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In Silico Study of the Mechanisms Underlying the Action of the Snake Natriuretic-Like Peptide Lebetin 2 during Cardiac Ischemia. Toxins (Basel) 2022; 14:toxins14110787. [PMID: 36422961 PMCID: PMC9699598 DOI: 10.3390/toxins14110787] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
Lebetin 2 (L2), a natriuretic-like peptide (NP), exerts potent cardioprotection in myocardial infarction (MI), with stronger effects than B-type natriuretic peptide (BNP). To determine the molecular mechanisms underlying its cardioprotection effect, we used molecular modeling, molecular docking and molecular dynamics (MD) simulation to describe the binding mode, key interaction residues as well as mechanistic insights into L2 interaction with NP receptors (NPRs). L2 binding affinity was determined for human, rat, mouse and chicken NPRs, and the stability of receptor-ligand complexes ascertained during 100 ns-long MD simulations. We found that L2 exhibited higher affinity for all human NPRs compared to BNP, with a rank preference for NPR-A > NPR-C > NPR-B. Moreover, L2 affinity for human NPR-A and NPR-C was higher in other species. Both docking and MD studies revealed that the NPR-C-L2 interaction was stronger in all species compared to BNP. Due to its higher affinity to human receptors, L2 could be used as a therapeutic approach in MI patients. Moreover, the stronger interaction of L2 with NPR-C could highlight a new L2 signaling pathway that would explain its additional effects during cardiac ischemia. Thus, L2 is a promising candidate for drug design toward novel compounds with high potency, affinity and stability.
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Lopez E, Fukuda S, Modis K, Fujiwara O, Enkhtaivan B, Trujillo-Abarca R, Ihara K, Lima-Lopez F, Perez-Bello D, Szabo C, Prough DS, Enkhbaatar P. Arginine vasopressin receptor 2 activation promotes microvascular permeability in sepsis. Pharmacol Res 2020; 163:105272. [PMID: 33160069 DOI: 10.1016/j.phrs.2020.105272] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 12/16/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) sepsis is a severe condition associated with vascular leakage and poor prognosis. The hemodynamic management of sepsis targets hypotension, but there is no specific treatment available for vascular leakage. Arginine vasopressin (AVP) has been used in sepsis to promote vasoconstriction by activating AVP receptor 1 (V1R). However, recent evidence suggests that increased fluid retention may be associated with the AVP receptor 2 (V2R) activation worsening the outcome of sepsis. Hence, we hypothesized that the inhibition of V2R activation ameliorates the severity of microvascular hyperpermeability during sepsis. The hypothesis was tested using a well-characterized and clinically relevant ovine model of MRSA pneumonia/sepsis and in vitro assays of human lung microvascular endothelial cells (HMVECs). in vivo experiments demonstrated that the treatment of septic sheep with tolvaptan (TLVP), an FDA-approved V2R antagonist, significantly attenuated the sepsis-induced fluid retention and markedly reduced the lung water content. These pathological changes were not affected by the treatment with V2R agonist, desmopressin (DDAVP). Additionally, the incubation of cultured HMVECs with DDAVP, and DDAVP along with MRSA significantly increased the paracellular permeability. Finally, both the DDAVP and MRSA-induced hyperpermeability was significantly attenuated by TLVP. Subsequent protein and gene expression assays determined that the V2R-induced increase in permeability is mediated by phospholipase C beta (PLCβ) and the potent permeability factor angiopoietin-2. In conclusion, our results indicate that the activation of the AVP-V2R axis is critical in the pathophysiology of severe microvascular hyperpermeability during Gram-positive sepsis. The use of the antagonist TLVP should be considered as adjuvant treatment for septic patients. The results from this clinically relevant animal study are highly translational to clinical practice.
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Affiliation(s)
- Ernesto Lopez
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA
| | - Satoshi Fukuda
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA
| | - Katalin Modis
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA; Department of Surgery, University of Texas Medical Branch Galveston, TX, USA
| | - Osamu Fujiwara
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA
| | - Baigal Enkhtaivan
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA
| | - Raul Trujillo-Abarca
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA
| | - Koji Ihara
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA; Department of Plastic and Reconstructive Surgery, Kagoshima City Hospital, Kagoshima, Japan
| | - Francisco Lima-Lopez
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA; Department of Surgery, University of Texas Medical Branch Galveston, TX, USA
| | - Dannelys Perez-Bello
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA
| | - Csaba Szabo
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA; Department of Pharmacology, University of Fribourg, Fribourg, Switzerland
| | - Donald S Prough
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA
| | - Perenlei Enkhbaatar
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA.
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Fukuoka H, Tachibana K, Shinoda Y, Minamisaka T, Inui H, Ueno K, Inoue S, Mine K, Ueda K, Hoshida S. Tolvaptan-induced hypernatremia related to low serum potassium level accompanying high blood pressure in patients with acute decompensated heart failure. BMC Cardiovasc Disord 2020; 20:467. [PMID: 33121430 PMCID: PMC7597047 DOI: 10.1186/s12872-020-01751-3] [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: 07/07/2020] [Accepted: 10/22/2020] [Indexed: 11/28/2022] Open
Abstract
Backgrounds Tolvaptan significantly increases urine volume in acute decompensated heart failure (ADHF); serum sodium level increases due to aquaresis in almost all cases. We aimed to elucidate clinical factors associated with hypernatremia in ADHF patients treated with tolvaptan. Methods We enrolled 117 ADHF patients treated with tolvaptan in addition to standard therapy. We examined differences in clinical factors at baseline between patients with and without hypernatremia in the initial three days of hospitalization. Results Systolic (p = 0.045) and diastolic (p = 0.004) blood pressure, serum sodium level (p = 0.002), and negative water balance (p = 0.036) were significantly higher and serum potassium level (p = 0.026) was significantly lower on admission day in patients with hypernatremia (n = 22). In multivariate regression analysis, hypernatremia was associated with low serum potassium level (p = 0.034). Among patients with serum potassium level ≤ 3.8 mEq/L, the cutoff value obtained using receiver operating characteristic curve analysis, those with hypernatremia related to tolvaptan treatment showed significantly higher diastolic blood pressure on admission day (p = 0.004). Conclusion In tolvaptan treatment combined with standard therapy in ADHF patients, serum potassium level ≤ 3.8 mEq/L may be a determinant factor for hypernatremia development. Among hypokalemic patients, those with higher diastolic blood pressure on admission may be carefully managed to prevent hypernatremia.
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Affiliation(s)
- Hidetada Fukuoka
- Department of Cardiovascular Medicine, Yao Municipal Hospital, 1-3-1 Ryuge-cho, Yao, Osaka, 581-0069, Japan
| | - Koichi Tachibana
- Department of Cardiovascular Medicine, Yao Municipal Hospital, 1-3-1 Ryuge-cho, Yao, Osaka, 581-0069, Japan
| | - Yukinori Shinoda
- Department of Cardiovascular Medicine, Yao Municipal Hospital, 1-3-1 Ryuge-cho, Yao, Osaka, 581-0069, Japan
| | - Tomoko Minamisaka
- Department of Cardiovascular Medicine, Yao Municipal Hospital, 1-3-1 Ryuge-cho, Yao, Osaka, 581-0069, Japan
| | - Hirooki Inui
- Department of Cardiovascular Medicine, Yao Municipal Hospital, 1-3-1 Ryuge-cho, Yao, Osaka, 581-0069, Japan
| | - Keisuke Ueno
- Department of Cardiovascular Medicine, Yao Municipal Hospital, 1-3-1 Ryuge-cho, Yao, Osaka, 581-0069, Japan
| | - Soki Inoue
- Department of Cardiovascular Medicine, Yao Municipal Hospital, 1-3-1 Ryuge-cho, Yao, Osaka, 581-0069, Japan
| | - Kentaro Mine
- Department of Cardiovascular Medicine, Yao Municipal Hospital, 1-3-1 Ryuge-cho, Yao, Osaka, 581-0069, Japan
| | - Kumpei Ueda
- Department of Cardiovascular Medicine, Yao Municipal Hospital, 1-3-1 Ryuge-cho, Yao, Osaka, 581-0069, Japan
| | - Shiro Hoshida
- Department of Cardiovascular Medicine, Yao Municipal Hospital, 1-3-1 Ryuge-cho, Yao, Osaka, 581-0069, Japan.
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Sharp TE, Polhemus DJ, Li Z, Spaletra P, Jenkins JS, Reilly JP, White CJ, Kapusta DR, Lefer DJ, Goodchild TT. Renal Denervation Prevents Heart Failure Progression Via Inhibition of the Renin-Angiotensin System. J Am Coll Cardiol 2019; 72:2609-2621. [PMID: 30466519 DOI: 10.1016/j.jacc.2018.08.2186] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/10/2018] [Accepted: 08/20/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND Previously, we have shown that radiofrequency (RF) renal denervation (RDN) reduces myocardial infarct size in a rat model of acute myocardial infarction (MI) and improves left ventricular (LV) function and vascular reactivity in the setting of heart failure following MI. OBJECTIVES The authors investigated the therapeutic efficacy of RF-RDN in a clinically relevant normotensive swine model of heart failure with reduced ejection fraction (HFrEF). METHODS Yucatan miniswine underwent 75 min of left anterior descending coronary artery balloon occlusion to induce MI followed by reperfusion (R) for 18 weeks. Cardiac function was assessed pre- and post-MI/R by transthoracic echocardiography and every 3 weeks for 18 weeks. HFrEF was classified by an LV ejection fraction <40%. Animals who met inclusion criteria were randomized to receive bilateral RF-RDN (n = 10) treatment or sham-RDN (n = 11) at 6 weeks post-MI/R using an RF-RDN catheter. RESULTS RF-RDN therapy resulted in significant reductions in renal norepinephrine content and circulating angiotensin I and II. RF-RDN significantly increased circulating B-type natriuretic peptide levels. Following RF-RDN, LV end-systolic volume was significantly reduced when compared with sham-treated animals, leading to a marked and sustained improvement in LV ejection fraction. Furthermore, RF-RDN improved LV longitudinal strain. Simultaneously, RF-RDN reduced LV fibrosis and improved coronary artery responses to vasodilators. CONCLUSIONS RF-RDN provides a novel therapeutic strategy to reduce renal sympathetic activity, inhibit the renin-angiotensin system, increase circulating B-type natriuretic peptide levels, attenuate LV fibrosis, and improve left ventricular performance and coronary vascular function. These cardioprotective mechanisms synergize to halt the progression of HFrEF following MI/R in a clinically relevant model system.
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Affiliation(s)
- Thomas E Sharp
- Cardiovascular Research Center, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana
| | - David J Polhemus
- Cardiovascular Research Center, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana; Department of Pharmacology and Experimental Therapeutics, Louisiana State University Health Science Center, New Orleans, Louisiana
| | - Zhen Li
- Cardiovascular Research Center, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana; Department of Pharmacology and Experimental Therapeutics, Louisiana State University Health Science Center, New Orleans, Louisiana
| | - Pablo Spaletra
- Cardiovascular Research Center, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana
| | - J Stephen Jenkins
- Department of Cardiology, Heart and Vascular Institute, Ochsner Medical Center, New Orleans, Louisiana
| | - John P Reilly
- Department of Cardiology, Heart and Vascular Institute, Ochsner Medical Center, New Orleans, Louisiana
| | - Christopher J White
- Department of Cardiology, Heart and Vascular Institute, Ochsner Medical Center, New Orleans, Louisiana
| | - Daniel R Kapusta
- Cardiovascular Research Center, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana; Department of Pharmacology and Experimental Therapeutics, Louisiana State University Health Science Center, New Orleans, Louisiana
| | - David J Lefer
- Cardiovascular Research Center, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana; Department of Pharmacology and Experimental Therapeutics, Louisiana State University Health Science Center, New Orleans, Louisiana.
| | - Traci T Goodchild
- Cardiovascular Research Center, School of Medicine, Louisiana State University Health Science Center, New Orleans, Louisiana; Department of Pharmacology and Experimental Therapeutics, Louisiana State University Health Science Center, New Orleans, Louisiana
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Tourki B, Dumesnil A, Belaidi E, Ghrir S, Godin-Ribuot D, Marrakchi N, Richard V, Mulder P, Messadi E. Lebetin 2, a Snake Venom-Derived B-Type Natriuretic Peptide, Provides Immediate and Prolonged Protection against Myocardial Ischemia-Reperfusion Injury via Modulation of Post-Ischemic Inflammatory Response. Toxins (Basel) 2019; 11:toxins11090524. [PMID: 31510060 PMCID: PMC6784001 DOI: 10.3390/toxins11090524] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/08/2019] [Accepted: 08/16/2019] [Indexed: 12/11/2022] Open
Abstract
Myocardial infarction (MI) followed by left ventricular (LV) remodeling is the most frequent cause of heart failure. Lebetin 2 (L2), a snake venom-derived natriuretic peptide, exerts cardioprotection during acute myocardial ischemia-reperfusion (IR) ex vivo. However, its effects on delayed consequences of IR injury, including post-MI inflammation and fibrosis have not been defined. Here, we determined whether a single L2 injection exerts cardioprotection in IR murine models in vivo, and whether inflammatory response to ischemic injury plays a role in L2-induced effects. We quantified infarct size (IS), fibrosis, inflammation, and both endothelial cell and cardiomyocyte densities in injured myocardium and compared these values with those induced by B-type natriuretic peptide (BNP). Both L2 and BNP reduced IS, fibrosis, and inflammatory response after IR, as evidenced by decreased leukocyte and proinflammatory M1 macrophage infiltrations in the infarcted area compared to untreated animals. However, only L2 increased anti-inflammatory M2-like macrophages. L2 also induced a higher density of endothelial cells and cardiomyocytes. Our data show that L2 has strong, acute, prolonged cardioprotective effects in post-MI that are mediated, at least in part, by the modulation of the post-ischemic inflammatory response and especially, by the enhancement of M2-like macrophages, thus reducing IR-induced necrotic and fibrotic effects.
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Affiliation(s)
- Bochra Tourki
- Laboratoire des Venins et Biomolécules Thérapeutiques (LR11IPT08) et Plateforme de Physiologie et de Physiopathologie Cardiovasculaires (P2C), Institut Pasteur de Tunis, Université Tunis El Manar, 1068 Tunis, Tunisia.
- Université Carthage Tunis, 1054 Bizerte, Tunisia.
| | - Anais Dumesnil
- Normandie Univ, UNIROUEN, Inserm U1096, FHU REMOD-VHF, 76000 Rouen, France.
| | - Elise Belaidi
- Université Grenoble Alpes, Inserm U1042, Laboratoire HP2, 38000 Grenoble, France.
| | - Slim Ghrir
- Laboratoire des Venins et Biomolécules Thérapeutiques (LR11IPT08) et Plateforme de Physiologie et de Physiopathologie Cardiovasculaires (P2C), Institut Pasteur de Tunis, Université Tunis El Manar, 1068 Tunis, Tunisia.
| | - Diane Godin-Ribuot
- Université Grenoble Alpes, Inserm U1042, Laboratoire HP2, 38000 Grenoble, France.
| | - Naziha Marrakchi
- Laboratoire des Venins et Biomolécules Thérapeutiques (LR11IPT08) et Plateforme de Physiologie et de Physiopathologie Cardiovasculaires (P2C), Institut Pasteur de Tunis, Université Tunis El Manar, 1068 Tunis, Tunisia.
| | - Vincent Richard
- Normandie Univ, UNIROUEN, Inserm U1096, FHU REMOD-VHF, 76000 Rouen, France.
| | - Paul Mulder
- Normandie Univ, UNIROUEN, Inserm U1096, FHU REMOD-VHF, 76000 Rouen, France.
| | - Erij Messadi
- Laboratoire des Venins et Biomolécules Thérapeutiques (LR11IPT08) et Plateforme de Physiologie et de Physiopathologie Cardiovasculaires (P2C), Institut Pasteur de Tunis, Université Tunis El Manar, 1068 Tunis, Tunisia.
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Baumwart RD, Hanzlicek AS, Lyon SD, Lee PM. Plasma N-terminal pro-brain natriuretic peptide concentrations before and after pericardiocentesis in dogs with cardiac tamponade secondary to spontaneous pericardial effusion. J Vet Cardiol 2017; 19:416-420. [PMID: 28988688 DOI: 10.1016/j.jvc.2017.08.007] [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: 11/09/2016] [Revised: 06/19/2017] [Accepted: 08/28/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine if concentrations of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) are increased in dogs with cardiac tamponade and if there is a significant increase in plasma NT-proBNP after pericardiocentesis. ANIMALS Ten client-owned dogs with spontaneous cardiac tamponade. METHODS Prospective clinical study. Cardiac tamponade was suspected from physical examination and confirmed with echocardiography. Blood was collected and plasma NT-proBNP concentrations were measured before and 30-60 min following pericardiocentesis and resolution of cardiac tamponade. Within-subject changes in plasma NT-proBNP were compared by the Wilcoxon signed-rank test. RESULTS The plasma NT-proBNP concentrations measured within the reference interval in seven of 10 dogs before pericardiocentesis and in six of 10 dogs following pericardiocentesis. Following pericardiocentesis, there was a statistically significant increase in median NT-proBNP concentration (733 pmol/L, range 250-3,297) compared with the values measured before (643 pmol/L, range 250-3,210, P = 0.004). The NT-proBNP concentration increased in 90% of the dogs following pericardiocentesis. CONCLUSIONS An upper reference limit of 900 pmol/L for plasma NT-proBNP is insensitive for the diagnosis of pericardial effusion and cardiac tamponade in dogs. Plasma NT-proBNP concentration commonly increases following pericardiocentesis, perhaps related to improved ventricular filling and stretch.
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Affiliation(s)
- R D Baumwart
- Department of Veterinary Clinical Sciences, Oklahoma State University, 2065 W. Farm Rd., Stillwater, OK 74078, United States.
| | - A S Hanzlicek
- Department of Veterinary Clinical Sciences, Oklahoma State University, 2065 W. Farm Rd., Stillwater, OK 74078, United States
| | - S D Lyon
- Department of Veterinary Clinical Sciences, Oklahoma State University, 2065 W. Farm Rd., Stillwater, OK 74078, United States
| | - P M Lee
- Department of Veterinary Clinical Sciences, Washington State University, PO Box 647060, Pullman, WA 99164-7060, United States
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Ichiki T, Huntley BK, Harty GJ, Sangaralingham SJ, Burnett JC. Early activation of deleterious molecular pathways in the kidney in experimental heart failure with atrial remodeling. Physiol Rep 2017; 5:5/9/e13283. [PMID: 28507167 PMCID: PMC5430128 DOI: 10.14814/phy2.13283] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 04/20/2017] [Accepted: 04/22/2017] [Indexed: 12/20/2022] Open
Abstract
Heart failure (HF) is a major health problem with worsening outcomes when renal impairment is present. Therapeutics for early phase HF may be effective for cardiorenal protection, however the detailed characteristics of the kidney in early‐stage HF (ES‐HF), and therefore treatment for potential renal protection, are poorly defined. We sought to determine the gene and protein expression profiles of specific maladaptive pathways of ES‐HF in the kidney and heart. Experimental canine ES‐HF, characterized by de‐novo HF with atrial remodeling but not ventricular fibrosis, was induced by right ventricular pacing for 10 days. Kidney cortex (KC), medulla (KM), left ventricle (LV), and left atrial (LA) tissues from ES‐HF versus normal canines (n = 4 of each) were analyzed using RT‐PCR microarrays and protein assays to assess genes and proteins related to inflammation, renal injury, apoptosis, and fibrosis. ES‐HF was characterized by increased circulating natriuretic peptides and components of the renin‐angiotensin‐aldosterone system and decreased sodium and water excretion with mild renal injury and up‐regulation of CNP and renin genes in the kidney. Compared to normals, widespread genes, especially genes of the inflammatory pathways, were up‐regulated in KC similar to increases seen in LA. Protein expressions related to inflammatory cytokines were also augmented in the KC. Gene and protein changes were less prominent in the LV and KM. The ES‐HF displayed mild renal injury with widespread gene changes and increased inflammatory cytokines. These changes may provide important clues into the pathophysiology of ES‐HF and for therapeutic molecular targets in the kidney of ES‐HF.
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Affiliation(s)
- Tomoko Ichiki
- Cardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Brenda K Huntley
- Cardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Gail J Harty
- Cardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - S Jeson Sangaralingham
- Cardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - John C Burnett
- Cardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
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Grimm G, Resl M, Heinisch BB, Hülsmann M, Luger A, Clodi M, Vila G. B-type natriuretic peptide increases cortisol and catecholamine concentrations in healthy subjects. J Appl Physiol (1985) 2017; 122:1249-1254. [DOI: 10.1152/japplphysiol.00360.2016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 11/23/2016] [Accepted: 12/16/2016] [Indexed: 11/22/2022] Open
Abstract
B-type natriuretic peptide (BNP) is a hormone released by the heart in response to volume load and exerts natriuretic properties. It is clinically used as a diagnostic and prognostic biomarker and investigated as a pharmacological agent in the therapy of heart failure. Here we investigate the changes in pituitary, adrenal, and thyroid hormones in response to BNP administration in a randomized single-blinded crossover study conducted in ten healthy men aged 21–29 yr. Participants received in two study sessions a continuous intravenous infusion during 4 h (once placebo and once 3 pmol·kg−1·min−1 BNP) and remained in supine position throughout the study. Circulating concentrations of pituitary, adrenal, and thyroid hormones, heart rate, and blood pressure were measured at baseline and hourly afterwards. BNP prevented the physiological decrease in cortisol during the late morning hours leading to elevated serum cortisol levels ( P = 0.022) and increased circulating epinephrine and norepinephrine concentrations ( P = 0.018 and P = 0.036, respectively). These hormone changes were accompanied by an increase in heart rate ( P = 0.019) but no differences in blood pressure. Taken together, the impact of BNP on the endocrine system extends beyond the well-known inhibition of the renin-angiotensin-aldosterone system and includes increased adrenergic activity and cortisol concentrations. This neuroendocrine activation might impact the outcome of therapeutical BNP administrations and should be further investigated in conditions associated with increased BNP secretion. NEW & NOTEWORTHY The heart hormone B-type natriuretic peptide (BNP) is increased in patients with heart failure, where it is thought to have beneficial effects by reducing the preload. Here we report that intravenous administration of BNP in men leads to increases in adrenal hormones cortisol, epinephrine, and norepinephrine. Cortisol and catecholamine levels are independent predictors of increased cardiovascular mortality risk; therefore, drugs targeting the BNP system should be evaluated regarding their effects on the neuroendocrine activation accompanying heart failure.
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Affiliation(s)
- Gabriele Grimm
- Department of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Austria
| | - Michael Resl
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Austria
| | - Birgit B. Heinisch
- Division of Gastroenterology, Department of Internal Medicine III, Medical University of Vienna, Austria; and
| | - Martin Hülsmann
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Anton Luger
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Austria
| | - Martin Clodi
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Austria
| | - Greisa Vila
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Austria
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Tourki B, Matéo P, Morand J, Elayeb M, Godin-Ribuot D, Marrakchi N, Belaidi E, Messadi E. Lebetin 2, a Snake Venom-Derived Natriuretic Peptide, Attenuates Acute Myocardial Ischemic Injury through the Modulation of Mitochondrial Permeability Transition Pore at the Time of Reperfusion. PLoS One 2016; 11:e0162632. [PMID: 27618302 PMCID: PMC5019389 DOI: 10.1371/journal.pone.0162632] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 08/25/2016] [Indexed: 12/28/2022] Open
Abstract
Cardiac ischemia is one of the leading causes of death worldwide. It is now well established that natriuretic peptides can attenuate the development of irreversible ischemic injury during myocardial infarction. Lebetin 2 (L2) is a new discovered peptide isolated from Macrovipera lebetina venom with structural similarity to B-type natriuretic peptide (BNP). Our objectives were to define the acute cardioprotective actions of L2 in isolated Langendorff-perfused rat hearts after regional or global ischemia-reperfusion (IR). We studied infarct size, left ventricular contractile recovery, survival protein kinases and mitochondrial permeability transition pore (mPTP) opening in injured myocardium. L2 dosage was determined by preliminary experiments at its ability to induce cyclic guanosine monophosphate (cGMP) release without changing hemodynamic effects in normoxic hearts. L2 was found to be as effective as BNP in reducing infarct size after the induction of either regional or global IR. Both peptides equally improved contractile recovery after regional IR, but only L2 increased coronary flow and reduced severe contractile dysfunction after global ischemia. Cardioprotection afforded by L2 was abolished after isatin or 5-hydroxydecanote pretreatment suggesting the involvement of natriuretic peptide receptors and mitochondrial KATP (mitoKATP) channels in the L2-induced effects. L2 also increased survival protein expression in the reperfused myocardium as evidenced by phosphorylation of signaling pathways PKCε/ERK/GSK3β and PI3K/Akt/eNOS. IR induced mitochondrial pore opening, but this effect was markedly prevented by L2 treatment. These data show that L2 has strong cardioprotective effect in acute ischemia through stimulation of natriuretic peptide receptors. These beneficial effects are mediated, at least in part, by mitoKATP channel opening and downstream activated survival kinases, thus delaying mPTP opening and improving IR-induced mitochondrial dysfunction.
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Affiliation(s)
- Bochra Tourki
- Laboratoire des Venins et Biomolécules Thérapeutiques (LR11IPT08) et Plateforme de Physiologie et de Physiopathologie Cardiovasculaires (P2C), Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
- Université Carthage Tunis, Bizerte, Tunisia
| | - Philippe Matéo
- Laboratoire de Signalisation et Physiopathologie Cardiovasculaire, UMR-S 1180, Faculté de Pharmacie, Université Paris Sud, Paris, France
| | - Jessica Morand
- Laboratoire d’Hypoxie et Physiopathologie Cardiaque, Inserm U1042, Faculté de Pharmacie, Université Grenoble Alpes, Grenoble, France
| | - Mohamed Elayeb
- Laboratoire des Venins et Biomolécules Thérapeutiques (LR11IPT08) et Plateforme de Physiologie et de Physiopathologie Cardiovasculaires (P2C), Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Diane Godin-Ribuot
- Laboratoire d’Hypoxie et Physiopathologie Cardiaque, Inserm U1042, Faculté de Pharmacie, Université Grenoble Alpes, Grenoble, France
| | - Naziha Marrakchi
- Laboratoire des Venins et Biomolécules Thérapeutiques (LR11IPT08) et Plateforme de Physiologie et de Physiopathologie Cardiovasculaires (P2C), Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Elise Belaidi
- Laboratoire d’Hypoxie et Physiopathologie Cardiaque, Inserm U1042, Faculté de Pharmacie, Université Grenoble Alpes, Grenoble, France
| | - Erij Messadi
- Laboratoire des Venins et Biomolécules Thérapeutiques (LR11IPT08) et Plateforme de Physiologie et de Physiopathologie Cardiovasculaires (P2C), Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
- * E-mail:
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10
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The short-term and long-term effects of tolvaptan in patients with heart failure: a meta-analysis of randomized controlled trials. Heart Fail Rev 2016; 20:633-42. [PMID: 26334632 DOI: 10.1007/s10741-015-9503-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
A comprehensive evaluation of the benefits of tolvaptan for the management of heart failure (HF) is lacking. The objective of this meta-analysis was to assess the short-term and long-term effects of tolvaptan in patients with HF. Articles were searched from PubMed, MEDLINE and Cochrane Library before March 31, 2015. Randomized controlled trials enrolling adult HF patients and reporting the all-cause mortality, cardiac events, body weight change or changes of serum electrolytes including sodium, potassium and creatinine were included in our meta-analysis. Ten studies covering 5574 patients met the inclusion criteria. Based on the data of meta-analysis, tolvaptan had no impact on the all-cause mortality [relative risk (RR) 0.96; 95 % confidence interval (CI) 0.87-1.06; P = 0.40] and incidence of cardiac events (RR 1.03; 95 % CI 0.96-1.11; P = 0.40) of HF patients. Furthermore, in comparison with control treatments, tolvaptan significantly decreased the body weight [weight mean difference (WMD), -0.87; 95 % CI -1.03 to -0.71; P < 0.001] and statistically increased serum sodium (WMD, 2.58; 95 % CI -1.83 to 3.33; P < 0.001) without any change in serum potassium (WMD, 0.01; 95 % CI -0.03 to 0.05; P = 0.577). However, serum creatinine may be increased slightly by tolvaptan (WMD, 0.05; 95 % CI 0.03-0.07; P < 0.001). This meta-analysis suggests that in HF patients, tolvaptan may not bring long-term benefits, but it effectively improves the volume overload and hyponatremia without obvious increases in serum potassium and creatinine. Hence, tolvaptan is likely to be a promising diuretic for the treatment of HF.
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11
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Eguchi A, Iwasaku T, Okuhara Y, Naito Y, Mano T, Masuyama T, Hirotani S. Long-term administration of tolvaptan increases myocardial remodeling and mortality via exacerbation of congestion in mice heart failure model after myocardial infarction. Int J Cardiol 2016; 221:302-9. [PMID: 27404696 DOI: 10.1016/j.ijcard.2016.07.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 07/04/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND In contrast to loop diuretics, tolvaptan does not cause neurohormonal activation in several animal heart failure models. However, it remains unknown whether chronic vasopressin type 2 receptor blockade exerts beneficial effects on mortality in murine heart failure after myocardial infarction (MI). In an experimental heart failure model, we tested the hypothesis that tolvaptan reduces myocardial remodeling and mortality. METHODS AND RESULTS MI was induced in 9-week-old male C57Bl6/J by the left coronary artery ligation. In study 1, animals were randomly assigned to treatment with placebo or tolvaptan starting 14days post-MI. In study 2, animals were randomized to tolvaptan or furosemide+tolvaptan starting 14days post-MI. Interestingly, results showed lower survival rate in tolvaptan group compared to placebo. Tolvaptan group had higher serum osmolality, heavier body weight, more severe myocardial remodeling, and lung congestion at day 28 of drug administration compared to placebo. In study 2, addition of furosemide significantly reduced mortality rate seen with tolvaptan, and presented with decreased osmolality, myocardial remodeling, and lung congestion compared to tolvaptan-treated mice. Increase in proximal tubular expression of aquaporin 1, Angiotensin II, and vasopressin seen with tolvaptan treatments were normalized to basal levels, similar to levels in placebo-treated mice. CONCLUSIONS Contrary to our hypothesis, tolvaptan was associated with increased mortality in murine heart failure after MI. This increase in lung congestion, myocardial remodeling, could be prevented by co-administration of furosemide, which resulted in normalized serum osmolality, neurohormonal activation, and renal aquaporin 1 expression, and hence decreased mortality post-MI.
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Affiliation(s)
- Akiyo Eguchi
- Division of Cardiovascular Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Toshihiro Iwasaku
- Division of Cardiovascular Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Yoshitaka Okuhara
- Division of Cardiovascular Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Yoshiro Naito
- Division of Cardiovascular Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Toshiaki Mano
- Division of Cardiovascular Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Tohru Masuyama
- Division of Cardiovascular Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Shinichi Hirotani
- Division of Cardiovascular Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
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12
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Nakada Y, Okayama S, Nakano T, Ueda T, Onoue K, Takeda Y, Kawakami R, Horii M, Uemura S, Fujimoto S, Saito Y. Echocardiographic characteristics of patients with acute heart failure requiring tolvaptan: a retrospective study. Cardiovasc Ultrasound 2015; 13:27. [PMID: 26049727 PMCID: PMC4458340 DOI: 10.1186/s12947-015-0022-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 06/01/2015] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND No study has investigated the admission echocardiographic characteristics of acute heart failure (AHF) patients who are resistant to conventional diuretics and require tolvaptan. METHODS We retrospectively analyzed the echocardiographic characteristics of AHF patients who were resistant to conventional diuretics and took tolvaptan (tolvaptan group: 26 patients), and compared them to those who were sensitive to conventional diuretics (conventional group: 180 patients). RESULTS The tolvaptan group had a higher left atrial volume index (96.0 ± 85.0 mL/m2 vs. 45.8 ± 25.9 mL/m2, p < 0.0001), maximum inferior vena cava diameter (20.7 ± 6.9 mm vs. 18.1 ± 4.2 mm, p < 0.01), and higher tricuspid regurgitation grade (1.1 ± 0.8 vs. 0.8 ± 0.6, p < 0.05) than the conventional group. However, the left ventricular ejection fraction and end diastolic diameter were similar between the groups. Responders of tolvaptan had no significant echocardiographic differences compared to the non-responders. CONCLUSIONS The admission echocardiographic characteristics of AHF patients requiring tolvaptan included a larger left atrium, inferior vena cava, and more severe tricuspid regurgitation. Echocardiography may provide useful information for the early and appropriate initiation of tolvaptan.
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Affiliation(s)
- Yasuki Nakada
- First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Satoshi Okayama
- First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
| | - Tomoya Nakano
- First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Tomoya Ueda
- First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Kenji Onoue
- First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Yukiji Takeda
- First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Rika Kawakami
- First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Manabu Horii
- Department of Cardiovascular Internal Medicine, Nara City Hospital, Nara, Japan
| | - Shiro Uemura
- First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | | | - Yoshihiko Saito
- First Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
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13
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Li J, Ariunbold U, Suhaimi N, Sunn N, Guo J, McMahon JA, McMahon AP, Little M. Collecting duct-derived cells display mesenchymal stem cell properties and retain selective in vitro and in vivo epithelial capacity. J Am Soc Nephrol 2014; 26:81-94. [PMID: 24904087 DOI: 10.1681/asn.2013050517] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
We previously described a mesenchymal stem cell (MSC)-like population within the adult mouse kidney that displays long-term colony-forming efficiency, clonogenicity, immunosuppression, and panmesodermal potential. Although phenotypically similar to bone marrow (BM)-MSCs, kidney MSC-like cells display a distinct expression profile. FACS sorting from Hoxb7/enhanced green fluorescent protein (GFP) mice identified the collecting duct as a source of kidney MSC-like cells, with these cells undergoing an epithelial-to-mesenchymal transition to form clonogenic, long-term, self-renewing MSC-like cells. Notably, after extensive passage, kidney MSC-like cells selectively integrated into the aquaporin 2-positive medullary collecting duct when microinjected into the kidneys of neonatal mice. No epithelial integration was observed after injection of BM-MSCs. Indeed, kidney MSC-like cells retained a capacity to form epithelial structures in vitro and in vivo, and conditioned media from these cells supported epithelial repair in vitro. To investigate the origin of kidney MSC-like cells, we further examined Hoxb7(+) fractions within the kidney across postnatal development, identifying a neonatal interstitial GFP(lo) (Hoxb7(lo)) population displaying an expression profile intermediate between epithelium and interstitium. Temporal analyses with Wnt4(GCE/+):R26(tdTomato/+) mice revealed evidence for the intercalation of a Wnt4-expressing interstitial population into the neonatal collecting duct, suggesting that such intercalation may represent a normal developmental mechanism giving rise to a distinct collecting duct subpopulation. These results extend previous observations of papillary stem cell activity and collecting duct plasticity and imply a role for such cells in collecting duct formation and, possibly, repair.
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Affiliation(s)
- Joan Li
- Institute for Molecular Bioscience, University of Queensland, St. Lucia, Queensland, Australia
| | - Usukhbayar Ariunbold
- Institute for Molecular Bioscience, University of Queensland, St. Lucia, Queensland, Australia
| | - Norseha Suhaimi
- Institute for Molecular Bioscience, University of Queensland, St. Lucia, Queensland, Australia
| | - Nana Sunn
- Diamantina Institute, University of Queensland, Woolloongabba, Queensland, Australia; and
| | - Jinjin Guo
- Department of Stem Cell Biology and Regenerative Medicine, Broad-CIRM Center for Regenerative Medicine and Stem Cell Research, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Jill A McMahon
- Department of Stem Cell Biology and Regenerative Medicine, Broad-CIRM Center for Regenerative Medicine and Stem Cell Research, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Andrew P McMahon
- Department of Stem Cell Biology and Regenerative Medicine, Broad-CIRM Center for Regenerative Medicine and Stem Cell Research, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Melissa Little
- Institute for Molecular Bioscience, University of Queensland, St. Lucia, Queensland, Australia;
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14
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Pitt B, Gheorghiade M. Vasopressin V1 receptor-mediated aldosterone production as a result of selective V2 receptor antagonism: a potential explanation for the failure of tolvaptan to reduce cardiovascular outcomes in the EVEREST trial. Eur J Heart Fail 2014; 13:1261-3. [DOI: 10.1093/eurjhf/hfr150] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Bertram Pitt
- University of Michigan School of Medicine, Cardiovascular Center; 1500 E. Medical Center Dr.; Ann Arbor MI 48109 USA
| | - Mihai Gheorghiade
- Center for Cardiovascular Innovation; Northwestern University Feinberg School of Medicine; 645 North Michigan Ave., Suite 1006 Chicago IL 60611 USA
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15
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Yamazaki T, Nakamura Y, Shiota M, Osada-Oka M, Fujiki H, Hanatani A, Shimada K, Miura K, Yoshiyama M, Iwao H, Izumi Y. Tolvaptan attenuates left ventricular fibrosis after acute myocardial infarction in rats. J Pharmacol Sci 2013; 123:58-66. [PMID: 24005048 DOI: 10.1254/jphs.13086fp] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Tolvaptan, a non-peptide V2-receptor antagonist, is a newly developed diuretic agent. Recently, we reported that tolvaptan has diuretic as well as anti-inflammatory and anti-fibrotic actions in chronic heart failure. In this study, we investigated whether tolvaptan has a cardioprotective effect in acute heart failure after myocardial infarction (MI). After MI induction, rats were randomized into 6 groups as follows: vehicle group, group treated with 15 mg∙kg⁻¹∙day⁻¹ furosemide, 2 groups treated with 3 or 10 mg∙kg⁻¹∙day⁻¹ tolvaptan, and 2 groups treated with 15 mg∙kg⁻¹∙day⁻¹ furosemide combined with 3 or 10 mg∙kg⁻¹∙day⁻¹ tolvaptan. Each agent was administered for 2 weeks, and blood pressure levels and infarct sizes were similar in all MI groups. Lower left ventricular end-systolic volumes and greater improvement of left ventricular ejection fraction were observed in the tolvaptan-treated groups compared with the vehicle group. In contrast, furosemide alone did not improve them. Sirius red staining revealed that tolvaptan significantly repressed MI-induced interstitial fibrosis in the left ventricle. MI-induced mRNA expressions related to cardiac load, inflammation, and fibrosis were significantly attenuated in the combination group. The combination treatment also repressed MI-induced mineralocorticoid receptor expression. Tolvaptan, or combination of furosemide and tolvaptan, may improve cardiac function in acute MI.
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Affiliation(s)
- Takanori Yamazaki
- Department of Cardiovascular Medicine, Osaka City University Medical School, Japan
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16
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Braam B, Cupples WA, Joles JA, Gaillard C. Systemic arterial and venous determinants of renal hemodynamics in congestive heart failure. Heart Fail Rev 2013; 17:161-75. [PMID: 21553212 DOI: 10.1007/s10741-011-9246-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Heart and kidney interactions are fascinating, in the sense that failure of the one organ strongly affects the function of the other. In this review paper, we analyze how principal driving forces for glomerular filtration and renal blood flow are changed in heart failure. Moreover, renal autoregulation and modulation of neurohumoral factors, which can both have repercussions on renal function, are analyzed. Two paradigms seem to apply. One is that the renin-angiotensin system (RAS), the sympathetic nervous system (SNS), and extracellular volume control are the three main determinants of renal function in heart failure. The other is that the classical paradigm to analyze renal dysfunction that is widely applied in nephrology also applies to the pathophysiology of heart failure: pre-renal, intra-renal, and post-renal alterations together determine glomerular filtration. At variance with the classical paradigm is that the most important post-renal factor in heart failure seems renal venous hypertension that, by increasing renal tubular pressure, decreases GFR. When different pharmacological strategies to inhibit the RAS and SNS and to assist renal volume control are considered, there is a painful lack in knowledge about how widely applied drugs affect primary driving forces for ultrafiltration, renal autoregulation, and neurohumoral control. We call for more clinical physiological studies.
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Affiliation(s)
- Branko Braam
- Department of Medicine/Division of Nephrology and Immunology, University of Alberta Hospital, 11-132 CSB Clinical Sciences Building, Edmonton, AB T6G 2G3, Canada.
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17
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Ichiki T, Boerrigter G, Huntley BK, Sangaralingham SJ, McKie PM, Harty GJ, Harders GE, Burnett JC. Differential expression of the pro-natriuretic peptide convertases corin and furin in experimental heart failure and atrial fibrosis. Am J Physiol Regul Integr Comp Physiol 2012; 304:R102-9. [PMID: 23152112 DOI: 10.1152/ajpregu.00233.2012] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
In heart failure (HF), the cardiac hormone natriuretic peptides (NPs) atrial (ANP), B-type (BNP), and C-type (CNP) play a key role to protect cardiac remodeling. The proprotein convertases corin and furin process their respective pro-NPs into active NPs. Here we define in a canine model of HF furin and corin gene and protein expression in normal and failing left atrium (LA) or ventricle (LV) testing the hypothesis that the NP proproteins convertases production is altered in experimental HF. Experimental canine HF was produced by rapid right ventricular pacing for 10 days. NPs, furin, and corin mRNA expression were determined by quantitative RT-PCR. Protein concentration or expression was determined by immunostaining, radioimmunoassay, or Western blot. Furin and corin proteins were present in normal canine LA and LV myocardium and vasculature and in smooth muscle cells. In normal canines, expression of NPs was dominant in the atrium compared with the ventricle. In experimental early stage HF characterized with marked atrial fibrosis, ANP, BNP, and CNP mRNA, and protein concentrations were higher in HF LA but not HF LV compared with normals. In LA, corin mRNA and protein expressions in HF were lower, whereas furin mRNA and protein expressions were higher than normals. NPs and furin expressions were augmented in the atrium in experimental early stage HF and, conversely, corin mRNA and protein expressions were decreased with atrial remodeling. Selective changes of these NP convertases may have significance in the regulation of pro-NP processing and atrial remodeling in early stage HF.
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Affiliation(s)
- Tomoko Ichiki
- Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
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18
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Yamazaki T, Izumi Y, Nakamura Y, Yamashita N, Fujiki H, Osada-Oka M, Shiota M, Hanatani A, Shimada K, Iwao H, Yoshiyama M. Tolvaptan Improves Left Ventricular Dysfunction after Myocardial Infarction in Rats. Circ Heart Fail 2012; 5:794-802. [DOI: 10.1161/circheartfailure.112.968750] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background—
Arginine vasopressin, which promotes the reabsorption of renal water is increased in chronic heart failure. Here, we compared the effects of tolvaptan, a newly developed nonpeptide V
2
receptor antagonist, with those of furosemide, a loop diuretic, and a combination of these 2 agents in rats with left ventricular dysfunction after myocardial infarction (MI).
Methods and Results—
After 10 weeks of MI induction, the rats were separated them into the following 6 groups adjusted to the infarct size: a vehicle group, a group treated with 15 mg·kg
-1
·day
-1
of furosemide, 2 groups treated with 3 or 10 mg·kg
−1
·day
−1
of tolvaptan; and 2 groups treated with 15 mg·kg
−1
·day
−1
of furosemide plus 3 or 10 mg·kg
−1
·day
−1
tolvaptan. Each treatment agent was administered for 4 weeks, and all groups had similar blood pressure levels and infarct size. The tolvaptan-treated groups were found to have lower levels of left ventricular end-diastolic and systolic cardiac volumes than the vehicle group did. Furthermore, the improvement in the ejection fraction in the tolvaptan-treated groups was significantly greater than those in the vehicle group. ED-1 immunostaining and Sirius red staining revealed that tolvaptan significantly repressed MI-induced macrophage infiltration and interstitial fibrosis in the left ventricle, respectively. Tolvaptan attenuated the MI-induced mRNA expressions of atrial and brain natriuretic peptides, monocyte chemotactic protein-1, transforming growth factor-β1, arginine vasopressin V
1a
receptor, and endothelin-1 in the marginal infarct region.
Conclusions—
Tolvaptan may improve cardiac dysfunction after MI, which is partially mediated by the suppression of V
1a
receptor, neurohumoral activation and inflammation.
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Affiliation(s)
- Takanori Yamazaki
- From the Department of Internal Medicine and Cardiology (T.Y., Y.N., A.H., K.S., M.Y.), and Department of Pharmacology (Y.I., N.Y., M.O., M.S., H.I.), Osaka City University Medical School, Osaka, Japan; and First Institute of New Drug Discovery, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan (H.F.)
| | - Yasukatsu Izumi
- From the Department of Internal Medicine and Cardiology (T.Y., Y.N., A.H., K.S., M.Y.), and Department of Pharmacology (Y.I., N.Y., M.O., M.S., H.I.), Osaka City University Medical School, Osaka, Japan; and First Institute of New Drug Discovery, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan (H.F.)
| | - Yasuhiro Nakamura
- From the Department of Internal Medicine and Cardiology (T.Y., Y.N., A.H., K.S., M.Y.), and Department of Pharmacology (Y.I., N.Y., M.O., M.S., H.I.), Osaka City University Medical School, Osaka, Japan; and First Institute of New Drug Discovery, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan (H.F.)
| | - Naoto Yamashita
- From the Department of Internal Medicine and Cardiology (T.Y., Y.N., A.H., K.S., M.Y.), and Department of Pharmacology (Y.I., N.Y., M.O., M.S., H.I.), Osaka City University Medical School, Osaka, Japan; and First Institute of New Drug Discovery, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan (H.F.)
| | - Hiroyuki Fujiki
- From the Department of Internal Medicine and Cardiology (T.Y., Y.N., A.H., K.S., M.Y.), and Department of Pharmacology (Y.I., N.Y., M.O., M.S., H.I.), Osaka City University Medical School, Osaka, Japan; and First Institute of New Drug Discovery, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan (H.F.)
| | - Mayuko Osada-Oka
- From the Department of Internal Medicine and Cardiology (T.Y., Y.N., A.H., K.S., M.Y.), and Department of Pharmacology (Y.I., N.Y., M.O., M.S., H.I.), Osaka City University Medical School, Osaka, Japan; and First Institute of New Drug Discovery, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan (H.F.)
| | - Masayuki Shiota
- From the Department of Internal Medicine and Cardiology (T.Y., Y.N., A.H., K.S., M.Y.), and Department of Pharmacology (Y.I., N.Y., M.O., M.S., H.I.), Osaka City University Medical School, Osaka, Japan; and First Institute of New Drug Discovery, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan (H.F.)
| | - Akihisa Hanatani
- From the Department of Internal Medicine and Cardiology (T.Y., Y.N., A.H., K.S., M.Y.), and Department of Pharmacology (Y.I., N.Y., M.O., M.S., H.I.), Osaka City University Medical School, Osaka, Japan; and First Institute of New Drug Discovery, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan (H.F.)
| | - Kenei Shimada
- From the Department of Internal Medicine and Cardiology (T.Y., Y.N., A.H., K.S., M.Y.), and Department of Pharmacology (Y.I., N.Y., M.O., M.S., H.I.), Osaka City University Medical School, Osaka, Japan; and First Institute of New Drug Discovery, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan (H.F.)
| | - Hiroshi Iwao
- From the Department of Internal Medicine and Cardiology (T.Y., Y.N., A.H., K.S., M.Y.), and Department of Pharmacology (Y.I., N.Y., M.O., M.S., H.I.), Osaka City University Medical School, Osaka, Japan; and First Institute of New Drug Discovery, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan (H.F.)
| | - Minoru Yoshiyama
- From the Department of Internal Medicine and Cardiology (T.Y., Y.N., A.H., K.S., M.Y.), and Department of Pharmacology (Y.I., N.Y., M.O., M.S., H.I.), Osaka City University Medical School, Osaka, Japan; and First Institute of New Drug Discovery, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan (H.F.)
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19
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Morooka H, Iwanaga Y, Tamaki Y, Takase T, Akahoshi Y, Nakano Y, Fujiki H, Miyazaki S. Chronic administration of oral vasopressin type 2 receptor antagonist tolvaptan exerts both myocardial and renal protective effects in rats with hypertensive heart failure. Circ Heart Fail 2012; 5:484-92. [PMID: 22628529 DOI: 10.1161/circheartfailure.111.965392] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although recent clinical trials have demonstrated the efficacy of the oral vasopressin (AVP) type 2 receptor (V2R) antagonist tolvaptan, its long-term effects on the myocardium and kidney in heart failure (HF) are not clear. We examined the chronic effects of tolvaptan administration on both the myocardium and kidney in a rat hypertensive HF model. METHODS AND RESULTS Not only circulating AVP level but also myocardial AVP and V1a receptor (V1aR) expressions, renal V1aR, and V2R expressions were significantly upregulated during the transition to HF. The animals were chronically treated with low-dose or high-dose (HD) tolvaptan or vehicle from the left ventricular (LV) hypertrophic stage. Chronic tolvaptan treatment persistently increased urine volume but did not affect blood pressure. In the HD group, the animal survival significantly improved (log-rank test, P<0.01). At the HF stage, the progression of LV dysfunction was prevented and lung congestion was suppressed. Activation of atrial natriuretic peptide, endothelin-1, AVP, and V1aR mRNA levels were significantly suppressed in the LV myocardium. Meanwhile, renal histopathologic damage was ameliorated and renal function was improved in the HD group at the HF stage. Concomitantly, not only activation of aquaporin-2 but also those of V2R, V1aR, renin, and endothelin-1 in the kidney were significantly suppressed (all P<0.05). CONCLUSIONS These results indicate that chronic tolvaptan treatment has beneficial effects by preventing not only the progression of LV dysfunction but also that of renal injury in hypertensive rats with HF. The underlying mechanism may be related to the suppression of myocardial and renal neurohumoral activation.
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Affiliation(s)
- Hanako Morooka
- Division of Cardiology, Department of Internal Medicine, Kinki University Faculty of Medicine, Osakasayama, Japan
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20
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Affiliation(s)
- Susan Cheng
- The Framingham Heart Study, MA 01702-5803, USA
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21
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Controlling the flood gates: vaptans, furosemide and the quest for a renal protective diuresis. J Card Fail 2011; 17:990-2. [PMID: 22123360 DOI: 10.1016/j.cardfail.2011.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Indexed: 11/23/2022]
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Veeraveedu PT, Palaniyandi SS, Yamaguchi K, Komai Y, Thandavarayan RA, Sukumaran V, Watanabe K. Arginine vasopressin receptor antagonists (vaptans): pharmacological tools and potential therapeutic agents. Drug Discov Today 2010; 15:826-41. [PMID: 20708094 DOI: 10.1016/j.drudis.2010.08.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Revised: 06/25/2010] [Accepted: 08/02/2010] [Indexed: 12/29/2022]
Abstract
Arginine vasopressin (AVP) attracted attention as a potentially important neurohormonal mediator of the heart failure (HF) syndrome and hyponatremic states in humans because AVP influences renal handling of free water, vasoconstriction and myocyte biology through activation of V₂ and V₁(a) receptors. Current research is exploring V₂- and dual V₁(a)/V₂ receptor antagonism for the treatment of hyponatremia, as well as for the congestion and edema associated with chronic HF, because vasopressin receptor antagonists might offer benefits in comparison with conventional loop diuretics. The purpose of this review is to update the current status of experimental and clinical studies with available vasopressin receptor antagonists (conivaptan and tolvaptan) and their potential role in the treatment of HF and hyponatremia of multiple causes.
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Affiliation(s)
- Punniyakoti T Veeraveedu
- Department of Clinical Pharmacology, Niigata University of Pharmacy and Applied Life Sciences, Higashijima Akiha-ku, Niigata City, Japan
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