the conversion of ADMA to citrulline in HEK293 cells that overexpress DDAH1. RESULTS In the clinical study, plasma ADMA was not significantly associated with any measure of hyperglycemia. L-homoarginine was positively associated with glucose (β = 0.067, p = 0.018) and SHR (β = 0.107, p < 0.001) after correction for glomerular filtration rate. However, as L-homoarginine is a negative predictor of mortality, the direction of these associations are the opposite of those expected if hyperglycemia was affecting mortality via changes in L-homoarginine. In vitro DDAH1 activity was not significantly influenced by glucose concentrations (p = 0.506). CONCLUSION In critically ill patients the association between relative hyperglycemia and mortality is not mediated by changes in ADMA or L-homoarginine. Trial registration ANZCTR Trial ID ACTRN12615001164583.
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Affiliation(s)
- Tien F Lee
- College of Medicine and Public Health, Flinders University, Flinders Drive, Bedford Park, SA, 5042, Australia
- Southern Adelaide Diabetes and Endocrine Services, Flinders Medical Centre, Flinders Drive, Bedford Park, SA, 5042, Australia
| | - Sara Tommasi
- College of Medicine and Public Health, Flinders University, Flinders Drive, Bedford Park, SA, 5042, Australia
- Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Bedford Park, SA, 5042, Australia
| | - Andrew Bersten
- College of Medicine and Public Health, Flinders University, Flinders Drive, Bedford Park, SA, 5042, Australia
- Department of Critical Care Medicine, Flinders University, Bedford Park, South Australia, Australia
| | - Leonie K Heilbronn
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Salvatore Sotgia
- Department of Biomedical Sciences, School of Medicine, University of Sassari, Sassari, Italy
| | - Angelo Zinellu
- Department of Biomedical Sciences, School of Medicine, University of Sassari, Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, School of Medicine, University of Sassari, Sassari, Italy
| | - Arduino A Mangoni
- College of Medicine and Public Health, Flinders University, Flinders Drive, Bedford Park, SA, 5042, Australia
- Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Bedford Park, SA, 5042, Australia
| | - Morton G Burt
- College of Medicine and Public Health, Flinders University, Flinders Drive, Bedford Park, SA, 5042, Australia.
- Southern Adelaide Diabetes and Endocrine Services, Flinders Medical Centre, Flinders Drive, Bedford Park, SA, 5042, Australia.
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Ng ML, Kuan WS, Pakkiri LS, Goh ECH, Wu LH, Drum CL. Deep phenotyping of oxidative stress in emergency room patients reveals homoarginine as a novel predictor of sepsis severity, length of hospital stay, and length of intensive care unit stay. Front Med (Lausanne) 2022; 9:1033083. [PMID: 36507541 PMCID: PMC9733670 DOI: 10.3389/fmed.2022.1033083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/10/2022] [Indexed: 11/27/2022] Open
Abstract
Background We aimed to determine primary markers of oxidative stress (OS) in ED patients which predict hospital length of stay (LoS), intensive care unit (ICU) LoS, and sepsis severity. Materials and methods This prospective, single center observational study was conducted in adult patients recruited from the ED who were diagnosed with either sepsis, infection without sepsis, or non-infectious, age-matched controls. 290 patients were admitted to the hospital and 24 patients had direct admission to the ICU. A panel of 269 OS and related metabolic markers were profiled for each cohort. Clinical outcomes were direct ICU admission, hospital LoS, ICU LoS, and post-hoc, adjudicated sepsis severity scoring. Bonferroni correction was used for pairwise comparisons. Principal component regression was used for dimensionality reduction and selection of plasma metabolites associated with sepsis. Multivariable negative binomial regression was applied to predict admission, hospital, and ICU LoS. Results Homoarginine (hArg) was the top discriminator of sepsis severity [sepsis vs. control: ROC-AUC = 0.86 (95% CI 0.81-0.91)], [sepsis vs. infection: ROC-AUC = 0.73 (95% CI 0.68-0.78)]. The 25th percentile of hArg [odds ratio (OR) = 8.57 (95% CI 1.05-70.06)] was associated with hospital LoS [IRR = 2.54 (95% CI 1.83-3.52)] and ICU LOS [IRR = 18.73 (95% CI 4.32-81.27)]. In prediction of outcomes, hArg had superior performance compared to arginine (Arg) [hArg ROC-AUC = 0.77 (95% CI 0.67-0.88) vs. Arg ROC-AUC = 0.66 (95% CI 0.55-0.78)], and dimethylarginines [SDMA ROC-AUC 0.68 (95% CI 0.55-0.79) and ADMA ROC-AUC = 0.68 (95% CI 0.56-0.79)]. Ratio of hArg and Arg/NO metabolic markers and creatinine clearance provided modest improvements in clinical prediction. Conclusion Homoarginine is associated with sepsis severity and predicts hospital and ICU LoS, making it a useful biomarker in guiding treatment decisions for ED patients.
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Affiliation(s)
- Mei Li Ng
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Win Sen Kuan
- Emergency Medicine Department, National University Hospital, National University Health System, Singapore, Singapore
| | | | - Eugene Chen Howe Goh
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lik Hang Wu
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Chester Lee Drum
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore,Cardiovascular Research Institute, National University Health System, Singapore, Singapore,Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore,*Correspondence: Chester Lee Drum,
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Do Antiepileptic Drugs Change the Levels of Arginine Derivatives in Epileptic Children Treated with Polytherapy? The Results of a Case–Control Study. CHILDREN 2022; 9:children9111709. [DOI: 10.3390/children9111709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/28/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022]
Abstract
Previously, a relation between therapy with antiepileptic drugs (AEDs) and the levels of biochemical parameters was observed in adult patients suffering from epilepsy. Among these biochemical factors, arginine derivatives are often analyzed, i.e., asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and homoarginine (hArg) as they may be linked with increased risk for cardiovascular disease (CVD). Since the levels of arginine derivatives may increase during therapy, and the treatment of epilepsy often lasts many years, patients may experience CVD faster. The aim of the present study was to analyze the levels of arginine derivatives in children with epilepsy who were treated with multiple AEDs to answer the question whether pediatric patients may be at increased risk of CVD in the future. We prospectively analyzed 21 children suffering from epilepsy who took ≥2 AEDs for at least 6 months and 22 children without epilepsy (reference group). The levels of the arginine derivatives, e.g., ADMA, SDMA, and hArg, were determined in the blood serum using the HPLC method. No differences in both the mean levels of ADMA and SDMA, as well as in the mean values of the arginine derivative ratios, were observed between the groups. The tendency toward a lower level of hArg was found in epileptic patients more than in the reference group (p = 0.091). Epileptic children receiving three or more AEDs had significantly lower concentrations of hArg and values of the hArg/ADMA ratio than the reference group (p = 0.023 and p = 0.006, respectively). In turn, the mean hArg/ADMA ratio was lower in children receiving three or more AEDs compared to children receiving two AEDs (p = 0.002). There was also a positive correlation between the hArg and ADMA concentrations in children with epilepsy taking two AEDs; the higher the level of hArg, the greater the level of ADMA on average (r = 0.650, p = 0.022). Taking three or more AEDs by epileptic children resulted in lower levels of both hArg and the value of the hArg/ADMA ratio.
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Chen ZZ, Pacheco JA, Gao Y, Deng S, Peterson B, Shi X, Zheng S, Tahir UA, Katz DH, Cruz DE, Ngo D, Benson MD, Robbins JM, Guo X, del Rocio Sevilla Gonzalez M, Manning A, Correa A, Meigs JB, Taylor KD, Rich SS, Goodarzi MO, Rotter JI, Wilson JG, Clish CB, Gerszten RE. Nontargeted and Targeted Metabolomic Profiling Reveals Novel Metabolite Biomarkers of Incident Diabetes in African Americans. Diabetes 2022; 71:2426-2437. [PMID: 35998269 PMCID: PMC9630088 DOI: 10.2337/db22-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/26/2022] [Indexed: 01/25/2023]
Abstract
Nontargeted metabolomics methods have increased potential to identify new disease biomarkers, but assessments of the additive information provided in large human cohorts by these less biased techniques are limited. To diversify our knowledge of diabetes-associated metabolites, we leveraged a method that measures 305 targeted or "known" and 2,342 nontargeted or "unknown" compounds in fasting plasma samples from 2,750 participants (315 incident cases) in the Jackson Heart Study (JHS)-a community cohort of self-identified African Americans-who are underrepresented in omics studies. We found 307 unique compounds (82 known) associated with diabetes after adjusting for age and sex at a false discovery rate of <0.05 and 124 compounds (35 known, including 11 not previously associated) after further adjustments for BMI and fasting plasma glucose. Of these, 144 and 68 associations, respectively, replicated in a multiethnic cohort. Among these is an apparently novel isomer of the 1-deoxyceramide Cer(m18:1/24:0) with functional geonomics and high-resolution mass spectrometry. Overall, known and unknown metabolites provided complementary information (median correlation ρ = 0.29), and their inclusion with clinical risk factors improved diabetes prediction modeling. Our findings highlight the importance of including nontargeted metabolomics methods to provide new insights into diabetes development in ethnically diverse cohorts.
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Affiliation(s)
- Zsu-Zsu Chen
- Division of Endocrinology, Diabetes, and Metabolism, Beth Israel Deaconess Medical Center, Boston, MA
- Harvard School of Medicine, Boston, MA
| | | | - Yan Gao
- University of Mississippi Medical Center, Jacksonville, MS
| | - Shuliang Deng
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Bennet Peterson
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Xu Shi
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Shuning Zheng
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Usman A. Tahir
- Harvard School of Medicine, Boston, MA
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Daniel H. Katz
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Daniel E. Cruz
- Harvard School of Medicine, Boston, MA
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Debby Ngo
- Harvard School of Medicine, Boston, MA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Mark D. Benson
- Harvard School of Medicine, Boston, MA
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Jeremy M. Robbins
- Harvard School of Medicine, Boston, MA
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA
| | - Magdalena del Rocio Sevilla Gonzalez
- Harvard School of Medicine, Boston, MA
- Broad Institute of MIT and Harvard, Boston, MA
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA
| | - Alisa Manning
- Harvard School of Medicine, Boston, MA
- Broad Institute of MIT and Harvard, Boston, MA
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA
| | - Adolfo Correa
- University of Mississippi Medical Center, Jacksonville, MS
| | - James B. Meigs
- Harvard School of Medicine, Boston, MA
- Broad Institute of MIT and Harvard, Boston, MA
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA
| | - Kent D. Taylor
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA
| | - Stephen S. Rich
- University of Virginia School of Medicine, Charlottesville, VA
| | - Mark O. Goodarzi
- Division of Endocrinology, Diabetes, and Metabolism, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Jerome I. Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA
| | - James G. Wilson
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | | | - Robert E. Gerszten
- Harvard School of Medicine, Boston, MA
- Broad Institute of MIT and Harvard, Boston, MA
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
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McAndrew DJ, Lake HA, Zervou S, Schwedhelm E, Schneider JE, Neubauer S, Lygate CA. Homoarginine and creatine deficiency do not exacerbate murine ischaemic heart failure. ESC Heart Fail 2022; 10:189-199. [PMID: 36178450 PMCID: PMC9871656 DOI: 10.1002/ehf2.14183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/23/2022] [Accepted: 09/15/2022] [Indexed: 01/27/2023] Open
Abstract
AIMS Low levels of homoarginine and creatine are associated with heart failure severity in humans, but it is unclear to what extent they contribute to pathophysiology. Both are synthesized via L-arginine:glycine amidinotransferase (AGAT), such that AGAT-/- mice have a combined creatine and homoarginine deficiency. We hypothesized that this would be detrimental in the setting of chronic heart failure. METHODS AND RESULTS Study 1: homoarginine deficiency-female AGAT-/- and wild-type mice were given creatine-supplemented diet so that both had normal myocardial creatine levels, but only AGAT-/- had low plasma homoarginine. Myocardial infarction (MI) was surgically induced and left ventricular (LV) structure and function assessed at 6-7 weeks by in vivo imaging and haemodynamics. Study 2: homoarginine and creatine-deficiency-as before, but AGAT-/- mice were given creatine-supplemented diet until 1 week post-MI, when 50% were changed to a creatine-free diet. Both groups therefore had low homoarginine levels, but one group also developed lower myocardial creatine levels. In both studies, all groups had LV remodelling and dysfunction commensurate with the development of chronic heart failure, for example, LV dilatation and mean ejection fraction <20%. However, neither homoarginine deficiency alone or in combination with creatine deficiency had a significant effect on mortality, LV remodelling, or on any indices of contractile and lusitropic function. CONCLUSIONS Low levels of homoarginine and creatine do not worsen chronic heart failure arguing against a major causative role in disease progression. This suggests that it is unnecessary to correct hArg deficiency in patients with heart failure, although supra-physiological levels may still be beneficial.
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Affiliation(s)
- Debra J. McAndrew
- Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUK,British Heart Foundation Centre for Research ExcellenceUniversity of OxfordOxfordUK,Wellcome Centre for Human GeneticsRoosevelt DriveOxfordOX3 7BNUK
| | - Hannah A. Lake
- Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUK,British Heart Foundation Centre for Research ExcellenceUniversity of OxfordOxfordUK,Wellcome Centre for Human GeneticsRoosevelt DriveOxfordOX3 7BNUK
| | - Sevasti Zervou
- Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUK,British Heart Foundation Centre for Research ExcellenceUniversity of OxfordOxfordUK,Wellcome Centre for Human GeneticsRoosevelt DriveOxfordOX3 7BNUK
| | - Edzard Schwedhelm
- Institute of Clinical Pharmacology and ToxicologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Jurgen E. Schneider
- Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUK,Experimental and Preclinical Imaging Centre (ePIC), Leeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUK,British Heart Foundation Centre for Research ExcellenceUniversity of OxfordOxfordUK
| | - Craig A. Lygate
- Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUK,British Heart Foundation Centre for Research ExcellenceUniversity of OxfordOxfordUK,Wellcome Centre for Human GeneticsRoosevelt DriveOxfordOX3 7BNUK
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10
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Nitz K, Lacy M, Bianchini M, Wichapong K, Kücükgöze IA, Bonfiglio CA, Migheli R, Wu Y, Burger C, Li Y, Forné I, Ammar C, Janjic A, Mohanta S, Duchene J, Heemskerk JWM, Megens RTA, Schwedhelm E, Huveneers S, Lygate CA, Santovito D, Zimmer R, Imhof A, Weber C, Lutgens E, Atzler D. The Amino Acid Homoarginine Inhibits Atherogenesis by Modulating T-Cell Function. Circ Res 2022; 131:701-712. [PMID: 36102188 DOI: 10.1161/circresaha.122.321094] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Amino acid metabolism is crucial for inflammatory processes during atherogenesis. The endogenous amino acid homoarginine is a robust biomarker for cardiovascular outcome and mortality with high levels being protective. However, the underlying mechanisms remain elusive. We investigated the effect of homoarginine supplementation on atherosclerotic plaque development with a particular focus on inflammation. METHODS Female ApoE-deficient mice were supplemented with homoarginine (14 mg/L) in drinking water starting 2 weeks before and continuing throughout a 6-week period of Western-type diet feeding. Control mice received normal drinking water. Immunohistochemistry and flow cytometry were used for plaque- and immunological phenotyping. T cells were characterized using mass spectrometry-based proteomics, by functional in vitro approaches, for example, proliferation and migration/chemotaxis assays as well as by super-resolution microscopy. RESULTS Homoarginine supplementation led to a 2-fold increase in circulating homoarginine concentrations. Homoarginine-treated mice exhibited reduced atherosclerosis in the aortic root and brachiocephalic trunk. A substantial decrease in CD3+ T cells in the atherosclerotic lesions suggested a T-cell-related effect of homoarginine supplementation, which was mainly attributed to CD4+ T cells. Macrophages, dendritic cells, and B cells were not affected. CD4+ T-cell proteomics and subsequent pathway analysis together with in vitro studies demonstrated that homoarginine profoundly modulated the spatial organization of the T-cell actin cytoskeleton and increased filopodia formation via inhibition of Myh9 (myosin heavy chain 9). Further mechanistic studies revealed an inhibition of T-cell proliferation as well as a striking impairment of the migratory capacities of T cells in response to relevant chemokines by homoarginine, all of which likely contribute to its atheroprotective effects. CONCLUSIONS Our study unravels a novel mechanism by which the amino acid homoarginine reduces atherosclerosis, establishing that homoarginine modulates the T-cell cytoskeleton and thereby mitigates T-cell functions important during atherogenesis. These findings provide a molecular explanation for the beneficial effects of homoarginine in atherosclerotic cardiovascular disease.
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Affiliation(s)
- Katrin Nitz
- Institute for Cardiovascular Prevention (K.N., M.L., M.B., I.A.K., C.A.B., R.M., Y.W., C.B., Y.L., S.M., J.D., R.T.A.M., D.S., C.W., E.L., D.A.), Ludwig-Maximilians-Universität, Munich, Germany.,DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (K.N., M.L., C.A.B., J.D., D.S., C.W., E.L., D.A.)
| | - Michael Lacy
- Institute for Cardiovascular Prevention (K.N., M.L., M.B., I.A.K., C.A.B., R.M., Y.W., C.B., Y.L., S.M., J.D., R.T.A.M., D.S., C.W., E.L., D.A.), Ludwig-Maximilians-Universität, Munich, Germany.,DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (K.N., M.L., C.A.B., J.D., D.S., C.W., E.L., D.A.).,Department of Medical Laboratory Sciences, Virginia Commonwealth University, Richmond (M.L.)
| | - Mariaelvy Bianchini
- Institute for Cardiovascular Prevention (K.N., M.L., M.B., I.A.K., C.A.B., R.M., Y.W., C.B., Y.L., S.M., J.D., R.T.A.M., D.S., C.W., E.L., D.A.), Ludwig-Maximilians-Universität, Munich, Germany
| | - Kanin Wichapong
- Institute for Cardiovascular Prevention (K.N., M.L., M.B., I.A.K., C.A.B., R.M., Y.W., C.B., Y.L., S.M., J.D., R.T.A.M., D.S., C.W., E.L., D.A.), Ludwig-Maximilians-Universität, Munich, Germany.,Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, the Netherlands (K.W., J.W.M.H., C.W.)
| | - Irem Avcilar Kücükgöze
- Institute for Cardiovascular Prevention (K.N., M.L., M.B., I.A.K., C.A.B., R.M., Y.W., C.B., Y.L., S.M., J.D., R.T.A.M., D.S., C.W., E.L., D.A.), Ludwig-Maximilians-Universität, Munich, Germany
| | - Cecilia A Bonfiglio
- Institute for Cardiovascular Prevention (K.N., M.L., M.B., I.A.K., C.A.B., R.M., Y.W., C.B., Y.L., S.M., J.D., R.T.A.M., D.S., C.W., E.L., D.A.), Ludwig-Maximilians-Universität, Munich, Germany.,DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (K.N., M.L., C.A.B., J.D., D.S., C.W., E.L., D.A.)
| | - Roberta Migheli
- Institute for Cardiovascular Prevention (K.N., M.L., M.B., I.A.K., C.A.B., R.M., Y.W., C.B., Y.L., S.M., J.D., R.T.A.M., D.S., C.W., E.L., D.A.), Ludwig-Maximilians-Universität, Munich, Germany
| | - Yuting Wu
- Institute for Cardiovascular Prevention (K.N., M.L., M.B., I.A.K., C.A.B., R.M., Y.W., C.B., Y.L., S.M., J.D., R.T.A.M., D.S., C.W., E.L., D.A.), Ludwig-Maximilians-Universität, Munich, Germany
| | - Carina Burger
- Institute for Cardiovascular Prevention (K.N., M.L., M.B., I.A.K., C.A.B., R.M., Y.W., C.B., Y.L., S.M., J.D., R.T.A.M., D.S., C.W., E.L., D.A.), Ludwig-Maximilians-Universität, Munich, Germany
| | - Yuanfang Li
- Institute for Cardiovascular Prevention (K.N., M.L., M.B., I.A.K., C.A.B., R.M., Y.W., C.B., Y.L., S.M., J.D., R.T.A.M., D.S., C.W., E.L., D.A.), Ludwig-Maximilians-Universität, Munich, Germany
| | - Ignasi Forné
- Biomedical Center Munich, Department of Molecular Biology (I.F., A.I.), Ludwig-Maximilians-Universität, Munich, Germany
| | - Constantin Ammar
- Institute of Bioinformatics, Department of Informatics (C.A., R.Z.), Ludwig-Maximilians-Universität, Munich, Germany
| | - Aleksandar Janjic
- Anthropology & Human Genomics, Department of Biology II (A.J.), Ludwig-Maximilians-Universität, Munich, Germany
| | - Sarajo Mohanta
- Institute for Cardiovascular Prevention (K.N., M.L., M.B., I.A.K., C.A.B., R.M., Y.W., C.B., Y.L., S.M., J.D., R.T.A.M., D.S., C.W., E.L., D.A.), Ludwig-Maximilians-Universität, Munich, Germany
| | - Johan Duchene
- Institute for Cardiovascular Prevention (K.N., M.L., M.B., I.A.K., C.A.B., R.M., Y.W., C.B., Y.L., S.M., J.D., R.T.A.M., D.S., C.W., E.L., D.A.), Ludwig-Maximilians-Universität, Munich, Germany.,DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (K.N., M.L., C.A.B., J.D., D.S., C.W., E.L., D.A.)
| | - Johan W M Heemskerk
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, the Netherlands (K.W., J.W.M.H., C.W.)
| | - Remco T A Megens
- Institute for Cardiovascular Prevention (K.N., M.L., M.B., I.A.K., C.A.B., R.M., Y.W., C.B., Y.L., S.M., J.D., R.T.A.M., D.S., C.W., E.L., D.A.), Ludwig-Maximilians-Universität, Munich, Germany.,Department of Biomedical Engineering, CARIM, Maastricht University, Maastricht, the Netherlands (R.T.A.M.)
| | - Edzard Schwedhelm
- Department of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Germany (E.S.).,DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Hamburg/Kiel/Lübeck, Germany (E.S.)
| | - Stephan Huveneers
- Department of Medical Biochemistry, Amsterdam University Medical Centre, Amsterdam Cardiovascular Sciences, the Netherlands (S.H.)
| | - Craig A Lygate
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine and the BHF Centre of Research Excellence, University of Oxford, United Kingdom (C.A.L.)
| | - Donato Santovito
- Institute for Cardiovascular Prevention (K.N., M.L., M.B., I.A.K., C.A.B., R.M., Y.W., C.B., Y.L., S.M., J.D., R.T.A.M., D.S., C.W., E.L., D.A.), Ludwig-Maximilians-Universität, Munich, Germany.,DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (K.N., M.L., C.A.B., J.D., D.S., C.W., E.L., D.A.)
| | - Ralf Zimmer
- Institute of Bioinformatics, Department of Informatics (C.A., R.Z.), Ludwig-Maximilians-Universität, Munich, Germany
| | - Axel Imhof
- Biomedical Center Munich, Department of Molecular Biology (I.F., A.I.), Ludwig-Maximilians-Universität, Munich, Germany
| | - Christian Weber
- Institute for Cardiovascular Prevention (K.N., M.L., M.B., I.A.K., C.A.B., R.M., Y.W., C.B., Y.L., S.M., J.D., R.T.A.M., D.S., C.W., E.L., D.A.), Ludwig-Maximilians-Universität, Munich, Germany.,DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (K.N., M.L., C.A.B., J.D., D.S., C.W., E.L., D.A.).,Department of Medical Laboratory Sciences, Virginia Commonwealth University, Richmond (M.L.)
| | - Esther Lutgens
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (K.N., M.L., C.A.B., J.D., D.S., C.W., E.L., D.A.).,Department of Cardiovascular Medicine, Experimental Cardiovascular Immunology Laboratory, Mayo Clinic, Rochester, MN (E.L.)
| | - Dorothee Atzler
- Institute for Cardiovascular Prevention (K.N., M.L., M.B., I.A.K., C.A.B., R.M., Y.W., C.B., Y.L., S.M., J.D., R.T.A.M., D.S., C.W., E.L., D.A.), Ludwig-Maximilians-Universität, Munich, Germany.,Walther Straub Institute of Pharmacology and Toxicology (D.A.), Ludwig-Maximilians-Universität, Munich, Germany.,DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Munich Heart Alliance, Munich, Germany (K.N., M.L., C.A.B., J.D., D.S., C.W., E.L., D.A.)
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11
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Schwedhelm E, Cordts K, Moritz E, Wesemann R, Choe CU, Böger R, Ittermann T, Dörr M, Friedrich N, Bahls M. Reference Interval for Serum L-Homoarginine Determined with Enzyme-Linked Immunosorbent Assay in the Population-Based Study of Health in Pomerania. J Appl Lab Med 2022; 7:1272-1282. [DOI: 10.1093/jalm/jfac074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/12/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Background
Low levels of the endogenous amino acid L-homoarginine are a risk factor for cardiovascular morbidity and mortality. For individual risk prediction, commercially available test systems are mandatory. This study aims at formulating sex- and age-specific reference intervals of serum L-homoarginine determined with an ELISA.
Methods
We determined reference intervals for serum L-homoarginine stratified by age and sex in a sample of 1285 healthy participants of the Study of Health in Pomerania (SHIP)-TREND cohort after exclusion of participants with cardiovascular diseases, diabetes mellitus, hypertension, metabolic syndrome, elevated liver enzymes, chronic kidney disease stages III or IV, or body mass index >25 kg/m2. Serum L-homoarginine was determined applying a commercially available ELISA.
Results
The reference cohort included 836 women (median age 41, 25th and 75th percentiles are 32 and 50 years) and 449 men (median age 38, 25th, and 75th percentiles are 30 and 49 years). The median serum concentration of L-homoarginine was 1.93 (25th 1.49; 75th 2.60) µmol/L in women and 2.02 (25th 1.63; 75th 2.61) µmol/L in men (P = 0.04). The reference intervals (2.5th to 97.5th percentile) were 0.89–5.29 µmol/L for women and 1.09–3.76 µmol/L for men. The L-homoarginine serum concentration declined over age decades in both sexes and a notable interaction with sex hormone intake in women was observed.
Conclusions
The novelty of our study is that we determined reference intervals specific for the L-isomer being lower than those previously reported for homoarginine in SHIP and thus might be helpful in identifying individuals suitable for oral L-homoarginine supplementation.
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Affiliation(s)
- Edzard Schwedhelm
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck , Hamburg , Germany
| | - Kathrin Cordts
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Eileen Moritz
- Institute of Pharmacology, University Medicine Greifswald , Greifswald , Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald , Greifswald , Germany
| | | | - Chi un Choe
- Department of Neurology, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Rainer Böger
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Till Ittermann
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald , Greifswald , Germany
- Institute for Community Medicine, University Medicine Greifswald , Greifswald , Germany
| | - Marcus Dörr
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald , Greifswald , Germany
- Department of Internal Medicine B, University Medicine Greifswald , Greifswald , Germany
| | - Nele Friedrich
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald , Greifswald , Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald , Greifswald , Germany
| | - Martin Bahls
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald , Greifswald , Germany
- Department of Internal Medicine B, University Medicine Greifswald , Greifswald , Germany
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12
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Mehanna M, McDonough CW, Smith SM, Gong Y, Gums JG, Chapman AB, Johnson JA, Cooper-DeHoff RM. Influence of Genetic West African Ancestry on Metabolomics among Hypertensive Patients. Metabolites 2022; 12:metabo12090783. [PMID: 36144188 PMCID: PMC9506508 DOI: 10.3390/metabo12090783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 12/02/2022] Open
Abstract
Patients with higher genetic West African ancestry (GWAA) have hypertension (HTN) that is more difficult to treat and have higher rates of cardiovascular diseases (CVD) and differential responses to antihypertensive drugs than those with lower GWAA. The mechanisms underlying these disparities are poorly understood. Using data from 84 ancestry-informative markers in US participants from the Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR) and PEAR-2 trials, the GWAA proportion was estimated. Using multivariable linear regression, the baseline levels of 886 metabolites were compared between PEAR participants with GWAA < 45% and those with GWAA ≥ 45% to identify differential metabolites and metabolic clusters. Metabolites with a false discovery rate (FDR) < 0.2 were used to create metabolic clusters, and a cluster analysis was conducted. Differential clusters were then tested for replication in PEAR-2 participants. We identified 353 differential metabolites (FDR < 0.2) between PEAR participants with GWAA < 45% (n = 383) and those with GWAA ≥ 45% (n = 250), which were used to create 24 metabolic clusters. Of those, 13 were significantly different between groups (Bonferroni p < 0.002). Four clusters, plasmalogen and lysoplasmalogen, sphingolipid metabolism and ceramide, cofactors and vitamins, and the urea cycle, were replicated in PEAR-2 (Bonferroni p < 0.0038) and have been previously linked to HTN and CVD. Our findings may give insights into the mechanisms underlying HTN racial disparities.
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Affiliation(s)
- Mai Mehanna
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - Caitrin W. McDonough
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - Steven M. Smith
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - Yan Gong
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - John G. Gums
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - Arlene B. Chapman
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Julie A. Johnson
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - Rhonda M. Cooper-DeHoff
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
- Correspondence: ; Tel.: +1-(352)-273-6184
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13
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Yuan X, Cai L, Hu F, Xie L, Chen X, Wu J, Li Q. Evaluation of the predictive values of elevated serum L-homoarginine and dimethylarginines in preeclampsia. Amino Acids 2022; 54:1215-1227. [PMID: 35752997 PMCID: PMC9365731 DOI: 10.1007/s00726-022-03177-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/28/2022] [Indexed: 01/14/2023]
Abstract
L-homoarginine (hARG) is involved in nitric oxide biosynthesis, but its role and concentration in preeclampsia (PE) have not been fully revealed. The purpose of this study was to develop and validate a feasible clinical assay to quantify serum hARG, arginine (ARG), asymmetric (ADMA) and symmetric dimethylarginines (SDMA) levels by LC-MS/MS and investigate their differences at different stages of pregnancy with or without preeclampsia. Serum samples were collected from 84 pregnant women without complications (controls), 84 with mild preeclampsia (MPE), and 81 with severe preeclampsia (SPE) at various gestation stages (before the 20th week, during the 20th-28th week or after the 28th week of gestation). No significant difference in ARG levels was observed between PE and controls at any stage (P > 0.05). The serum hARG levels and hARG/ADMA ratios of MPE before the 20th week were higher than those of controls (P < 0.001). ADMA levels of MPE were higher than those of controls during the 20th-28th week (P < 0.01). SDMA levels of SPE were higher than those of MPE (P < 0.01) and controls (P < 0.05) after the 28th week. Elevated serum hARG before the 20th week was identified as an independent predictor for PE (OR = 1.478, 95% CI 1.120-1.950). ROC curve analysis showed serum hARG before the 20th week had a good potential to predict MPE (AUC = 0.875, 95% CI 0.759-0.948). In conclusion, our study indicated that elevated serum hARG and dimethylarginine levels detected by LC-MS/MS might serve as potential biomarkers for the early prediction of PE.
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Affiliation(s)
- Xiangmei Yuan
- Department of Laboratory Medicine, Wusong Branch, Zhongshan Hospital, Fudan University, Shanghai, 200940, China
| | - Leiming Cai
- Department of Laboratory Medicine, Wusong Branch, Zhongshan Hospital, Fudan University, Shanghai, 200940, China
| | - Fengmei Hu
- Shanghai AB Sciex Analytical Instrument Trading Co., Ltd., Shanghai, 200050, China
| | - Li Xie
- Department of Laboratory Medicine, Wusong Branch, Zhongshan Hospital, Fudan University, Shanghai, 200940, China
| | - Xiong Chen
- Department of Gynecology and Obstetrics, Wusong Branch, Zhongshan Hospital, Fudan University, Shanghai, 200940, China
| | - Jingjing Wu
- Department of Gynecology and Obstetrics, Wusong Branch, Zhongshan Hospital, Fudan University, Shanghai, 200940, China
| | - Qian Li
- Department of Laboratory Medicine, Wusong Branch, Zhongshan Hospital, Fudan University, Shanghai, 200940, China.
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14
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Koch V, Gruenewald LD, Gruber‐Rouh T, Martin S, Eichler K, Booz C, Yel I, Vogl TJ, Buchner K, Hagenmueller M, März W, Frey N, Hardt SE, Riffel JH. Homoarginine treatment of rats improves cardiac function and remodeling in response to pressure overload. Fundam Clin Pharmacol 2022; 36:992-1004. [DOI: 10.1111/fcp.12808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Vitali Koch
- Goethe University Frankfurt Frankfurt am Main Germany
- Department of Cardiology, Angiology, and Pulmonology Heidelberg University Hospital Heidelberg Germany
| | | | | | - Simon Martin
- Goethe University Frankfurt Frankfurt am Main Germany
| | | | | | - Ibrahim Yel
- Goethe University Frankfurt Frankfurt am Main Germany
| | | | - Kristina Buchner
- Institute of Human Genetics, Section for Developmental Genetics University of Heidelberg Heidelberg Germany
| | - Marco Hagenmueller
- Department of Cardiology, Angiology, and Pulmonology Heidelberg University Hospital Heidelberg Germany
| | - Winfried März
- Synlab Academy Synlab Holding Deutschland GmbH Augsburg Germany
| | - Norbert Frey
- Department of Cardiology, Angiology, and Pulmonology Heidelberg University Hospital Heidelberg Germany
| | - Stefan E. Hardt
- Department of Cardiology, Angiology, and Pulmonology Heidelberg University Hospital Heidelberg Germany
| | - Johannes H. Riffel
- Department of Cardiology, Angiology, and Pulmonology Heidelberg University Hospital Heidelberg Germany
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15
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Kleist CJ, Choe CU, Atzler D, Schönhoff M, Böger R, Schwedhelm E, Wicha SG. Population kinetics of homoarginine and optimized supplementation for cardiovascular risk reduction. Amino Acids 2022; 54:889-896. [PMID: 35618975 PMCID: PMC9213336 DOI: 10.1007/s00726-022-03169-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/01/2022] [Indexed: 11/24/2022]
Abstract
Homoarginine is an endogenous amino acid whose levels are reduced in patients with renal, cardio- and cerebrovascular disease. Moreover, low homoarginine concentrations independently predict morbidity and mortality in these patients. Besides endogenous synthesis, homoarginine is also a constituent of the human diet. The objective of the present study was to analyze the kinetics of orally supplemented homoarginine in human plasma by means of a pharmacometric approach. We developed a pharmacometric model to evaluate different dosing regimens, especially the regimen of 125 mg once weekly, based on a previous clinical study (n = 20). The model was adapted to account for differences in baseline homoarginine plasma concentrations between healthy and diseased individuals. A novel dosing regimen of 25 mg once daily led to higher attainment of homoarginine reference concentrations using clinical trial simulations. With 25 mg/day, the trough concentration of only 6% of the older and 3.8% of the younger population was predicted to be below the target concentration of 2.0-4.1 µmol/L. In synopsis, the new dosing regimen recapitulates the kinetics of homoarginine in healthy individuals optimally.
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Affiliation(s)
- Christine J Kleist
- Department of Clinical Pharmacy, Institute of Pharmacy, University of Hamburg, Bundesstraße 45, 20146, Hamburg, Germany
| | - Chi-Un Choe
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dorothee Atzler
- Institute for Cardiovascular Prevention, Ludwig-Maximilians-Universität, Munich, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
- Walther Straub Institute of Pharmacology and Toxicology, Ludwig-Maximilians-Universität, Munich, Germany
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mirjam Schönhoff
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rainer Böger
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Edzard Schwedhelm
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Sebastian G Wicha
- Department of Clinical Pharmacy, Institute of Pharmacy, University of Hamburg, Bundesstraße 45, 20146, Hamburg, Germany.
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16
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Screening of commonly prescribed drugs for effects on the CAT1-mediated transport of L-arginine and arginine derivatives. Amino Acids 2022; 54:1101-1108. [PMID: 35377022 PMCID: PMC9217908 DOI: 10.1007/s00726-022-03156-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/13/2022] [Indexed: 12/27/2022]
Abstract
The cationic amino acid transporter 1 (CAT1/SLC7A1) plays a key role in the cellular uptake or export of l-arginine and some of its derivatives. This study investigated the effect of 113 chemically diverse and commonly used drugs (at 20 and 200 µM) on the CAT1-mediated cellular uptake of l-arginine, l-homoarginine, and asymmetric dimethylarginine (ADMA). Twenty-three (20%) of the tested substances showed weak inhibitory or stimulatory effects, but only verapamil showed consistent inhibitory effects on CAT1-mediated transport of all tested substrates.
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17
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Expression of cardiovascular-related microRNAs is altered in L-arginine:glycine amidinotransferase deficient mice. Sci Rep 2022; 12:5108. [PMID: 35332188 PMCID: PMC8948300 DOI: 10.1038/s41598-022-08846-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/09/2022] [Indexed: 11/09/2022] Open
Abstract
In humans and mice, L-arginine:glycine amidinotransferase (AGAT) and its metabolites homoarginine (hArg) and creatine have been linked to cardiovascular disease (CVD), specifically myocardial infarction (MI) and heart failure (HF). The underlying molecular and regulatory mechanisms, however, remain unclear. To identify potential pathways of cardiac AGAT metabolism, we sequenced microRNA (miRNA) in left ventricles of wild-type (wt) compared to AGAT-deficient (AGAT-/-) mice. Using literature search and validation by qPCR, we identified eight significantly regulated miRNAs in AGAT-/- mice linked to atherosclerosis, MI and HF: miR-30b, miR-31, miR-130a, miR-135a, miR-148a, miR-204, miR-298, and let-7i. Analysis of Gene Expression Omnibus (GEO) data confirmed deregulation of these miRNAs in mouse models of MI and HF. Quantification of miRNA expression by qPCR in AGAT-/- mice supplemented with creatine or hArg revealed that miR-30b, miR-31, miR-130a, miR-148a, and miR-204 were regulated by creatine, while miR-135a and miR-298 showed a trend of regulation by hArg. Finally, bioinformatics-based target prediction showed that numerous AGAT-dependent genes previously linked to CVD are likely to be regulated by the identified miRNAs. Taken together, AGAT deficiency and hArg/creatine supplementation are associated with cardiac miRNA expression which may influence cardiac (dys)function and CVD.
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18
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Surrer DB, Fromm MF, Maas R, König J. L-Arginine and Cardioactive Arginine Derivatives as Substrates and Inhibitors of Human and Mouse NaCT/Nact. Metabolites 2022; 12:metabo12040273. [PMID: 35448460 PMCID: PMC9026504 DOI: 10.3390/metabo12040273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/17/2022] [Accepted: 03/19/2022] [Indexed: 01/25/2023] Open
Abstract
The uptake transporter NaCT (gene symbol SLC13A5) is expressed in liver and brain and important for energy metabolism and brain development. Substrates include tricarboxylic acid cycle intermediates, e.g., citrate and succinate. To gain insights into the substrate spectrum of NaCT, we tested whether arginine and the cardioactive L-arginine metabolites asymmetric dimethylarginine (ADMA) and L-homoarginine are also transported by human and mouse NaCT/Nact. Using HEK293 cells overexpressing human or mouse NaCT/Nact we characterized these substances as substrates. Furthermore, inhibition studies were performed using the arginine derivative symmetric dimethylarginine (SDMA), the NaCT transport inhibitor BI01383298, and the prototypic substrate citrate. Arginine and the derivatives ADMA and L-homoarginine were identified as substrates of human and mouse NaCT. Transport of arginine and derivatives mediated by human and mouse NaCT were dose-dependently inhibited by SDMA. Whereas BI01383298 inhibited only human NaCT-mediated citrate uptake, it inhibits the uptake of arginine and derivatives mediated by both human NaCT and mouse Nact. In contrast, the prototypic substrate citrate inhibited the transport of arginine and derivatives mediated only by human NaCT. These results demonstrate a so far unknown link between NaCT/Nact and L-arginine and its cardiovascular important derivatives.
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Affiliation(s)
| | | | | | - Jörg König
- Correspondence: ; Tel.: +49-9131-8522077
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19
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Koch V, Weber C, Riffel JH, Buchner K, Buss SJ, Hein S, Mereles D, Hagenmueller M, Erbel C, März W, Booz C, Albrecht MH, Vogl TJ, Frey N, Hardt SE, Ochs M. Impact of Homoarginine on Myocardial Function and Remodeling in a Rat Model of Chronic Renal Failure. J Cardiovasc Pharmacol Ther 2022; 27:10742484211054620. [PMID: 34994208 DOI: 10.1177/10742484211054620] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Low plasma concentrations of the amino acid homoarginine (HA) have been shown to correlate with adverse cardiovascular outcome, particularly in patients with chronic kidney disease. The present study sought to investigate the effect of HA treatment on cardiac remodeling in rats undergoing artificially induced renal insufficiency by 5/6 nephrectomy (5/6 Nx). METHODS A total of 33 male Wistar rats were randomly divided into sham and 5/6 Nx groups, receiving either placebo treatment or 400 mg·kg-1·day-1 HA over a 4-week period. RESULTS 5/6 Nx per se resulted in adverse myocardial remodeling with aggravated cardiac function and associated cardiac overload as the most obvious alteration (-23% ejection fraction, P < 0.0001), as well as increased myocardial fibrosis (+80%, P = 0.0005) compared to placebo treated sham animals. HA treatment of 5/6 Nx rats has led to an improvement of ejection fraction (+24%, P = 0.0003) and fractional shortening (+21%, P = 0.0126), as well as a decrease of collagen deposition (-32%, P = 0.0041), left ventricular weight (-14%, P = 0.0468), and myocyte cross-sectional area (-12%, P < 0.0001). These changes were accompanied by a downregulation of atrial natriuretic factor (-65% P < 0.0001) and collagen type V alpha 1 chain (-44%, P = 0.0006). Sham animals revealed no significant changes in cardiac function, myocardial fibrosis, or any of the aforementioned molecular changes after drug treatment. CONCLUSION Dietary HA supplementation appears to have the potential of preventing cardiac remodeling and improving heart function in the setting of chronic kidney disease. Our findings shed new light on HA as a possible new therapeutic agent for patients at high cardiovascular risk.
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Affiliation(s)
- Vitali Koch
- Department of Cardiology, Angiology and Pulmonology, 27178Heidelberg University Hospital, Heidelberg, Germany
| | - Christophe Weber
- Department of Cardiology, Angiology and Pulmonology, 27178Heidelberg University Hospital, Heidelberg, Germany
| | - Johannes H Riffel
- Department of Cardiology, Angiology and Pulmonology, 27178Heidelberg University Hospital, Heidelberg, Germany
| | - Kristina Buchner
- Institute of Human Genetics, Section for Developmental Genetics, 27178University of Heidelberg, Heidelberg, Germany
| | - Sebastian J Buss
- Department of Cardiology, Angiology and Pulmonology, 27178Heidelberg University Hospital, Heidelberg, Germany
| | - Selina Hein
- Department of Cardiology, Angiology and Pulmonology, 27178Heidelberg University Hospital, Heidelberg, Germany
| | - Derliz Mereles
- Department of Cardiology, Angiology and Pulmonology, 27178Heidelberg University Hospital, Heidelberg, Germany
| | - Marco Hagenmueller
- Department of Cardiology, Angiology and Pulmonology, 27178Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Erbel
- Department of Cardiology, Angiology and Pulmonology, 27178Heidelberg University Hospital, Heidelberg, Germany
| | - Winfried März
- Synlab Academy, Synlab Holding Deutschland GmbH, Augsburg, Germany
| | - Christian Booz
- 9173Goethe University Frankfurt, Frankfurt am Main, Germany
| | | | - Thomas J Vogl
- 9173Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Norbert Frey
- Department of Cardiology, Angiology and Pulmonology, 27178Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan E Hardt
- Department of Cardiology, Angiology and Pulmonology, 27178Heidelberg University Hospital, Heidelberg, Germany
| | - Marco Ochs
- Department of Cardiology, Angiology and Pulmonology, 27178Heidelberg University Hospital, Heidelberg, Germany
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20
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Zhloba AA, Subbotina TF. Homoarginine test for evaluation of metabolic renal dysfunction. Klin Lab Diagn 2021; 66:709-717. [PMID: 35020282 DOI: 10.51620/0869-2084-2021-66-12-709-717] [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: 11/06/2022]
Abstract
Low plasma L-homoarginine (hArg) concentration is an independent predictor of adverse cardiovascular outcomes and overall mortality, as well as the progression of chronic kidney disease (CKD). The enzyme L-arginine:glycinamidinotransferase (AGAT, EC 2.1.4.1) acts in the mitochondrial membrane of the renal tubular epithelium, forming the precursor of creatine, guanidinoacetic acid, and additionnaly by-product hArg. As it was shown recently, there is a decreased level of hArg in the late stages of CKD, however, the the level of hArg in the early stages of CKD remained unexplored. The aim of this study was to determine the diagnostic threshold levels of hArg in the blood of patients with stages 1 and 2 of CKD. In patients with the initial stages of CKD (n = 44) at the age of 58 (45-67) years, compared with the group of donors of 55 (42-58) years (n = 30), a significant decrease of hArg level was found. In the subgroup with stage CKD 2, the cut-off point of 1.59 μM threshold was characterized by greater sensitivity and specificity than in the subgroup with stage CKD 1 with 1.66 μM threshold level of hArg. For the full group, the hArg cut-off threshold was 1.60 μM, which is about to 0.2 μM lower than the lower limit of the reference interval for healthy individuals. It can be assumed that even before the formation of symptoms of proteinuria and albuminuria, a significant part of individuals from population cohort develops a state of decreased AGAT activity, since the expression of this enzyme is associated with a certain regulatory feedback inhibition at the body level. As a result of the study, it can be noted that in patients with early stages of CKD in the age group 45-67 years, there is a disturbance of the kidneys metabolic function. These metabolic changes can be detected by testing the level of hArg.
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Affiliation(s)
- A A Zhloba
- Pavlov First Saint Petersburg State Medical University of Minzdrav of Russia
| | - T F Subbotina
- Pavlov First Saint Petersburg State Medical University of Minzdrav of Russia
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21
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Arginine metabolism and nitric oxide turnover in the ZSF1 animal model for heart failure with preserved ejection fraction. Sci Rep 2021; 11:20684. [PMID: 34667218 PMCID: PMC8526609 DOI: 10.1038/s41598-021-00216-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/07/2021] [Indexed: 12/21/2022] Open
Abstract
Endothelial dysfunction and altered nitric oxide (NO) metabolism are considered causal factors in heart failure with preserved ejection fraction (HFpEF). NO synthase activity depends on the availability of arginine and its derivatives. Thus, we analyzed arginine, associated metabolites, arginine-metabolizing enzymes and NO turnover in 20-week-old female healthy lean (L-ZSF1) and obese ZSF1 rats (O-ZSF1) with HFpEF. Serum, urine and lysates of liver, kidney and heart were analyzed. There were significantly lower lysine (− 28%), arginine (− 31%), homoarginine (− 72%) and nitrite (− 32%) levels in serum of O-ZSF1 rats. Ornithine (+ 60%) and citrulline (+ 20%) levels were higher. Similar results were found in the heart. Expression of arginine consuming enzymes in liver and kidney was unchanged. Instead, we observed a 5.8-fold higher arginase 1 expression, presumably of granulocyte origin, in serum and > fourfold increased cardiac macrophage invasion in O-ZSF1. We conclude that inflammatory cells in blood and heart consume arginine and probably homoarginine via arginase 1 and inducible NO synthase and release ornithine and citrulline. In combination with evidence for decreased NO turnover in O-ZSF1 rats, we assume lower arginine bioavailability to endothelial NO synthase.
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22
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Homoarginine and methylarginines independently predict long-term outcome in patients presenting with suspicion of venous thromboembolism. Sci Rep 2021; 11:9569. [PMID: 33953241 PMCID: PMC8100302 DOI: 10.1038/s41598-021-88986-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/12/2021] [Indexed: 11/09/2022] Open
Abstract
Endogenous arginine derivatives homoarginine, asymmetric dimethylarginine (ADMA) and symmetric dimethyarginine (SDMA) are independent mortality predictors in atherosclerotic cardiovascular disease (CVD). Our study reports the first analysis, whether homoarginine, ADMA and SDMA predict venous thromboembolism (VTE) recurrence and overall mortality in patients with suspected acute VTE. We assessed serum levels of homoarginine, ADMA and SDMA by LC-MS/MS in 865 individuals from a prospective consecutive cohort of patients with clinical suspicion of VTE. The median follow-up time for mortality was 1196 days. VTE was confirmed by imaging in 418 patients and excluded in 447 patients. Low levels of homoarginine and high levels of ADMA or SDMA independently predicted all-cause mortality after adjustment for sex, age, oral anticoagulants, body mass index, arterial hypertension, diabetes mellitus, smoking, dyslipidemia, chronic heart failure, history of stroke, creatinine and cancer both in patients with VTE and without VTE. Interestingly, none of those parameters was predictive for VTE recurrence. We provide the first report that low circulating levels of homoarginine and high circulating levels of ADMA and SDMA independently predict all-cause mortality in patients with suspected VTE. These parameters might serve as markers of "frailty" and should be considered for future risk stratification approaches in this clinical population. Taking into account that homoarginine supplementation is protective in animal models of CVD and safe in healthy human volunteers, our study provides the basis for future homoarginine supplementation studies in patients with suspected VTE to investigate possible direct protective effects of homoarginine in this population.
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23
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Mokhaneli MC, Botha-Le Roux S, Fourie CMT, Böger R, Schwedhelm E, Mels CMC. L-homoarginine is associated with decreased cardiovascular- and all-cause mortality. Eur J Clin Invest 2021; 51:e13472. [PMID: 33320332 DOI: 10.1111/eci.13472] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/10/2020] [Accepted: 12/10/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Increasing evidence suggests that L-homoarginine, an endogenous analogue of the amino acid L-arginine, may have beneficial effects on vascular homeostasis. We examined whether L-homoarginine is associated with 10-year risk of all-cause and cardiovascular mortality in a black South African population. METHODS We included 669 black South African participants (mean age 59.5 years), 143 of whom died during the 10-year follow-up period. Mortality data were acquired via verbal autopsy. Plasma L-homoarginine (and other related markers) were analysed with liquid chromatography-tandem mass spectrometry. RESULTS Survivors had higher L-homoarginine levels compared with nonsurvivors (1.25 µM vs. 0.89 µM; P < .001). Multivariable Cox regression analyses revealed that higher plasma L-homoarginine predicted a reduction in 10-year cardiovascular (hazard ratio [HR] per SD increment, 0.61; 95% CI 0.50 to 0.75) and all-cause (hazard ratio [HR] per SD increment, 0.59; 95% CI 0.41 to 0.84) mortality risk. CONCLUSION Higher L-homoarginine levels are associated with reduced risk of 10-year cardiovascular and all-cause mortality. Regulation of L-homoarginine levels as a therapeutic target in the management of cardiovascular disease should be investigated.
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Affiliation(s)
- Maserame Cleopatra Mokhaneli
- Faculty of Health Sciences, Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Shani Botha-Le Roux
- Faculty of Health Sciences, Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Carla Maria Theresia Fourie
- Faculty of Health Sciences, Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Rainer Böger
- Department of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Deutsches Zentrum fuer Herz-Kreislauf-Forschung E.V. (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Edzard Schwedhelm
- Department of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Deutsches Zentrum fuer Herz-Kreislauf-Forschung E.V. (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Catharina Martha Cornelia Mels
- Faculty of Health Sciences, Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
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24
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Wetzel MD, Stanley K, Maity S, Madesh M, Bopassa JC, Awad AS. Homoarginine ameliorates diabetic nephropathy independent of nitric oxide synthase-3. Physiol Rep 2021; 9:e14766. [PMID: 33713581 PMCID: PMC7955794 DOI: 10.14814/phy2.14766] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 02/07/2023] Open
Abstract
Recently we showed that homoarginine supplementation confers kidney protection in diabetic mouse models. In this study we tested whether the protective effect of homoarginine is nitric oxide synthase-3 (NOS3)-independent in diabetic nephropathy (DN). Experiments were conducted in NOS3 deficient (NOS3-/- ) mice and their wild type littermate using multiple low doses of vehicle or streptozotocin and treated with homoarginine via drinking water for 24 weeks. Homoarginine supplementation for 24 weeks in diabetic NOS3-/- mice significantly attenuated albuminuria, increased blood urea nitrogen, histopathological changes and kidney fibrosis, kidney fibrotic markers, and kidney macrophage recruitment compared with vehicle-treated diabetic NOS3-/- mice. Furthermore, homoarginine supplementation restored kidney mitochondrial function following diabetes. Importantly, there were no significant changes in kidney NOS1 or NOS2 mRNA expression between all groups. In addition, homoarginine supplementation improved cardiac function and reduced cardiac fibrosis following diabetes. These data demonstrate that the protective effect of homoarginine is independent of NOS3, which will ultimately change our understanding of the mechanism(s) by which homoarginine induce renal and cardiac protection in DN. Homoarginine protective effect in DN could be mediated via improving mitochondrial function.
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Affiliation(s)
- Michael D. Wetzel
- Department of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
| | - Kristen Stanley
- Department of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
| | - Soumya Maity
- Department of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
| | - Muniswamy Madesh
- Department of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
| | - Jean C. Bopassa
- Department of Cellular and Integrative PhysiologyUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
| | - Alaa S. Awad
- Department of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTXUSA
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25
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Lee HY, Lim S, Park S. Role of Inflammation in Arterial Calcification. Korean Circ J 2021; 51:114-125. [PMID: 33525066 PMCID: PMC7853899 DOI: 10.4070/kcj.2020.0517] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 12/24/2020] [Indexed: 01/11/2023] Open
Abstract
Arterial calcification, characterized by calcium phosphate deposition in the arteries, can be divided into intimal calcification and medial calcification. The former is the predominant form of calcification in coronary artery plaques; the latter mostly affects peripheral arteries and aortas. Both forms of arterial calcification have strong correlations with adverse cardiovascular events. Intimal microcalcification is associated with increased risk of plaque disruption while the degree of burden of coronary calcification, measured by coronary calcium score, is a marker of overall plaque burden. Continuous research on vascular calcification has been performed during the past few decades, and several cellular and molecular mechanisms and therapeutic targets were identified. However, despite clinical trials to evaluate the efficacy of drug therapies to treat vascular calcification, none have been shown to have efficacy until the present. Therefore, more extensive research is necessary to develop appropriate therapeutic strategies based on a thorough understanding of vascular calcification. In this review, we mainly focus on intimal calcification, namely the pathobiology of arterial calcification, and its clinical implications.
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Affiliation(s)
- Hae Young Lee
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Soyeon Lim
- Institute for Bio-Medical Convergence, College of Medicine, Catholic Kwandong University, Gangneung, Korea
| | - Sungha Park
- Division of Cardiology, Severance Cardiovascular Hospital and Integrative Research Center for Cerebrovascular and Cardiovascular Diseases, Yonsei University College of Medicine, Seoul, Korea.
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26
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Transport of L-Arginine Related Cardiovascular Risk Markers. J Clin Med 2020; 9:jcm9123975. [PMID: 33302555 PMCID: PMC7764698 DOI: 10.3390/jcm9123975] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 12/15/2022] Open
Abstract
L-arginine and its derivatives, asymmetric and symmetric dimethylarginine (ADMA and SDMA) and L-homoarginine, have emerged as cardiovascular biomarkers linked to cardiovascular outcomes and various metabolic and functional pathways such as NO-mediated endothelial function. Cellular uptake and efflux of L-arginine and its derivatives are facilitated by transport proteins. In this respect the cationic amino acid transporters CAT1 and CAT2 (SLC7A1 and SLC7A2) and the system y+L amino acid transporters (SLC7A6 and SLC7A7) have been most extensively investigated, so far, but the number of transporters shown to mediate the transport of L-arginine and its derivatives is constantly increasing. In the present review we assess the growing body of evidence regarding the function, expression, and clinical relevance of these transporters and their possible relation to cardiovascular diseases.
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27
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Asymmetric dimethylarginine and l-homoarginine prospectively relate to carotid wall thickness in a South African cohort. Amino Acids 2020; 52:965-973. [DOI: 10.1007/s00726-020-02866-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 06/23/2020] [Indexed: 02/06/2023]
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28
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Association of Lower Plasma Homoarginine Concentrations with Greater Risk of All-Cause Mortality in the Community: The Framingham Offspring Study. J Clin Med 2020; 9:jcm9062016. [PMID: 32604958 PMCID: PMC7356383 DOI: 10.3390/jcm9062016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/03/2020] [Accepted: 06/24/2020] [Indexed: 02/06/2023] Open
Abstract
Lower circulating homoarginine concentrations have been associated with morbidity and mortality in patients with established cardiovascular disease (CVD). We assayed plasma homoarginine concentrations in 3331 Framingham Offspring Study participants attending examination cycle six (mean age 58.6 years, 53% women). We evaluated correlates of plasma homoarginine and related homoarginine to incident CVD and death. We also classified participants as having higher (upper quartile) versus lower (lower three quartiles) homoarginine and previously assayed asymmetric dimethylarginine (ADMA) concentrations, and created cross-classification groups. We observed 630 incident CVD events and 940 deaths during a median follow-up of 18 years. In multivariable regression analysis, homoarginine was associated positively with male sex, body mass index, anti-hypertensive medication use and systolic blood pressure, but inversely with age and smoking. Higher homoarginine levels were associated with a lower mortality risk (hazard ratio (HR) per SD increment, 0.83, 95% CI: 0.74–0.93) adjusting for standard CVD risk factors, and ADMA. Among the cross-classification groups, participants with higher homoarginine and lower ADMA had a lower mortality risk (HR, 0.81, 95% CI: 0.67–0.98) compared to those with low levels of both. Further studies are needed to dissect the mechanisms of the association of homoarginine and mortality over decades in the community.
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Arginine derivatives in atrial fibrillation progression phenotypes. J Mol Med (Berl) 2020; 98:999-1008. [PMID: 32504111 PMCID: PMC8556202 DOI: 10.1007/s00109-020-01932-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/20/2020] [Accepted: 05/27/2020] [Indexed: 10/24/2022]
Abstract
Arginine, homoarginine (hArg), asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA) affect nitric oxide metabolism and altered concentrations are associated with cardiovascular morbidity and mortality. We analyzed these metabolites using liquid chromatography-tandem mass spectrometry in patients with atrial fibrillation (AF) (n = 241) with a focus on heart rhythm at blood withdrawal, AF progression phenotypes, and successful sinus rhythm (SR) restoration (n = 22). AF progression phenotypes were defined as paroxysmal AF with/without low voltage areas (LVA) and persistent AF with/without LVA. While arginine, ADMA, and hArg were within reference limits for healthy controls, SDMA was higher in the AF cohort (0.57 ± 0.12 vs. 0.53 μmol/L (97.5th percentile in reference cohort)). SR restoration in AF patients resulted in normalization of SDMA concentrations (0.465 ± 0.082 vs. 0.570 ± 0.134 μmol/L at baseline, p < 0.001). Patients with AF at the time of blood sampling had significantly lower hArg (1.65 ± 0.51 vs. 1.85 ± 0.60 μmol/L, p = 0.006) and higher ADMA concentrations (0.526 ± 0.08 vs. 0.477 ± 0.08 μmol/L, p < 0.001) compared with AF patients in SR. hArg concentrations were lower in patients with advanced AF progression phenotypes (persistent AF with LVA (p = 0.046)) independent of heart rhythm at blood sampling. Summarizing, arginine metabolism imbalance is associated with AF in general and AF progression and may contribute to associated risk. KEY MESSAGES: • Heart rhythm at blood withdrawal affects ADMA and hArg level in AF patients. • SDMA is higher in AF patients. • SDMA levels normalize after sinus rhythm restoration. • hArg levels decrease in advanced AF progression phenotypes.
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Analysis of L-arginine:glycine amidinotransferase-, creatine- and homoarginine-dependent gene regulation in the murine heart. Sci Rep 2020; 10:4821. [PMID: 32179820 PMCID: PMC7076046 DOI: 10.1038/s41598-020-61638-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 02/06/2020] [Indexed: 02/04/2023] Open
Abstract
L-arginine:glycine amidinotransferase (AGAT) and its metabolites creatine and homoarginine (HA) have been linked to cardiovascular pathologies in both human and murine studies, but the underlying molecular mechanisms are poorly understood. Here, we report the first analysis of heart transcriptome variation using microarrays in an AGAT-deficient (AGAT−/−) mouse model to evaluate AGAT-, creatine- and HA-dependent gene regulation. Our data revealed significant differences of gene expression between AGAT−/− and wild-type (WT) mice, affecting cardiac energy metabolism (Fbp2, Ucp2), cardiac hypertrophy and fibrosis (Nppa, Ctgf), immune response (Fgl2), and the conduction system of the heart (Dsc2, Ehd4, Hcn2, Hcn4, Scn4a, Scn4b). All of these genes being expressed on WT level in creatine-supplemented mice. Using in silico analysis based on the GEO database we found that most of these candidate genes (Ctgf, Dsc2, Fbp2, Fgl2, Hcn2, Nppa) revealed significant alterations in a WT mouse model of myocardial infarction underlining a pathophysiological relationship between AGAT metabolism and cardiovascular disease.
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Jensen M, Müller C, Schwedhelm E, Arunachalam P, Gelderblom M, Magnus T, Gerloff C, Zeller T, Choe CU. Homoarginine- and Creatine-Dependent Gene Regulation in Murine Brains with l-Arginine:Glycine Amidinotransferase Deficiency. Int J Mol Sci 2020; 21:ijms21051865. [PMID: 32182846 PMCID: PMC7084559 DOI: 10.3390/ijms21051865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/28/2020] [Accepted: 03/07/2020] [Indexed: 12/14/2022] Open
Abstract
l-arginine:glycine amidinotransferase (AGAT) and its metabolites homoarginine (hArg) and creatine have been linked to stroke pathology in both human and mouse studies. However, a comprehensive understanding of the underlying molecular mechanism is lacking. To investigate transcriptional changes in cerebral AGAT metabolism, we applied a transcriptome analysis in brains of wild-type (WT) mice compared to untreated AGAT-deficient (AGAT−/−) mice and AGAT−/− mice with creatine or hArg supplementation. We identified significantly regulated genes between AGAT−/− and WT mice in two independent cohorts of mice which can be linked to amino acid metabolism (Ivd, Lcmt2), creatine metabolism (Slc6a8), cerebral myelination (Bcas1) and neuronal excitability (Kcnip3). While Ivd and Kcnip3 showed regulation by hArg supplementation, Bcas1 and Slc6a8 were creatine dependent. Additional regulated genes such as Pla2g4e and Exd1 need further evaluation of their influence on cerebral function. Experimental stroke models showed a significant regulation of Bcas1 and Slc6a8. Together, these results reveal that AGAT deficiency, hArg and creatine regulate gene expression in the brain, which may be critical in stroke pathology.
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Affiliation(s)
- Märit Jensen
- University Heart and Vascular Centre Hamburg, Clinic for Cardiology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (M.J.); (C.M.); (T.Z.)
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (P.A.); (M.G.); (T.M.); (C.G.)
| | - Christian Müller
- University Heart and Vascular Centre Hamburg, Clinic for Cardiology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (M.J.); (C.M.); (T.Z.)
- German Centre for Cardiovascular Research (DZHK e.V.), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany;
| | - Edzard Schwedhelm
- German Centre for Cardiovascular Research (DZHK e.V.), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany;
- Institute of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Priyadharshini Arunachalam
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (P.A.); (M.G.); (T.M.); (C.G.)
| | - Mathias Gelderblom
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (P.A.); (M.G.); (T.M.); (C.G.)
| | - Tim Magnus
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (P.A.); (M.G.); (T.M.); (C.G.)
| | - Christian Gerloff
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (P.A.); (M.G.); (T.M.); (C.G.)
| | - Tanja Zeller
- University Heart and Vascular Centre Hamburg, Clinic for Cardiology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (M.J.); (C.M.); (T.Z.)
- German Centre for Cardiovascular Research (DZHK e.V.), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany;
| | - Chi-un Choe
- German Centre for Cardiovascular Research (DZHK e.V.), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany;
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (P.A.); (M.G.); (T.M.); (C.G.)
- Correspondence: ; Tel.: +49-40-7410-53770
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Grosse GM, Schwedhelm E, Worthmann H, Choe CU. Arginine Derivatives in Cerebrovascular Diseases: Mechanisms and Clinical Implications. Int J Mol Sci 2020; 21:ijms21051798. [PMID: 32150996 PMCID: PMC7084464 DOI: 10.3390/ijms21051798] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/27/2020] [Accepted: 03/01/2020] [Indexed: 02/07/2023] Open
Abstract
The amino acid L-arginine serves as substrate for the nitric oxide synthase which is crucial in vascular function and disease. Derivatives of arginine, such as asymmetric (ADMA) and symmetric dimethylarginine (SDMA), are regarded as markers of endothelial dysfunction and have been implicated in vascular disorders. While there is a variety of studies consolidating ADMA as biomarker of cerebrovascular risk, morbidity and mortality, SDMA is currently emerging as an interesting metabolite with distinct characteristics in ischemic stroke. In contrast to dimethylarginines, homoarginine is inversely associated with adverse events and mortality in cerebrovascular diseases and might constitute a modifiable protective risk factor. This review aims to provide an overview of the current evidence for the pathophysiological role of arginine derivatives in cerebrovascular ischemic diseases. We discuss the complex mechanisms of arginine metabolism in health and disease and its potential clinical implications in diverse aspects of ischemic stroke.
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Affiliation(s)
- Gerrit M. Grosse
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany;
- Correspondence:
| | - Edzard Schwedhelm
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, 20249 Hamburg, Germany;
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.), partner site Hamburg/Kiel/Lübeck, 20249 Hamburg, Germany
| | - Hans Worthmann
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany;
| | - Chi-un Choe
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20249 Hamburg, Germany;
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Karetnikova ES, Jarzebska N, Markov AG, Weiss N, Lentz SR, Rodionov RN. Is Homoarginine a Protective Cardiovascular Risk Factor? Arterioscler Thromb Vasc Biol 2020; 39:869-875. [PMID: 30866658 DOI: 10.1161/atvbaha.118.312218] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
A series of recent epidemiological studies have implicated the endogenous nonproteinogenic amino acid l-homoarginine as a novel candidate cardiovascular risk factor. The association between homoarginine levels and the risk of adverse cardiovascular outcomes is inverse (ie, high cardiovascular risk is predicted by low rather than high homoarginine levels), which makes it plausible to normalize systemic homoarginine levels via oral supplementation. The emergence of homoarginine as a potentially treatable protective cardiovascular risk factor has generated a wave of hope in the field of cardiovascular prevention. Herein, we review the biochemistry, physiology, and metabolism of homoarginine, summarize the strengths and weaknesses of the epidemiological evidence linking homoarginine to cardiovascular disease and its potential protective cardiovascular effects, and identify priorities for future research needed to define the clinical utility of homoarginine as a prognostic factor and therapeutic target in cardiovascular disease.
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Affiliation(s)
- Ekaterina S Karetnikova
- From the Department of Physiology, Saint-Petersburg State University, Russia (E.S.K., A.G.M.)
| | - Natalia Jarzebska
- Division of Angiology, Department of Internal Medicine III, University Center for Vascular Medicine, University Hospital "Carl Gustav Carus", Technische Universität Dresden, Germany (N.J., N.W., R.N.R.)
| | - Alexander G Markov
- From the Department of Physiology, Saint-Petersburg State University, Russia (E.S.K., A.G.M.)
| | - Norbert Weiss
- Division of Angiology, Department of Internal Medicine III, University Center for Vascular Medicine, University Hospital "Carl Gustav Carus", Technische Universität Dresden, Germany (N.J., N.W., R.N.R.)
| | - Steven R Lentz
- Department of Internal Medicine, University of Iowa Carver College of Medicine (S.R.L.)
| | - Roman N Rodionov
- Division of Angiology, Department of Internal Medicine III, University Center for Vascular Medicine, University Hospital "Carl Gustav Carus", Technische Universität Dresden, Germany (N.J., N.W., R.N.R.).,Flinders University, Adelaide, Australia (R.N.R.)
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Mangoni AA, Rodionov RN, McEvoy M, Zinellu A, Carru C, Sotgia S. New horizons in arginine metabolism, ageing and chronic disease states. Age Ageing 2019; 48:776-782. [PMID: 31268522 DOI: 10.1093/ageing/afz083] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/16/2019] [Accepted: 06/10/2019] [Indexed: 11/14/2022] Open
Abstract
The elucidation of the metabolic pathways of the amino acid arginine and their role in health and disease have been an intensive focus of basic and clinical research for over a century. The recent advent of robust analytical techniques for biomarker assessment in large population cohorts has allowed the investigation of the pathophysiological role of specific arginine metabolites in key chronic disease states in old age, particularly those characterised by a reduced synthesis of endothelial nitric oxide, with consequent vascular disease and atherosclerosis. Two arginine metabolites have been increasingly studied in regard to their potential role in risk stratification and in the identification of novel therapeutic targets: the methylated arginine asymmetric dimethylarginine (ADMA) and the arginine analogue homoarginine. Higher circulating concentrations of ADMA, a potent inhibitor of nitric oxide synthesis, have been shown to predict adverse cardiovascular outcomes. By contrast, there is emerging evidence that homoarginine might exert cardioprotective effects. This review highlights recent advances in the biological and clinical role of ADMA and homoarginine in cardiovascular disease and other emerging fields, particularly chronic obstructive pulmonary disease, dementia, and depression. It also discusses opportunities for future research directions with the ultimate goal of translating knowledge of arginine metabolism, and its role in health and disease, into the clinical care of older adults.
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Affiliation(s)
- Arduino A Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia
| | - Roman N Rodionov
- University Centre for Vascular Medicine, Technische Universität Dresden, Dresden, Germany
| | - Mark McEvoy
- Faculty of Health and Medicine, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- Quality Control Unit, University Hospital of Sassari (AOU-SS), Sassari, Italy
| | - Salvatore Sotgia
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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Vora A, de Lemos JA, Ayers C, Grodin JL, Lingvay I. Association of Galectin-3 With Diabetes Mellitus in the Dallas Heart Study. J Clin Endocrinol Metab 2019; 104:4449-4458. [PMID: 31162551 DOI: 10.1210/jc.2019-00398] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 05/29/2019] [Indexed: 12/13/2022]
Abstract
CONTEXT Galectin-3 is a biomarker associated with inflammation and fibrosis in cardiac, liver, and renal disease. Galectin-3 is higher in overweight and obese individuals; whether an association with diabetes exists independent of weight is unknown. OBJECTIVE To evaluate if galectin-3 is associated with diabetes mellitus. DESIGN We performed measurements of galectin-3 among participants in the Dallas Heart Study (DHS) Phases 1 and 2 (DHS-1 and DHS-2; n = 3392, and n = 3194, respectively). Of these, 1989 participants were evaluated longitudinally in both studies. Associations of galectin-3 with prevalent and incident type 2 diabetes were determined using logistic regression models. Associations of galectin-3 with relevant biomarkers and fat compartments were evaluated using Spearman correlation coefficients and multivariable linear regression models, respectively. SETTING AND PARTICIPANTS DHS is a population-based, single-site, multiethnic study conducted in Dallas County, Texas, with oversampling to comprise 50% blacks. RESULTS Galectin-3 levels were associated with diabetes prevalence in DHS-1 [OR 1.56 per SD change in log-galectin (95% CI 1.41 to 1.73)] and DHS-2 [OR 1.86 (95% CI 1.67 to 2.06)]. Galectin-3 levels in DHS-1 also associated with incident diabetes mellitus over the 7.1 (interquartile range 6.6 to 7.6)-year follow-up period [OR 1.34 (95% CI 1.14 to 1.58)]. These associations maintained significance in models adjusted for traditional metabolic risk factors (age, sex, race, body mass index, and hypertension) and renal function. Galectin-3 levels correlated with levels of biomarkers implicated in inflammation (high-sensitivity C-reactive peptide, IL-18, monocyte chemoattractant protein 1, soluble TNF receptor 1A, myeloperoxidase), insulin secretion (C-peptide and C-peptide/homeostatic model assessment for insulin resistance), and subcutaneous adiposity. CONCLUSIONS Galectin-3 is associated with diabetes prevalence and incidence, possibly through the inflammatory pathway contributing to β-cell fibrosis and impaired insulin secretion.
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Affiliation(s)
- Amy Vora
- Division of Endocrinology, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Texas
| | - James A de Lemos
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Texas
| | - Colby Ayers
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Texas
| | - Justin L Grodin
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Texas
| | - Ildiko Lingvay
- Division of Endocrinology, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Texas
- Department of Clinical Sciences, University of Texas Southwestern Medical Center at Dallas, Texas
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36
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Ottosson F, Ericson U, Almgren P, Smith E, Brunkwall L, Hellstrand S, Nilsson PM, Orho-Melander M, Fernandez C, Melander O. Dimethylguanidino Valerate: A Lifestyle-Related Metabolite Associated With Future Coronary Artery Disease and Cardiovascular Mortality. J Am Heart Assoc 2019; 8:e012846. [PMID: 31533499 PMCID: PMC6806048 DOI: 10.1161/jaha.119.012846] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Identification of lifestyle modifiable metabolic pathways related to cardiometabolic disease risk is essential for improvement of primary prevention in susceptible individuals. It was recently shown that plasma dimethylguanidino valerate (DMGV) levels are associated with incident type 2 diabetes mellitus. Our aims were to investigate whether plasma DMGV is related to risk of future coronary artery disease and with cardiovascular mortality and to replicate the association with type 2 diabetes mellitus and pinpoint candidate lifestyle interventions susceptible to modulate DMGV levels. Methods and Results Plasma DMGV levels were measured using liquid chromatography‐mass spectrometry in a total of 5768 participants from the MDC (Malmö Diet and Cancer Study—Cardiovascular Cohort), MPP (Malmö Preventive Project), and MOS (Malmö Offspring Study). Dietary intake assessment was performed in the MOS. Baseline levels of DMGV associated with incident coronary artery disease in both the MDC (hazard ratio=1.29; CI=1.16–1.43; P<0.001) and MPP (odds ratio=1.25; CI=1.08–1.44; P=2.4e‐3). In the MDC, DMGV was associated with cardiovascular mortality and incident coronary artery disease, independently of traditional risk factors. Furthermore, the association between DMGV and incident type 2 diabetes mellitus was replicated in both the MDC (hazard ratio=1.83; CI=1.63–2.05; P<0.001) and MPP (odds ratio=1.65; CI=1.38–1.98; P<0.001). Intake of sugar‐sweetened beverages was associated with increased levels of DMGV, whereas intake of vegetables and level of physical activity was associated with lower DMGV. Conclusions We discovered novel independent associations between plasma DMGV and incident coronary artery disease and cardiovascular mortality, while replicating the previously reported association with incident type 2 diabetes mellitus. Additionally, strong associations with sugar‐sweetened beverages, vegetable intake, and physical activity suggest the potential to modify DMGV levels using lifestyle interventions.
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Affiliation(s)
- Filip Ottosson
- Department of Clinical Sciences Lund University Malmö Sweden
| | - Ulrika Ericson
- Department of Clinical Sciences Lund University Malmö Sweden
| | - Peter Almgren
- Department of Clinical Sciences Lund University Malmö Sweden
| | - Einar Smith
- Department of Clinical Sciences Lund University Malmö Sweden
| | | | | | - Peter M Nilsson
- Department of Clinical Sciences Lund University Malmö Sweden
| | | | | | - Olle Melander
- Department of Clinical Sciences Lund University Malmö Sweden
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Wetzel MD, Gao T, Venkatachalam M, Morris SM, Awad AS. l-Homoarginine supplementation prevents diabetic kidney damage. Physiol Rep 2019; 7:e14235. [PMID: 31552707 PMCID: PMC6759505 DOI: 10.14814/phy2.14235] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 08/27/2019] [Indexed: 12/22/2022] Open
Abstract
l-homoarginine is an endogenous, non-proteinogenic amino acid that has emerged as a new player in health and disease. Specifically, low l-homoarginine levels are associated with cardiovascular diseases, stroke, and reduced kidney function. However, the role of l-homoarginine in the pathogenesis of diabetic nephropathy (DN) is not known. Experiments were conducted in 6-week-old Ins2Akita mice supplemented with l-homoarginine via drinking water or mini osmotic pump for 12 weeks. Both plasma and kidney l-homoarginine levels were significantly reduced in diabetic mice compared to nondiabetic controls. Untreated Ins2Akita mice showed significant increases in urinary albumin excretion, histological changes, glomerular macrophage recruitment, the inflammatory cytokine KC-GRO/CXCL1, and urinary thiobarbituric acid reactive substances (TBARS) excretion as an indicator of oxidative stress, along with a significant reduction in kidney nitrate + nitrite levels compared to control mice at 18 weeks of age. In contrast, l-homoarginine supplementation for 12 weeks in Ins2Akita mice, via either drinking water or mini osmotic pump, significantly reduced albuminuria, renal histological changes, glomerular macrophage recruitment, KC-GRO/CXCL1 levels, urinary TBARS excretion, and largely restored kidney nitrate + nitrite levels. These data demonstrate that l-homoarginine supplementation attenuates specific features of DN in mice and could be a potential new therapeutic tool for treating diabetic patients.
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Affiliation(s)
- Michael D. Wetzel
- Department of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTexas
| | - Ting Gao
- Department of MedicinePenn State University College of MedicineHersheyPennsylvania
| | - Manjeri Venkatachalam
- Department of PathologyUniversity of Texas Health Science Center at San AntonioSan AntonioTexas
| | - Sidney M. Morris
- Department of Microbiology & Molecular GeneticsUniversity of PittsburghPittsburghPennsylvania
| | - Alaa S. Awad
- Department of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTexas
- Department of MedicinePenn State University College of MedicineHersheyPennsylvania
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Rodionov RN, Begmatov H, Jarzebska N, Patel K, Mills MT, Ghani Z, Khakshour D, Tamboli P, Patel MN, Abdalla M, Assaf M, Bornstein SR, Millan JL, Bode-Böger SM, Martens-Lobenhoffer J, Weiss N, Savinova OV. Homoarginine Supplementation Prevents Left Ventricular Dilatation and Preserves Systolic Function in a Model of Coronary Artery Disease. J Am Heart Assoc 2019; 8:e012486. [PMID: 31304837 PMCID: PMC6662144 DOI: 10.1161/jaha.119.012486] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background Homoarginine (hArg) has been shown to be cardioprotective in a model of ischemic heart failure; however, the mechanism remains unknown. hArg can inhibit tissue‐nonspecific alkaline phosphatase (TNAP), an enzyme that promotes vascular calcification. We hypothesized that hArg will exert beneficial effects by reducing calcification in a mouse model of coronary artery disease associated with TNAP overexpression and hypercholesterolemia. Methods and Results TNAP was overexpressed in the endothelium in mice homozygous for a low‐density lipoprotein receptor mutation (wicked high cholesterol [WHC] allele). WHC and WHC–endothelial TNAP mice received placebo or hArg supplementation (14 mg/L in drinking water) starting at 6 weeks of age simultaneously with an atherogenic diet. Outcomes were compared between the groups after 4 to 5 weeks on treatment. Experiments were performed in males, which presented a study limitation. As expected, WHC–endothelial TNAP mice on the placebo had increased mortality (median survival 27 days, P<0.0001), increased coronary calcium and lipids (P<0.01), increased left ventricular end‐diastolic diameter (P<0.0001), reduced ejection fraction (P<0.05), and increased myocardial fibrosis (P<0.0001) compared with WHC mice. Contrary to our hypothesis, hArg neither inhibited TNAP activity in vivo nor reduced coronary artery calcification and atherosclerosis in WHC–endothelial TNAP mice; however, compared with the placebo, hArg prevented left ventricular dilatation (P<0.01), preserved ejection fraction (P<0.05), and reduced myocardial fibrosis (P<0.001). Conclusions The beneficial effect of hArg supplementation in the setting of calcified coronary artery disease is likely due to its direct protective actions on the myocardial response to the ischemic injury and not to the inhibition of TNAP activity and calcification.
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Affiliation(s)
- Roman N Rodionov
- 1 University Center for Vascular Medicine Technische Universität Dresden Dresden Germany
| | - Hoshimjon Begmatov
- 2 Department of Biomedical Sciences New York Institute of Technology College of Osteopathic Medicine Old Westbury NY
| | - Natalia Jarzebska
- 1 University Center for Vascular Medicine Technische Universität Dresden Dresden Germany.,3 Department of Anesthesiology and Intensive Care Unit Medicine Pulmonary Engineering Group University Hospital Carl Gustav Carus Technische Universität Dresden Dresden Germany
| | - Ketul Patel
- 2 Department of Biomedical Sciences New York Institute of Technology College of Osteopathic Medicine Old Westbury NY
| | - Matthew T Mills
- 2 Department of Biomedical Sciences New York Institute of Technology College of Osteopathic Medicine Old Westbury NY
| | - Zulaikha Ghani
- 2 Department of Biomedical Sciences New York Institute of Technology College of Osteopathic Medicine Old Westbury NY
| | - Doreen Khakshour
- 2 Department of Biomedical Sciences New York Institute of Technology College of Osteopathic Medicine Old Westbury NY
| | - Pankti Tamboli
- 2 Department of Biomedical Sciences New York Institute of Technology College of Osteopathic Medicine Old Westbury NY
| | - Mitul N Patel
- 2 Department of Biomedical Sciences New York Institute of Technology College of Osteopathic Medicine Old Westbury NY
| | - Mirette Abdalla
- 2 Department of Biomedical Sciences New York Institute of Technology College of Osteopathic Medicine Old Westbury NY
| | - Maryann Assaf
- 2 Department of Biomedical Sciences New York Institute of Technology College of Osteopathic Medicine Old Westbury NY
| | - Stefan R Bornstein
- 4 Department of Internal Medicine III University Hospital Carl Gustav Carus Technische Universität Dresden Dresden Germany
| | - Jose Luis Millan
- 5 Human Genetics Program Sanford Burnham Prebys Medical Discovery Institute La Jolla CA
| | | | | | - Norbert Weiss
- 1 University Center for Vascular Medicine Technische Universität Dresden Dresden Germany
| | - Olga V Savinova
- 2 Department of Biomedical Sciences New York Institute of Technology College of Osteopathic Medicine Old Westbury NY
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39
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Faller KME, Atzler D, McAndrew DJ, Zervou S, Whittington HJ, Simon JN, Aksentijevic D, Ten Hove M, Choe CU, Isbrandt D, Casadei B, Schneider JE, Neubauer S, Lygate CA. Impaired cardiac contractile function in arginine:glycine amidinotransferase knockout mice devoid of creatine is rescued by homoarginine but not creatine. Cardiovasc Res 2019; 114:417-430. [PMID: 29236952 PMCID: PMC5982714 DOI: 10.1093/cvr/cvx242] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 12/08/2017] [Indexed: 01/09/2023] Open
Abstract
Aims Creatine buffers cellular adenosine triphosphate (ATP) via the creatine kinase reaction. Creatine levels are reduced in heart failure, but their contribution to pathophysiology is unclear. Arginine:glycine amidinotransferase (AGAT) in the kidney catalyses both the first step in creatine biosynthesis as well as homoarginine (HA) synthesis. AGAT-/- mice fed a creatine-free diet have a whole body creatine-deficiency. We hypothesized that AGAT-/- mice would develop cardiac dysfunction and rescue by dietary creatine would imply causality. Methods and results Withdrawal of dietary creatine in AGAT-/- mice provided an estimate of myocardial creatine efflux of ∼2.7%/day; however, in vivo cardiac function was maintained despite low levels of myocardial creatine. Using AGAT-/- mice naïve to dietary creatine we confirmed absence of phosphocreatine in the heart, but crucially, ATP levels were unchanged. Potential compensatory adaptations were absent, AMPK was not activated and respiration in isolated mitochondria was normal. AGAT-/- mice had rescuable changes in body water and organ weights suggesting a role for creatine as a compatible osmolyte. Creatine-naïve AGAT-/- mice had haemodynamic impairment with low LV systolic pressure and reduced inotropy, lusitropy, and contractile reserve. Creatine supplementation only corrected systolic pressure despite normalization of myocardial creatine. AGAT-/- mice had low plasma HA and supplementation completely rescued all other haemodynamic parameters. Contractile dysfunction in AGAT-/- was confirmed in Langendorff perfused hearts and in creatine-replete isolated cardiomyocytes, indicating that HA is necessary for normal cardiac function. Conclusions Our findings argue against low myocardial creatine per se as a major contributor to cardiac dysfunction. Conversely, we show that HA deficiency can impair cardiac function, which may explain why low HA is an independent risk factor for multiple cardiovascular diseases.
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Affiliation(s)
- Kiterie M E Faller
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, BHF Centre of Research Excellence at the University of Oxford and the Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Dorothee Atzler
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, BHF Centre of Research Excellence at the University of Oxford and the Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7BN, UK.,German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Institute for Cardiovascular Prevention (IPEK), Pettenkoferstraße 8a & 9, 80336 Munich, Germany.,Walther-Straub Institute of Pharmacology and Toxicology, Ludwig Maximilians University, Goethestrasse 33, 80336 Munich, Germany
| | - Debra J McAndrew
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, BHF Centre of Research Excellence at the University of Oxford and the Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Sevasti Zervou
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, BHF Centre of Research Excellence at the University of Oxford and the Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Hannah J Whittington
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, BHF Centre of Research Excellence at the University of Oxford and the Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Jillian N Simon
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, BHF Centre of Research Excellence at the University of Oxford and the Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Dunja Aksentijevic
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, BHF Centre of Research Excellence at the University of Oxford and the Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Michiel Ten Hove
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, BHF Centre of Research Excellence at the University of Oxford and the Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Chi-Un Choe
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Dirk Isbrandt
- Experimental Neurophysiology, German Center for Neurodegenerative Diseases (DZNE), 53175 Bonn, Germany.,The Institute for Molecular and Behavioral Neuroscience, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Barbara Casadei
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, BHF Centre of Research Excellence at the University of Oxford and the Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Jurgen E Schneider
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, BHF Centre of Research Excellence at the University of Oxford and the Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7BN, UK.,Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, BHF Centre of Research Excellence at the University of Oxford and the Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Craig A Lygate
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, BHF Centre of Research Excellence at the University of Oxford and the Wellcome Trust Centre for Human Genetics, Roosevelt Drive, Oxford OX3 7BN, UK
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Sarecka-Hujar B, Szołtysek-Bołdys I, Kopyta I, Dolińska B, Sobczak A. Concentrations of the Selected Biomarkers of Endothelial Dysfunction in Response to Antiepileptic Drugs: A Literature Review. Clin Appl Thromb Hemost 2019; 25:1076029619859429. [PMID: 31238702 PMCID: PMC6714895 DOI: 10.1177/1076029619859429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Epilepsy is a disease arising from morphological and metabolic changes in the brain. Approximately 60% of patients with seizures can be controlled with 1 antiepileptic drug (AED), while in others, polytherapy is required. The AED treatment affects a number of biochemical processes in the body, including increasing the risk of cardiovascular diseases (CVDs). It is indicated that the duration of AED therapy with some AEDs significantly accelerates the process of atherosclerosis. Most of AEDs increase levels of homocysteine (HCys) as well as may affect concentrations of new, nonclassical risk factors for atherosclerosis, that is, asymmetric dimethylarginine (ADMA) and homoarginine (hArg). Because of the role of these parameters in the pathogenesis of CVD, knowledge of HCys, ADMA, and hArg concentrations in patients with epilepsia treated with AED, both pediatric and adult, appears to be of significant importance.
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Affiliation(s)
- Beata Sarecka-Hujar
- 1 Department of Pharmaceutical Technology, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Sosnowiec, Poland
| | - Izabela Szołtysek-Bołdys
- 2 Department of General and Inorganic Chemistry, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Sosnowiec, Poland
| | - Ilona Kopyta
- 3 Department of Pediatric Neurology, School of Medicine in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Barbara Dolińska
- 1 Department of Pharmaceutical Technology, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Sosnowiec, Poland
| | - Andrzej Sobczak
- 2 Department of General and Inorganic Chemistry, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Sosnowiec, Poland
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41
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Distinct associations between plasma osteoprotegerin, homoarginine and asymmetric dimethylarginine in chronic kidney disease male patients with coronary artery disease. Amino Acids 2019; 51:977-982. [DOI: 10.1007/s00726-019-02738-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 04/25/2019] [Indexed: 12/17/2022]
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Nitz K, Lacy M, Atzler D. Amino Acids and Their Metabolism in Atherosclerosis. Arterioscler Thromb Vasc Biol 2019; 39:319-330. [DOI: 10.1161/atvbaha.118.311572] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
As a leading cause of death worldwide, cardiovascular disease is a global health concern. The development and progression of atherosclerosis, which ultimately gives rise to cardiovascular disease, has been causally linked to hypercholesterolemia. Mechanistically, the interplay between lipids and the immune system during plaque progression significantly contributes to the chronic inflammation seen in the arterial wall during atherosclerosis. Localized inflammation and increased cell-to-cell interactions may influence polarization and proliferation of immune cells via changes in amino acid metabolism. Specifically, the amino acids
l
-arginine (Arg),
l
-homoarginine (hArg) and
l
-tryptophan (Trp) have been widely studied in the context of cardiovascular disease, and their metabolism has been established as key regulators of vascular homeostasis, as well as immune cell function. Cyclic effects between endothelial cells, innate, and adaptive immune cells exist during Arg and hArg, as well as Trp metabolism, that may have distinct effects on the development of atherosclerosis. In this review, we describe the current knowledge surrounding the metabolism, biological function, and clinical perspective of Arg, hArg, and Trp in the context of atherosclerosis.
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Affiliation(s)
- Katrin Nitz
- From the Institute for Cardiovascular Prevention (K.N., M.L., D.A.), Ludwig-Maximilians-University, Munich, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany (K.N., M.L., D.A.)
| | - Michael Lacy
- From the Institute for Cardiovascular Prevention (K.N., M.L., D.A.), Ludwig-Maximilians-University, Munich, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany (K.N., M.L., D.A.)
| | - Dorothee Atzler
- From the Institute for Cardiovascular Prevention (K.N., M.L., D.A.), Ludwig-Maximilians-University, Munich, Germany
- Walther Straub Institute of Pharmacology and Toxicology (D.A.), Ludwig-Maximilians-University, Munich, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany (K.N., M.L., D.A.)
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Tanianskii DA, Jarzebska N, Birkenfeld AL, O'Sullivan JF, Rodionov RN. Beta-Aminoisobutyric Acid as a Novel Regulator of Carbohydrate and Lipid Metabolism. Nutrients 2019; 11:E524. [PMID: 30823446 PMCID: PMC6470580 DOI: 10.3390/nu11030524] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 02/22/2019] [Accepted: 02/26/2019] [Indexed: 01/04/2023] Open
Abstract
The prevalence and incidence of metabolic syndrome is reaching pandemic proportions worldwide, thus warranting an intensive search for novel preventive and treatment strategies. Recent studies have identified a number of soluble factors secreted by adipocytes and myocytes (adipo-/myokines), which link sedentary life style, abdominal obesity, and impairments in carbohydrate and lipid metabolism. In this review, we discuss the metabolic roles of the recently discovered myokine β-aminoisobutyric acid (BAIBA), which is produced by skeletal muscle during physical activity. In addition to physical activity, the circulating levels of BAIBA are controlled by the mitochondrial enzyme alanine: glyoxylate aminotransferase 2 (AGXT2), which is primarily expressed in the liver and kidneys. Recent studies have shown that BAIBA can protect from diet-induced obesity in animal models. It induces transition of white adipose tissue to a "beige" phenotype, which induces fatty acids oxidation and increases insulin sensitivity. While the exact mechanisms of BAIBA-induced metabolic effects are still not well understood, we discuss some of the proposed pathways. The reviewed data provide new insights into the connection between physical activity and energy metabolism and suggest that BAIBA might be a potential novel drug for treatment of the metabolic syndrome and its cardiovascular complications.
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Affiliation(s)
- Dmitrii A Tanianskii
- Department of Biochemistry, Institute of Experimental Medicine, Acad. Pavlov St., 12, 197376 St. Petersburg, Russia.
- Department of Fundamental Medicine and Medical Technology, St.Petersburg State University, 8 liter A, 21st Line V.O., 199034 St. Petersburg, Russia.
| | - Natalia Jarzebska
- University Center for Vascular Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
| | - Andreas L Birkenfeld
- Medical Clinic III, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
| | - John F O'Sullivan
- Medical Clinic III, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
- Charles Perkins Centre and Heart Research Institute, The University of Sydney, 7 Eliza St, Newtown NSW, Sydney 2042, Australia.
| | - Roman N Rodionov
- University Center for Vascular Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
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Guanidino compound ratios are associated with stroke etiology, internal carotid artery stenosis and CHA2DS2-VASc score in three cross-sectional studies. J Neurol Sci 2019; 397:156-161. [DOI: 10.1016/j.jns.2018.12.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 12/23/2018] [Accepted: 12/31/2018] [Indexed: 02/07/2023]
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45
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Maas R, Mieth M, Titze SI, Hübner S, Fromm MF, Kielstein JT, Schmid M, Köttgen A, Kronenberg F, Krane V, Hausknecht B, Eckardt KU, Schneider MP. Drugs linked to plasma homoarginine in chronic kidney disease patients—a cross-sectional analysis of the German Chronic Kidney Disease cohort. Nephrol Dial Transplant 2018; 35:1187-1195. [DOI: 10.1093/ndt/gfy342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 09/25/2018] [Indexed: 01/16/2023] Open
Abstract
Abstract
Background
Elevated plasma concentrations of symmetric and asymmetric dimethylarginine (SDMA and ADMA, respectively) and a lower plasma concentration of the structurally related homoarginine are commonly observed in patients with chronic kidney disease (CKD) and independently predict total mortality as well as progression of renal disease. We aimed to identify drugs that may alter this adverse metabolite pattern in a favourable fashion.
Methods
Plasma ADMA, SDMA, homoarginine and l-arginine were determined by liquid chromatography–tandem mass spectrometry in 4756 CKD patients ages 18–74 years with an estimated glomerular filtration rate (eGFR) of 30–60 mL/min/1.73 m2 or an eGFR >60 mL/min/1.73 m2 and overt proteinuria who were enrolled in the German Chronic Kidney Disease (GCKD) study. Associations between laboratory, clinical and medication data were assessed.
Results
Intake of several commonly used drugs was independently associated with plasma concentrations of homoarginine and/or related metabolites. Among these, the peroxisome proliferator-activated receptor alpha (PPAR-α) agonist fenofibrate was associated with the most profound differences in ADMA, SDMA and homoarginine plasma concentrations: 66 patients taking fenofibrate had a multivariable adjusted odds ratio (OR) of 5.83 [95% confidence interval (CI) 2.82–12.03, P < 0.001] to have a plasma homoarginine concentration above the median. The median homoarginine plasma concentration in patients taking fenofibrate was 2.30 µmol/L versus 1.55 in patients not taking the drug (P < 0.001). In addition, fibrates were significantly associated with lower plasma SDMA and higher l-arginine concentrations. In contrast, glucocorticoids were associated with lower plasma homoarginine, with adjusted ORs of 0.52 (95% CI 0.40–0.67, P < 0.001) and 0.53 (95% CI 0.31–0.90, P = 0.018) for prednisolone and methylprednisolone, respectively.
Conclusions
In a large cohort of CKD patients, intake of fenofibrate and glucocorticoids were independently associated with higher and lower plasma homoarginine concentrations, respectively. Effects on plasma homoarginine and methylarginines warrant further investigation as potential mechanisms mediating beneficial or adverse drug effects.
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Affiliation(s)
- Renke Maas
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Maren Mieth
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Stephanie I Titze
- Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Silvia Hübner
- Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Martin F Fromm
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Jan T Kielstein
- Divison of Nephrology, Medical School Hannover, Hannover, Germany
- Medical Clinic V Nephrology Rheumatology Blood Purification, Klinikum Braunschweig, Braunschweig, Germany
| | - Matthias Schmid
- Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Anna Köttgen
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Centre, University of Freiburg, Freiburg, Germany
| | - Florian Kronenberg
- Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Vera Krane
- Department of Medicine I, Division of Nephrology, University Hospital Würzburg, Würzburg, Germany
| | - Birgit Hausknecht
- Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Kai-Uwe Eckardt
- Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Markus P Schneider
- Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Cross-Sectional Associations between Homoarginine, Intermediate Phenotypes, and Atrial Fibrillation in the Community-The Gutenberg Health Study. Biomolecules 2018; 8:biom8030086. [PMID: 30200232 PMCID: PMC6165554 DOI: 10.3390/biom8030086] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/26/2018] [Accepted: 08/27/2018] [Indexed: 01/19/2023] Open
Abstract
Homoarginine has come into the focus of interest as a biomarker for cardiovascular disease. Atrial fibrillation (AF) causes a substantial increase in morbidity and mortality. Whether circulating homoarginine is associated with occurrence or persistence of AF and may serve as a new predictive biomarker remains unknown. We measured plasma levels of homoarginine in the population-based Gutenberg health study (3761 patients included, of them 51.7% males), mean age 55.6 ± 10.9 years-old. Associations between homoarginine and intermediate electrocardiographic and echocardiographic phenotypes and manifest AF were examined. Patients with AF (124 patients, of them 73.4% males) had a mean age 64.8 ± 8.6 years-old compared to a mean age of 55.3 ± 10.9 in the population without AF (p-value < 0.001) and showed a less beneficial risk factor profile. The median homoarginine levels in individuals with and without AF were 1.9 μmol/L (interquartile range (IQR) 1.5–2.5) and 2.0 μmol/L (IQR 1.5–2.5), respectively, p = 0.56. In multivariable-adjusted regression analyses homoarginine was not statistically significantly related to electrocardiographic variables. Among echocardiographic variables beta per standard deviation increase was −0.12 (95% confidence interval (CI) −0.23–(−0.02); p = 0.024) for left atrial area and −0.01 (95% CI −0.02–(−0.003); p = 0.013) for E/A ratio. The odds ratio between homoarginine and AF was 0.91 (95% CI 0.70–1.16; p = 0.45). In our large, population-based cross-sectional study, we did not find statistically significant correlations between lower homoarginine levels and occurrence or persistence of AF or most standard electrocardiographic phenotypes, but some moderate inverse associations with echocardiographic left atrial size and E/A. Homoarginine may not represent a strong biomarker to identify individuals at increased risk for AF. Further investigations will be needed to elucidate the role of homoarginine and cardiac function.
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47
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Loso J, Lund N, Avanesov M, Muschol N, Lezius S, Cordts K, Schwedhelm E, Patten M. Serum Biomarkers of Endothelial Dysfunction in Fabry Associated Cardiomyopathy. Front Cardiovasc Med 2018; 5:108. [PMID: 30159316 PMCID: PMC6104487 DOI: 10.3389/fcvm.2018.00108] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 07/17/2018] [Indexed: 12/13/2022] Open
Abstract
Background: Fabry disease (FD) is characterized by early development of vasculopathy and endothelial dysfunction. However, it is unclear whether these findings also play a pivotal role in cardiac manifestation. As Fabry cardiomyopathy (FC) is the leading cause of death in FD, we aimed to gather a better insight in pathological mechanisms of the disease. Methods: Serum samples were obtained from 17 healthy controls, 15 FD patients with and 7 without FC. FC was defined by LV wall thickening of >12 mm in cardiac magnetic resonance imaging and serum level of proBNP, high sensitive Troponin T (hsT), and globotriaosylsphingosine (lyso-GB3) were obtained. A multiplex ELISA-Assay for 23 different angiogenesis markers was performed in pooled samples. Markers showing significant differences among groups were further analyzed in single samples using specific Elisa antibody assays. L-homoarginine (hArg), L-arginine, asymmetric (ADMA), and symmetric Dimethylarginine (SDMA) were quantified by liquid chromatography—mass spectrometry. Results: Angiostatin and matrix metalloproteinase 9 (MMP-9) were elevated in FD patients compared to controls independently of the presence of FC (angiostatin: 98 ± 25 vs. 75 ± 15 ng/mL; p = 0.001; MMP-9: 8.0 ± 3.4 vs. 5.0 ± 2.4 μg/mL; p = 0.002). SDMA concentrations were highest in patients with FC (0.90 ± 0.64 μmol/l) compared to patients without (0.57 ± 0.10 μmol/l; p = 0.027) and vs. controls (0.58 ± 0.12 μmol/l; p = 0.006) and was positively correlated with indexed LV-mass (r = 0.61; p = 0.003), hsT (r = 0.56, p = 0.008), and lyso-Gb3 (r = 0.53, p = 0.013). Accordingly, the ratio of L-homoarginine to SDMA (hArg/SDMA) was lowest in patients with FC (2.63 ± 1.78) compared to controls (4.16 ± 1.44; p = 0.005). For L-arginine, hArg and ADMA no significant differences among groups could be detected, although a trend toward higher ADMA and lower hArg levels could be observed in the FC group. Furthermore, a significant relationship between kidney and cardiac function could be revealed (p = 0.045). Conclusion: Elevated MMP-9 and angiostatin levels suggest an increased extracellular matrix turnover in FD patients. Furthermore, endothelial dysfunction may also be involved in FC, as SDMA and hArg/SDMA are altered in these patients.
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Affiliation(s)
- Jefferson Loso
- Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany
| | - Natalie Lund
- Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany
| | - Maxim Avanesov
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg- Eppendorf, Hamburg, Germany
| | - Nicole Muschol
- Department of Pediatrics, University Medical Center Hamburg- Eppendorf, Hamburg, Germany
| | - Susanne Lezius
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg- Eppendorf, Hamburg, Germany
| | - Kathrin Cordts
- Department of Experimental Pharmacology and Toxicology, University Medical Center Hamburg- Eppendorf, Hamburg, Germany.,DZHK (German Center for Cardiovascular Research e.V.), Hamburg, Germany
| | - Edzard Schwedhelm
- Department of Experimental Pharmacology and Toxicology, University Medical Center Hamburg- Eppendorf, Hamburg, Germany.,DZHK (German Center for Cardiovascular Research e.V.), Hamburg, Germany
| | - Monica Patten
- Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.,DZHK (German Center for Cardiovascular Research e.V.), Hamburg, Germany
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48
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Zinellu A, Paliogiannis P, Carru C, Mangoni AA. Homoarginine and all-cause mortality: A systematic review and meta-analysis. Eur J Clin Invest 2018; 48:e12960. [PMID: 29806958 DOI: 10.1111/eci.12960] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/24/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Homoarginine, a basic amino acid and analogue of L-arginine, has been shown to exert salutary effects on vascular homoeostasis, possibly through interaction with the enzymes nitric oxide synthase and arginase. This might translate into improved survival outcomes, particularly in subjects with moderate-high cardiovascular risk. We conducted a systematic review and meta-analysis to investigate the association between circulating homoarginine concentrations and all-cause mortality in observational studies of human cohorts. MATERIALS AND METHODS Studies reporting baseline circulating homoarginine concentrations and all-cause mortality as outcome were searched using the MEDLINE, Scopus and Cochrane databases until January 2018. Hazard ratios (HRs) with 95% confidence intervals (CIs) derived from multivariate Cox's proportional-hazards analysis were extracted from individual studies. RESULTS A total of 13 studies in 11 964 participants were included in the final analysis. Homoarginine concentrations were inversely associated with all-cause mortality (HR 0.64, 95% CI 0.57-0.73). This association remained significant in participant sub-groups with predominant cardiovascular disease (HR 0.64, 95% CI 0.55-0.76) and renal disease (HR 0.60, 95% CI 0.46-0.68). CONCLUSIONS This meta-analysis of observational studies showed an inverse association between circulating homoarginine concentrations and all-cause mortality. Further research is warranted to investigate the direct effects of homoarginine on cardiovascular homoeostasis, the associations between homoarginine and all-cause mortality in other population groups, and the effects of interventions on homoarginine concentrations on clinical outcomes.
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Affiliation(s)
- Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | | | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.,Quality Control Unit, University Hospital (AOUSS), Sassari, Italy
| | - Arduino A Mangoni
- Department of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia
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49
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The prognostic biomarker L-homoarginine is a substrate of the cationic amino acid transporters CAT1, CAT2A and CAT2B. Sci Rep 2017; 7:4767. [PMID: 28684763 PMCID: PMC5500509 DOI: 10.1038/s41598-017-04965-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 05/22/2017] [Indexed: 02/05/2023] Open
Abstract
Low plasma concentration of L-homoarginine is an independent predictor of cardiovascular events and total mortality. Experimental data indicate that supplementation of L-homoarginine may have protective effects. We aimed to elucidate the mechanisms involved in the cellular uptake of L-homoarginine, which are little understood, so far. Using human embryonic kidney (HEK293) cell lines stably overexpressing the human cationic amino acid transporters CAT1 [solute carrier family 7 (SLC7A1)], CAT2A (SLC7A2A) or CAT2B (SLC7A2B) we assessed the transport kinetics of L-homoarginine and interactions with the CAT substrates L-arginine and asymmetric dimethylarginine (ADMA). Significant uptake of L-homoarginine was observed for all three CATs with apparent KM-values of 175 ± 7 µM for CAT1 and 523 ± 35 µM for CAT2B. Saturation of CAT2A-mediated L-homoarginine uptake could not be reached. Uptake of L-homoarginine by any of the three CATs could be inhibited by L-arginine and ADMA. Significant inhibition of CAT1-mediated uptake of L-homoarginine by L-arginine already occurred in the physiological concentration range. Taken together these data demonstrate that L-homoarginine is a substrate of CAT1, CAT2A and CAT2B and that CAT1 is a key site with regard to physiological relevance and interactions with related substrates such as L-arginine.
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Lew J, Sanghavi M, Ayers CR, McGuire DK, Omland T, Atzler D, Gore MO, Neeland I, Berry JD, Khera A, Rohatgi A, de Lemos JA. Sex-Based Differences in Cardiometabolic Biomarkers. Circulation 2017; 135:544-555. [PMID: 28153991 DOI: 10.1161/circulationaha.116.023005] [Citation(s) in RCA: 118] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 10/24/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Few data are available comparing cardiovascular disease (CVD) biomarker profiles between women and men in the general population. We analyzed sex-based differences in multiple biomarkers reflecting distinct pathophysiological pathways, accounting for differences between women and men in CVD risk factors, body composition, and cardiac morphology. METHODS A cross-sectional analysis was performed using data from the Dallas Heart Study, a multiethnic population-based study. Associations between sex and 30 distinct biomarkers representative of 6 pathophysiological categories were evaluated using multivariable linear regression adjusting for age, race, traditional CVD risk factors, kidney function, insulin resistance, MRI and dual-energy x-ray absorptiometry measures of body composition and fat distribution, and left ventricular mass. RESULTS After excluding participants with CVD, the study population included 3439 individuals, mean age 43 years, 56% women, and 52% black. Significant sex-based differences were seen in multiple categories of biomarkers, including lipids, adipokines, and biomarkers of inflammation, endothelial dysfunction, myocyte injury and stress, and kidney function. In fully adjusted models, women had higher levels of high-density lipoprotein cholesterol and high-density lipoprotein particle concentration, leptin, d-dimer, homoarginine, and N-terminal pro B-type natriuretic peptide, and lower levels of low-density lipoprotein cholesterol, adiponectin, lipoprotein-associated phospholipase A2 mass and activity, monocyte chemoattractant protein-1, soluble endothelial cell adhesion molecule, symmetrical dimethylarginine, asymmetrical dimethylarginine, high-sensitivity troponin T, and cystatin C. CONCLUSIONS Biomarker profiles differ significantly between women and men in the general population. Sex differences were most apparent for biomarkers of adiposity, endothelial dysfunction, inflammatory cell recruitment, and cardiac stress and injury. Future studies are needed to characterize whether pathophysiological processes delineated by these biomarkers contribute to sex-based differences in the development and complications of CVD.
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Affiliation(s)
- Jeanney Lew
- From Departments of Medicine (J.L., M.S., D.K.M., M.O.G., I.N., J.D.B., A.K., A.R., J.A.d.L.) and Clinical Sciences (C.R.A., D.K.M., J.D.B.), UT Southwestern Medical Center, Dallas, TX; Division of Medicine, Akershus University Hospital, Lørenskog, and University of Oslo, Norway (T.O.); Department of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (D.A.); and Department of Cardiovascular Medicine, University of Oxford, United Kingdom (D.A.)
| | - Monika Sanghavi
- From Departments of Medicine (J.L., M.S., D.K.M., M.O.G., I.N., J.D.B., A.K., A.R., J.A.d.L.) and Clinical Sciences (C.R.A., D.K.M., J.D.B.), UT Southwestern Medical Center, Dallas, TX; Division of Medicine, Akershus University Hospital, Lørenskog, and University of Oslo, Norway (T.O.); Department of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (D.A.); and Department of Cardiovascular Medicine, University of Oxford, United Kingdom (D.A.)
| | - Colby R Ayers
- From Departments of Medicine (J.L., M.S., D.K.M., M.O.G., I.N., J.D.B., A.K., A.R., J.A.d.L.) and Clinical Sciences (C.R.A., D.K.M., J.D.B.), UT Southwestern Medical Center, Dallas, TX; Division of Medicine, Akershus University Hospital, Lørenskog, and University of Oslo, Norway (T.O.); Department of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (D.A.); and Department of Cardiovascular Medicine, University of Oxford, United Kingdom (D.A.)
| | - Darren K McGuire
- From Departments of Medicine (J.L., M.S., D.K.M., M.O.G., I.N., J.D.B., A.K., A.R., J.A.d.L.) and Clinical Sciences (C.R.A., D.K.M., J.D.B.), UT Southwestern Medical Center, Dallas, TX; Division of Medicine, Akershus University Hospital, Lørenskog, and University of Oslo, Norway (T.O.); Department of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (D.A.); and Department of Cardiovascular Medicine, University of Oxford, United Kingdom (D.A.)
| | - Torbjørn Omland
- From Departments of Medicine (J.L., M.S., D.K.M., M.O.G., I.N., J.D.B., A.K., A.R., J.A.d.L.) and Clinical Sciences (C.R.A., D.K.M., J.D.B.), UT Southwestern Medical Center, Dallas, TX; Division of Medicine, Akershus University Hospital, Lørenskog, and University of Oslo, Norway (T.O.); Department of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (D.A.); and Department of Cardiovascular Medicine, University of Oxford, United Kingdom (D.A.)
| | - Dorothee Atzler
- From Departments of Medicine (J.L., M.S., D.K.M., M.O.G., I.N., J.D.B., A.K., A.R., J.A.d.L.) and Clinical Sciences (C.R.A., D.K.M., J.D.B.), UT Southwestern Medical Center, Dallas, TX; Division of Medicine, Akershus University Hospital, Lørenskog, and University of Oslo, Norway (T.O.); Department of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (D.A.); and Department of Cardiovascular Medicine, University of Oxford, United Kingdom (D.A.)
| | - Maria O Gore
- From Departments of Medicine (J.L., M.S., D.K.M., M.O.G., I.N., J.D.B., A.K., A.R., J.A.d.L.) and Clinical Sciences (C.R.A., D.K.M., J.D.B.), UT Southwestern Medical Center, Dallas, TX; Division of Medicine, Akershus University Hospital, Lørenskog, and University of Oslo, Norway (T.O.); Department of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (D.A.); and Department of Cardiovascular Medicine, University of Oxford, United Kingdom (D.A.)
| | - Ian Neeland
- From Departments of Medicine (J.L., M.S., D.K.M., M.O.G., I.N., J.D.B., A.K., A.R., J.A.d.L.) and Clinical Sciences (C.R.A., D.K.M., J.D.B.), UT Southwestern Medical Center, Dallas, TX; Division of Medicine, Akershus University Hospital, Lørenskog, and University of Oslo, Norway (T.O.); Department of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (D.A.); and Department of Cardiovascular Medicine, University of Oxford, United Kingdom (D.A.)
| | - Jarett D Berry
- From Departments of Medicine (J.L., M.S., D.K.M., M.O.G., I.N., J.D.B., A.K., A.R., J.A.d.L.) and Clinical Sciences (C.R.A., D.K.M., J.D.B.), UT Southwestern Medical Center, Dallas, TX; Division of Medicine, Akershus University Hospital, Lørenskog, and University of Oslo, Norway (T.O.); Department of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (D.A.); and Department of Cardiovascular Medicine, University of Oxford, United Kingdom (D.A.)
| | - Amit Khera
- From Departments of Medicine (J.L., M.S., D.K.M., M.O.G., I.N., J.D.B., A.K., A.R., J.A.d.L.) and Clinical Sciences (C.R.A., D.K.M., J.D.B.), UT Southwestern Medical Center, Dallas, TX; Division of Medicine, Akershus University Hospital, Lørenskog, and University of Oslo, Norway (T.O.); Department of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (D.A.); and Department of Cardiovascular Medicine, University of Oxford, United Kingdom (D.A.)
| | - Anand Rohatgi
- From Departments of Medicine (J.L., M.S., D.K.M., M.O.G., I.N., J.D.B., A.K., A.R., J.A.d.L.) and Clinical Sciences (C.R.A., D.K.M., J.D.B.), UT Southwestern Medical Center, Dallas, TX; Division of Medicine, Akershus University Hospital, Lørenskog, and University of Oslo, Norway (T.O.); Department of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (D.A.); and Department of Cardiovascular Medicine, University of Oxford, United Kingdom (D.A.)
| | - James A de Lemos
- From Departments of Medicine (J.L., M.S., D.K.M., M.O.G., I.N., J.D.B., A.K., A.R., J.A.d.L.) and Clinical Sciences (C.R.A., D.K.M., J.D.B.), UT Southwestern Medical Center, Dallas, TX; Division of Medicine, Akershus University Hospital, Lørenskog, and University of Oslo, Norway (T.O.); Department of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (D.A.); and Department of Cardiovascular Medicine, University of Oxford, United Kingdom (D.A.).
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