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Mayoral-González I, Calderón-Sánchez EM, Galeano-Otero I, Martín-Bórnez M, Gutiérrez-Carretero E, Fernández-Velasco M, Domenech N, Crespo-Leiro MG, Gómez AM, Ordóñez-Fernández A, Hmadcha A, Smani T. Cardiac protection induced by urocortin-2 enables the regulation of apoptosis and fibrosis after ischemia and reperfusion involving miR-29a modulation. MOLECULAR THERAPY. NUCLEIC ACIDS 2022; 27:838-853. [PMID: 35141045 PMCID: PMC8807986 DOI: 10.1016/j.omtn.2022.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 01/07/2022] [Indexed: 12/31/2022]
Abstract
Urocortin-2 (Ucn-2) has demonstrated cardioprotective actions against myocardial ischemia-reperfusion (I/R) injuries. Herein, we explored the protective role of Ucn-2 through microRNAs (miRNAs) post-transcriptional regulation of apoptotic and pro-fibrotic genes. We determined that the intravenous administration of Ucn-2 before heart reperfusion in a Wistar rat model of I/R recovered cardiac contractility and decreased fibrosis, lactate dehydrogenase release, and apoptosis. The infusion of Ucn-2 also inhibited the upregulation of 6 miRNAs in revascularized heart. The in silico analysis indicated that miR-29a and miR-451_1∗ are predicted to target many apoptotic and fibrotic genes. Accordingly, the transfection of neonatal rat ventricular myocytes with mimics overexpressing miR-29a, but not miR-451_1∗, prevented I/R-induced expression of pro- and anti-apoptotic genes such as Apaf-1, Hmox-1, and Cycs, as well as pro-fibrotic genes Col-I and Col-III. We also confirmed that Hmox-1, target of miR-29a, is highly expressed at the mRNA and protein levels in adult rat heart under I/R, whereas, Ucn-2 abolished I/R-induced mRNA and protein upregulation of HMOX-1. Interestingly, a significant upregulation of Hmox-1 was observed in the ventricle of ischemic patients with heart failure, correlating negatively with the left ventricle ejection fraction. Altogether, these data indicate that Ucn-2, through miR-29a regulation, provides long-lasting cardioprotection, involving the post-transcriptional regulation of apoptotic and fibrotic genes.
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Affiliation(s)
- Isabel Mayoral-González
- Department of Surgery, University of Seville, Seville, Spain
- Group of Cardiovascular Pathophysiology, Institute of Biomedicine of Seville (IBiS), University Hospital of Virgen del Rocío/University of Seville/CSIC, Seville, Spain
| | - Eva M. Calderón-Sánchez
- Group of Cardiovascular Pathophysiology, Institute of Biomedicine of Seville (IBiS), University Hospital of Virgen del Rocío/University of Seville/CSIC, Seville, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Madrid, Spain
| | - Isabel Galeano-Otero
- Group of Cardiovascular Pathophysiology, Institute of Biomedicine of Seville (IBiS), University Hospital of Virgen del Rocío/University of Seville/CSIC, Seville, Spain
- Department of Medical Physiology and Biophysics, University of Seville, Seville, Spain
| | - Marta Martín-Bórnez
- Department of Surgery, University of Seville, Seville, Spain
- Group of Cardiovascular Pathophysiology, Institute of Biomedicine of Seville (IBiS), University Hospital of Virgen del Rocío/University of Seville/CSIC, Seville, Spain
| | - Encarnación Gutiérrez-Carretero
- Department of Surgery, University of Seville, Seville, Spain
- Group of Cardiovascular Pathophysiology, Institute of Biomedicine of Seville (IBiS), University Hospital of Virgen del Rocío/University of Seville/CSIC, Seville, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Madrid, Spain
| | - María Fernández-Velasco
- Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Madrid, Spain
- Innate Immune Response Group, IdiPAZ, La Paz University Hospital, Madrid, Spain
| | - Nieves Domenech
- Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Madrid, Spain
- Cardiology Department, Instituto de Investigación Biomédica de A Coruña, Complexo Hospitalario Universitario de A Coruña, Servicio Gallego de Salud, Universidade da Coruña, Coruña, Spain
| | - María Generosa Crespo-Leiro
- Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Madrid, Spain
- Cardiology Department, Instituto de Investigación Biomédica de A Coruña, Complexo Hospitalario Universitario de A Coruña, Servicio Gallego de Salud, Universidade da Coruña, Coruña, Spain
| | - Ana María Gómez
- Signaling and Cardiovascular Pathophysiology, INSERM, Université Paris Saclay, Châtenay-Malabry, France
| | - Antonio Ordóñez-Fernández
- Department of Surgery, University of Seville, Seville, Spain
- Group of Cardiovascular Pathophysiology, Institute of Biomedicine of Seville (IBiS), University Hospital of Virgen del Rocío/University of Seville/CSIC, Seville, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Madrid, Spain
| | - Abdelkrim Hmadcha
- Department of Biotechnology, University of Alicante, Alicante, Spain
- University of Pablo Olavide, Seville, Spain
| | - Tarik Smani
- Group of Cardiovascular Pathophysiology, Institute of Biomedicine of Seville (IBiS), University Hospital of Virgen del Rocío/University of Seville/CSIC, Seville, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Madrid, Spain
- Department of Medical Physiology and Biophysics, University of Seville, Seville, Spain
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Urocortins as biomarkers in cardiovascular disease. Clin Sci (Lond) 2022; 136:1-14. [PMID: 34939089 DOI: 10.1042/cs20210732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022]
Abstract
The urocortins (Ucns) belong to the corticotropin-releasing factor (CRF) family of peptides and have multiple effects within the central nervous and the cardiovascular systems. With growing evidence indicating significant cardioprotective properties and cardiovascular actions of these peptides, the question arises as to whether the plasma profiles of the Ucns are altered in pathologic settings. While reports have shown conflicting results and findings have not been corroborated in multiple independent cohorts, it seems likely that plasma Ucn concentrations are elevated in multiple cardiovascular conditions. The degree of increase and accurate determination of circulating values of the Ucns requires further validation.
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Urocortin Role in Ischemia Cardioprotection and the Adverse Cardiac Remodeling. Int J Mol Sci 2021; 22:ijms222212115. [PMID: 34829997 PMCID: PMC8622004 DOI: 10.3390/ijms222212115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/24/2021] [Accepted: 11/05/2021] [Indexed: 11/17/2022] Open
Abstract
Despite the considerable progress in strategies of myocardial protection, ischemic heart diseases (IHD) and consequent heart failure (HF) remain the main cause of mortality worldwide. Several procedures are used routinely to guarantee the prompt and successful reestablishment of blood flow to preserve the myocardial viability of infarcted hearts from ischemia injuries. However, ischemic heart reperfusion/revascularization triggers additional damages that occur when oxygen-rich blood re-enters the vulnerable myocardial tissue, which is a phenomenon known as ischemia and reperfusion (I/R) syndrome. Complications of I/R injuries provoke the adverse cardiac remodeling, involving inflammation, mishandling of Ca2+ homeostasis, apoptotic genes activation, cardiac myocytes loss, etc., which often progress toward HF. Therefore, there is an urgent need to develop new cardioprotective therapies for IHD and HF. Compelling evidence from animal studies and pilot clinical trials in HF patients suggest that urocortin (Ucn) isoforms, which are peptides associated with stress and belonging to the corticotropin releasing factor family, have promising potential to improve cardiovascular functions by targeting many signaling pathways at different molecular levels. This review highlights the current knowledge on the role of urocortin isoforms in cardioprotection, focusing on its acute and long-term effects.
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Kovács DK, Farkas N, Soós A, Hegyi P, Kelava L, Eitmann S, Schekk A, Molnár Z, Erőss B, Balaskó M. Assessment of clinical data on urocortins and their therapeutic potential in cardiovascular diseases: A systematic review and meta-analysis. Clin Transl Sci 2021; 14:2461-2473. [PMID: 34378854 PMCID: PMC8604231 DOI: 10.1111/cts.13114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 05/26/2021] [Accepted: 06/22/2021] [Indexed: 12/11/2022] Open
Abstract
Heart failure (HF) and cardiovascular diseases present public health challenges. Although great progress was achieved in their treatment, there is continuous need for new therapies. Urocortins of the corticotropin neuropeptide family were reported to exert beneficial effects in animal models of HF and cardiovascular diseases. We aimed to assess the available clinical evidence on the potential role of urocortins in HF and other cardiovascular diseases. We explored MEDLINE, Embase, CENTRAL, and Scopus databases. Twenty‐seven studies were included in the qualitative and 15 studies (2005 patients) in the quantitative syntheses. Available data allowed us to meta‐analyze the blood pressure (BP) lowering and heart rate (HR) increasing effects of urocortin 2 in HF with reduced ejection fraction. We applied meta‐regression to explore the association between left ventricular ejection fraction and serum urocortin 1 and urocortin 2 levels. Short‐term urocortin 2 infusion decreased mean arterial pressure in chronic HF with reduced ejection fraction (mean difference = −9.161 mmHg, 95% confidence interval [CI] −12.661 to −5.660 mmHg, p < 0.001). Such infusions increased HR mildly (mean difference = 5.629 beats/min, 95% CI 1.612 to 9.646 beats/min, p = 0.006). Although some studies reported increased urocortin 1 and urocortin 2 levels in HF with growing severity, our meta‐regressions failed to confirm associations between blood urocortin levels and left ventricular ejection fraction. Clinical evidence confirms short‐term BP lowering effects of urocortin 2, whereas individual studies report additional beneficial effects. Further clinical investigations are necessary to confirm the latter and the long‐term value of these peptides in cardiovascular diseases. Review protocol: CRD42020163203.
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Affiliation(s)
- Dóra K Kovács
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Nelli Farkas
- Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Alexandra Soós
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.,Department of Translational Medicine, First Department of Internal Medicine, University of Pécs, Pécs, Hungary.,MTA-SZTE Translational Gastroenterology Research Group, University of Szeged, Szeged, Hungary
| | - Leonardo Kelava
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Szimonetta Eitmann
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Anna Schekk
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Zsolt Molnár
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Bálint Erőss
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Márta Balaskó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
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Abstract
Heart failure (HF) is the end result of many different cardiac and non-cardiac abnormalities leading to a complex clinical entity. In this view, the use of biomarkers in HF should be deeply reconsidered; indeed, the same biomarker may carry a different significance in patients with preserved or reduced EF. The aim of this review is to reconsider the role of biomarkers in HF, based on the different clinical characteristics of this syndrome. The role of cardiac and non-cardiac biomarkers will be reviewed with respect of the different clinical manifestations of this syndrome.
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Do urocortins have a role in treating cardiovascular disease? Drug Discov Today 2019; 24:279-284. [DOI: 10.1016/j.drudis.2018.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/20/2018] [Accepted: 09/05/2018] [Indexed: 02/02/2023]
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Abstract
The identification of corticotropin-releasing hormone (CRH) has led to the discovery of a growing family of ligands and receptors. CRH receptor 1 (CRHR1) and CRHR2 are mammalian G-protein coupled receptors (GPCRs) with high affinity for CRH and the CRH family of peptides. CRHR1 is predominantly expressed in the brain and plays a vital role in the hypothalamic-pituitary-adrenal (HPA) axis stress responses by secreting adrenal corticotropic hormone (ACTH). CRHR2 is predominantly expressed in the heart, and a CRHR2-specific ligand, urocortin 2 (UCN2), shows positive cardiac chronotropic and inotropic effects through 3´,5´-cyclic adenosine monophosphate (cAMP) signaling in response to CRHR2-mediated Gαs activation in mice and humans. Central administration of the CRH family of peptides increases mean arterial pressure through CRHR1 activation, whereas peripheral administration of the peptides decreases mean arterial pressure through CRHR2 activation. These observations have led to further investigations of CRHR2 as an important and unique GPCR in the physiological and pathological functioning of the cardiovascular (CV) system. Moreover, recent clinical trials demonstrate CRHR2 as a potentially therapeutic target in the treatment of heart failure. We present recent reviews of the role of CRHRs in basic CV physiology and in the pathophysiology of CV diseases.
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Affiliation(s)
- Mikito Takefuji
- Department of Cardiology, Nagoya University School of Medicine
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Natural and synthetic peptides in the cardiovascular diseases: An update on diagnostic and therapeutic potentials. Arch Biochem Biophys 2018; 662:15-32. [PMID: 30481494 DOI: 10.1016/j.abb.2018.11.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/31/2018] [Accepted: 11/21/2018] [Indexed: 02/07/2023]
Abstract
Several peptides play an important role in physiological and pathological conditions into the cardiovascular system. In addition to well-known vasoactive agents such as angiotensin II, endothelin, serotonin or natriuretic peptides, the vasoconstrictor Urotensin-II (Uro-II) and the vasodilators Urocortins (UCNs) and Adrenomedullin (AM) have been implicated in the control of vascular tone and blood pressure as well as in cardiovascular disease states including congestive heart failure, atherosclerosis, coronary artery disease, and pulmonary and systemic hypertension. Therefore these peptides, together with their receptors, become important therapeutic targets in cardiovascular diseases (CVDs). Circulating levels of these agents in the blood are markedly modified in patients with specific CVDs compared with those in healthy patients, becoming also potential biomarkers for these pathologies. This review will provide an overview of current knowledge about the physiological roles of Uro-II, UCN and AM in the cardiovascular system and their implications in cardiovascular diseases. It will further focus on the structural modifications carried out on original peptide sequences in the search of analogues with improved physiochemical properties as well as in the delivery methods. Finally, we have overviewed the possible application of these peptides and/or their precursors as biomarkers of CVDs.
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Rademaker MT, Richards AM. Urocortins: Actions in health and heart failure. Clin Chim Acta 2017; 474:76-87. [DOI: 10.1016/j.cca.2017.09.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 09/04/2017] [Indexed: 01/21/2023]
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Pilbrow AP, Lewis KA, Perrin MH, Sweet WE, Moravec CS, Tang WHW, Huising MO, Troughton RW, Cameron VA. Cardiac CRFR1 Expression Is Elevated in Human Heart Failure and Modulated by Genetic Variation and Alternative Splicing. Endocrinology 2016; 157:4865-4874. [PMID: 27754786 PMCID: PMC5133347 DOI: 10.1210/en.2016-1448] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Corticotropin-releasing factor (CRF) and the CRF-related peptides, urocortin (Ucn)-1, Ucn2, and Ucn3 signal through receptors CRFR1 and CRFR2 to restore homeostasis in response to stress. The Ucns exert potent cardioprotective effects and may have clinical utility in heart failure. To explore the activity of this system in the heart, we measured the levels of myocardial gene expression of the CRF/Ucn family of ligands/receptors and investigated genetic variation and alternative splicing of CRFR1 in 110 heart failure patients and 108 heart donors. Using quantitative real-time PCR, we detected CRFR1, CRFR2, CRF, Ucn1, Ucn2, and Ucn3 in all samples. CRFR2α was the most abundant receptor and Ucn3 the most abundant ligand, both in patients and donors. Compared with donors, cardiac expression of CRFR1, CRF, and Ucn3 was higher (P < .001) and CRFR2α lower (P = .012) in patients. In patients and donors, genetic variation within CRFR1, represented by the chromosome 17q21.31 inversion polymorphism, was associated with markedly higher CRFR1 expression (P < .001), making CRFR1 and CRFR2α expression almost equivalent in some patients. A novel, truncated splice variant of CRFR1, designated CRFR1j, was identified and shown to exert a dominant-negative effect on CRFR1 signaling in vitro. The novel variant was expressed in a greater proportion of patients (60%) than donors (3%, P < .001). In summary, cardiac expression of CRFR1, CRF, and Ucn3 genes is elevated in heart failure and may contribute to the activation of the CRF/Ucn system in these patients. A common variant within the CRFR1 gene and a novel CRFR1 splice variant may modulate CRFR1 expression and signaling.
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Affiliation(s)
- Anna P Pilbrow
- Peptide Biology Laboratories (A.P.P., K.A.L., M.H.P., M.O.H.), The Salk Institute for Biological Studies, La Jolla, California 92037; Christchurch Heart Institute (A.P.P., R.W.T., V.A.C.), Department of Medicine, University of Otago, Christchurch 8011, New Zealand; Kaufman Center for Heart Failure (W.E.S., C.S.M., W.H.W.T.), Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio 44195
| | - Kathy A Lewis
- Peptide Biology Laboratories (A.P.P., K.A.L., M.H.P., M.O.H.), The Salk Institute for Biological Studies, La Jolla, California 92037; Christchurch Heart Institute (A.P.P., R.W.T., V.A.C.), Department of Medicine, University of Otago, Christchurch 8011, New Zealand; Kaufman Center for Heart Failure (W.E.S., C.S.M., W.H.W.T.), Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio 44195
| | - Marilyn H Perrin
- Peptide Biology Laboratories (A.P.P., K.A.L., M.H.P., M.O.H.), The Salk Institute for Biological Studies, La Jolla, California 92037; Christchurch Heart Institute (A.P.P., R.W.T., V.A.C.), Department of Medicine, University of Otago, Christchurch 8011, New Zealand; Kaufman Center for Heart Failure (W.E.S., C.S.M., W.H.W.T.), Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio 44195
| | - Wendy E Sweet
- Peptide Biology Laboratories (A.P.P., K.A.L., M.H.P., M.O.H.), The Salk Institute for Biological Studies, La Jolla, California 92037; Christchurch Heart Institute (A.P.P., R.W.T., V.A.C.), Department of Medicine, University of Otago, Christchurch 8011, New Zealand; Kaufman Center for Heart Failure (W.E.S., C.S.M., W.H.W.T.), Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio 44195
| | - Christine S Moravec
- Peptide Biology Laboratories (A.P.P., K.A.L., M.H.P., M.O.H.), The Salk Institute for Biological Studies, La Jolla, California 92037; Christchurch Heart Institute (A.P.P., R.W.T., V.A.C.), Department of Medicine, University of Otago, Christchurch 8011, New Zealand; Kaufman Center for Heart Failure (W.E.S., C.S.M., W.H.W.T.), Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio 44195
| | - W H Wilson Tang
- Peptide Biology Laboratories (A.P.P., K.A.L., M.H.P., M.O.H.), The Salk Institute for Biological Studies, La Jolla, California 92037; Christchurch Heart Institute (A.P.P., R.W.T., V.A.C.), Department of Medicine, University of Otago, Christchurch 8011, New Zealand; Kaufman Center for Heart Failure (W.E.S., C.S.M., W.H.W.T.), Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio 44195
| | - Mark O Huising
- Peptide Biology Laboratories (A.P.P., K.A.L., M.H.P., M.O.H.), The Salk Institute for Biological Studies, La Jolla, California 92037; Christchurch Heart Institute (A.P.P., R.W.T., V.A.C.), Department of Medicine, University of Otago, Christchurch 8011, New Zealand; Kaufman Center for Heart Failure (W.E.S., C.S.M., W.H.W.T.), Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio 44195
| | - Richard W Troughton
- Peptide Biology Laboratories (A.P.P., K.A.L., M.H.P., M.O.H.), The Salk Institute for Biological Studies, La Jolla, California 92037; Christchurch Heart Institute (A.P.P., R.W.T., V.A.C.), Department of Medicine, University of Otago, Christchurch 8011, New Zealand; Kaufman Center for Heart Failure (W.E.S., C.S.M., W.H.W.T.), Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio 44195
| | - Vicky A Cameron
- Peptide Biology Laboratories (A.P.P., K.A.L., M.H.P., M.O.H.), The Salk Institute for Biological Studies, La Jolla, California 92037; Christchurch Heart Institute (A.P.P., R.W.T., V.A.C.), Department of Medicine, University of Otago, Christchurch 8011, New Zealand; Kaufman Center for Heart Failure (W.E.S., C.S.M., W.H.W.T.), Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio 44195
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Abstract
Heart failure (HF) is one of the most common causes of hospitalization and mortality in the modern Western world and an increasing proportion of the population will be affected by HF in the future. Although HF management has improved quality of life and prognosis, mortality remains very high despite therapeutic options. Medical management consists of a neurohormonal blockade of an overly activated neurohormonal axis. No single marker has been able to predict or monitor HF with respect to disease progression, hospitalization, or mortality. New methods for diagnosis, monitoring therapy, and prognosis are warranted. Copeptin, a precursor of pre-provasopressin, is a new biomarker in HF with promising potential. Copeptin has been found to be elevated in both acute and chronic HF and is associated with prognosis. Copeptin, in combination with other biomarkers, could be a useful marker in the monitoring of disease severity and as a predictor of prognosis and survival in HF.
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Affiliation(s)
- Louise Balling
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
| | - Finn Gustafsson
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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12
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Yıldırım E, Cengiz M, Yıldırım N, Aslan K, İpek E, Korkmaz AF, Ulusoy FR, Hatem E. The evaluation of the clinical utility of urocortin 1 and adrenomedullin versus proBNP in systolic heart failure. Anatol J Cardiol 2015; 17:184-190. [PMID: 25868038 PMCID: PMC5864977 DOI: 10.5152/akd.2014.5793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Objective: Urocortin 1 (UCN1) has vasodilator, diuretic, and natriuretic effects, and its expression increases in heart failure (HF). Adrenomedullin (ADM) increases cardiac output and lowers blood pressure in healthy men and in patients with heart failure. The aim of the study was to determine UCN1 and ADM levels in patients with HF, to evaluate the relationship of UCN1 and ADM with various clinical parameters, and to assess UCN1 and ADM as diagnostic markers in HF, in comparison with pro-brain natriuretic peptide (pro-BNP). Methods: We investigated serum levels of UCN1, ADM, and pro-BNP in 86 consecutive patients with systolic HF [ejection fraction (EF) ≤45%] and 85 healthy controls. Serum UCN1, ADM, and pro-BNP levels were measured with the ELISA method. Transthoracic echocardiography was performed to determine left ventricular EF and pulmonary artery systolic pressure. Results: UCN1 and ADM levels were higher in HF patients (446.2±145.7 pg/mL, p<0.001; 87.9±4.2 pg/mL, p<0.001 respectively). UCN1 was positively correlated with pro-BNP (r=0.963, p<0.001), ADM (r=0.915, p<0.001), and NYHA (r=0.879, p<0.001); ADM was positively correlated with pro-BNP (r=0.956, p<0.001) and NYHA (r=0.944, p<0.001). Receiver operating characteristic curves yielded an area under the curve of 1.00 (p<0.001) for UCN1, 1.00 (p<0.001) for ADM, and 0.99 (p<0.001) for pro-BNP in the diagnosis of HF. Conclusion: UCN1 and ADM increase with worsening HF and left ventricular dysfunction. They may be used as diagnostic biomarkers in systolic HF, but the incremental value of measuring UCN1 and ADM in patients tested for pro-BNP is questionable.
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Affiliation(s)
| | - Mahir Cengiz
- Clinic of Cardiology, Erzurum Research and Training Hospital; Erzurum-Turkey.
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Adão R, Santos-Ribeiro D, Rademaker MT, Leite-Moreira AF, Brás-Silva C. Urocortin 2 in cardiovascular health and disease. Drug Discov Today 2015; 20:906-14. [PMID: 25748088 DOI: 10.1016/j.drudis.2015.02.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 02/03/2015] [Accepted: 02/27/2015] [Indexed: 01/14/2023]
Abstract
Urocortin (Ucn)-2 - corticotropin-releasing hormone receptor 2 signaling has favorable effects in the cardiovascular system, including coronary vasodilatation, with increased coronary blood flow and conductance and augmented cardiac contractility and output, as well as protection against ischemia/reperfusion injury. Indeed, several animal studies have confirmed the salutary therapeutic effects of Ucn-2 in chronic heart failure, with improvements in cardiac performance and animal survival. In addition, recent clinical trials have demonstrated the benefits of Ucn-2 in patients with stable chronic heart failure on optimal medical therapy.
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Affiliation(s)
- Rui Adão
- Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, Porto 4200-319, Portugal
| | - Diana Santos-Ribeiro
- Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, Porto 4200-319, Portugal
| | - Miriam T Rademaker
- Christchurch Heart Institute, Department of Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand
| | - Adelino F Leite-Moreira
- Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, Porto 4200-319, Portugal
| | - Carmen Brás-Silva
- Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, Porto 4200-319, Portugal; Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.
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Vasoprotective effects of urocortin 1 against atherosclerosis in vitro and in vivo. PLoS One 2014; 9:e110866. [PMID: 25462164 PMCID: PMC4251828 DOI: 10.1371/journal.pone.0110866] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 09/18/2014] [Indexed: 11/19/2022] Open
Abstract
AIM Atherosclerosis is the complex lesion that consists of endothelial inflammation, macrophage foam cell formation, vascular smooth muscle cell (VSMC) migration and proliferation, and extracellular matrix production. Human urocortin 1 (Ucn1), a 40-amino acid peptide member of the corticotrophin-releasing factor/urotensin I family, has potent cardiovascular protective effects. This peptide induces potent and long-lasting hypotension and coronary vasodilation. However, the relationship of Ucn1 with atherosclerosis remains unclear. The present study was performed to clarify the effects of Ucn1 on atherosclerosis. METHODS We assessed the effects of Ucn1 on the inflammatory response and proliferation of human endothelial cells (ECs), human macrophage foam cell formation, migration and proliferation of human VSMCs, extracellular matrix expression in VSMCs, and the development of atherosclerosis in apolipoprotein E-deficient (Apoe-/-) mice. RESULTS Ucn1 significantly suppressed cell proliferation without inducing apoptosis, and lipopolysaccharide-induced up-regulation of monocyte chemoattractant protein-1 and intercellular adhesion molecule-1 in human ECs. Ucn1 significantly reduced oxidized low-density lipoprotein-induced foam cell formation with a significant down-regulation of CD36 and acyl-CoA:cholesterol acyltransferase 1 in human monocyte-derived macrophages. Ucn1 significantly suppressed the migration and proliferation of human VSMCs and increased the activities of matrix metalloproteinase-2 (MMP2) and MMP9 in human VSMCs. Intraperitoneal injection of Ucn1 into Apoe-/- mice for 4 weeks significantly retarded the development of aortic atherosclerotic lesions. CONCLUSIONS This study provided the first evidence that Ucn1 prevents the development of atherosclerosis by suppressing EC inflammatory response and proliferation, macrophage foam cell formation, and VSMC migration and proliferation. Thus, Ucn1 could serve as a novel therapeutic target for atherosclerotic cardiovascular diseases.
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Targeting urocortin signaling pathways to enhance cardioprotection: is it time to move from bench to bedside? Cardiovasc Drugs Ther 2014; 27:451-63. [PMID: 23824484 DOI: 10.1007/s10557-013-6468-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Despite the exponential growth in medical knowledge, cardiovascular diseases (CVDs) contribute to more than one-third of worldwide morbidity and mortality. A range of therapies already exist for established CVDs, although there is significant interest in further understanding their pathogenesis. The urocortins (Ucns) are peptide members of the corticotrophin-releasing factor family, a group of evolutionary conserved peptides with homologues in fish, amphibians and mammals and considered to play a pivotal role in energy homeostasis and local tissue repair. A number of preclinical studies in vitro, in-vivo and ex-vivo have defined a multifaceted effect of Ucns on the cardiovascular system. Different G-protein coupled signaling and protein-kinase pathways have been shown to be activated by Ucns, together with different transcriptional and translational effects, all of which preferentially converge on the mitochondria, where the modulation of apoptosis is considered their principal action. It has been demonstrated in experimental models, and consequentially suggested in human diseases, that Ucn-mediated inhibition of apoptosis can be exploited for the improvement of both therapeutic and preventative strategies against CVDs. Specifically, some unavoidable iatrogenic ischemia/reperfusion (I/R) injuries, e.g. during cardiac surgery or percutaneous coronary angioplasty, may greatly benefit from the anti-apoptotic effect of Ucns. However, few studies on the topic have been employed in humans to date. Therefore, this review will focus on the different intra-cellular mechanisms of action of Urocortins, and detail the different Ucn-mediated pathways identified so far. It will also highlight the limited evidence already existing in human clinical and surgical settings, as well as emphasize the potential uses of Ucns in human cardiac pathology.
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Liew OW, Ang CX, Peh YP, Chong PCJ, Ng YX, Hwang LA, Koh XY, Yip YM, Liu W, Richards AM. A His6-SUMO-eXact tag for producing human prepro-urocortin 2 in Escherichia coli for raising monoclonal antibodies. J Immunol Methods 2013; 403:37-51. [PMID: 24291344 DOI: 10.1016/j.jim.2013.11.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 10/04/2013] [Accepted: 11/19/2013] [Indexed: 11/29/2022]
Abstract
This is a first report of recombinant production of human prepro-Urocortin 2 in Escherichia coli by N-terminal fusion with a triple His₆-SUMO-eXact tag and its subsequent use as an antigen for the production and screening of very high affinity monoclonal antibodies. The rationale for this combinatorial construct is that the His tag allows first step protein purification of insoluble and soluble proteins, the SUMO tag enhances protein expression level and solubility, while the eXact tag facilitates anion-triggered on-column cleavage of the triple tag to recover pure native proteins in a simple two-step protein purification procedure. Compared with an eXact fusion alone, the presence of the SUMO moiety enhanced overall expression levels by 4 to 10 fold but not the solubility of the highly basic prepro-Urocortin 2. Insoluble SUMO-eXact-preproUCN2 was purified in milligram quantities by denaturing IMAC and solubilized in native phosphate buffer by on-column refolding or step-wise dialysis. Only a small fraction of this solubilized protein was able to bind onto the eXact™ affinity column and cleaved by NaF treatment. To test whether binding and cleavage failure was due to improperly refolded SUMO-eXact-preproUCN2 or to the presence of N- and C-terminal sequences flanking the eXact moiety, we created a SUMO-eXact-thioredoxin construct which was overexpressed mainly in the soluble form. This protein bound to and was cleaved efficiently on the eXact™ column to yield native thioredoxin. Solubilized SUMO-eXact-preproUCN2 was used successfully to generate two high affinity mouse monoclonal antibodies (KD~10⁻¹⁰ and 10⁻¹¹ M) specific to the pro-region of Urocortin 2.
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Affiliation(s)
- Oi Wah Liew
- Cardiovascular Research Institute, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 14 Medical Drive, Singapore 117599, Singapore.
| | - Cui Xia Ang
- Cardiovascular Research Institute, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 14 Medical Drive, Singapore 117599, Singapore
| | - Yu Pei Peh
- Cardiovascular Research Institute, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 14 Medical Drive, Singapore 117599, Singapore
| | - Pek Ching Jenny Chong
- Cardiovascular Research Institute, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 14 Medical Drive, Singapore 117599, Singapore
| | - Yan Xia Ng
- Cardiovascular Research Institute, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 14 Medical Drive, Singapore 117599, Singapore
| | - Le-Ann Hwang
- Institute of Molecular and Cell Biology, 61 Biopolis Drive, Singapore 138673, Singapore
| | - Xin Yu Koh
- Institute of Molecular and Cell Biology, 61 Biopolis Drive, Singapore 138673, Singapore
| | - Yin Mun Yip
- Institute of Molecular and Cell Biology, 61 Biopolis Drive, Singapore 138673, Singapore
| | - Wei Liu
- Thermo Fisher Scientific Inc., 2650 Crescent Drive, Suite #100, Lafayette, CO 80026, United States
| | - A Mark Richards
- Cardiovascular Research Institute, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 14 Medical Drive, Singapore 117599, Singapore
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19
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Haass-Koffler CL, Bartlett SE. Stress and addiction: contribution of the corticotropin releasing factor (CRF) system in neuroplasticity. Front Mol Neurosci 2012; 5:91. [PMID: 22973190 PMCID: PMC3434418 DOI: 10.3389/fnmol.2012.00091] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Accepted: 08/15/2012] [Indexed: 12/22/2022] Open
Abstract
Corticotropin releasing factor (CRF) has been shown to induce various behavioral changes related to adaptation to stress. Dysregulation of the CRF system at any point can lead to a variety of psychiatric disorders, including substance use disorders (SUDs). CRF has been associated with stress-induced drug reinforcement. Extensive literature has identified CRF to play an important role in the molecular mechanisms that lead to an increase in susceptibility that precipitates relapse to SUDs. The CRF system has a heterogeneous role in SUDs. It enhances the acute effects of drugs of abuse and is also responsible for the potentiation of drug-induced neuroplasticity evoked during the withdrawal period. We present in this review the brain regions and circuitries where CRF is expressed and may participate in stress-induced drug abuse. Finally, we attempt to evaluate the role of modulating the CRF system as a possible therapeutic strategy for treating the dysregulation of emotional behaviors that result from the acute positive reinforcement of substances of abuse as well as the negative reinforcement produced by withdrawal.
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Affiliation(s)
- Carolina L Haass-Koffler
- Ernest Gallo Clinic and Research Center at the University of California San Francisco Emeryville, CA, USA
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20
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Devetzis V, Zarogoulidis P, Kakolyris S, Vargemezis V, Chatzaki E. The corticotropin releasing factor system in the kidney: perspectives for novel therapeutic intervention in nephrology. Med Res Rev 2012; 33:847-72. [PMID: 22622997 DOI: 10.1002/med.21268] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The adaptation to endogenous and exogenous stress stimuli is crucial for survival but also for the onset of various diseases in humans. Corticotropin releasing factor (CRF) system is the major regulator of stress response and homeostasis. The members of this family of peptides extend their actions also outside CNS to the periphery where they may affect various body systems independently, acting via vagal and/or autocrine/paracrine pathways. In search for peripheral targets, kidney has rarely been studied separately, regarding expression and action of CRF and CRF-related peptides. We reviewed the existing literature concerning expression and action of the CRF system in normal and pathological renal tissue and explored possible clinical implications in nephrology. CRF system components are expressed in the kidney of experimental animals and in humans. The intrarenal distribution is reported to be equally extensive, suggesting a physiological or pathophysiological role in renal function and in the occurrence of renal disease. Urocortins have given multiple interesting observations in experimental models of renal disease and clinical studies, showing robust effects in renal regulation mechanisms. We summarize the relevant data and put them in context, proposing applications with clinical significance in the field of hypertension, diabetic nephropathy, chronic kidney disease, cardiorenal syndrome, and peritoneal dialysis.
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Affiliation(s)
- Vassilis Devetzis
- Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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Takahashi K. Distribution of urocortins and corticotropin-releasing factor receptors in the cardiovascular system. Int J Endocrinol 2012; 2012:395284. [PMID: 22675352 PMCID: PMC3362921 DOI: 10.1155/2012/395284] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2011] [Revised: 03/10/2012] [Accepted: 03/15/2012] [Indexed: 12/27/2022] Open
Abstract
Urocortins are human homologues of urotensin I, a fish corticotropin-releasing-factor- (CRF-) like peptide secreted from the urophysis. There are three urocortins: urocortin 1, urocortin 2, and urocortin 3 in mammals. We have shown that urocortin 1 and urocortin 3 are endogenously synthesized in the myocardial cells of human heart and may act on CRF type 2 receptor (CRFR2) expressed in the heart. Expression levels of urocortin 1 in the heart and plasma urocortin 1 levels are elevated in patients with heart failure. Recent studies have shown that urocortins have various biological actions in the cardiovascular system, such as a vasodilator action, a positive inotropic action, a cardioprotective action against ischemia/reperfusion injury, and suppressive actions against the renin angiotensin system and the sympathetic nervous system. Urocortins and CRFR2 may therefore be a potential therapeutic target for cardiovascular diseases, such as congestive heart failure, hypertension, and myocardial infarction.
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Affiliation(s)
- Kazuhiro Takahashi
- Departments of Endocrinology and Applied Medical Science, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
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Kageyama K, Teui K, Tamasawa N, Suda T. Regulation and roles of urocortins in the vascular system. Int J Endocrinol 2012; 2012:873723. [PMID: 22654906 PMCID: PMC3359671 DOI: 10.1155/2012/873723] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 03/06/2012] [Accepted: 03/06/2012] [Indexed: 12/04/2022] Open
Abstract
Urocortins (Ucns) are members of the corticotropin-releasing factor (CRF) family of peptides. Ucns would have potent effects on the cardiovascular system via the CRF receptor type 2 (CRF(2) receptor). Regulation and roles of each Ucn have been determined in the vascular system. Ucns have more potent vasodilatory effects than CRF. Human umbilical vein endothelial cells (HUVECs) express Ucns1-3 mRNAs, and the receptor, CRF(2a) receptor mRNA. Ucns1-3 mRNA levels are differentially regulated in HUVECs. Differential regulation of Ucns may suggest differential roles of those in HUVECs. Ucn1 and Ucn2 have strong effects on interleukin (IL)-6 gene expression and secretion in rat aortic smooth muscle A7r5 cells. The increase that we observed in IL-6 levels following Ucn treatment of A7r5 cells suggests that smooth muscle cells may be a source of IL-6 secretion under physiological stress conditions. Ucns are important and unique modulators of vascular smooth muscle cells and act directly or indirectly as autocrine and paracrine factors in the vascular system.
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Affiliation(s)
- Kazunori Kageyama
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
- *Kazunori Kageyama:
| | - Ken Teui
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
| | - Naoki Tamasawa
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
| | - Toshihiro Suda
- Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
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Ikeda K, Fujioka K, Manome Y, Tojo K. Clinical perspectives of urocortin and related agents for the treatment of cardiovascular disease. Int J Endocrinol 2012; 2012:198628. [PMID: 22548056 PMCID: PMC3324148 DOI: 10.1155/2012/198628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 02/07/2012] [Accepted: 02/07/2012] [Indexed: 11/29/2022] Open
Abstract
The effects of corticotropin-releasing hormone, also known as corticotropin-releasing factor (CRF), on the cardiovascular system have been intensively researched since its discovery. Moreover, the actions of urocortin (Ucn) I on the cardiovascular system have also been intensively scrutinized following the cloning and identification of its receptor, CRF receptor type 2 (CRFR2), in peripheral tissues including the heart. Given the cardioprotective actions of CRFR2 ligands, the clinical potential of not only Ucn I but also Ucn II and III, which were later identified as more specific ligands for CRFR2, has received considerable attention from researchers. In addition, recent work has indicated that CRF type 1 receptor may be also involved in cardioprotection against ischemic/reperfusion injury. Here we provide a historical overview of research on Ucn I and related agents, their effects on the cardiovascular system, and the clinical potential of the use of such agents to treat cardiovascular diseases.
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Affiliation(s)
- Keiichi Ikeda
- Department of Molecular Cell Biology, Institute of DNA Medicine, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo 105-8461, Japan
- *Keiichi Ikeda:
| | - Kouki Fujioka
- Department of Molecular Cell Biology, Institute of DNA Medicine, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Yoshinobu Manome
- Department of Molecular Cell Biology, Institute of DNA Medicine, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Katsuyoshi Tojo
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo 105-8461, Japan
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Gruson D, Thys F, Verschuren F. Diagnosing destabilized heart failure in the emergency setting: current and future biomarker tests. Mol Diagn Ther 2011; 15:327-40. [PMID: 22188636 DOI: 10.1007/bf03256468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Acute or destabilized heart failure (DHF) is characterized by new or worsening signs and symptoms of heart failure leading to admission to an emergency department. Biomarkers may support the diagnosis, the prognosis and the management of DHF patients. The aim of this review article is to discuss and evaluate the clinical usefulness of both recognized and potential new biomarker tests for use in heart failure.
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Affiliation(s)
- Damien Gruson
- Pôle de Recherche en Endocrinologie, Diabète et Nutrition, Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium.
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Abstract
BACKGROUND Until recently, biomarker testing in heart failure (HF) syndromes has been viewed as an elective supplement to diagnostic evaluation of patients suspected to suffer from this condition. This approach to the use of biomarker testing contrasts with other cardiovascular diagnoses such as acute myocardial infarction, for which biomarkers are integral to disease process definition, risk stratification, and in some cases treatment decision making. CONTENT In this review we consider various perspectives on the evaluation of biomarkers in HF. In addition, we examine recent advances in the understanding of established biomarkers in HF (such as the natriuretic peptides), the elucidation of novel biomarkers potentially useful for the evaluation and management of patients with HF, and the growing understanding of important and relevant comorbidities in HF. We also review candidate biomarkers from a number of classes: (a) myocyte stretch, (b) myocyte necrosis, (c) systemic inflammation, (d) oxidative stress, (e) extracellular matrix turnover, (f) neurohormones, and (g) biomarkers of extracardiac processes, such as renal function. SUMMARY Novel applications of established biomarkers of HF as well as elucidation and validation of emerging assays for HF syndromes have collectively led to a growing interest in the more widespread use of such testing in patients affected by the diagnosis.
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Emeto TI, Moxon JV, Rush C, Woodward L, Golledge J. Relevance of urocortins to cardiovascular disease. J Mol Cell Cardiol 2011; 51:299-307. [PMID: 21689660 DOI: 10.1016/j.yjmcc.2011.06.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 05/26/2011] [Accepted: 06/02/2011] [Indexed: 11/19/2022]
Abstract
Acquired cardiovascular diseases such as coronary heart disease, peripheral artery disease and related vascular problems contribute to more than one-third of worldwide morbidity and mortality. In many instances, particularly in the under developed world, cardiovascular diseases are diagnosed at a late stage limiting the scope for improving outcomes. A range of therapies already exist for established cardiovascular disease, although there is significant interest in further understanding disease pathogenesis in order to improve diagnosis and achieve primary and secondary therapeutic goals. The urocortins are a group of recently defined peptide members of the corticotrophin-releasing factor family. Previous pre-clinical work and human association studies suggest that urocortins have potential to exert some beneficial and other detrimental effects on the heart and major blood vessels. More current evidence however favours beneficial effects of urocortins, for example these peptides have been shown to inhibit production of reactive oxygen species and vascular cell apoptosis, and thus may have potential to antagonise the progression of cardiovascular disease. This review summarises published data on the potential role of urocortins in cardiovascular disease.
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Affiliation(s)
- Theophilus I Emeto
- Vascular Biology Unit, School of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
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Smani T, Calderon E, Rodriguez-Moyano M, Dominguez-Rodriguez A, Diaz I, Ordóñez A. Urocortin-2 induces vasorelaxation of coronary arteries isolated from patients with heart failure. Clin Exp Pharmacol Physiol 2011; 38:71-6. [PMID: 21105894 DOI: 10.1111/j.1440-1681.2010.05466.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
1. Urocortin-2 (Ucn2) is a vasoactive peptide belonging to the corticotrophin-releasing factor (CRF) family that has potent cardiovascular actions. It has been suggested that Ucn2 participates in the pathophysiology of heart failure. However, little is known about the mechanisms underlying the action of Ucn2 in human coronary arteries. The aim of the present study was to assess the effects of Ucn2 on the vascular tone of human coronary arteries dissected from heart failure patients. 2. Human coronary arteries were dissected from the hearts of patients subjected to orthotopic heart transplantation. Coronary arteries were obtained from 17 patients with heart failure due to dilated cardiomyopathy of ischaemic origin in Stage III-IV of the New York Heart Association classification. Changes in tone were measured in arterial rings using force transducers. 3. Application of increasing concentrations of Ucn2 (5-20 nmol/L) to arterial rings precontracted with agonists induced dose-dependent relaxation of the coronary artery, which was independent of endothelial cell activation. Furthermore, the inhibition of the adenylyl cyclase by MDL-12 (100 nmol/L) and protein kinase A (PKA) by H89 (1 μmol/L) prevented Ucn2-mediated relaxation of coronary artery rings. 4. The results of the present study suggest that, in heart failure patients, Ucn2 could be useful in modulating coronary artery circulation independent of endothelial integrity through mechanisms that involve adenylyl cyclase activation and PKA stimulation. The findings warrant further investigation of the role of Ucn2 in circulatory regulation and its potential therapeutic application in heart disease.
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Affiliation(s)
- Tarik Smani
- Institute of Biomedicine from Seville, Universitary Hospital of Virgen del Rocío, University of Seville, Spain.
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Avellino A, Collins SP, Fermann GJ. Risk stratification and short-term prognosis in acute heart failure syndromes: A review of novel biomarkers. Biomarkers 2011; 16:379-92. [PMID: 21534728 DOI: 10.3109/1354750x.2011.574234] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Ariadne Avellino
- Department of Emergency Medicine, University of Cincinnati, Ohio, USA
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Urocortin-induced cardiomyocytes hypertrophy is associated with regulation of the GSK-3β pathway. Heart Vessels 2011; 27:202-7. [PMID: 21505854 DOI: 10.1007/s00380-011-0141-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2010] [Accepted: 03/25/2011] [Indexed: 01/13/2023]
Abstract
Urocortin-1 (UCN), a member of the corticotropin-releasing factor, is a cardioprotective peptide, and is also involved in cardiac hypertrophy. The involvement of GSK-3β, a pivotal kinase in cardiac hypertrophy, in response to UCN is not yet documented. Cardiomyocytes from adult rats were stimulated for 48 h with UCN. Cell size, protein, and DNA contents were determined. Phosphorylated and total forms GSK-3β and the total amount of β-catenin were quantified by Western immunoblots. The effects of astressin, a UCN competitive receptor antagonist, were also evaluated. UCN increased cell size and the protein-to-DNA ratio, in accordance with a hypertrophic response. This effect was associated with increased phosphorylation of GSK-3β and marked accumulation of β-catenin, a downstream element to GSK-3β. All these effects were prevented by astressin and LY294002, an inhibitor of the phosphatidyl-inositol-3-kinase. UCN-induced cardiomyocytes hypertrophy is associated with regulation of GSK-3β, a pivotal kinase involved in cardiac hypertrophy, in a PI3K-dependent manner. Furthermore, the pharmacological blockade of UCN receptors was able to prevent UCN-induced hypertrophy, which leads to inhibition of the Akt/GSK-3β pathway.
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May K, Conduit-Hulbert S, Villar J, Kirtley S, Kennedy S, Becker C. Peripheral biomarkers of endometriosis: a systematic review. Hum Reprod Update 2010; 16:651-74. [PMID: 20462942 PMCID: PMC2953938 DOI: 10.1093/humupd/dmq009] [Citation(s) in RCA: 260] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 01/27/2010] [Accepted: 04/06/2010] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Endometriosis is estimated to affect 1 in 10 women during the reproductive years. There is often delay in making the diagnosis, mainly due to the non-specific nature of the associated symptoms and the need to verify the disease surgically. A biomarker that is simple to measure could help clinicians to diagnose (or at least exclude) endometriosis; it might also allow the effects of treatment to be monitored. If effective, such a marker or panel of markers could prevent unnecessary diagnostic procedures and/or recognize treatment failure at an early stage. METHODS We used QUADAS (Quality Assessment of Diagnostic Accuracy Studies) criteria to perform a systematic review of the literature over the last 25 years to assess critically the clinical value of all proposed biomarkers for endometriosis in serum, plasma and urine. RESULTS We identified over 100 putative biomarkers in publications that met the selection criteria. We were unable to identify a single biomarker or panel of biomarkers that have unequivocally been shown to be clinically useful. CONCLUSIONS Peripheral biomarkers show promise as diagnostic aids, but further research is necessary before they can be recommended in routine clinical care. Panels of markers may allow increased sensitivity and specificity of any diagnostic test.
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Affiliation(s)
- K.E. May
- Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - S.A. Conduit-Hulbert
- Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - J. Villar
- Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - S. Kirtley
- Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - S.H. Kennedy
- Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - C.M. Becker
- Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
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Venkatasubramanian S, Newby DE, Lang NN. Urocortins in heart failure. Biochem Pharmacol 2010; 80:289-96. [DOI: 10.1016/j.bcp.2010.03.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Revised: 03/25/2010] [Accepted: 03/26/2010] [Indexed: 11/30/2022]
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Tang WW, Shrestha K, Martin MG, Borowski AG, Jasper S, Yandle TG, Richards AM, Klein AL, Troughton RW. Clinical Significance of Endogenous Vasoactive Neurohormones in Chronic Systolic Heart Failure. J Card Fail 2010; 16:635-40. [DOI: 10.1016/j.cardfail.2010.03.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Revised: 03/19/2010] [Accepted: 03/29/2010] [Indexed: 12/20/2022]
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Veloso GF, Ohad DG, Francis AJ, Vaughan JM, Brownstein DG, Culshaw GJ, Vale WW, French AT, Jamieson PM. Expression of urocortin peptides in canine myocardium and plasma. Vet J 2010; 188:318-24. [PMID: 20554462 DOI: 10.1016/j.tvjl.2010.05.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Revised: 03/21/2010] [Accepted: 05/16/2010] [Indexed: 11/20/2022]
Abstract
Urocortin (Ucn) peptides are the endogenous ligands for the corticotropin-releasing factor type 2 receptor (CRFR2). They have potentially important roles in cardiovascular physiology in health and disease, and show promise as therapeutics for congestive heart failure. Analysis of canine heart tissue showed mRNA expression of Ucn 1, Ucn 3 and CRFR2 in all heart chambers. Immunohistochemistry also demonstrated Ucns 1 and 3 expression in cardiomyocytes. To assess the potential usefulness of circulating Ucns as markers of heart disease, plasma samples from 45 dogs with cardiac disease and 15 controls were analysed by radioimmunoassay. Both Ucns 1 and 3 were measurable but the presence of cardiac disease did not alter their concentrations. Therefore, whilst Ucns are expressed in canine myocardium (where they may play a role in the endogenous neurohumoral response to cardiac disease or failure) they do not appear to be sensitive biomarkers of cardiac disease in our canine patient population.
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Affiliation(s)
- Gemma Fraga Veloso
- Royal (Dick) School of Veterinary Studies, University of Edinburgh Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin EH25 9RG, UK
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Jonathan R Dalzell, Colette E Jackson. Novel neurohormonal insights with therapeutic potential in chronic heart failure. Future Cardiol 2010; 6:361-72. [DOI: 10.2217/fca.10.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Despite considerable therapeutic advances over recent years, chronic heart failure remains associated with significant morbidity and mortality. Further improvements in the treatment of this syndrome are therefore needed and this will require advances in the understanding of its underlying pathophysiology. This article reviews the literature regarding recently identified neurohormonal pathways that are declaring themselves as potential therapeutic targets in chronic heart failure.
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Gruson D, Ahn SA, Ketelslegers JM, Rousseau MF. Circulating levels of stress associated peptide Urocortin in heart failure patients. Peptides 2010; 31:354-6. [PMID: 19961889 DOI: 10.1016/j.peptides.2009.11.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2009] [Revised: 11/23/2009] [Accepted: 11/23/2009] [Indexed: 10/20/2022]
Abstract
The available data suggest that Urocortin (UCN), a cardioprotective and vasoactive peptide known from fish neuroendocrinology, is involved in cardiac regulation. The aim of this study was to determine UCN plasma concentrations in patients with heart failure (HF). Plasma concentrations of UCN, measured in 42 fully treated HF patients. UCN, were determined using a specific ELISA assay after acidic extraction with Sep-Pak C18 columns. Circulating levels of other neurohormones Nt-proBNP, Nt-proANP and Big ET-1 were also determined. Reference values were obtained from 20 healthy age- and sex-matched subjects. In comparison with controls, UCN plasma concentrations (geometric mean [95% CI]) were significantly increased in HF patients (88 pmol/L [75-105] vs 46 [39-54], p<0.001). As expected, the other neurohormones were also significantly increased in HF patients (Nt-proBNP: 3501 pg/ml [2356-5202] vs 35 [24-51], Nt-proANP: 5498 pg/ml [4336-6971] vs 324 [255-411] and Big ET-1: 15.8 pg/ml [13.6-18.4] vs 5.9 [5.2-6.8]; p<0.01 for all vs controls). No significant correlation was observed between UCN and the other HF biomarkers. Our results demonstrate that plasma concentrations of UCN are significantly increased in patients with HF and that UCN may participate in the neurohumoral response of HF.
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Affiliation(s)
- D Gruson
- Unit of Diabetes and Nutrition, Cliniques Universitaires St-Luc, Brussels, Belgium.
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