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Single-nucleotide polymorphism of ADRβ2 and CDKN1B genes in Egyptian patients with coronary artery in-stent restenosis. Coron Artery Dis 2022; 33:277-283. [DOI: 10.1097/mca.0000000000001123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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A single nucleotide polymorphism of cyclin-dependent kinase inhibitor 1B (p27 Kip1) associated with human vein graft failure affects growth of human venous adventitial cells but not smooth muscle cells. J Vasc Surg 2017; 67:309-317.e7. [PMID: 28526559 DOI: 10.1016/j.jvs.2016.12.113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 12/12/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND Cyclin-dependent kinase inhibitor 1B (p27Kip1) is a cell-cycle inhibitor whose -838C>A single nucleotide polymorphism (rs36228499; hereafter called p27 SNP) has been associated with the clinical failure of peripheral vein grafts, but the functional effects of this SNP have not been demonstrated. METHODS Human saphenous vein adventitial cells and intimal/medial smooth muscle cells (SMCs) were derived from explants obtained at the time of lower extremity bypass operations. We determined the following in adventitial cells and SMCs as a function of the p27 SNP genotype: (1) p27 promoter activity, (2) p27 messenger (m)RNA and protein levels, and (3) growth and collagen gel contraction. Deoxyribonuclease I footprinting was also performed in adventitial cells and SMCs. RESULTS p27 promoter activity, deoxyribonuclease I footprinting, p27 mRNA levels, and p27 protein levels demonstrated that the p27 SNP is functional in adventitial cells and SMCs. Both cell types with the graft failure protective AA genotype had more p27 mRNA and protein. As predicted because of higher levels of p27 protein, adventitial cells with the AA genotype grew slower than those of the CC genotype. Unexpectedly, SMCs did not show this genotype-dependent growth response. CONCLUSIONS These results support the functionality of the p27 SNP in venous SMCs and adventitial cells, but an effect of the SNP on cell proliferation is limited to only adventitial cells. These data point to a potential role for adventitial cells in human vein graft failure and also suggest that SMCs express factors that interfere with the activity of p27.
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Wilhelmson AS, Fagman JB, Johansson I, Zou ZV, Andersson AG, Svedlund Eriksson E, Johansson ME, Lindahl P, Fogelstrand P, Tivesten Å. Increased Intimal Hyperplasia After Vascular Injury in Male Androgen Receptor-Deficient Mice. Endocrinology 2016; 157:3915-3923. [PMID: 27533884 DOI: 10.1210/en.2016-1100] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Intimal hyperplasia is a vascular pathological process involved in the pathogenesis of atherosclerosis. Data suggest that T, the most important sex steroid hormone in males, protects men from atherosclerotic cardiovascular disease. T mainly acts via the androgen receptor (AR), and in this study we evaluated formation of intimal hyperplasia in male AR knockout (ARKO) mice using a vascular injury model. Two weeks after ligation of the carotid artery, male ARKO mice showed increased intimal area and intimal thickness compared with controls. After endothelial denudation by an in vivo scraping injury, there was no difference in the reendothelialization in ARKO compared with control mice. Ex vivo, we observed increased outgrowth of vascular smooth muscle cells from ARKO compared with control aortic tissue explants; the number of outgrown cells was almost doubled in ARKO. In vitro, stimulation of human aortic vascular smooth muscle cells with a physiological T concentration inhibited both migration and proliferation of the cells. Analyzing the expression of central regulators of cell proliferation and migration, we found that mRNA and protein levels of p27 were lower in uninjured arteries from ARKO mice and that T replacement to castrated male mice increased p27 mRNA in an AR-dependent manner. In conclusion, AR deficiency in male mice increases intimal hyperplasia in response to vascular injury, potentially related to the effects of androgens/AR to inhibit proliferation and migration of smooth muscle cells.
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Affiliation(s)
- Anna S Wilhelmson
- Wallenberg Laboratory for Cardiovascular and Metabolic Research (A.S.W., J.B.F., I.J., Z.V.Z., A.G.A., E.S.E., P.L., P.F., Å.T.), Institute of Medicine; Sahlgrenska Cancer Center (J.B.F.), Department of Surgery, Institute of Clinical Sciences; and Department of Physiology (M.E.J.), Institute of Neuroscience and Physiology; Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden; The Finsen Laboratory (A.S.W), Rigshospitalet, Faculty of Health Sciences, Biotech Research and Innovation Centre, Danish Stem Cell Centre (DanStem), Faculty of Health Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Johan B Fagman
- Wallenberg Laboratory for Cardiovascular and Metabolic Research (A.S.W., J.B.F., I.J., Z.V.Z., A.G.A., E.S.E., P.L., P.F., Å.T.), Institute of Medicine; Sahlgrenska Cancer Center (J.B.F.), Department of Surgery, Institute of Clinical Sciences; and Department of Physiology (M.E.J.), Institute of Neuroscience and Physiology; Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden; The Finsen Laboratory (A.S.W), Rigshospitalet, Faculty of Health Sciences, Biotech Research and Innovation Centre, Danish Stem Cell Centre (DanStem), Faculty of Health Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Inger Johansson
- Wallenberg Laboratory for Cardiovascular and Metabolic Research (A.S.W., J.B.F., I.J., Z.V.Z., A.G.A., E.S.E., P.L., P.F., Å.T.), Institute of Medicine; Sahlgrenska Cancer Center (J.B.F.), Department of Surgery, Institute of Clinical Sciences; and Department of Physiology (M.E.J.), Institute of Neuroscience and Physiology; Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden; The Finsen Laboratory (A.S.W), Rigshospitalet, Faculty of Health Sciences, Biotech Research and Innovation Centre, Danish Stem Cell Centre (DanStem), Faculty of Health Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Zhiyuan V Zou
- Wallenberg Laboratory for Cardiovascular and Metabolic Research (A.S.W., J.B.F., I.J., Z.V.Z., A.G.A., E.S.E., P.L., P.F., Å.T.), Institute of Medicine; Sahlgrenska Cancer Center (J.B.F.), Department of Surgery, Institute of Clinical Sciences; and Department of Physiology (M.E.J.), Institute of Neuroscience and Physiology; Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden; The Finsen Laboratory (A.S.W), Rigshospitalet, Faculty of Health Sciences, Biotech Research and Innovation Centre, Danish Stem Cell Centre (DanStem), Faculty of Health Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Axel G Andersson
- Wallenberg Laboratory for Cardiovascular and Metabolic Research (A.S.W., J.B.F., I.J., Z.V.Z., A.G.A., E.S.E., P.L., P.F., Å.T.), Institute of Medicine; Sahlgrenska Cancer Center (J.B.F.), Department of Surgery, Institute of Clinical Sciences; and Department of Physiology (M.E.J.), Institute of Neuroscience and Physiology; Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden; The Finsen Laboratory (A.S.W), Rigshospitalet, Faculty of Health Sciences, Biotech Research and Innovation Centre, Danish Stem Cell Centre (DanStem), Faculty of Health Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Elin Svedlund Eriksson
- Wallenberg Laboratory for Cardiovascular and Metabolic Research (A.S.W., J.B.F., I.J., Z.V.Z., A.G.A., E.S.E., P.L., P.F., Å.T.), Institute of Medicine; Sahlgrenska Cancer Center (J.B.F.), Department of Surgery, Institute of Clinical Sciences; and Department of Physiology (M.E.J.), Institute of Neuroscience and Physiology; Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden; The Finsen Laboratory (A.S.W), Rigshospitalet, Faculty of Health Sciences, Biotech Research and Innovation Centre, Danish Stem Cell Centre (DanStem), Faculty of Health Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Maria E Johansson
- Wallenberg Laboratory for Cardiovascular and Metabolic Research (A.S.W., J.B.F., I.J., Z.V.Z., A.G.A., E.S.E., P.L., P.F., Å.T.), Institute of Medicine; Sahlgrenska Cancer Center (J.B.F.), Department of Surgery, Institute of Clinical Sciences; and Department of Physiology (M.E.J.), Institute of Neuroscience and Physiology; Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden; The Finsen Laboratory (A.S.W), Rigshospitalet, Faculty of Health Sciences, Biotech Research and Innovation Centre, Danish Stem Cell Centre (DanStem), Faculty of Health Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Per Lindahl
- Wallenberg Laboratory for Cardiovascular and Metabolic Research (A.S.W., J.B.F., I.J., Z.V.Z., A.G.A., E.S.E., P.L., P.F., Å.T.), Institute of Medicine; Sahlgrenska Cancer Center (J.B.F.), Department of Surgery, Institute of Clinical Sciences; and Department of Physiology (M.E.J.), Institute of Neuroscience and Physiology; Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden; The Finsen Laboratory (A.S.W), Rigshospitalet, Faculty of Health Sciences, Biotech Research and Innovation Centre, Danish Stem Cell Centre (DanStem), Faculty of Health Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Per Fogelstrand
- Wallenberg Laboratory for Cardiovascular and Metabolic Research (A.S.W., J.B.F., I.J., Z.V.Z., A.G.A., E.S.E., P.L., P.F., Å.T.), Institute of Medicine; Sahlgrenska Cancer Center (J.B.F.), Department of Surgery, Institute of Clinical Sciences; and Department of Physiology (M.E.J.), Institute of Neuroscience and Physiology; Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden; The Finsen Laboratory (A.S.W), Rigshospitalet, Faculty of Health Sciences, Biotech Research and Innovation Centre, Danish Stem Cell Centre (DanStem), Faculty of Health Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Åsa Tivesten
- Wallenberg Laboratory for Cardiovascular and Metabolic Research (A.S.W., J.B.F., I.J., Z.V.Z., A.G.A., E.S.E., P.L., P.F., Å.T.), Institute of Medicine; Sahlgrenska Cancer Center (J.B.F.), Department of Surgery, Institute of Clinical Sciences; and Department of Physiology (M.E.J.), Institute of Neuroscience and Physiology; Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden; The Finsen Laboratory (A.S.W), Rigshospitalet, Faculty of Health Sciences, Biotech Research and Innovation Centre, Danish Stem Cell Centre (DanStem), Faculty of Health Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
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Ankri-Eliahoo G, Weitz K, Cox TC, Tang GL. p27 kip1 Knockout enhances collateralization in response to hindlimb ischemia. J Vasc Surg 2016; 63:1351-9. [DOI: 10.1016/j.jvs.2014.12.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 12/17/2014] [Indexed: 12/22/2022]
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Dai X, Wiernek S, Evans JP, Runge MS. Genetics of coronary artery disease and myocardial infarction. World J Cardiol 2016; 8:1-23. [PMID: 26839654 PMCID: PMC4728103 DOI: 10.4330/wjc.v8.i1.1] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 10/18/2015] [Accepted: 11/10/2015] [Indexed: 02/06/2023] Open
Abstract
Atherosclerotic coronary artery disease (CAD) comprises a broad spectrum of clinical entities that include asymptomatic subclinical atherosclerosis and its clinical complications, such as angina pectoris, myocardial infarction (MI) and sudden cardiac death. CAD continues to be the leading cause of death in industrialized society. The long-recognized familial clustering of CAD suggests that genetics plays a central role in its development, with the heritability of CAD and MI estimated at approximately 50% to 60%. Understanding the genetic architecture of CAD and MI has proven to be difficult and costly due to the heterogeneity of clinical CAD and the underlying multi-decade complex pathophysiological processes that involve both genetic and environmental interactions. This review describes the clinical heterogeneity of CAD and MI to clarify the disease spectrum in genetic studies, provides a brief overview of the historical understanding and estimation of the heritability of CAD and MI, recounts major gene discoveries of potential causal mutations in familial CAD and MI, summarizes CAD and MI-associated genetic variants identified using candidate gene approaches and genome-wide association studies (GWAS), and summarizes the current status of the construction and validations of genetic risk scores for lifetime risk prediction and guidance for preventive strategies. Potential protective genetic factors against the development of CAD and MI are also discussed. Finally, GWAS have identified multiple genetic factors associated with an increased risk of in-stent restenosis following stent placement for obstructive CAD. This review will also address genetic factors associated with in-stent restenosis, which may ultimately guide clinical decision-making regarding revascularization strategies for patients with CAD and MI.
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Affiliation(s)
- Xuming Dai
- Xuming Dai, Szymon Wiernek, Marschall S Runge, Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Szymon Wiernek
- Xuming Dai, Szymon Wiernek, Marschall S Runge, Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - James P Evans
- Xuming Dai, Szymon Wiernek, Marschall S Runge, Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Marschall S Runge
- Xuming Dai, Szymon Wiernek, Marschall S Runge, Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
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Candidate Gene Analysis of Mortality in Dialysis Patients. PLoS One 2015; 10:e0143079. [PMID: 26587841 PMCID: PMC4654483 DOI: 10.1371/journal.pone.0143079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 10/31/2015] [Indexed: 12/19/2022] Open
Abstract
Background Dialysis patients have high cardiovascular mortality risk. This study aimed to investigate the association between SNPs of genes involved in vascular processes and mortality in dialysis patients. Methods Forty two SNPs in 25 genes involved in endothelial function, vascular remodeling, cell proliferation, inflammation, coagulation and calcium/phosphate metabolism were genotyped in 1330 incident dialysis patients. The effect of SNPs on 5-years cardiovascular and non-cardiovascular mortality was investigated. Results The mortality rate was 114/1000 person-years and 49.4% of total mortality was cardiovascular. After correction for multiple testing, VEGF rs699947 was associated with all-cause mortality (HR1.48, 95% CI 1.14–1.92). The other SNPs were not associated with mortality. Conclusions This study provides further evidence that a SNP in the VEGF gene may contribute to the comorbid conditions of dialysis patients. Future studies should unravel the underlying mechanisms responsible for the increase in mortality in these patients.
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Time and flow-dependent changes in the p27(kip1) gene network drive maladaptive vascular remodeling. J Vasc Surg 2014; 62:1296-302.e2. [PMID: 24953896 DOI: 10.1016/j.jvs.2014.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Accepted: 05/06/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Although clinical studies have identified that a single nucleotide polymorphism in the p27(kip1) gene is associated with success or failure after vein bypass grafting, the underlying mechanisms for this difference are not well defined. Using a high-throughput approach in a flow-dependent vein graft model, we explored the differences in p27(kip1)-related genes that drive the enhanced hyperplastic response under low-flow conditions. METHODS Bilateral rabbit carotid artery interposition grafts with jugular vein were placed with a unilateral distal outflow branch ligation to create differential flow states. Grafts were harvested at 2 hours and at 1, 3, 7, 14, and 28 days after implantation, measured for neointimal area, and assayed for cell proliferation. Whole-vessel messenger RNA was isolated and analyzed using an Affymetrix (Santa Clara, Calif) gene array platform. Ingenuity Pathway Analysis (Ingenuity, Redwood City, Calif) was used to identify the gene networks surrounding p27(kip1). This gene set was then analyzed for temporal expression changes after graft placement and for differential expression in the alternate flow conditions. RESULTS Outflow branch ligation resulted in an eightfold difference in mean flow rates throughout the 28-day perfusion period (P < .001). Flow reduction led to a robust hyperplastic response, resulting in a significant increase in intimal area by 7 days (0.13 ± 0.04 mm(2) vs 0.014 ± 0.006 mm(2); P < .005) and progressive growth to 28 days (1.37 ± 0.05 mm(2) vs 0.39 ± 0.06 mm(2); P < .001). At 7 days, low-flow grafts demonstrated a burst of actively dividing intimal cells (36.4 ± 9.4 cells/mm(2) vs 11.5 ± 1.9 cells/mm(2); P = .04). Sixty-five unique genes within the microarray were identified as components of the p27(kip1) network. At a false discovery rate of 0.05, 26 genes demonstrated significant temporal changes, and two dominant patterns of expression were identified. Class comparison analysis identified differential expression of 11 genes at 2 hours and seven genes and 14 days between the high-flow and low-flow grafts (P < .05). At 2 hours, oncostatin M and cadherin 1 were the most differentially expressed. Cadherin 1 and protein kinase B exhibited the greatest differential expression at 14 days. CONCLUSIONS Alterations in flow and shear stress result in divergent patterns of vein graft remodeling. Associated with the dramatic increase in neointimal expansion observed in low-flow vs high-flow grafts is a subset of differentially expressed p27(kip1)-associated genes that correlate with critical stages in the adaptive response. These represent potential biologic targets whose activity may be altered to augment maladaptive vascular remodeling.
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Silvestre-Roig C, Fernández P, Mansego ML, van Tiel CM, Viana R, Anselmi CV, Condorelli G, de Winter RJ, Martín-Fuentes P, Solanas-Barca M, Civeira F, Focaccio A, de Vries CJM, Chaves FJ, Andrés V. Genetic variants in CCNB1 associated with differential gene transcription and risk of coronary in-stent restenosis. ACTA ACUST UNITED AC 2014; 7:59-70. [PMID: 24395923 DOI: 10.1161/circgenetics.113.000305] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The development of diagnostic tools to assess restenosis risk after stent deployment may enable the intervention to be tailored to the individual patient, for example, by targeting the use of drug-eluting stent to high-risk patients, with the goal of improving safety and reducing costs. The CCNB1 gene (encoding cyclin B1) positively regulates cell proliferation, a key component of in-stent restenosis. Therefore, we hypothesized that single-nucleotide polymorphisms in CCNB1 may serve as useful tools in risk stratification for in-stent restenosis. METHODS AND RESULTS We identified 3 single-nucleotide polymorphisms in CCNB1 associated with increased restenosis risk in a cohort of 284 patients undergoing coronary angioplasty and stent placement (rs350099: TT versus CC+TC; odds ratio [OR], 1.82; 95% confidence interval [CI], 1.09-3.03; P=0.023; rs350104: CC versus CT+TT; OR, 1.82; 95% CI, 1.02-3.26; P=0.040; and rs164390: GG versus GT+TT; OR, 2.27; 95% CI, 1.33-3.85; P=0.002). These findings were replicated in another cohort study of 715 patients (rs350099: TT versus CC+TC; OR, 1.88; 95% CI, 0.92-3.81; P=0.080; rs350104: CC versus CT+TT; OR, 2.23; 95% CI, 1.18-4.25; P=0.016; and rs164390: GG versus GT+TT; OR, 1.87; 95% CI, 1.03-3.47; P=0.040). Moreover, the haplotype containing all 3 risk alleles is associated with higher CCNB1 mRNA expression in circulating lymphocytes and increased in-stent restenosis risk (OR, 1.43; 95% CI, 1.00-1.823; P=0.039). The risk variants of rs350099, rs350104, and rs164390 are associated with increased reporter gene expression through binding of transcription factors nuclear factor-Y, activator protein 1, and specificity protein 1, respectively. CONCLUSIONS Allele-dependent transcriptional regulation of CCNB1 associated with rs350099, rs350104, and rs164390 affects the risk of in-stent restenosis. These findings reveal these common genetic variations as attractive diagnostic tools in risk stratification for restenosis.
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Breitenstein A, Akhmedov A, Camici GG, Lüscher TF, Tanner FC. p27(Kip1) inhibits tissue factor expression. Biochem Biophys Res Commun 2013; 439:559-63. [PMID: 24021283 DOI: 10.1016/j.bbrc.2013.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 09/02/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND The cyclin-dependent kinase inhibitor (CDKI) p27(Kip1) regulates cell proliferation and thus inhibits atherosclerosis and vascular remodeling. Expression of tissue factor (TF), the key initator of the coagulation cascade, is associated with atherosclerosis. Yet, it has not been studied whether p27(Kip1) influences the expression of TF. METHODS AND RESULTS p27(Kip1) overexpression in human aortic endothelial cells was achieved by adenoviral transfection. Cells were rendered quiescent for 24h in 0.5% fetal-calf serum. After stimulation with TNF-α (5 ng/ml), TF protein expression and activity was significantly reduced (n=4; P<0.001) in cells transfected with p27(Kip1). In line with this, p27(Kip1) overexpression reduced cytokine-induced TF mRNA expression (n=4; P<0.01) and TF promotor activity (n=4; P<0.05). In contrast, activation of the MAP kinases p38, ERK and JNK was not affected by p27(Kip1) overexpression. CONCLUSION This in vitro study suggests that p27(Kip1) inhibits TF expression at the transcriptional level. These data indicate an interaction between p27(Kip1) and TF in important pathological alterations such as atherosclerosis and vascular remodeling.
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Affiliation(s)
- Alexander Breitenstein
- Cardiology, University Heart Center, University Hospital Zurich, Switzerland; Cardiovascular Research, Physiology Institute, University of Zurich, Switzerland; Center for Integrative Human Physiology (ZHIP), University of Zurich, Switzerland.
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Verschuren JJW, Trompet S, Sampietro ML, Heijmans BT, Koch W, Kastrati A, Houwing-Duistermaat JJ, Slagboom PE, Quax PHA, Jukema JW. Pathway analysis using genome-wide association study data for coronary restenosis--a potential role for the PARVB gene. PLoS One 2013; 8:e70676. [PMID: 23950981 PMCID: PMC3739784 DOI: 10.1371/journal.pone.0070676] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 06/21/2013] [Indexed: 12/20/2022] Open
Abstract
Background Coronary restenosis after percutaneous coronary intervention (PCI) still remains a significant limitation of the procedure. The causative mechanisms of restenosis have not yet been fully identified. The goal of the current study was to perform gene-set analysis of biological pathways related to inflammation, proliferation, vascular function and transcriptional regulation on coronary restenosis to identify novel genes and pathways related to this condition. Methods The GENetic DEterminants of Restenosis (GENDER) databank contains genotypic data of 556,099SNPs of 295 cases with restenosis and 571 matched controls. Fifty-four pathways, related to known restenosis-related processes, were selected. Gene-set analysis was performed using PLINK, GRASS and ALIGATOR software. Pathways with a p<0.01 were fine-mapped and significantly associated SNPs were analyzed in an independent replication cohort. Results Six pathways (cell-extracellular matrix (ECM) interactions pathway, IL2 signaling pathway, IL6 signaling pathway, platelet derived growth factor pathway, vitamin D receptor pathway and the mitochondria pathway) were significantly associated in one or two of the software packages. Two SNPs in the cell-ECM interactions pathway were replicated in an independent restenosis cohort. No replication was obtained for the other pathways. Conclusion With these results we demonstrate a potential role of the cell-ECM interactions pathway in the development of coronary restenosis. These findings contribute to the increasing knowledge of the genetic etiology of restenosis formation and could serve as a hypothesis-generating effort for further functional studies.
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Affiliation(s)
| | - Stella Trompet
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - M. Lourdes Sampietro
- Department Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
- Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands
| | - Bastiaan T. Heijmans
- Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
- Netherlands Consortium for Healthy Ageing, Leiden University Medical Center, Leiden, The Netherlands
| | - Werner Koch
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Adnan Kastrati
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | | | - P. Eline Slagboom
- Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
- Netherlands Consortium for Healthy Ageing, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul H. A. Quax
- Department of Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - J. Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Netherlands Consortium for Healthy Ageing, Leiden University Medical Center, Leiden, The Netherlands
- Durrer Center for Cardiogenetic Research, Amsterdam, The Netherlands
- Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands
- * E-mail:
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Conte MS, Owens CD, Belkin M, Creager MA, Edwards KL, Gasper WJ, Kenagy RD, LeBoeuf RC, Sobel M, Clowes A. A single nucleotide polymorphism in the p27(Kip1) gene is associated with primary patency of lower extremity vein bypass grafts. J Vasc Surg 2013; 57:1179-85.e1-2. [PMID: 23312942 DOI: 10.1016/j.jvs.2012.11.040] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 11/02/2012] [Accepted: 11/03/2012] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Factors responsible for the variability in outcomes after lower extremity vein bypass grafting (LEVBG) are poorly understood. Recent evidence has suggested that a single nucleotide polymorphism (SNP) in the promoter region of the p27(Kip1) gene, a cell-cycle regulator, is associated with coronary in-stent restenosis. We hypothesized an association with vein graft patency. METHODS This was a retrospective genetic association study nested within a prospective cohort of 204 patients from three referral centers undergoing LEVBG for claudication or critical ischemia. The main outcome measure was primary vein graft patency. RESULTS All patients were followed up for a minimum of 1 year with duplex graft surveillance (median follow-up, 893 days; interquartile range, 539-1315). Genomic DNA was isolated and SNP analysis for the p27(Kip1)-838C>A variants was performed. Allele frequencies were correlated with graft outcome using survival analysis and Cox proportional hazards modeling. The p27(Kip1)-838C>A allele frequencies observed were CA, 53%; CC, 30%; and AA, 17%, satisfying Hardy-Weinberg equilibrium. Race (P = .025) and history of coronary artery disease (P = .027) were different across the genotypes; all other baseline variables were similar. Primary graft patency was greater among patients with the -838AA genotype (75% AA vs 55% CA/CC at 3 years; P = .029). In a Cox proportional hazards model including age, sex, race, diabetes, critical limb ischemia, redo (vs primary) bypass, vein type, and baseline C-reactive protein level, the p27(Kip1)-838AA genotype was significantly associated with higher graft patency (hazard ratio for failure, 0.4; 95% confidence interval, 0.17-0.93). Genotype was also associated with early (0-1 month) changes in graft lumen diameter by ultrasound imaging. CONCLUSIONS These data suggest that the p27(Kip1)-838C>A SNP is associated with LEVBG patency and, together with previous reports, underscore a central role for p27(Kip1) in the generic response to vascular injury.
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Affiliation(s)
- Michael S Conte
- Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco, Calif 94143, USA.
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Khouzam RN, Shaheen M, Aziz RK, Ibebuogu UN. The Important Role of Inflammatory Biomarkers Pre and Post Bare–Metal and Drug–Eluting Stent Implantation. Can J Cardiol 2012; 28:700-5. [DOI: 10.1016/j.cjca.2012.05.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 05/23/2012] [Accepted: 05/24/2012] [Indexed: 12/18/2022] Open
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Systematic testing of literature reported genetic variation associated with coronary restenosis: results of the GENDER Study. PLoS One 2012; 7:e42401. [PMID: 22879966 PMCID: PMC3411750 DOI: 10.1371/journal.pone.0042401] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 07/05/2012] [Indexed: 12/13/2022] Open
Abstract
Background Coronary restenosis after percutaneous coronary intervention still remains a significant problem, despite all medical advances. Unraveling the mechanisms leading to restenosis development remains challenging. Many studies have identified genetic markers associated with restenosis, but consistent replication of the reported markers is scarce. The aim of the current study was to analyze the joined effect of previously in literature reported candidate genes for restenosis in the GENetic DEterminants of Restenosis (GENDER) databank. Methodology/Principal Findings Candidate genes were selected using a MEDLINE search including the terms ‘genetic polymorphism’ and ‘coronary restenosis’. The final set included 36 genes. Subsequently, all single nucleotide polymorphisms (SNPs) in the genomic region of these genes were analyzed in GENDER using set-based analysis in PLINK. The GENDER databank contains genotypic data of 2,571,586 SNPs of 295 cases with restenosis and 571 matched controls. The set, including all 36 literature reported genes, was, indeed, significantly associated with restenosis, p = 0.024 in the GENDER study. Subsequent analyses of the individual genes demonstrated that the observed association of the complete set was determined by 6 of the 36 genes. Conclusion Despite overt inconsistencies in literature, with regard to individual candidate gene studies, this is the first study demonstrating that the joint effect of all these genes together, indeed, is associated with restenosis.
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Bot I, de Vries H, Korporaal SJA, Foks AC, Bot M, van Veldhoven J, Ter Borg MND, van Santbrink PJ, van Berkel TJC, Kuiper J, Ijzerman AP. Adenosine A₂B receptor agonism inhibits neointimal lesion development after arterial injury in apolipoprotein E-deficient mice. Arterioscler Thromb Vasc Biol 2012; 32:2197-205. [PMID: 22743060 DOI: 10.1161/atvbaha.112.252924] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The A(2B) adenosine receptor (A(2B)R) is highly expressed in macrophages and vascular smooth muscle cells and has been established as an important regulator of inflammation and vascular adhesion. Recently, it has been demonstrated that A(2B)R deficiency enhances neointimal lesion formation after vascular injury. Therefore, we hypothesize that A(2B)R agonism protects against injury-induced intimal hyperplasia. METHODS AND RESULTS Apolipoprotein E-deficient mice were fed a Western-type diet for 1 week, after which the left common carotid artery was denuded. Mice were treated with the A(2B) receptor agonist BAY60-6583 or vehicle control for 18 days. Interestingly, lumen stenosis as defined by the neointima/lumen ratio was inhibited by treatment with the A(2B) receptor agonist, caused by reduced smooth muscle cell proliferation. Collagen content was significantly increased in the BAY60-6583-treated mice, whereas macrophage content remained unchanged. In vitro, vascular smooth muscle cell proliferation decreased dose dependently whereas collagen content of cultured smooth muscle cells was increased by BAY60-6583. CONCLUSIONS Our data show that activation of the adenosine A(2B) receptor protects against vascular injury, while it also enhances plaque stability as indicated by increased collagen content. These outcomes thus point to A(2B) receptor agonism as a new therapeutic approach in the prevention of restenosis.
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Affiliation(s)
- Ilze Bot
- Division of Biopharmaceutics, Leiden/Amsterdam Center for Drug Research, Gorlaeus Laboratories, Leiden University, Einsteinweg 55, 2333 CC, Leiden, The Netherlands.
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Jukema JW, Verschuren JJW, Ahmed TAN, Quax PHA. Restenosis after PCI. Part 1: pathophysiology and risk factors. Nat Rev Cardiol 2011; 9:53-62. [PMID: 21912414 DOI: 10.1038/nrcardio.2011.132] [Citation(s) in RCA: 212] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Restenosis is a complex disease for which the pathophysiological mechanisms have not yet been fully elucidated, but are thought to include inflammation, proliferation, and matrix remodeling. Over the years, many predictive clinical, biological, (epi)genetic, lesion-related, and procedural risk factors for restenosis have been identified. These factors are not only useful in risk stratification of patients, they also contribute to our understanding of this condition. Furthermore, these factors provide evidence on which to base treatment tailored to the individual and aid in the development of novel therapeutic modalities. In this Review, we will evaluate the available evidence on the pathophysiological mechanisms of restenosis and provide an overview of the various risk factors, together with the possible clinical application of this knowledge.
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Affiliation(s)
- J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
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Niccoli G, Montone RA, Ferrante G, Crea F. The evolving role of inflammatory biomarkers in risk assessment after stent implantation. J Am Coll Cardiol 2011; 56:1783-93. [PMID: 21087705 DOI: 10.1016/j.jacc.2010.06.045] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Revised: 06/14/2010] [Accepted: 06/28/2010] [Indexed: 01/04/2023]
Abstract
The main adverse reactions to coronary stents are in-stent restenosis (ISR) and stent thrombosis. Along with procedural factors, individual susceptibility to these events plays an important role. In particular, inflammatory status, as assessed by C-reactive protein levels, predicts the risk of ISR after bare-metal stent implantation, although it does not predict the risk of stent thrombosis. Conversely, C-reactive protein levels fail to predict the risk of ISR after drug-eluting stent (DES) implantation, although they appear to predict the risk of stent thrombosis. Of note, DES have abated ISR rates occurring in the classical 1-year window, but new concern is emerging regarding late restenosis and thrombosis. The pathogenesis of these late events seems to be related to delayed healing and allergic reactions to polymers, a process in which eosinophils seem to play an important role by enhancing restenosis and thrombosis. The identification of high-risk individuals based on biomarker assessment may be important for the management of patients receiving stent implantation. In this report, we review the evolving role of inflammatory biomarkers in predicting the risk of ISR and stent thrombosis.
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Affiliation(s)
- Giampaolo Niccoli
- Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
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Kuriyama N, Kobayashi Y, Nakama T, Mine D, Nishihira K, Shimomura M, Nomura K, Ashikaga K, Matsuyama A, Shibata Y. Late restenosis following sirolimus-eluting stent implantation. JACC Cardiovasc Interv 2011; 4:123-8. [PMID: 21251639 DOI: 10.1016/j.jcin.2010.09.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 07/26/2010] [Accepted: 09/03/2010] [Indexed: 01/24/2023]
Abstract
OBJECTIVES This serial angiographic study evaluated the incidence and predictors of late restenosis after sirolimus-eluting stent (SES) implantation. BACKGROUND Previous studies showed late restenosis (i.e., late catch-up phenomenon) after implantation of 7-hexanoyltaxol-eluting stents and nonpolymeric, paclitaxel-eluting stents. METHODS Between August 2004 and December 2006, SES implantation was performed in 1,393 patients with 2,008 lesions, in whom 8-month and 2-year follow-up coronary angiography were planned. RESULTS Of 2,008 lesions, 1,659 (83%) underwent 8-month follow-up angiography (8.3 ± 2.2 months). Restenosis was observed in 122 lesions (7.4%). Coronary angiography 2 years (1.9 ± 0.4 years) after SES deployment was performed in 1,168 lesions (74% of lesions without restenosis at 8-month follow-up angiography). Late restenosis was observed in 83 lesions (7.1%). There was significant decrease in minimum luminal diameter (MLD) between 8-month and 2-year follow-up (2.56 ± 0.56 mm vs. 2.35 ± 0.71 mm, p < 0.001). Multivariate analysis showed in-stent restenosis before SES implantation and MLD at 8-month follow-up as independent predictors of late restenosis. CONCLUSIONS Between 8-month and 2-year follow-up after SES implantation, MLD decreases, which results in late restenosis in some lesions. In-stent restenosis before SES implantation and MLD at 8-month follow-up are independent predictors of late restenosis.
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Affiliation(s)
- Nehiro Kuriyama
- Department of Cardiology, Miyazaki Medical Association Hospital, Miyazaki, Japan
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Xu DQ, Luo Y, Liu Y, Wang J, Zhang B, Xu M, Wang YX, Dong HY, Dong MQ, Zhao PT, Niu W, Liu ML, Gao YQ, Li ZC. Beta-estradiol attenuates hypoxic pulmonary hypertension by stabilizing the expression of p27kip1 in rats. Respir Res 2010; 11:182. [PMID: 21182801 PMCID: PMC3022723 DOI: 10.1186/1465-9921-11-182] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Accepted: 12/24/2010] [Indexed: 12/29/2022] Open
Abstract
Background Pulmonary vascular structure remodeling (PVSR) is a hallmark of pulmonary hypertension. P27kip1, one of critical cyclin-dependent kinase inhibitors, has been shown to mediate anti-proliferation effects on various vascular cells. Beta-estradiol (β-E2) has numerous biological protective effects including attenuation of hypoxic pulmonary hypertension (HPH). In the present study, we employed β-E2 to investigate the roles of p27kip1 and its closely-related kinase (Skp-2) in the progression of PVSR and HPH. Methods Sprague-Dawley rats treated with or without β-E2 were challenged by intermittent chronic hypoxia exposure for 4 weeks to establish hypoxic pulmonary hypertension models, which resemble moderate severity of hypoxia-induced PH in humans. Subsequently, hemodynamic and pulmonary pathomorphology data were gathered. Additionally, pulmonary artery smooth muscle cells (PASMCs) were cultured to determine the anti-proliferation effect of β-E2 under hypoxia exposure. Western blotting or reverse transcriptional polymerase chain reaction (RT-PCR) were adopted to test p27kip1, Skp-2 and Akt-P changes in rat lung tissue and cultured PASMCs. Results Chronic hypoxia significantly increased right ventricular systolic pressures (RVSP), weight of right ventricle/left ventricle plus septum (RV/LV+S) ratio, medial width of pulmonary arterioles, accompanied with decreased expression of p27kip1 in rats. Whereas, β-E2 treatment repressed the elevation of RVSP, RV/LV+S, attenuated the PVSR of pulmonary arterioles induced by chronic hypoxia, and stabilized the expression of p27kip1. Study also showed that β-E2 application suppressed the proliferation of PASMCs and elevated the expression of p27kip1 under hypoxia exposure. In addition, experiments both in vivo and in vitro consistently indicated an escalation of Skp-2 and phosphorylated Akt under hypoxia condition. Besides, all these changes were alleviated in the presence of β-E2. Conclusions Our results suggest that β-E2 can effectively attenuate PVSR and HPH. The underlying mechanism may partially be through the increased p27kip1 by inhibiting Skp-2 through Akt signal pathway. Therefore, targeting up-regulation of p27kip1 or down-regulation of Skp-2 might provide new strategies for treatment of HPH.
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Affiliation(s)
- Dun-Quan Xu
- Department of Pathology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, PR China
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Bergheanu SC, Pons D, Karalis I, Özsoy O, Verschuren JJW, Ewing MM, Quax PHA, Jukema JW. Genetic determinants of adverse outcome (restenosis, malapposition and thrombosis) after stent implantation. Interv Cardiol 2010. [DOI: 10.2217/ica.10.9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Fuster JJ, Fernández P, González-Navarro H, Silvestre C, Nabah YNA, Andrés V. Control of cell proliferation in atherosclerosis: insights from animal models and human studies. Cardiovasc Res 2009; 86:254-64. [PMID: 19900964 DOI: 10.1093/cvr/cvp363] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Excessive hyperplastic cell growth within occlusive vascular lesions has been recognized as a key component of the inflammatory response associated with atherosclerosis, restenosis post-angioplasty, and graft atherosclerosis after coronary artery bypass. Understanding the molecular mechanisms that regulate arterial cell proliferation is therefore essential for the development of new tools for the treatment of these diseases. Mammalian cell proliferation is controlled by a large number of proteins that modulate the mitotic cell cycle, including cyclin-dependent kinases, cyclins, and tumour suppressors. The purpose of this review is to summarize current knowledge about the role of these cell cycle regulators in the development of native and graft atherosclerosis that has arisen from animal studies, histological examination of specimens from human patients, and genetic studies.
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Affiliation(s)
- José J Fuster
- Laboratory of Vascular Biology, Department of Molecular and Cellular Pathology and Therapy, Instituto de Biomedicina de Valencia-CSIC, C/Jaime Roig 11, 46010 Valencia, Spain
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