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Huang K, Wen XQ, Zhang W, Wang JX, Liang Y, Li WQ, Wang YH, Liang MM, Jing AR, Ma J, Zhang X, Liu Y, Gao J. Predictive Value of 5-Methoxytryptophan on Long-Term Clinical Outcome after PCI in Patients with Acute Myocardial Infarction-a Prospective Cohort Study. J Cardiovasc Transl Res 2024:10.1007/s12265-024-10518-6. [PMID: 38683422 DOI: 10.1007/s12265-024-10518-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 04/19/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND In recent years, 5-Methoxytryptophan (5-MTP) has been identified as an endothelial factor with vaso-protective and anti-inflammatory properties. METHODS In this prospective cohort study, a total of 407 patients with acute myocardial infarction (AMI) who underwent percutaneous coronary intervention (PCI) successfully were enrolled. A 1-year follow-up Kaplan-Meier survival analysis was used for evaluating the correlation between 5-MTP and major adverse cardiovascular event (MACE) while Cox proportional-hazards regression was used to identify predictive values of 5-MTP on MACE after AMI. RESULTS Increased 5-MTP level led to a significant downtrend in the incidence of MACE (All Log-rank p < 0.05). Thus, a high baseline 5-MTP could reduce the 1-year incidence of MACE (HR = 0.33, 95%Cl 0.17-0.64, p = 0.001) and heart failure (HF) (HR = 0.28, 95% Cl 0.13-0.62, p = 0.002). Subgroup analysis indicated the predictive value of 5-MTP was more significant in patients aged ≤ 65 years and those with higher baseline NT-proBNP, T2DM, STEMI, and baseline HF with preserved LVEF (HFpEF) characteristics. CONCLUSIONS Plasma 5-MTP is an independent and protective early biomarker for 1-year MACE and HF events in patients with AMI, especially in younger patients and those with T2DM, STEMI, and baseline HFpEF characteristics.
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Affiliation(s)
- Kui Huang
- Thoracic Clinical College, Tianjin Medical University, No.22 Qi Xiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
- Department of Cardiology, Tianjin Chest Hospital, No.261 Tai Erzhuang Road, Jinnan District, Tianjin, 300222, People's Republic of China
| | - Xiao-Qin Wen
- Department of Cardiology, Tianjin Hospital, Tianjin, People's Republic of China
| | - Wei Zhang
- Department of Cardiology, Tianjin Chest Hospital, No.261 Tai Erzhuang Road, Jinnan District, Tianjin, 300222, People's Republic of China
| | - Jing-Xian Wang
- Thoracic Clinical College, Tianjin Medical University, No.22 Qi Xiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Yan Liang
- Thoracic Clinical College, Tianjin Medical University, No.22 Qi Xiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Wen-Qing Li
- Thoracic Clinical College, Tianjin Medical University, No.22 Qi Xiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Yu-Hang Wang
- Thoracic Clinical College, Tianjin Medical University, No.22 Qi Xiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Miao-Miao Liang
- Thoracic Clinical College, Tianjin Medical University, No.22 Qi Xiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - An-Ran Jing
- Thoracic Clinical College, Tianjin Medical University, No.22 Qi Xiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Jing Ma
- Cardiovascular Institute, Tianjin Chest Hospital, No.261 Tai Erzhuang Road, Jinnan District, Tianjin, 300222, People's Republic of China
| | - Xu Zhang
- Cardiovascular Institute, Tianjin Chest Hospital, No.261 Tai Erzhuang Road, Jinnan District, Tianjin, 300222, People's Republic of China
| | - Yin Liu
- Department of Cardiology, Tianjin Chest Hospital, No.261 Tai Erzhuang Road, Jinnan District, Tianjin, 300222, People's Republic of China.
| | - Jing Gao
- Thoracic Clinical College, Tianjin Medical University, No.22 Qi Xiangtai Road, Heping District, Tianjin, 300070, People's Republic of China.
- Cardiovascular Institute, Tianjin Chest Hospital, No.261 Tai Erzhuang Road, Jinnan District, Tianjin, 300222, People's Republic of China.
- Tianjin Key Laboratory of Cardiovascular Emergency and Critical Care, Tianjin Municipal Science and Technology Bureau, Tianjin, People's Republic of China.
- Chest Hospital, Tianjin University, No.92 Weijin Road Nankai District, Tianjin, 300072, People's Republic of China.
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Wu KK. Control of Tissue Fibrosis by 5-Methoxytryptophan, an Innate Anti-Inflammatory Metabolite. Front Pharmacol 2021; 12:759199. [PMID: 34858185 PMCID: PMC8632247 DOI: 10.3389/fphar.2021.759199] [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: 08/16/2021] [Accepted: 10/28/2021] [Indexed: 12/23/2022] Open
Abstract
Tissue fibrosis causes debilitating human diseases such as liver cirrhosis, heart failure, chronic kidney disease and pulmonary insufficiency. It is a dynamic process orchestrated by specific subsets of monocyte-macrophages, fibroblasts, pericytes and hepatic stellate cells. Fibrosis is linked to tissue inflammation. Pro-inflammatory macrophages promote fibrosis by driving myofibroblast differentiation and macrophage myofibroblast transition. Myofibroblasts express α-smooth muscle cell actin (α-SMA) and secrete extracellular matrix (ECM) proteins notably collagen I and III. Deposition of ECM proteins at injury sites and interstitial tissues distorts normal structure and impairs vital functions. Despite advances in the mechanisms of fibrosis at cellular, molecular and genetic levels, prevention and treatment of fibrotic diseases remain poorly developed. Recent reports suggest that 5-methoxytryptophan (5-MTP) is effective in attenuating injury-induced liver, kidney, cardiac and pulmonary fibrosis. It inhibits macrophage activation and blocks fibroblast differentiation to myofibroblasts. Furthermore, it inhibits hepatic stellate cell differentiation into myofibroblasts. As 5-MTP is an endogenous molecule derived from tryptophan catabolism via tryptophan hydroxylase pathway, it is well-suited as a lead compound for developing new anti-fibrotic drugs. This article provides an overview of 5-MTP synthesis, and a critical review of its anti-fibrotic activities. Its mechanisms of actions and potential therapeutic value will be discussed.
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Affiliation(s)
- Kenneth K Wu
- Institute of Cellular and System Medicine, National Health Research Institutes, Zhunan, Taiwan.,Institute of Biotechnology, College of Life Science, National Tsing-Hua University, Hsinchu, Taiwan
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Erkens R, Totzeck M, Brum A, Duse D, Bøtker HE, Rassaf T, Kelm M. Endothelium-dependent remote signaling in ischemia and reperfusion: Alterations in the cardiometabolic continuum. Free Radic Biol Med 2021; 165:265-281. [PMID: 33497796 DOI: 10.1016/j.freeradbiomed.2021.01.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/15/2021] [Accepted: 01/19/2021] [Indexed: 02/07/2023]
Abstract
Intact endothelial function plays a fundamental role for the maintenance of cardiovascular (CV) health. The endothelium is also involved in remote signaling pathway-mediated protection against ischemia/reperfusion (I/R) injury. However, the transfer of these protective signals into clinical practice has been hampered by the complex metabolic alterations frequently observed in the cardiometabolic continuum, which affect redox balance and inflammatory pathways. Despite recent advances in determining the distinct roles of hyperglycemia, insulin resistance (InR), hyperinsulinemia, and ultimately diabetes mellitus (DM), which define the cardiometabolic continuum, our understanding of how these conditions modulate endothelial signaling remains challenging. It is widely accepted that endothelial cells (ECs) undergo functional changes within the cardiometabolic continuum. Beyond vascular tone and platelet-endothelium interaction, endothelial dysfunction may have profound negative effects on outcome during I/R. In this review, we summarize the current knowledge of the influence of hyperglycemia, InR, hyperinsulinemia, and DM on endothelial function and redox balance, their influence on remote protective signaling pathways, and their impact on potential therapeutic strategies to optimize protective heterocellular signaling.
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Affiliation(s)
- Ralf Erkens
- Department of Cardiology, Pulmonology and Angiology Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
| | - Matthias Totzeck
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Germany
| | - Amanda Brum
- Department of Cardiology, Pulmonology and Angiology Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Dragos Duse
- Department of Cardiology, Pulmonology and Angiology Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Hans Erik Bøtker
- Department of Cardiology, Institute of Clinical Medicine, Aarhus University Hospital, Denmark
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Germany
| | - Malte Kelm
- Department of Cardiology, Pulmonology and Angiology Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
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Wu KK, Kuo CC, Yet SF, Lee CM, Liou JY. 5-methoxytryptophan: an arsenal against vascular injury and inflammation. J Biomed Sci 2020; 27:79. [PMID: 32635910 PMCID: PMC7341587 DOI: 10.1186/s12929-020-00671-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/01/2020] [Indexed: 12/21/2022] Open
Abstract
5-methoxytryptophan (5-MTP) is an endothelial factor with anti-inflammatory properties. It is synthesized from L-tryptophan via two enzymatic steps: tryptophan hydroxylase-1 (TPH-1) and hydroxyindole O-methyltransferase. Lipopolysaccharide (LPS) and pro-inflammatory cytokines suppress endothelial 5-MTP production by inhibiting TPH-1 expression. 5-MTP protects endothelial barrier function and promotes endothelial repair, while it blocks vascular smooth muscle cell migration and proliferation by inhibiting p38 MAPK activation. 5-MTP controls macrophage transmigration and activation by inhibiting p38 MAPK and NF-κB activation. 5-MTP administration attenuates arterial intimal hyperplasia, defends against systemic inflammation and prevents renal fibrosis in relevant murine models. Serum 5-MTP level is depressed in human sepsis as well as in mice with sepsis-like disorder. It is reduced in chronic kidney disease and acute myocardial infarction in humans. The reported data suggest that serum 5-MTP may be a theranostic biomarker. In summary, 5-MTP represents a new class of tryptophan metabolite which defends against inflammation and inflammation-mediated tissue damage and fibrosis. It may be a valuable lead compound for developing new drugs to treat complex human inflammatory disorders.
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Affiliation(s)
- Kenneth K Wu
- Institute of Cellular and System Medicine, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli County, 35053, Taiwan. .,College of Life Sciences, National Tsing-Hua University, Hsinchu, Taiwan. .,School of Medicine, China Medical University, Taichung, Taiwan. .,College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Cheng-Chin Kuo
- Institute of Cellular and System Medicine, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli County, 35053, Taiwan
| | - Shaw-Fang Yet
- Institute of Cellular and System Medicine, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli County, 35053, Taiwan
| | - Chii-Ming Lee
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jun-Yang Liou
- Institute of Cellular and System Medicine, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli County, 35053, Taiwan
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