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Oliver T, Nguyen NY, Tully CB, McCormack NM, Sun CM, Fiorillo AA, Heier CR. The glucocorticoid receptor acts locally to protect dystrophic muscle and heart during disease. Dis Model Mech 2024; 17:dmm050397. [PMID: 38770680 PMCID: PMC11139035 DOI: 10.1242/dmm.050397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 03/28/2024] [Indexed: 05/22/2024] Open
Abstract
Absence of dystrophin results in muscular weakness, chronic inflammation and cardiomyopathy in Duchenne muscular dystrophy (DMD). Pharmacological corticosteroids are the DMD standard of care; however, they have harsh side effects and unclear molecular benefits. It is uncertain whether signaling by physiological corticosteroids and their receptors plays a modifying role in the natural etiology of DMD. Here, we knocked out the glucocorticoid receptor (GR, encoded by Nr3c1) specifically in myofibers and cardiomyocytes within wild-type and mdx52 mice to dissect its role in muscular dystrophy. Double-knockout mice showed significantly worse phenotypes than mdx52 littermate controls in measures of grip strength, hang time, inflammatory pathology and gene expression. In the heart, GR deletion acted additively with dystrophin loss to exacerbate cardiomyopathy, resulting in enlarged hearts, pathological gene expression and systolic dysfunction, consistent with imbalanced mineralocorticoid signaling. The results show that physiological GR functions provide a protective role during muscular dystrophy, directly contrasting its degenerative role in other disease states. These data provide new insights into corticosteroids in disease pathophysiology and establish a new model to investigate cell-autonomous roles of nuclear receptors and mechanisms of pharmacological corticosteroids.
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MESH Headings
- Animals
- Mice
- Cardiomyopathies/pathology
- Cardiomyopathies/metabolism
- Dystrophin/metabolism
- Dystrophin/genetics
- Dystrophin/deficiency
- Mice, Inbred C57BL
- Mice, Inbred mdx
- Mice, Knockout
- Muscle, Skeletal/pathology
- Muscle, Skeletal/metabolism
- Muscular Dystrophy, Animal/pathology
- Muscular Dystrophy, Animal/metabolism
- Muscular Dystrophy, Duchenne/pathology
- Muscular Dystrophy, Duchenne/metabolism
- Myocardium/pathology
- Myocardium/metabolism
- Myocytes, Cardiac/metabolism
- Myocytes, Cardiac/pathology
- Myocytes, Cardiac/drug effects
- Phenotype
- Receptors, Glucocorticoid/metabolism
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Affiliation(s)
- Trinitee Oliver
- Center for Genetic Medicine Research, Children's National Hospital, Washington, DC 20010, USA
- Department of Biology, Howard University, Washington, DC 20059, USA
- Graduate School of Biomedical Sciences, Cedars-Sinai Medical Center, West Hollywood, CA 90048, USA
| | - Nhu Y. Nguyen
- Center for Genetic Medicine Research, Children's National Hospital, Washington, DC 20010, USA
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC 27607, USA
| | - Christopher B. Tully
- Center for Genetic Medicine Research, Children's National Hospital, Washington, DC 20010, USA
| | - Nikki M. McCormack
- Center for Genetic Medicine Research, Children's National Hospital, Washington, DC 20010, USA
| | - Christina M. Sun
- Center for Genetic Medicine Research, Children's National Hospital, Washington, DC 20010, USA
| | - Alyson A. Fiorillo
- Center for Genetic Medicine Research, Children's National Hospital, Washington, DC 20010, USA
- Department of Genomics and Precision Medicine, The George Washington University, Washington, DC 20037, USA
- Center for Inherited Muscle Research, Department of Neurology, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Christopher R. Heier
- Center for Genetic Medicine Research, Children's National Hospital, Washington, DC 20010, USA
- Department of Genomics and Precision Medicine, The George Washington University, Washington, DC 20037, USA
- Center for Inherited Muscle Research, Department of Neurology, Virginia Commonwealth University, Richmond, VA 23298, USA
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Wang YL, Bai L, Shi XR, Zhu H, Du LJ, Liu Y, Ma XX, Lin WZ, Liu T, Sun JY, Liu Y, Guo XG, Zhou LJ, Chen BY, Shao S, Meng XQ, Li YL, Li RG, Duan SZ. Osteoblast MR deficiency protects against adverse ventricular remodeling after myocardial infarction. J Mol Cell Cardiol 2022; 167:40-51. [PMID: 35314145 DOI: 10.1016/j.yjmcc.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/27/2022] [Accepted: 03/15/2022] [Indexed: 11/30/2022]
Abstract
RATIONALE Mineralocorticoid receptor (MR) antagonists have been clinically used to treat heart failure. However, the underlying cellular and molecular mechanisms remain incompletely understood. METHODS AND RESULTS Using osteoblast MR knockout (MRobko) mouse in combination with myocardial infarction (MI) model, we demonstrated that MR deficiency in osteoblasts significantly improved cardiac function, promoted myocardial healing, as well as attenuated cardiac hypertrophy, fibrosis and inflammatory response after MI. Gene expression profiling using RNA sequencing revealed suppressed expression of osteocalcin (OCN) in calvaria from MRobko mice compared to littermate control (MRfl/fl) mice with or without MI. Plasma levels of undercarboxylated OCN (ucOCN) were also markedly decreased in MRobko mice compared to MRfl/fl mice. Administration of ucOCN abolished the protective effects of osteoblast MR deficiency on infarcted hearts. Mechanistically, ucOCN treatment promoted proliferation and inflammatory cytokine secretion in macrophages. Spironolactone, an MR antagonist, significantly inhibited the expression and secretion of OCN in post-MI mice. More importantly, spironolactone decreased plasma levels of ucOCN and inflammatory cytokines in heart failure patients. CONCLUSIONS MR deficiency in osteoblasts alleviates pathological ventricular remodeling after MI, likely through its regulation on OCN. Spironolactone may work through osteoblast MR/OCN axis to exert its therapeutic effects on pathological ventricular remodeling and heart failure in mice and human patients.
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Affiliation(s)
- Yong-Li Wang
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China; Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Lan Bai
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Xue-Rui Shi
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Hong Zhu
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Lin-Juan Du
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Yuan Liu
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Xiao-Xin Ma
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Wen-Zhen Lin
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Ting Liu
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Jian-Yong Sun
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Yan Liu
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Xu-Guang Guo
- Department of Clinical Laboratory Medicine, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Lu-Jun Zhou
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Bo-Yan Chen
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Shuai Shao
- Department of Neurosurgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Xiao-Qian Meng
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Yu-Lin Li
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - Ruo-Gu Li
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Sheng-Zhong Duan
- Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China.
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3
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Barrera-Chimal J, Bonnard B, Jaisser F. Roles of Mineralocorticoid Receptors in Cardiovascular and Cardiorenal Diseases. Annu Rev Physiol 2022; 84:585-610. [PMID: 35143332 DOI: 10.1146/annurev-physiol-060821-013950] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Mineralocorticoid receptor (MR) activation in the heart and vessels leads to pathological effects, such as excessive extracellular matrix accumulation, oxidative stress, and sustained inflammation. In these organs, the MR is expressed in cardiomyocytes, fibroblasts, endothelial cells, smooth muscle cells, and inflammatory cells. We review the accumulating experimental and clinical evidence that pharmacological MR antagonism has a positive impact on a battery of cardiac and vascular pathological states, including heart failure, myocardial infarction, arrhythmic diseases, atherosclerosis, vascular stiffness, and cardiac and vascular injury linked to metabolic comorbidities and chronic kidney disease. Moreover, we present perspectives on optimization of the use of MR antagonists in patients more likely to respond to such therapy and review the evidence suggesting that novel nonsteroidal MR antagonists offer an improved safety profile while retaining their cardiovascular protective effects. Finally, we highlight future therapeutic applications of MR antagonists in cardiovascular injury.
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Affiliation(s)
- Jonatan Barrera-Chimal
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico.,Laboratorio de Fisiología Cardiovascular y Trasplante Renal, Unidad de Investigación UNAM-INC, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Benjamin Bonnard
- INSERM, UMRS 1138, Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Paris, France;
| | - Frederic Jaisser
- INSERM, UMRS 1138, Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Paris, France; .,INSERM Centre d'Investigations Cliniques-Plurithématique 1433, UMR 1116, CHRU de Nancy, French-Clinical Research Infrastructure Network (F-CRIN INI-CRCT), Université de Lorraine, Nancy, France
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4
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Heier CR, Yu Q, Fiorillo AA, Tully CB, Tucker A, Mazala DA, Uaesoontrachoon K, Srinivassane S, Damsker JM, Hoffman EP, Nagaraju K, Spurney CF. Vamorolone targets dual nuclear receptors to treat inflammation and dystrophic cardiomyopathy. Life Sci Alliance 2019; 2:2/1/e201800186. [PMID: 30745312 PMCID: PMC6371196 DOI: 10.26508/lsa.201800186] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 01/25/2019] [Accepted: 01/28/2019] [Indexed: 12/25/2022] Open
Abstract
Cardiomyopathy is a leading cause of death for Duchenne muscular dystrophy. Here, we find that the mineralocorticoid receptor (MR) and glucocorticoid receptor (GR) can share common ligands but play distinct roles in dystrophic heart and skeletal muscle pathophysiology. Comparisons of their ligand structures indicate that the Δ9,11 modification of the first-in-class drug vamorolone enables it to avoid interaction with a conserved receptor residue (N770/N564), which would otherwise activate transcription factor properties of both receptors. Reporter assays show that vamorolone and eplerenone are MR antagonists, whereas prednisolone is an MR agonist. Macrophages, cardiomyocytes, and CRISPR knockout myoblasts show vamorolone is also a dissociative GR ligand that inhibits inflammation with improved safety over prednisone and GR-specific deflazacort. In mice, hyperaldosteronism activates MR-driven hypertension and kidney phenotypes. We find that genetic dystrophin loss provides a second hit for MR-mediated cardiomyopathy in Duchenne muscular dystrophy model mice, as aldosterone worsens fibrosis, mass and dysfunction phenotypes. Vamorolone successfully prevents MR-activated phenotypes, whereas prednisolone activates negative MR and GR effects. In conclusion, vamorolone targets dual nuclear receptors to treat inflammation and cardiomyopathy with improved safety.
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Affiliation(s)
- Christopher R Heier
- Department of Genomics and Precision Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA .,Center for Genetic Medicine Research, Children's National Medical Center, Washington, DC, USA
| | - Qing Yu
- Center for Genetic Medicine Research, Children's National Medical Center, Washington, DC, USA
| | - Alyson A Fiorillo
- Department of Genomics and Precision Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.,Center for Genetic Medicine Research, Children's National Medical Center, Washington, DC, USA
| | - Christopher B Tully
- Center for Genetic Medicine Research, Children's National Medical Center, Washington, DC, USA
| | - Asya Tucker
- Center for Genetic Medicine Research, Children's National Medical Center, Washington, DC, USA
| | - Davi A Mazala
- Center for Genetic Medicine Research, Children's National Medical Center, Washington, DC, USA
| | | | | | | | - Eric P Hoffman
- AGADA Biosciences Incorporated, Halifax, Nova Scotia, Canada.,ReveraGen BioPharma, Incorporated, Rockville, MD, USA.,School of Pharmacy and Pharmaceutical Sciences, Binghamton University-State University of New York (SUNY), Binghamton, NY, USA
| | - Kanneboyina Nagaraju
- AGADA Biosciences Incorporated, Halifax, Nova Scotia, Canada.,ReveraGen BioPharma, Incorporated, Rockville, MD, USA.,School of Pharmacy and Pharmaceutical Sciences, Binghamton University-State University of New York (SUNY), Binghamton, NY, USA
| | - Christopher F Spurney
- Department of Genomics and Precision Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.,Center for Genetic Medicine Research, Children's National Medical Center, Washington, DC, USA.,Division of Cardiology, Children's National Heart Institute, Children's National Medical Center, Washington, DC, USA
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6
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Buonafine M, Bonnard B, Jaisser F. Mineralocorticoid Receptor and Cardiovascular Disease. Am J Hypertens 2018; 31:1165-1174. [PMID: 30192914 DOI: 10.1093/ajh/hpy120] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 08/09/2018] [Indexed: 12/14/2022] Open
Abstract
Activation of the mineralocorticoid receptor (MR) in the distal nephron by its ligand, aldosterone, plays an important role in sodium reabsorption and blood pressure regulation. However, expression of the MR goes beyond the kidney. It is expressed in a variety of other tissues in which its activation could lead to tissue injury. Indeed, MR activation in the cardiovascular (CV) system has been shown to promote hypertension, fibrosis, and inflammation. Pharmacological blockade of the MR has protective effects in several animal models of CV disease. Furthermore, the use of MR antagonists is beneficial for heart failure patients, preventing mortality and morbidity. A better understanding of the implications of the MR in the setting of CV diseases is critical for refining treatments and improving patient care. The mechanisms involved in the deleterious effects of MR activation are complex and include oxidative stress, inflammation, and fibrosis. This review will discuss the pathological role of the MR in the CV system and the major mechanisms underlying it.
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Affiliation(s)
- Mathieu Buonafine
- INSERM, UMRS, Centre de Recherche des Cordeliers, Sorbonne University, Paris, France
- Paris Descartes University, Paris, France
| | - Benjamin Bonnard
- INSERM, UMRS, Centre de Recherche des Cordeliers, Sorbonne University, Paris, France
- Paris Descartes University, Paris, France
| | - Frédéric Jaisser
- INSERM, UMRS, Centre de Recherche des Cordeliers, Sorbonne University, Paris, France
- Paris Descartes University, Paris, France
- INSERM, Clinical Investigation Centre, French-Clinical Research Infrastructure Network (F-CRIN) INI-CRCT, RHU Fight-HF, Nancy, France
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de Paula Vasconcelos PC, Tirloni CAS, Palozi RAC, Leitão MM, Carneiro MTS, Schaedler MI, Silva AO, Souza RIC, Salvador MJ, Junior AG, Kassuya CAL. Diuretic herb Gomphrena celosioides Mart. (Amaranthaceae) promotes sustained arterial pressure reduction and protection from cardiac remodeling on rats with renovascular hypertension. JOURNAL OF ETHNOPHARMACOLOGY 2018; 224:126-133. [PMID: 29842964 DOI: 10.1016/j.jep.2018.05.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 05/21/2018] [Accepted: 05/24/2018] [Indexed: 06/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Gomphrena celosioides Mart., belonging to the Amaranthaceae family, is a weed known as "perpétua," and its ethnopharmacological use is to treat of urinary tract disorders and kidney stones. Urinary tract disorders and kidney stones could include several pathological conditions such hypertension, diuretic and lithiasic problems. In the present work a model of renovascular hypertension was developed in vivo to investigate its usefulness as an antihypertensive drug. AIM OF THE STUDY Evaluate the effect of acute and 28 day oral administration of G. celosioides extract on systemic arterial pressure and diuresis of renovascular-hypertensive rats, as well as its effect on cardiac remodeling and vascular reactivity. MATERIALS AND METHODS Ethanolic extract of G. celosioides (EEGC) was used. To induce renovascular hypertension, adult male Wistar rats were submitted to Goldblatt 1K1C or 2K1C surgery. The mean arterial pressure (MAP) of 1K1C animals was directly assessed by cannulation of the carotid artery before and after intraduodenal acute administration of 30, 100 or 300 mg/kg of EEGC. For the 4-week assay, 2K1C animals received daily treatments with water (control group), 100 mg/kg EEGC or 15 mg/kg enalapril for 28 days. Diuresis and caudal blood pressure were assessed weekly, and at the 28th day of treatment, the MAP was directly quantified shortly before euthanasia. Internal organs were removed, weighed and routinely processed for histology and the left ventricle wall was measured. Blood was collected for biochemical analysis and mechanism investigation by quantification of angiotensin converting enzyme (ACE) activity and aldosterone, nitrite and thiobarbituric acid reactive substances (TBARS) concentration. The rats' mesenteric beds were isolated and cannulated to have their pressure variation assessed after crescent doses of phenylephrine (Phe), acetylcholine (ACh) and sodium nitroprusside (SNP). RESULTS EEGC acutely reduced MAP the dose of 100 mg/kg. In the 4-week assay, EEGC acted as diuretic after acute administration after 1, 2, 3 and 4 weeks of treatment. EEGC also acted as an antihypertensive and it showed significant difference already after 1 week (and after 3 and 4 weeks) compared to control, with its MAP close to pre-surgery values at the end of the experiment. It promoted ACE inhibition, which led to lower aldosterone levels. The lower TBARS and higher nitrite concentration found in the EEGC group suggest antioxidant activity and NO maintenance. Moreover, EEGC counteracted the impairment of vascular reactivity induced by renovascular hypertension. The extract group presented thinner left ventricle wall compared to the control, meaning reduced hypertension-induced cardiac remodeling. CONCLUSIONS The G. celosioides diuretic effect is maintained on renovascular hypertensive rats and can reduce the blood pressure after the first week of treatment by inhibiting ACE and these effects are longstanding and strong enough to promote protection against cardiac remodeling. Therefore, it shows potential as an antihypertensive drug.
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Affiliation(s)
| | | | | | - Maicon Matos Leitão
- College of Health Science, Federal University of Grande Dourados, Dourados, MS, Brazil.
| | | | | | - Aniely Oliveira Silva
- College of Health Science, Federal University of Grande Dourados, Dourados, MS, Brazil.
| | | | - Marcos José Salvador
- Institute of Biology, Department of Plant Biology, PPG BTPB, Faculty of Pharmaceutical Science, State University of Campinas (UNICAMP), Campinas, SP, Brazil.
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Aldosterone and Mineralocorticoid Receptor System in Cardiovascular Physiology and Pathophysiology. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:1204598. [PMID: 30327709 PMCID: PMC6169243 DOI: 10.1155/2018/1204598] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/14/2018] [Accepted: 08/16/2018] [Indexed: 12/22/2022]
Abstract
The mineralocorticoid hormone aldosterone (Aldo) has been intensively studied for its ability to influence both the physiology and pathophysiology of the cardiovascular system. Indeed, although research on Aldo actions for decades has mainly focused on its effects in the kidney, several lines of evidence have now demonstrated that this hormone exerts disparate extrarenal adverse effects, especially in the circulatory system. Accordingly, in the last lusters, a number of studies in preclinical models (in vitro and in vivo) and in humans have established that Aldo, following the interaction with its receptor-the mineralocorticoid receptor (MR)-is able to activate specific intracellular genomic and nongenomic pathways, thus regulating the homeostasis of the cardiovascular system. Importantly, through this mechanism of action, this hormone becomes a crucial regulator of the function and growth of different types of cells, including fibroblasts, cardiomyocytes, and vascular cells. For this main reason, it is plausible that when Aldo is present at high levels in the blood, it profoundly modifies the physiology of these cells, therefore being at the foundation of several cardiovascular disorders, such as heart failure (HF). On these grounds, in this review, we will provide an updated account on the current knowledge concerning Aldo activity in the cardiovascular system and the most recent preclinical studies and clinical trials designed to test better approaches able to counter the hyperactivity of the Aldo/MR signaling pathway in the setting of cardiovascular diseases.
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Wu F, Lin Y, Liu Q. The emerging role of aldosterone/mineralocorticoid receptors in the pathogenesis of erectile dysfunction. Endocrine 2018; 61:372-382. [PMID: 29721801 DOI: 10.1007/s12020-018-1610-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 04/17/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE Aldosterone is an old hormone that has been discovered for more than fifty years. The clinical application of its receptors' inhibitors, especially spirolactone, has benifited patients for decades worldwide. In this review, we briefly summarized the molecular mechanism of aldosterone/mineralocorticoid receptors (Ald-MRs) signaling in cardiovascular diseases and its emerging role in erectile dysfunction. METHODS We searched PubMed, Web of Science, and Scopus for manuscripts published prior to December 2017 using key words " aldosterone " AND " erectile dysfunction " OR " cardiovascular disease " OR " mineralocorticoid receptors ". Related literature and clinical perspectives were collated, summarized and discussed in this review. RESULTS The increase of reactive oxygen species production, inhibition of endothelial nitric oxide synthase system, and induction of inflammation are ubiquitous in vascular endothelial cells or vascular smooth muscle cells after the activation of Ald-MRs pathway. In addition, in cardiovascular diseases with over-active Ald-MRs signaling, MRs blockade could reverse the injury and improve the prognosis. Notably, multiple studies have correlated aldosterone and MRs to the pathogenesis of erectile function, while the mechanism is largely unperfectly identified. CONCLUSION In conclusion, we summarize the current evidence to highlight the potential role of aldosterone in erectile dysfunction and provide critical insights into the treatment of the disease.
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Affiliation(s)
- Fei Wu
- Department of Urology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, 250014, China.
| | - Yun Lin
- Department of Urology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, 250014, China
| | - Qingyong Liu
- Department of Urology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, 250014, China.
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James R, Guillot E, Garelli-Paar C, Huxley J, Grassi V, Cobb M. The SEISICAT study: a pilot study assessing efficacy and safety of spironolactone in cats with congestive heart failure secondary to cardiomyopathy. J Vet Cardiol 2017; 20:1-12. [PMID: 29277469 DOI: 10.1016/j.jvc.2017.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 11/07/2017] [Accepted: 11/09/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The pathophysiology of heart failure involves activation of several neurohormonal systems including the renin-angiotensin-aldosterone system. The mineralocorticoid receptor antagonist spironolactone has been shown to be beneficial in humans and dogs with heart failure. The objective of this pilot study was to investigate the efficacy and safety of spironolactone in cats with heart failure secondary to cardiomyopathy already treated with furosemide and an angiotensin-converting enzyme inhibitor. ANIMALS Twenty cats with heart failure due to cardiomyopathy. METHODS The study was a double-blind, randomised, placebo-controlled, multicentre clinical study assessing the effect of spironolactone on survival and clinical parameters in cats with heart failure due to cardiomyopathy. The primary end point was mortality, defined as death (spontaneous or by euthanasia) due to cardiac causes. RESULTS Twenty cats were enrolled: 9 in the spironolactone group and 11 in the placebo group of which 56% (5/9) and 0% (0/11) completed the 15-month period respectively. At inclusion, differences in systemic blood pressure, body condition score, electrocardiographic abnormalities and LA/Ao ratio suggested that disease may be less severe in the spironolactone group. Twenty-two percent (2/9) of cats in the spironolactone group and 82% (9/11) in the control group reached the primary end point (Fisher's exact test, p = 0.0216). No safety issues were identified in either group. CONCLUSIONS This study suggests that spironolactone is well tolerated, and preliminary results support further investigation to evaluate the efficacy of spironolactone in the treatment of cats with cardiac failure due to cardiomyopathy.
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Affiliation(s)
- Rachel James
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Loughborough, Leicestershire, LE12 5RD, United Kingdom
| | - Emilie Guillot
- Ceva Santé Animale, 10 av. de la Ballastière, 33500 Libourne, France
| | | | - Jacqueline Huxley
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Loughborough, Leicestershire, LE12 5RD, United Kingdom
| | - Vanessa Grassi
- Ceva Santé Animale, 10 av. de la Ballastière, 33500 Libourne, France
| | - Malcolm Cobb
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, Loughborough, Leicestershire, LE12 5RD, United Kingdom.
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Kittana N. Angiotensin-converting enzyme 2-Angiotensin 1-7/1-9 system: novel promising targets for heart failure treatment. Fundam Clin Pharmacol 2017; 32:14-25. [DOI: 10.1111/fcp.12318] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 08/17/2017] [Indexed: 01/28/2023]
Affiliation(s)
- Naim Kittana
- Department of Biomedical Sciences; An-Najah National University; New Campus, Pharmacy Building, 2nd Floor, Akademia Street, PO Box: 7 Nablus West-Bank Palestine
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12
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Mayyas F, Alzoubi KH, Bonyan R. The role of spironolactone on myocardial oxidative stress in rat model of streptozotocin-induced diabetes. Cardiovasc Ther 2017; 35. [DOI: 10.1111/1755-5922.12242] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 12/04/2016] [Accepted: 12/09/2016] [Indexed: 11/30/2022] Open
Affiliation(s)
- Fadia Mayyas
- Department of Clinical Pharmacy; Faculty of Pharmacy; Jordan University of Science and Technology; Irbid Jordan
| | - Karem H. Alzoubi
- Department of Clinical Pharmacy; Faculty of Pharmacy; Jordan University of Science and Technology; Irbid Jordan
| | - Ruwidah Bonyan
- Department of Clinical Pharmacy; Faculty of Pharmacy; Jordan University of Science and Technology; Irbid Jordan
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13
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Jaisser F, Farman N. Emerging Roles of the Mineralocorticoid Receptor in Pathology: Toward New Paradigms in Clinical Pharmacology. Pharmacol Rev 2016; 68:49-75. [PMID: 26668301 DOI: 10.1124/pr.115.011106] [Citation(s) in RCA: 199] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The mineralocorticoid receptor (MR) and its ligand aldosterone are the principal modulators of hormone-regulated renal sodium reabsorption. In addition to the kidney, there are several other cells and organs expressing MR, in which its activation mediates pathologic changes, indicating potential therapeutic applications of pharmacological MR antagonism. Steroidal MR antagonists have been used for decades to fight hypertension and more recently heart failure. New therapeutic indications are now arising, and nonsteroidal MR antagonists are currently under development. This review is focused on nonclassic MR targets in cardiac, vascular, renal, metabolic, ocular, and cutaneous diseases. The MR, associated with other risk factors, is involved in organ fibrosis, inflammation, oxidative stress, and aging; for example, in the kidney and heart MR mediates hormonal tissue-specific ion channel regulation. Genetic and epigenetic modifications of MR expression/activity that have been documented in hypertension may also present significant risk factors in other diseases and be susceptible to MR antagonism. Excess mineralocorticoid signaling, mediated by aldosterone or glucocorticoids binding, now appears deleterious in the progression of pathologies that may lead to end-stage organ failure and could therefore benefit from the repositioning of pharmacological MR antagonists.
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Affiliation(s)
- F Jaisser
- INSERM UMR 1138 Team 1, Cordeliers Research Center, Pierre et Marie Curie University, Paris, France (F.J., N.F); and University Paris-Est Creteil, Creteil, France (F.J.)
| | - N Farman
- INSERM UMR 1138 Team 1, Cordeliers Research Center, Pierre et Marie Curie University, Paris, France (F.J., N.F); and University Paris-Est Creteil, Creteil, France (F.J.)
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14
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Zempo H, Suzuki JI, Ogawa M, Watanabe R, Fujiu K, Manabe I, Conway SJ, Taniyama Y, Morishita R, Hirata Y, Isobe M, Nagai R. Influence of periostin-positive cell-specific Klf5 deletion on aortic thickening in DOCA-salt hypertensive mice. Hypertens Res 2016; 39:764-768. [PMID: 27334059 DOI: 10.1038/hr.2016.65] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 04/30/2016] [Accepted: 05/05/2016] [Indexed: 12/30/2022]
Abstract
Chronic hypertension causes vascular remodeling that is associated with an increase in periostin- (postn) positive cells, including fibroblasts and smooth muscle cells. Krüppel-like factor (KLF) 5, a transcription factor, is also observed in vascular remodeling; however, it is unknown what role KLF5 plays in postn-positive cells during vascular remodeling induced by deoxycorticosterone-acetate (DOCA) salt. We used postn-positive cell-specific Klf5-deficient mice (Klf5PostnKO: Klf5flox/flox; PostnCre/-) and wild-type mice (WT: Klf5flox/flox; Postn-/-). We implanted a DOCA pellet and provided drinking water containing 0.9% NaCl for 8 weeks. The DOCA-salt treatment induced hypertension in both genotypes, as observed by increases in systolic blood pressure. In WT animals, DOCA-salt treatment increased the aortic medial area compared with the non-treated controls. Similarly, Tgfb1 was overexpressed in the aortas of the DOCA-salt treated WT mice compared with the controls. Immunofluorescence staining revealed that fibroblast-specific protein 1 (FSP1)+-α smooth muscle actin (αSMA)+ myofibroblasts exist in the medial area of the WT aortas after DOCA-salt intervention. Importantly, these changes were not observed in the Klf5PostnKO animals. In conclusion, the results of this study suggest that the presence of KLF5 in postn-positive cells contributes to the pathogenesis of aortic thickening induced by DOCA-salt hypertension.
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Affiliation(s)
- Hirofumi Zempo
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Jun-Ichi Suzuki
- Department of Advanced Clinical Science and Therapeutics, The University of Tokyo, Tokyo, Japan
| | - Masahito Ogawa
- Westmead Millennium Institute for Medical Research, Westmead, New South Wales, Australia
| | - Ryo Watanabe
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsuhito Fujiu
- Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan
| | - Ichiro Manabe
- Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan
| | - Simon J Conway
- Developmental Biology and Neonatal Medicine Program, Herman B Wells Center for Pediatric Research, Indiana University of Medicine, Indianapolis, IN, USA
| | | | | | - Yasunobu Hirata
- Department of Advanced Clinical Science and Therapeutics, The University of Tokyo, Tokyo, Japan
| | - Mitsuaki Isobe
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryozo Nagai
- Jichi Medical University, Shimotsuke City, Tochigi, Japan
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15
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Cannavo A, Liccardo D, Eguchi A, Elliott KJ, Traynham CJ, Ibetti J, Eguchi S, Leosco D, Ferrara N, Rengo G, Koch WJ. Myocardial pathology induced by aldosterone is dependent on non-canonical activities of G protein-coupled receptor kinases. Nat Commun 2016; 7:10877. [PMID: 26932512 PMCID: PMC4778065 DOI: 10.1038/ncomms10877] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 01/28/2016] [Indexed: 12/20/2022] Open
Abstract
Hyper-aldosteronism is associated with myocardial dysfunction including induction of cardiac fibrosis and maladaptive hypertrophy. Mechanisms of these cardiotoxicities are not fully understood. Here we show that mineralocorticoid receptor (MR) activation by aldosterone leads to pathological myocardial signalling mediated by mitochondrial G protein-coupled receptor kinase 2 (GRK2) pro-death activity and GRK5 pro-hypertrophic action. Moreover, these MR-dependent GRK2 and GRK5 non-canonical activities appear to involve cross-talk with the angiotensin II type-1 receptor (AT1R). Most importantly, we show that ventricular dysfunction caused by chronic hyper-aldosteronism in vivo is completely prevented in cardiac Grk2 knockout mice (KO) and to a lesser extent in Grk5 KO mice. However, aldosterone-induced cardiac hypertrophy is totally prevented in Grk5 KO mice. We also show human data consistent with MR activation status in heart failure influencing GRK2 levels. Therefore, our study uncovers GRKs as targets for ameliorating pathological cardiac effects associated with high-aldosterone levels.
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Affiliation(s)
- Alessandro Cannavo
- Department of Pharmacology and Center for Translational Medicine, Temple University School of Medicine, N. Broad Street, Philadelphia, Pennsylvania 19140, USA
| | - Daniela Liccardo
- Department of Pharmacology and Center for Translational Medicine, Temple University School of Medicine, N. Broad Street, Philadelphia, Pennsylvania 19140, USA
| | - Akito Eguchi
- Department of Pharmacology and Center for Translational Medicine, Temple University School of Medicine, N. Broad Street, Philadelphia, Pennsylvania 19140, USA
| | - Katherine J. Elliott
- Department of Physiology and Cardiovascular Research Center, Temple University School of Medicine, N. Broad Street, Philadelphia, Pennsylvania 19140, USA
| | - Christopher J. Traynham
- Department of Pharmacology and Center for Translational Medicine, Temple University School of Medicine, N. Broad Street, Philadelphia, Pennsylvania 19140, USA
| | - Jessica Ibetti
- Department of Pharmacology and Center for Translational Medicine, Temple University School of Medicine, N. Broad Street, Philadelphia, Pennsylvania 19140, USA
| | - Satoru Eguchi
- Department of Physiology and Cardiovascular Research Center, Temple University School of Medicine, N. Broad Street, Philadelphia, Pennsylvania 19140, USA
| | - Dario Leosco
- Department of Translational Medical Science, University of Naples Federico II, Via Pansini, 5, Naples 80131, Italy
| | - Nicola Ferrara
- Department of Translational Medical Science, University of Naples Federico II, Via Pansini, 5, Naples 80131, Italy
- Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme,Via bagni vecchi, 1, Telese Terme, Benevento 82037, Italy
| | - Giuseppe Rengo
- Department of Translational Medical Science, University of Naples Federico II, Via Pansini, 5, Naples 80131, Italy
- Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme,Via bagni vecchi, 1, Telese Terme, Benevento 82037, Italy
| | - Walter J. Koch
- Department of Pharmacology and Center for Translational Medicine, Temple University School of Medicine, N. Broad Street, Philadelphia, Pennsylvania 19140, USA
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16
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Grübler MR, Kienreich K, Gaksch M, Verheyen N, Hartaigh BÓ, Fahrleitner-Pammer A, März W, Schmid J, Oberreither EM, Wetzel J, Catena C, Sechi LA, Pieske B, Tomaschitz A, Pilz S. Aldosterone-to-Renin Ratio Is Associated With Reduced 24-Hour Heart Rate Variability and QTc Prolongation in Hypertensive Patients. Medicine (Baltimore) 2016; 95:e2794. [PMID: 26937909 PMCID: PMC4779006 DOI: 10.1097/md.0000000000002794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Aldosterone is considered to exert direct effects on the myocardium and the sympathetic nervous system. Both QT time and heart rate (HR) variability (HRV) are considered to be markers of arrhythmic risk and autonomous dysregulation. In this study, we investigated the associations between aldosterone, QT time, and HRV in patients with arterial hypertension.We recruited 477 hypertensive patients (age: 60.2 ± 10.2 years; 52.3% females) with a mean systolic/diastolic 24-hour ambulatory blood pressure monitoring (ABPM) value of 128 ± 12.8/77.1 ± 9.2 mmHg and with a median of 2 (IQR: 1-3) antihypertensive agents. Patients were recruited from the outpatient clinic at the Department of Internal Medicine of the Medical University of Graz, Austria. Blood samples, 24-hour HRV derived from 24-hour blood pressure monitoring (ABPM) and ECG's were obtained. Plasma aldosterone and plasma renin concentrations were measured by means of a radioimmunoassay. Twenty-four-hour urine specimens were collected in parallel with ABPM.Mean QTc was 423.3 ± 42.0 milliseconds for males and 434.7 ± 38.3 milliseconds for females. Mean 24H-HR and 24H-HRV was 71.9 ± 9.8 and 10.0 ± 3.6 bpm, respectively. In linear regression analyses adjusted for age, sex, body mass index, ABPM, and current medication, aldosterone to active renin ratio (AARR) was significantly associated with the QTc interval, a marker for cardiac repolarization abnormalities (mean = 426 ± 42.4 milliseconds; β-coefficient = 0.121; P = 0.03) as well as with the 24-hour heart rate variability a surrogate for autonomic dysfunction (median = 9.67 [IQR = 7.38-12.22 bpm]; β-coefficient = -0.133; P = 0.01).In hypertensive patients, AARR is significantly related to QTc prolongation as well as HRV. Further studies investigating the effects of mineralocorticoid receptor blocker and aldosterone synthase inhibitors on QTc and HRV are warranted.
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Affiliation(s)
- Martin R Grübler
- From the Division of Endocrinology and Metabolism, Department of Internal Medicine (MRG, KK, MG, AF-P, E-MO, SP), Department of Cardiology (NV, JS, JW, BP, AT), Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria (WM), Swiss Cardiovascular Center Bern, Department of Cardiology, Bern University Hospital, Bern, Switzerland (MRG), Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY (BOH), Synlab Academy, Synlab Services GmbH (WM), Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, and Rheumatology), Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany (WM), Clinical Medical Sciences, University of Udine, Udine, Italy (CC, LAS), Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (BP, AT), Specialist Clinic for Rehabilitation PV Bad Aussee, Bad Aussee, Austria (AT), Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (SP)
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17
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Bernardi S, Michelli A, Zuolo G, Candido R, Fabris B. Update on RAAS Modulation for the Treatment of Diabetic Cardiovascular Disease. J Diabetes Res 2016; 2016:8917578. [PMID: 27652272 PMCID: PMC5019930 DOI: 10.1155/2016/8917578] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 07/27/2016] [Indexed: 02/07/2023] Open
Abstract
Since the advent of insulin, the improvements in diabetes detection and the therapies to treat hyperglycemia have reduced the mortality of acute metabolic emergencies, such that today chronic complications are the major cause of morbidity and mortality among diabetic patients. More than half of the mortality that is seen in the diabetic population can be ascribed to cardiovascular disease (CVD), which includes not only myocardial infarction due to premature atherosclerosis but also diabetic cardiomyopathy. The importance of renin-angiotensin-aldosterone system (RAAS) antagonism in the prevention of diabetic CVD has demonstrated the key role that the RAAS plays in diabetic CVD onset and development. Today, ACE inhibitors and angiotensin II receptor blockers represent the first line therapy for primary and secondary CVD prevention in patients with diabetes. Recent research has uncovered new dimensions of the RAAS and, therefore, new potential therapeutic targets against diabetic CVD. Here we describe the timeline of paradigm shifts in RAAS understanding, how diabetes modifies the RAAS, and what new parts of the RAAS pathway could be targeted in order to achieve RAAS modulation against diabetic CVD.
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Affiliation(s)
- Stella Bernardi
- Department of Medical Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume, 34100 Trieste, Italy
- Division of Medicina Clinica, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Cattinara Teaching Hospital, Strada di Fiume, 34100 Trieste, Italy
- *Stella Bernardi:
| | - Andrea Michelli
- Department of Medical Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume, 34100 Trieste, Italy
| | - Giulia Zuolo
- Department of Medical Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume, 34100 Trieste, Italy
| | - Riccardo Candido
- Diabetes Centre, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Via Puccini, 34100 Trieste, Italy
| | - Bruno Fabris
- Department of Medical Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume, 34100 Trieste, Italy
- Division of Medicina Clinica, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Cattinara Teaching Hospital, Strada di Fiume, 34100 Trieste, Italy
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18
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Gromotowicz-Poplawska A, Stankiewicz A, Kramkowski K, Gradzka A, Wojewodzka-Zelezniakowicz M, Dzieciol J, Szemraj J, Chabielska E. The acute prothrombotic effect of aldosterone in rats is partially mediated via angiotensin II receptor type 1. Thromb Res 2015; 138:114-120. [PMID: 26709040 DOI: 10.1016/j.thromres.2015.12.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 11/26/2015] [Accepted: 12/12/2015] [Indexed: 11/15/2022]
Abstract
INTRODUCTION We showed previously that the prothrombotic effect of one hour aldosterone (ALDO) infusion in rats was only partially mediated by the mineralocorticoid receptor (MR). Bearing in mind that ALDO potentiates the effects of angiotensin II (Ang II), in the present study we investigated the role of Ang II receptor type 1 - AT1 in acute ALDO prothrombotic action. MATERIALS AND METHODS The experiments were performed in a stasis-induced venous thrombosis model in male Wistar, normotensive rats. ALDO (30μg/kg) was infused for 1h. Valsartan (VAL; 10mg/kg), a selective AT1 receptor antagonist, was administered in a single bolus injection before ALDO infusion. Eplerenone (EPL, 100mg/kg), a selective MR receptor antagonist, was administered per os before ALDO. Thrombus weight and incidences of thrombosis were assayed. Bleeding time and platelet adhesion to collagen were evaluated as primary hemostasis parameters. The plasma levels of some coagulation and fibrinolysis parameters, and plasma NO metabolite levels were assayed. RESULTS AT1 blockade with valsartan significantly reduced ALDO-induced thrombosis expressed as a reduced thrombus mass (p<0.05 vs ALDO) and diminished the incidence of thrombosis. Valsartan reduced the ALDO-induced changes in bleeding time and platelet adhesion, as well as in coagulation, fibrinolysis, and NO metabolite levels. The effect of AT1 blockade in ALDO-induced thrombosis was similar to the effect of MR blockade. However, dual blockade of AT1 and MR showed no additional benefit. CONCLUSIONS ALDO prothrombotic action is partially mediated via AT1 receptor in the mechanism involving enhanced platelet activation, induced coagulation, impaired fibrinolysis and reduced NO bioavailability.
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Affiliation(s)
| | - Adrian Stankiewicz
- Department of Biopharmacy, Medical University of Bialystok, Mickiewicza 2c, 15-089 Bialystok, Poland
| | - Karol Kramkowski
- Department of Biopharmacy, Medical University of Bialystok, Mickiewicza 2c, 15-089 Bialystok, Poland
| | - Anna Gradzka
- Department of Biopharmacy, Medical University of Bialystok, Mickiewicza 2c, 15-089 Bialystok, Poland
| | | | - Janusz Dzieciol
- Department of Human Anatomy, Medical University of Bialystok, Mickiewicza 2a, 15-230 Bialystok, Poland
| | - Janusz Szemraj
- Department of Medical Biochemistry, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland
| | - Ewa Chabielska
- Department of Biopharmacy, Medical University of Bialystok, Mickiewicza 2c, 15-089 Bialystok, Poland
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Pojoga LH, Yao TM, Opsasnick LA, Siddiqui WT, Reslan OM, Adler GK, Williams GH, Khalil RA. Cooperative Role of Mineralocorticoid Receptor and Caveolin-1 in Regulating the Vascular Response to Low Nitric Oxide-High Angiotensin II-Induced Cardiovascular Injury. J Pharmacol Exp Ther 2015; 355:32-47. [PMID: 26183312 DOI: 10.1124/jpet.115.226043] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 07/14/2015] [Indexed: 12/22/2022] Open
Abstract
Aldosterone interacts with mineralocorticoid receptor (MR) to stimulate sodium reabsorption in renal tubules and may also affect the vasculature. Caveolin-1 (cav-1), an anchoring protein in plasmalemmal caveolae, binds steroid receptors and also endothelial nitric oxide synthase, thus limiting its translocation and activation. To test for potential MR/cav-1 interaction in the vasculature, we investigated if MR blockade in cav-1-replete or -deficient states would alter vascular function in a mouse model of low nitric oxide (NO)-high angiotensin II (AngII)-induced cardiovascular injury. Wild-type (WT) and cav-1 knockout mice (cav-1(-/-)) consuming a high salt diet (4% NaCl) received Nω-nitro-l-arginine methyl ester (L-NAME) (0.1-0.2 mg/ml in drinking water at days 1-11) plus AngII (0.7-2.8 mg/kg per day via an osmotic minipump at days 8-11) ± MR antagonist eplerenone (EPL) 100 mg/kg per day in food. In both genotypes, blood pressure increased with L-NAME + AngII. EPL minimally changed blood pressure, although its dose was sufficient to block MR and reverse cardiac expression of the injury markers cluster of differentiation 68 and plasminogen activator inhibitor-1 in L-NAME+AngII treated mice. In aortic rings, phenylephrine and KCl contraction was enhanced with EPL in L-NAME+AngII treated WT mice, but not cav-1(-/-) mice. AngII-induced contraction was not different, and angiotensin type 1 receptor expression was reduced in L-NAME + AngII treated WT and cav-1(-/-) mice. In WT mice, acetylcholine-induced relaxation was enhanced with L-NAME + AngII treatment and reversed with EPL. Acetylcholine relaxation in cav-1(-/-) mice was greater than in WT mice, not modified by L-NAME + AngII or EPL, and blocked by ex vivo L-NAME, 1H-(1,2,4)oxadiazolo(4,3-a)quinoxalin-1-one (ODQ), or endothelium removal, suggesting the role of NO-cGMP. Cardiac endothelial NO synthase was increased in cav-1(-/-) versus WT mice, further increased with L-NAME + AngII, and not affected by EPL. Vascular relaxation to the NO donor sodium nitroprusside was increased with L-NAME + AngII in WT mice but not in cav-1(-/-) mice. Plasma aldosterone levels increased and cardiac MR expression decreased in L-NAME + AngII treated WT and cav-1(-/-) mice and did not change with EPL. Thus, during L-NAME + AngII induced hypertension, MR blockade increases contraction and alters vascular relaxation via NO-cGMP, and these changes are absent in cav-1 deficiency states. The data suggest a cooperative role of MR and cav-1 in regulating vascular contraction and NO-cGMP-mediated relaxation during low NO-high AngII-dependent cardiovascular injury.
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Affiliation(s)
- Luminita H Pojoga
- Cardiovascular Endocrinology Section, Endocrinology, Diabetes, and Hypertension Division (L.H.P., T.M.Y., G.K.A., G.H.W.), and Division of Vascular and Endovascular Surgery (L.A.O., W.T.S., O.M.R., R.A.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Tham M Yao
- Cardiovascular Endocrinology Section, Endocrinology, Diabetes, and Hypertension Division (L.H.P., T.M.Y., G.K.A., G.H.W.), and Division of Vascular and Endovascular Surgery (L.A.O., W.T.S., O.M.R., R.A.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Lauren A Opsasnick
- Cardiovascular Endocrinology Section, Endocrinology, Diabetes, and Hypertension Division (L.H.P., T.M.Y., G.K.A., G.H.W.), and Division of Vascular and Endovascular Surgery (L.A.O., W.T.S., O.M.R., R.A.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Waleed T Siddiqui
- Cardiovascular Endocrinology Section, Endocrinology, Diabetes, and Hypertension Division (L.H.P., T.M.Y., G.K.A., G.H.W.), and Division of Vascular and Endovascular Surgery (L.A.O., W.T.S., O.M.R., R.A.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ossama M Reslan
- Cardiovascular Endocrinology Section, Endocrinology, Diabetes, and Hypertension Division (L.H.P., T.M.Y., G.K.A., G.H.W.), and Division of Vascular and Endovascular Surgery (L.A.O., W.T.S., O.M.R., R.A.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Gail K Adler
- Cardiovascular Endocrinology Section, Endocrinology, Diabetes, and Hypertension Division (L.H.P., T.M.Y., G.K.A., G.H.W.), and Division of Vascular and Endovascular Surgery (L.A.O., W.T.S., O.M.R., R.A.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Gordon H Williams
- Cardiovascular Endocrinology Section, Endocrinology, Diabetes, and Hypertension Division (L.H.P., T.M.Y., G.K.A., G.H.W.), and Division of Vascular and Endovascular Surgery (L.A.O., W.T.S., O.M.R., R.A.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Raouf A Khalil
- Cardiovascular Endocrinology Section, Endocrinology, Diabetes, and Hypertension Division (L.H.P., T.M.Y., G.K.A., G.H.W.), and Division of Vascular and Endovascular Surgery (L.A.O., W.T.S., O.M.R., R.A.K.), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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20
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Pathophysiology and treatment of resistant hypertension: the role of aldosterone and amiloride-sensitive sodium channels. Semin Nephrol 2015; 34:532-9. [PMID: 25416662 DOI: 10.1016/j.semnephrol.2014.08.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Resistant hypertension is a clinically distinct subgroup of hypertension defined by the failure to achieve blood pressure control on optimal dosing of at least 3 antihypertensive medications of different classes, including a diuretic. The pathophysiology of hypertension can be attributed to aldosterone excess in more than 20% of patients with resistant hypertension. Existing dogma attributes the increase in blood pressure seen with increases in aldosterone to its antinatriuretic effects in the distal nephron. However, emerging research, which has identified and has begun to define the function of amiloride-sensitive sodium channels and mineralocorticoid receptors in the systemic vasculature, challenges impaired natriuresis as the sole cause of aldosterone-mediated resistant hypertension. This review integrates these findings to better define the role of the vasculature and aldosterone in the pathophysiology of resistant hypertension. In addition, a brief guide to the treatment of resistant hypertension is presented.
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de Almeida PWM, Melo MB, Lima RDF, Gavioli M, Santiago NM, Greco L, Jesus ICG, Nocchi E, Parreira A, Alves MNM, Mitraud L, Resende RR, Campagnole-Santos MJ, Dos Santos RAS, Guatimosim S. Beneficial effects of angiotensin-(1-7) against deoxycorticosterone acetate-induced diastolic dysfunction occur independently of changes in blood pressure. Hypertension 2015; 66:389-95. [PMID: 26077567 DOI: 10.1161/hypertensionaha.114.04893] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 04/13/2015] [Indexed: 01/26/2023]
Abstract
Mineralocorticoids have been implicated in the pathogenesis of diastolic heart failure. On the contrary, angiotensin (Ang)-(1-7) has emerged as a potential strategy for treatment of cardiac dysfunction induced by excessive mineralocorticoid receptor activation. A critical question about the cardioprotective effect of Ang-(1-7) in hypertensive models is its dependence on blood pressure (BP) reduction. Here, we addressed this question by investigating the mechanisms involved in Ang-(1-7) cardioprotection against mineralocorticoid receptor activation. Sprague-Dawley (SD) and transgenic (TG) rats that overexpress an Ang-(1-7) producing fusion protein (TG(A1-7)3292) were treated with deoxycorticosterone acetate (DOCA) for 6 weeks. After treatment, SD rats became hypertensive and developed ventricular hypertrophy. These parameters were attenuated in TG-DOCA. SD-DOCA rats developed diastolic dysfunction which was associated at the cellular level with reduced Ca(2+) transient. Oppositely, TG-DOCA myocytes presented enhanced Ca(2+) transient. Moreover, higher extracellular signal-regulated kinase phosphorylation, type 1 phosphatase, and protein kinase Cα levels were found in SD-DOCA cells. In vivo, pressor effects of DOCA can contribute to the diastolic dysfunction, raising the question of whether protection in TG was a consequence of reduced BP. To address this issue, BP in SD-DOCA was kept at TG-DOCA level by giving hydralazine or by reducing the DOCA amount given to rats (Low-DOCA). Under similar BP, diastolic dysfunction and molecular changes were still evident in DOCA-hydralazine and SD-low-DOCA, but not in TG-DOCA. In conclusion, Ang-(1-7) protective signaling against DOCA-induced diastolic dysfunction occurs independently of BP attenuation and is mediated by the activation of pathways involved in Ca(2+) handling, hypertrophy, and survival.
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Affiliation(s)
- Pedro W Machado de Almeida
- From the Department of Physiology and Biophysics, Institute of Biological Sciences (P.W.M.d.A., M.B.M., R.d.F.L., M.G., N.M.S., L.G., I.C.G.J., E.N., A.P., M.N.M.A., L.M., M.J.C.-S., R.A.S.d.S., S.G.), Department of Biochemistry and Immunology, Institute of Biological Sciences (R.R.R.), and National Institute of Science and Technology in Nanobiopharmaceutics (M.B.M., M.J.C.-S., R.A.S.d.S., S.G.), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marcos Barrouin Melo
- From the Department of Physiology and Biophysics, Institute of Biological Sciences (P.W.M.d.A., M.B.M., R.d.F.L., M.G., N.M.S., L.G., I.C.G.J., E.N., A.P., M.N.M.A., L.M., M.J.C.-S., R.A.S.d.S., S.G.), Department of Biochemistry and Immunology, Institute of Biological Sciences (R.R.R.), and National Institute of Science and Technology in Nanobiopharmaceutics (M.B.M., M.J.C.-S., R.A.S.d.S., S.G.), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo de Freitas Lima
- From the Department of Physiology and Biophysics, Institute of Biological Sciences (P.W.M.d.A., M.B.M., R.d.F.L., M.G., N.M.S., L.G., I.C.G.J., E.N., A.P., M.N.M.A., L.M., M.J.C.-S., R.A.S.d.S., S.G.), Department of Biochemistry and Immunology, Institute of Biological Sciences (R.R.R.), and National Institute of Science and Technology in Nanobiopharmaceutics (M.B.M., M.J.C.-S., R.A.S.d.S., S.G.), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariana Gavioli
- From the Department of Physiology and Biophysics, Institute of Biological Sciences (P.W.M.d.A., M.B.M., R.d.F.L., M.G., N.M.S., L.G., I.C.G.J., E.N., A.P., M.N.M.A., L.M., M.J.C.-S., R.A.S.d.S., S.G.), Department of Biochemistry and Immunology, Institute of Biological Sciences (R.R.R.), and National Institute of Science and Technology in Nanobiopharmaceutics (M.B.M., M.J.C.-S., R.A.S.d.S., S.G.), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Nivia M Santiago
- From the Department of Physiology and Biophysics, Institute of Biological Sciences (P.W.M.d.A., M.B.M., R.d.F.L., M.G., N.M.S., L.G., I.C.G.J., E.N., A.P., M.N.M.A., L.M., M.J.C.-S., R.A.S.d.S., S.G.), Department of Biochemistry and Immunology, Institute of Biological Sciences (R.R.R.), and National Institute of Science and Technology in Nanobiopharmaceutics (M.B.M., M.J.C.-S., R.A.S.d.S., S.G.), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leonardo Greco
- From the Department of Physiology and Biophysics, Institute of Biological Sciences (P.W.M.d.A., M.B.M., R.d.F.L., M.G., N.M.S., L.G., I.C.G.J., E.N., A.P., M.N.M.A., L.M., M.J.C.-S., R.A.S.d.S., S.G.), Department of Biochemistry and Immunology, Institute of Biological Sciences (R.R.R.), and National Institute of Science and Technology in Nanobiopharmaceutics (M.B.M., M.J.C.-S., R.A.S.d.S., S.G.), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Itamar C G Jesus
- From the Department of Physiology and Biophysics, Institute of Biological Sciences (P.W.M.d.A., M.B.M., R.d.F.L., M.G., N.M.S., L.G., I.C.G.J., E.N., A.P., M.N.M.A., L.M., M.J.C.-S., R.A.S.d.S., S.G.), Department of Biochemistry and Immunology, Institute of Biological Sciences (R.R.R.), and National Institute of Science and Technology in Nanobiopharmaceutics (M.B.M., M.J.C.-S., R.A.S.d.S., S.G.), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Eduardo Nocchi
- From the Department of Physiology and Biophysics, Institute of Biological Sciences (P.W.M.d.A., M.B.M., R.d.F.L., M.G., N.M.S., L.G., I.C.G.J., E.N., A.P., M.N.M.A., L.M., M.J.C.-S., R.A.S.d.S., S.G.), Department of Biochemistry and Immunology, Institute of Biological Sciences (R.R.R.), and National Institute of Science and Technology in Nanobiopharmaceutics (M.B.M., M.J.C.-S., R.A.S.d.S., S.G.), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Amanda Parreira
- From the Department of Physiology and Biophysics, Institute of Biological Sciences (P.W.M.d.A., M.B.M., R.d.F.L., M.G., N.M.S., L.G., I.C.G.J., E.N., A.P., M.N.M.A., L.M., M.J.C.-S., R.A.S.d.S., S.G.), Department of Biochemistry and Immunology, Institute of Biological Sciences (R.R.R.), and National Institute of Science and Technology in Nanobiopharmaceutics (M.B.M., M.J.C.-S., R.A.S.d.S., S.G.), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marcia N M Alves
- From the Department of Physiology and Biophysics, Institute of Biological Sciences (P.W.M.d.A., M.B.M., R.d.F.L., M.G., N.M.S., L.G., I.C.G.J., E.N., A.P., M.N.M.A., L.M., M.J.C.-S., R.A.S.d.S., S.G.), Department of Biochemistry and Immunology, Institute of Biological Sciences (R.R.R.), and National Institute of Science and Technology in Nanobiopharmaceutics (M.B.M., M.J.C.-S., R.A.S.d.S., S.G.), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luciana Mitraud
- From the Department of Physiology and Biophysics, Institute of Biological Sciences (P.W.M.d.A., M.B.M., R.d.F.L., M.G., N.M.S., L.G., I.C.G.J., E.N., A.P., M.N.M.A., L.M., M.J.C.-S., R.A.S.d.S., S.G.), Department of Biochemistry and Immunology, Institute of Biological Sciences (R.R.R.), and National Institute of Science and Technology in Nanobiopharmaceutics (M.B.M., M.J.C.-S., R.A.S.d.S., S.G.), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rodrigo Ribeiro Resende
- From the Department of Physiology and Biophysics, Institute of Biological Sciences (P.W.M.d.A., M.B.M., R.d.F.L., M.G., N.M.S., L.G., I.C.G.J., E.N., A.P., M.N.M.A., L.M., M.J.C.-S., R.A.S.d.S., S.G.), Department of Biochemistry and Immunology, Institute of Biological Sciences (R.R.R.), and National Institute of Science and Technology in Nanobiopharmaceutics (M.B.M., M.J.C.-S., R.A.S.d.S., S.G.), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria José Campagnole-Santos
- From the Department of Physiology and Biophysics, Institute of Biological Sciences (P.W.M.d.A., M.B.M., R.d.F.L., M.G., N.M.S., L.G., I.C.G.J., E.N., A.P., M.N.M.A., L.M., M.J.C.-S., R.A.S.d.S., S.G.), Department of Biochemistry and Immunology, Institute of Biological Sciences (R.R.R.), and National Institute of Science and Technology in Nanobiopharmaceutics (M.B.M., M.J.C.-S., R.A.S.d.S., S.G.), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Robson Augusto Souza Dos Santos
- From the Department of Physiology and Biophysics, Institute of Biological Sciences (P.W.M.d.A., M.B.M., R.d.F.L., M.G., N.M.S., L.G., I.C.G.J., E.N., A.P., M.N.M.A., L.M., M.J.C.-S., R.A.S.d.S., S.G.), Department of Biochemistry and Immunology, Institute of Biological Sciences (R.R.R.), and National Institute of Science and Technology in Nanobiopharmaceutics (M.B.M., M.J.C.-S., R.A.S.d.S., S.G.), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Silvia Guatimosim
- From the Department of Physiology and Biophysics, Institute of Biological Sciences (P.W.M.d.A., M.B.M., R.d.F.L., M.G., N.M.S., L.G., I.C.G.J., E.N., A.P., M.N.M.A., L.M., M.J.C.-S., R.A.S.d.S., S.G.), Department of Biochemistry and Immunology, Institute of Biological Sciences (R.R.R.), and National Institute of Science and Technology in Nanobiopharmaceutics (M.B.M., M.J.C.-S., R.A.S.d.S., S.G.), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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22
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Mihailidou AS, Ashton AW. Cardiac effects of aldosterone: does gender matter? Steroids 2014; 91:32-7. [PMID: 25173820 DOI: 10.1016/j.steroids.2014.08.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 07/15/2014] [Accepted: 08/04/2014] [Indexed: 12/28/2022]
Abstract
Ischemic heart disease (IHD) continues to be the most common cause of death globally, although mortality rates are decreasing with significant advances in treatment. Higher prevalence of co-morbidities in women only partly explains the lack of decrease in mortality rates in younger women due to. Until recently there has been gender bias in pre-clinical studies and many clinical trials, resulting in a significant gap in knowledge whether there are differential responses to therapy for women, particularly younger women. There is increasing evidence that there are significant gender-specific differences in the outcome of post-infarction remodelling, prevalence of hypertension and sudden cardiac death. These differences indicate that cardiac tissue in females displays significant physiological and biochemical differences compared to males. However, the mechanisms mediating these differences, and how they change with age, are poorly understood. Circulating levels and physiological effects of aldosterone vary across the menstrual cycle suggesting female steroid sex hormones may not only regulate production of, but also responses to, aldosterone in pre-menopausal women. This modified tissue response may foster a homeostatic environment where higher levels of aldosterone are tolerated without adverse cardiac effect. Moreover, there is limited data on the direct regulation of this signalling axis by androgens in female animals/subjects. This review explores the relationship between gender and the effects of aldosterone in cardiovascular disease (CVD), an issue of significant need that may lead to changes in best practice to optimise clinical care and improve outcomes for females with CVD.
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Affiliation(s)
- Anastasia S Mihailidou
- Kolling Institute of Medical Research, Royal North Shore Hospital, and The University of Sydney, Sydney, Australia; Department of Cardiology, Royal North Shore Hospital, Sydney, Australia.
| | - Anthony W Ashton
- Kolling Institute of Medical Research, Royal North Shore Hospital, and The University of Sydney, Sydney, Australia; Division of Perinatal Research, Royal North Shore Hospital, Sydney, Australia
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23
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Meinel S, Gekle M, Grossmann C. Mineralocorticoid receptor signaling: crosstalk with membrane receptors and other modulators. Steroids 2014; 91:3-10. [PMID: 24928729 DOI: 10.1016/j.steroids.2014.05.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 05/16/2014] [Accepted: 05/28/2014] [Indexed: 12/30/2022]
Abstract
The mineralocorticoid receptor (MR) belongs to the steroid receptor superfamily. Classically, it acts as a ligand-bound transcription factor in epithelial tissues, where it regulates water and electrolyte homeostasis and controls blood pressure. Additionally, the MR has been shown to elicit pathophysiological effects including inflammation, fibrosis and remodeling processes in the cardiovascular system and the kidneys and MR antagonists have proven beneficial for patients with certain cardiovascular and renal disease. The underlying molecular mechanisms that mediate MR effects have not been fully elucidated but very likely rely on interactions with other signaling pathways in addition to genomic actions at hormone response elements. In this review we will focus on interactions of MR signaling with different membrane receptors, namely receptor tyrosine kinases and the angiotensin II receptor because of their potential relevance for disease. In addition, GPR30 is discussed as a new aldosterone receptor. To gain insights into the problem why the MR only seems to mediate pathophysiological effects in the presence of additional permissive factors we will also briefly discuss factors that lead to modulation of MR activity as well. Overall, MR signaling is part of an intricate network that still needs to be investigated further.
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Affiliation(s)
- S Meinel
- Julius Bernstein Institute of Physiology, Martin Luther University Halle-Wittenberg, Germany
| | - M Gekle
- Julius Bernstein Institute of Physiology, Martin Luther University Halle-Wittenberg, Germany
| | - C Grossmann
- Julius Bernstein Institute of Physiology, Martin Luther University Halle-Wittenberg, Germany.
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24
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Lother A, Moser M, Bode C, Feldman RD, Hein L. Mineralocorticoids in the heart and vasculature: new insights for old hormones. Annu Rev Pharmacol Toxicol 2014; 55:289-312. [PMID: 25251996 DOI: 10.1146/annurev-pharmtox-010814-124302] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The mineralocorticoid aldosterone is a key regulator of water and electrolyte homeostasis. Numerous recent developments have advanced the field of mineralocorticoid pharmacology—namely, clinical trials have shown the beneficial effects of aldosterone antagonists in chronic heart failure and post-myocardial infarction treatment. Experimental studies using cell type-specific gene targeting of the mineralocorticoid receptor (MR) gene in mice have revealed the importance of extrarenal aldosterone signaling in cardiac myocytes, endothelial cells, vascular smooth cells, and macrophages. In addition, several molecular pathways involving signal transduction via the classical MR as well as the G protein-coupled receptor GPER mediate the diverse spectrum of effects of aldosterone on cells. This knowledge has initiated the development of new pharmacological ligands to specifically interfere with targets on different levels of aldosterone signaling. For example, aldosterone synthase inhibitors such as LCI699 and the novel nonsteroidal MR antagonist BAY 94-8862 have been tested in clinical trials. Interference with the interaction between MR and its coregulators seems to be a promising strategy toward the development of selective MR modulators.
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Affiliation(s)
- Achim Lother
- Heart Center, Department of Cardiology and Angiology I, University of Freiburg, 79106 Freiburg, Germany;
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25
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Nakagawa H, Oberwinkler H, Nikolaev VO, Gaßner B, Umbenhauer S, Wagner H, Saito Y, Baba HA, Frantz S, Kuhn M. Atrial Natriuretic Peptide Locally Counteracts the Deleterious Effects of Cardiomyocyte Mineralocorticoid Receptor Activation. Circ Heart Fail 2014; 7:814-21. [DOI: 10.1161/circheartfailure.113.000885] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background—
The endocrine balance between atrial natriuretic peptide (ANP) and the renin–angiotensin–aldosterone system is critical for the maintenance of arterial blood pressure and volume homeostasis. This study investigated whether a cardiac imbalance between ANP and aldosterone, toward increased mineralocorticoid receptor (MR) signaling, contributes to adverse left ventricular remodeling in response to pressure overload.
Methods and Results—
We used the MR-selective antagonist eplerenone to test the role of MRs in mediating pressure overload–induced dilatative cardiomyopathy of mice with abolished local, cardiac ANP activity. In response to 21 days of transverse aortic constriction, mice with cardiomyocyte-restricted inactivation (knockout) of the ANP receptor (guanylyl cyclase [GC]-A) or the downstream cGMP-dependent protein kinase I developed enhanced left ventricular hypertrophy and fibrosis together with contractile dysfunction. Treatment with eplerenone (100 mg/kg/d) attenuated left ventricular hypertrophy and fully prevented fibrosis, dilatation, and failure. Transverse aortic constriction induced the cardiac expression of profibrotic connective tissue growth factor and attenuated the expression of SERCA2a (sarcoplasmic reticulum Ca
2+
-ATPase) in knockout mice, but not in controls. These genotype-dependent molecular changes were similarly prevented by eplerenone. ANP attenuated the aldosterone-induced nuclear translocation of MRs via GC-A/cGMP-dependent protein kinase I in transfected HEK 293 (human embryonic kidney) cells. Coimmunoprecipitation and fluorescence resonance energy transfer experiments demonstrated that a population of MRs were membrane associated in close interaction with GC-A and cGMP-dependent protein kinase I and, moreover, that aldosterone caused a conformational change of this membrane MR/GC-A protein complex which was prevented by ANP.
Conclusions—
ANP counter-regulates cardiac MR activation in hypertensive heart disease. An imbalance in cardiac ANP/GC-A (inhibition) and aldosterone/MR signaling (augmentation) favors adverse cardiac remodeling in chronic pressure overload.
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Affiliation(s)
- Hitoshi Nakagawa
- From the Institute of Physiology (H.N., H.O., B.G., M.K.) and Comprehensive Heart Failure Center (H.N., S.F., M.K.), University Würzburg, Würzburg, Germany; Emmy Noether Group of the Deutsche Forschungsgemeinschaft, Department of Cardiology and Pneumology, University Göttingen, Göttingen, Germany (V.O.N.); Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (S.U., H.W, S.F.); First Department of Internal Medicine, Nara Medical University, Kashihara, Japan (Y.S.); and
| | - Heike Oberwinkler
- From the Institute of Physiology (H.N., H.O., B.G., M.K.) and Comprehensive Heart Failure Center (H.N., S.F., M.K.), University Würzburg, Würzburg, Germany; Emmy Noether Group of the Deutsche Forschungsgemeinschaft, Department of Cardiology and Pneumology, University Göttingen, Göttingen, Germany (V.O.N.); Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (S.U., H.W, S.F.); First Department of Internal Medicine, Nara Medical University, Kashihara, Japan (Y.S.); and
| | - Viacheslav O. Nikolaev
- From the Institute of Physiology (H.N., H.O., B.G., M.K.) and Comprehensive Heart Failure Center (H.N., S.F., M.K.), University Würzburg, Würzburg, Germany; Emmy Noether Group of the Deutsche Forschungsgemeinschaft, Department of Cardiology and Pneumology, University Göttingen, Göttingen, Germany (V.O.N.); Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (S.U., H.W, S.F.); First Department of Internal Medicine, Nara Medical University, Kashihara, Japan (Y.S.); and
| | - Birgit Gaßner
- From the Institute of Physiology (H.N., H.O., B.G., M.K.) and Comprehensive Heart Failure Center (H.N., S.F., M.K.), University Würzburg, Würzburg, Germany; Emmy Noether Group of the Deutsche Forschungsgemeinschaft, Department of Cardiology and Pneumology, University Göttingen, Göttingen, Germany (V.O.N.); Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (S.U., H.W, S.F.); First Department of Internal Medicine, Nara Medical University, Kashihara, Japan (Y.S.); and
| | - Sandra Umbenhauer
- From the Institute of Physiology (H.N., H.O., B.G., M.K.) and Comprehensive Heart Failure Center (H.N., S.F., M.K.), University Würzburg, Würzburg, Germany; Emmy Noether Group of the Deutsche Forschungsgemeinschaft, Department of Cardiology and Pneumology, University Göttingen, Göttingen, Germany (V.O.N.); Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (S.U., H.W, S.F.); First Department of Internal Medicine, Nara Medical University, Kashihara, Japan (Y.S.); and
| | - Helga Wagner
- From the Institute of Physiology (H.N., H.O., B.G., M.K.) and Comprehensive Heart Failure Center (H.N., S.F., M.K.), University Würzburg, Würzburg, Germany; Emmy Noether Group of the Deutsche Forschungsgemeinschaft, Department of Cardiology and Pneumology, University Göttingen, Göttingen, Germany (V.O.N.); Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (S.U., H.W, S.F.); First Department of Internal Medicine, Nara Medical University, Kashihara, Japan (Y.S.); and
| | - Yoshihiko Saito
- From the Institute of Physiology (H.N., H.O., B.G., M.K.) and Comprehensive Heart Failure Center (H.N., S.F., M.K.), University Würzburg, Würzburg, Germany; Emmy Noether Group of the Deutsche Forschungsgemeinschaft, Department of Cardiology and Pneumology, University Göttingen, Göttingen, Germany (V.O.N.); Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (S.U., H.W, S.F.); First Department of Internal Medicine, Nara Medical University, Kashihara, Japan (Y.S.); and
| | - Hideo A. Baba
- From the Institute of Physiology (H.N., H.O., B.G., M.K.) and Comprehensive Heart Failure Center (H.N., S.F., M.K.), University Würzburg, Würzburg, Germany; Emmy Noether Group of the Deutsche Forschungsgemeinschaft, Department of Cardiology and Pneumology, University Göttingen, Göttingen, Germany (V.O.N.); Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (S.U., H.W, S.F.); First Department of Internal Medicine, Nara Medical University, Kashihara, Japan (Y.S.); and
| | - Stefan Frantz
- From the Institute of Physiology (H.N., H.O., B.G., M.K.) and Comprehensive Heart Failure Center (H.N., S.F., M.K.), University Würzburg, Würzburg, Germany; Emmy Noether Group of the Deutsche Forschungsgemeinschaft, Department of Cardiology and Pneumology, University Göttingen, Göttingen, Germany (V.O.N.); Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (S.U., H.W, S.F.); First Department of Internal Medicine, Nara Medical University, Kashihara, Japan (Y.S.); and
| | - Michaela Kuhn
- From the Institute of Physiology (H.N., H.O., B.G., M.K.) and Comprehensive Heart Failure Center (H.N., S.F., M.K.), University Würzburg, Würzburg, Germany; Emmy Noether Group of the Deutsche Forschungsgemeinschaft, Department of Cardiology and Pneumology, University Göttingen, Göttingen, Germany (V.O.N.); Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany (S.U., H.W, S.F.); First Department of Internal Medicine, Nara Medical University, Kashihara, Japan (Y.S.); and
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26
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Ng KP, Jain P, Heer G, Redman V, Chagoury OL, Dowswell G, Greenfield S, Freemantle N, Townend JN, Gill PS, McManus RJ, Ferro CJ. Spironolactone to prevent cardiovascular events in early-stage chronic kidney disease (STOP-CKD): study protocol for a randomized controlled pilot trial. Trials 2014; 15:158. [PMID: 24886272 PMCID: PMC4113230 DOI: 10.1186/1745-6215-15-158] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 04/25/2014] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Chronic kidney disease is associated with increased arterial stiffness even in the early stages and this is thought to be a key mediator in the pathophysiology of the increased cardiovascular risk associated with this condition. The use of low-dose spironolactone has previously been shown to improve arterial stiffness and reduce left ventricular mass safely in early-stage chronic kidney disease in the context of careful monitoring at a university hospital. However, the majority of patients with chronic kidney disease are managed by their general practitioners in the community. It is not known whether similar beneficial effects can be achieved safely using spironolactone in the primary care setting. The aim of this study is to determine whether low-dose spironolactone can safely lower arterial stiffness in patients with stage 3 chronic kidney disease in the primary care setting. METHODS/DESIGN STOP-CKD is a multicentre, prospective, randomized, double-blind, placebo-controlled pilot trial of 240 adult patients with stage 3 chronic kidney disease recruited from up to 20 general practices in South Birmingham, England. Participants will be randomly allocated using a secured web-based computer randomization system to receive either spironolactone 25 mg once daily or a matching inactive placebo for 40 weeks, followed by a wash-out period of 6 weeks. Investigators, outcome assessors, data analysts and participants will all be blinded to the treatment allocation. The primary endpoint is improved arterial stiffness, as measured by carotid-femoral pulse wave velocity between baseline and 40 weeks. The secondary endpoints are incidence of hyperkalaemia, change in estimated glomerular filtration rate, change in urine albumin:creatinine ratio, change in brachial blood pressure, change in pulse waveform characteristics and overall tolerability of spironolactone. An additional quality control study, aiming to compare the laboratory serum potassium results of samples processed via two methods (utilizing routine transport or centrifugation on site before rapid transport to the laboratory) for 100 participants and a qualitative research study exploring patients' and general practitioners' attitudes to research and the use of spironolactone in chronic kidney disease in the community setting will be embedded in this pilot study. TRIAL REGISTRATION Current Controlled Trials ISRCTN80658312.
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Affiliation(s)
- Khai P Ng
- Department of Renal Medicine, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham B15 2WB, UK
| | - Poorva Jain
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Gurdip Heer
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Val Redman
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Odette L Chagoury
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - George Dowswell
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Sheila Greenfield
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Nick Freemantle
- Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK
| | - Jonathan N Townend
- Department of Cardiology, Queen Elizabeth Hospital Birmingham, Birmingham B15 2WB, UK
| | - Paramjit S Gill
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Richard J McManus
- Department of Primary Care Health Sciences, University of Oxford, 2nd Floor, 23-38 Hythe Bridge Street, Oxford OX1 2ET, UK
| | - Charles J Ferro
- Department of Renal Medicine, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham B15 2WB, UK
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Marques-Neto SR, Ferraz EB, Rodrigues DC, Njaine B, Rondinelli E, Campos de Carvalho AC, Nascimento JHM. AT1 and aldosterone receptors blockade prevents the chronic effect of nandrolone on the exercise-induced cardioprotection in perfused rat heart subjected to ischemia and reperfusion. Cardiovasc Drugs Ther 2014; 28:125-35. [PMID: 24258356 DOI: 10.1007/s10557-013-6503-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE Myocardial tolerance to ischaemia/reperfusion (I/R) injury is improved by exercise training, but this cardioprotection is impaired by the chronic use of anabolic androgenic steroids (AAS). The present study evaluated whether blockade of angiotensin II receptor (AT1-R) with losartan and aldosterone receptor (mineralocorticoid receptor, MR) with spironolactone could prevent the deleterious effect of AAS on the exercise-induced cardioprotection. METHODS AND RESULTS Male Wistar rats were exercised and treated with either vehicle, nandrolone decanoate (10 mg/kg/week i.m.) or the same dose of nandrolone plus losartan or spironolactone (20 mg/kg/day orally) for 8 weeks. Langendorff-perfused hearts were subjected to I/R and evaluated for the postischaemic recovery of left ventricle (LV) function and infarct size. mRNA and protein expression of angiotensin II type 1 receptor (AT1-R), mineralocorticoid receptor (MR), and KATP channels were determined by reverse-transcriptase polymerase chain reaction and Western blotting. Postischaemic recovery of LV function was better and infarct size was smaller in the exercised rat hearts than in the sedentary rat hearts. Nandrolone impaired the exercise-induced cardioprotection, but this effect was prevented by losartan (AT1-R antagonist) and spironolactone (MR antagonist) treatments. Myocardial AT1-R and MR expression levels were increased, and the expression of the KATP channel subunits SUR2a and Kir6.1 was decreased and Kir6.2 increased in the nandrolone-treated rat hearts. The nandrolone-induced changes of AT1-R, MR, and KATP subunits expression was normalized by the losartan and spironolactone treatments. CONCLUSION The chronic nandrolone treatment impairs the exercise-induced cardioprotection against ischaemia/reperfusion injury by activating the cardiac renin-angiotensin-aldosterone system and downregulating KATP channel expression.
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Affiliation(s)
- Silvio Rodrigues Marques-Neto
- Laboratório de Eletrofisiologia Cardíaca Antonio Paes de Carvalho, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho, 373, CCS, Bloco G, 21.941-902, Rio de Janeiro, Brazil
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Abstract
The mineralocorticoid receptor (MR) is a ligand-dependent transcription factor that physiologically regulates water-electrolyte homeostasis and controls blood pressure. The MR can also elicit inflammatory and remodeling processes in the cardiovascular system and the kidneys, which require the presence of additional pathological factors like for example nitrosative stress. However, the underlying molecular mechanism(s) for pathophysiological MR effects remain(s) elusive. The inactive MR is located in the cytosol associated with chaperone molecules including HSP90. After ligand binding, the MR monomer rapidly translocates into the nucleus while still being associated to HSP90 and after dissociation from HSP90 binds to hormone-response-elements called glucocorticoid response elements (GREs) as a dimer. There are indications that rapid MR trafficking is modulated in the presence of high salt, oxidative or nitrosative stress, hypothetically by induction or posttranslational modifications. Additionally, glucocorticoids and the enzyme 11beta hydroxysteroid dehydrogenase may also influence MR activation. Because MR trafficking and its modulation by micro-milieu factors influence MR cellular localization, it is not only relevant for genomic but also for nongenomic MR effects.
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Affiliation(s)
- M Gekle
- Julius Bernstein Institute of Physiology, Martin Luther University Halle-Wittenberg, Germany
| | - M Bretschneider
- Julius Bernstein Institute of Physiology, Martin Luther University Halle-Wittenberg, Germany
| | - S Meinel
- Julius Bernstein Institute of Physiology, Martin Luther University Halle-Wittenberg, Germany
| | - S Ruhs
- Julius Bernstein Institute of Physiology, Martin Luther University Halle-Wittenberg, Germany
| | - C Grossmann
- Julius Bernstein Institute of Physiology, Martin Luther University Halle-Wittenberg, Germany.
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Warnock DG, Kusche-Vihrog K, Tarjus A, Sheng S, Oberleithner H, Kleyman TR, Jaisser F. Blood pressure and amiloride-sensitive sodium channels in vascular and renal cells. Nat Rev Nephrol 2014; 10:146-57. [PMID: 24419567 DOI: 10.1038/nrneph.2013.275] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Sodium transport in the distal nephron is mediated by epithelial sodium channel activity. Proteolytic processing of external domains and inhibition with increased sodium concentrations are important regulatory features of epithelial sodium channel complexes expressed in the distal nephron. By contrast, sodium channels expressed in the vascular system are activated by increased external sodium concentrations, which results in changes in the mechanical properties and function of endothelial cells. Mechanosensitivity and shear stress affect both epithelial and vascular sodium channel activity. Guyton's hypothesis stated that blood pressure control is critically dependent on vascular tone and fluid handling by the kidney. The synergistic effects, and complementary regulation, of the epithelial and vascular systems are consistent with the Guytonian model of volume and blood pressure regulation, and probably reflect sequential evolution of the two systems. The integration of vascular tone, renal perfusion and regulation of renal sodium reabsorption is the central underpinning of the Guytonian model. In this Review, we focus on the expression and regulation of sodium channels, and we outline the emerging evidence that describes the central role of amiloride-sensitive sodium channels in the efferent (vascular) and afferent (epithelial) arms of this homeostatic system.
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Affiliation(s)
- David G Warnock
- Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL 34294-0007, USA
| | - Kristina Kusche-Vihrog
- Institut für Physiologie II, Westfälische Wilhelms Universität, Robert-Koch-Straße 27, 48149 Münster, Germany
| | - Antoine Tarjus
- INSERM U872 Team 1, Centre de Recherche des Cordeliers, Université René Descartes, Université Pierre et Marie Curie, 15 rue de l'Ecole de Médecine, 75006 Paris, France
| | - Shaohu Sheng
- Renal and Electrolyte Division, Department of Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA 15261, USA
| | - Hans Oberleithner
- Institut für Physiologie II, Westfälische Wilhelms Universität, Robert-Koch-Straße 27, 48149 Münster, Germany
| | - Thomas R Kleyman
- Renal and Electrolyte Division, Department of Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA 15261, USA
| | - Frederic Jaisser
- INSERM U872 Team 1, Centre de Recherche des Cordeliers, Université René Descartes, Université Pierre et Marie Curie, 15 rue de l'Ecole de Médecine, 75006 Paris, France
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Eplerenone enhances cardioprotective effects of standard heart failure therapy through matricellular proteins in hypertensive heart failure. J Hypertens 2013; 31:2309-18; discussion 2319. [DOI: 10.1097/hjh.0b013e328364abd6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Tsai CF, Yang SF, Chu HJ, Ueng KC. Cross-talk between mineralocorticoid receptor/angiotensin II type 1 receptor and mitogen-activated protein kinase pathways underlies aldosterone-induced atrial fibrotic responses in HL-1 cardiomyocytes. Int J Cardiol 2013; 169:17-28. [PMID: 24120080 DOI: 10.1016/j.ijcard.2013.06.046] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Revised: 05/08/2013] [Accepted: 06/28/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Aldosterone is increasingly recognized for its involvement in atrial structural remodeling. However, the precise molecular mechanisms and signal pathways underlying aldosterone-induced atrial fibrosis are unknown. METHODS Western blotting was used to investigate the effects of aldosterone on the expression of mineralocorticoid receptor (MR), angiotensin II type I receptor (AT1), mitogen-activated protein kinases (MAPKs), and fibrotic marker proteins in cultured HL-1 cardiomyocytes. RESULTS Aldosterone upregulated MR and AT1 expressions in a concentration-dependent and time-dependent manner. Aldosterone (10(-6)M) significantly and time-dependently increased activation of the extracellular signal-regulated protein kinase (ERK), c-Jun N-terminal kinase (JNK), p38MAPK pathways, and the protein expression of collagen 1A and 3A (COL1A and COL3A), transforming growth factor (TGF)-β1, and α-smooth muscle actin (SMA). Pre-treatment with eplerenone (10(-10)M) prevented the increased expression of MR, MAPK signals and the above profibrotic molecules, but amplified the increase in AT1 level stimulated by aldosterone (10(-6)M). Pre-treatment with losartan (10(-10)M) or MAPK pathway inhibitors (U0126 or SP600125) abolished aldosterone-induced MR upregulation and significantly inhibited the expression of the above fibrotic marker proteins, indicating the critical role of MR and the requirement for active AT1 in the development of aldosterone-induced atrial fibrosis. CONCLUSIONS Elevated MR activity plays a central role in aldosterone-mediated activation of the MAPK signaling pathway and subsequent profibrotic effects in HL-1 atrial cells. MR/AT1 and the MAPK signaling pathway interact to trigger the molecular mechanism underlying the aldosterone-induced atrial fibrotic response. Our results support the view that MR blockade in conjunction with AT1 blockade can prevent the occurrence of atrial fibrillation.
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Affiliation(s)
- Chin-Feng Tsai
- Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Escoubet B, Couffignal C, Laisy JP, Mangin L, Chillon S, Laouénan C, Serfaty JM, Jeunemaitre X, Mentré F, Zennaro MC. Cardiovascular Effects of Aldosterone. ACTA ACUST UNITED AC 2013; 6:381-90. [DOI: 10.1161/circgenetics.113.000115] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background—
High plasma aldosterone has deleterious cardiovascular effects that are independent of blood pressure, but the role of the mineralocorticoid receptor remains unclear. Renal pseudohypoaldosteronism type 1 is a rare autosomal-dominant disease caused by
NR3C2
loss-of-function mutations, which is characterized by renal salt loss and compensatory high renin and aldo secretion. We aimed to assess the cardiovascular outcomes in adults carrying NR3C2 mutations.
Methods and Results—
In this case-control study, 39
NR3C2
mutation carriers were compared with sex- and age-paired noncarriers. Patients underwent cardiac and vascular ultrasound, cardiac MRI with gadolinium injection, measurement of pulse wave velocity, extracellular water, 24-hour ambulatory blood pressure, and autonomous nervous system activity. Mutation carriers showed increased aldo and renin plasma levels (4.5- and 1.6-fold, respectively;
P
<0.0001), together with increased salt appetite (1.8-fold;
P
=0.002), with normal extracellular water and blood pressure, and no autonomous nervous system activation. Cardiac and vascular parameters were not significantly different between mutation carriers and noncarriers (no left ventricular remodeling or fibrosis, normal left ventricular systolic function, and aorta stiffness). Tissue Doppler showed better diastolic left ventricular function in mutation carriers (e′,
P
=0.001; E/e′,
P
=0.003). Mutation carriers had significantly more frequent history of slow body weight recovery at birth, symptomatic hypotension, and miscarriage in women.
Conclusions—
Despite life-long increase in plasma aldosterone and renin levels, no adverse cardiovascular outcome occurred in pseudohypoaldosteronism type 1, but rather an improved diastolic left ventricular function. This suggests that the cardiovascular consequences of aldosterone excess require full mineralocorticoid receptor signaling.
Clinical Trial Registration—
http://www.clinicaltrials.gov
; unique identifier: NCT00646828.
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Affiliation(s)
- Brigitte Escoubet
- From the Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Paris, France (B.E., C.C., J.-P.L., L.M., S.C., C.L., J.-M.S., F.M.); Université Paris Diderot, Sorbonne Paris Cité (B.E., C.C., J.-P.L., L.M., C.L., J.-M.S., F.M.); Inserm, UMR 872, Centre de Recherche des Cordeliers CRC (B.E.); Inserm UMR-S 738 (C.C., C.L., F.M.); Laboratoire Matière et Systèmes Complexes, UMR-7057 CNRS (L.M.); Inserm, UMR 970 Paris Cardiovascular Research Centre (X.J., M.-C.Z.); Assistance Publique
| | - Camille Couffignal
- From the Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Paris, France (B.E., C.C., J.-P.L., L.M., S.C., C.L., J.-M.S., F.M.); Université Paris Diderot, Sorbonne Paris Cité (B.E., C.C., J.-P.L., L.M., C.L., J.-M.S., F.M.); Inserm, UMR 872, Centre de Recherche des Cordeliers CRC (B.E.); Inserm UMR-S 738 (C.C., C.L., F.M.); Laboratoire Matière et Systèmes Complexes, UMR-7057 CNRS (L.M.); Inserm, UMR 970 Paris Cardiovascular Research Centre (X.J., M.-C.Z.); Assistance Publique
| | - Jean-Pierre Laisy
- From the Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Paris, France (B.E., C.C., J.-P.L., L.M., S.C., C.L., J.-M.S., F.M.); Université Paris Diderot, Sorbonne Paris Cité (B.E., C.C., J.-P.L., L.M., C.L., J.-M.S., F.M.); Inserm, UMR 872, Centre de Recherche des Cordeliers CRC (B.E.); Inserm UMR-S 738 (C.C., C.L., F.M.); Laboratoire Matière et Systèmes Complexes, UMR-7057 CNRS (L.M.); Inserm, UMR 970 Paris Cardiovascular Research Centre (X.J., M.-C.Z.); Assistance Publique
| | - Laurence Mangin
- From the Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Paris, France (B.E., C.C., J.-P.L., L.M., S.C., C.L., J.-M.S., F.M.); Université Paris Diderot, Sorbonne Paris Cité (B.E., C.C., J.-P.L., L.M., C.L., J.-M.S., F.M.); Inserm, UMR 872, Centre de Recherche des Cordeliers CRC (B.E.); Inserm UMR-S 738 (C.C., C.L., F.M.); Laboratoire Matière et Systèmes Complexes, UMR-7057 CNRS (L.M.); Inserm, UMR 970 Paris Cardiovascular Research Centre (X.J., M.-C.Z.); Assistance Publique
| | - Sylvie Chillon
- From the Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Paris, France (B.E., C.C., J.-P.L., L.M., S.C., C.L., J.-M.S., F.M.); Université Paris Diderot, Sorbonne Paris Cité (B.E., C.C., J.-P.L., L.M., C.L., J.-M.S., F.M.); Inserm, UMR 872, Centre de Recherche des Cordeliers CRC (B.E.); Inserm UMR-S 738 (C.C., C.L., F.M.); Laboratoire Matière et Systèmes Complexes, UMR-7057 CNRS (L.M.); Inserm, UMR 970 Paris Cardiovascular Research Centre (X.J., M.-C.Z.); Assistance Publique
| | - Cédric Laouénan
- From the Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Paris, France (B.E., C.C., J.-P.L., L.M., S.C., C.L., J.-M.S., F.M.); Université Paris Diderot, Sorbonne Paris Cité (B.E., C.C., J.-P.L., L.M., C.L., J.-M.S., F.M.); Inserm, UMR 872, Centre de Recherche des Cordeliers CRC (B.E.); Inserm UMR-S 738 (C.C., C.L., F.M.); Laboratoire Matière et Systèmes Complexes, UMR-7057 CNRS (L.M.); Inserm, UMR 970 Paris Cardiovascular Research Centre (X.J., M.-C.Z.); Assistance Publique
| | - Jean-Michel Serfaty
- From the Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Paris, France (B.E., C.C., J.-P.L., L.M., S.C., C.L., J.-M.S., F.M.); Université Paris Diderot, Sorbonne Paris Cité (B.E., C.C., J.-P.L., L.M., C.L., J.-M.S., F.M.); Inserm, UMR 872, Centre de Recherche des Cordeliers CRC (B.E.); Inserm UMR-S 738 (C.C., C.L., F.M.); Laboratoire Matière et Systèmes Complexes, UMR-7057 CNRS (L.M.); Inserm, UMR 970 Paris Cardiovascular Research Centre (X.J., M.-C.Z.); Assistance Publique
| | - Xavier Jeunemaitre
- From the Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Paris, France (B.E., C.C., J.-P.L., L.M., S.C., C.L., J.-M.S., F.M.); Université Paris Diderot, Sorbonne Paris Cité (B.E., C.C., J.-P.L., L.M., C.L., J.-M.S., F.M.); Inserm, UMR 872, Centre de Recherche des Cordeliers CRC (B.E.); Inserm UMR-S 738 (C.C., C.L., F.M.); Laboratoire Matière et Systèmes Complexes, UMR-7057 CNRS (L.M.); Inserm, UMR 970 Paris Cardiovascular Research Centre (X.J., M.-C.Z.); Assistance Publique
| | - France Mentré
- From the Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Paris, France (B.E., C.C., J.-P.L., L.M., S.C., C.L., J.-M.S., F.M.); Université Paris Diderot, Sorbonne Paris Cité (B.E., C.C., J.-P.L., L.M., C.L., J.-M.S., F.M.); Inserm, UMR 872, Centre de Recherche des Cordeliers CRC (B.E.); Inserm UMR-S 738 (C.C., C.L., F.M.); Laboratoire Matière et Systèmes Complexes, UMR-7057 CNRS (L.M.); Inserm, UMR 970 Paris Cardiovascular Research Centre (X.J., M.-C.Z.); Assistance Publique
| | - Maria-Christina Zennaro
- From the Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Paris, France (B.E., C.C., J.-P.L., L.M., S.C., C.L., J.-M.S., F.M.); Université Paris Diderot, Sorbonne Paris Cité (B.E., C.C., J.-P.L., L.M., C.L., J.-M.S., F.M.); Inserm, UMR 872, Centre de Recherche des Cordeliers CRC (B.E.); Inserm UMR-S 738 (C.C., C.L., F.M.); Laboratoire Matière et Systèmes Complexes, UMR-7057 CNRS (L.M.); Inserm, UMR 970 Paris Cardiovascular Research Centre (X.J., M.-C.Z.); Assistance Publique
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Zwadlo C, Bauersachs J. Mineralocorticoid receptor antagonists for therapy of coronary artery disease and related complications. Curr Opin Pharmacol 2013; 13:280-6. [DOI: 10.1016/j.coph.2012.12.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 12/09/2012] [Accepted: 12/28/2012] [Indexed: 01/05/2023]
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Messaoudi S, Gravez B, Tarjus A, Pelloux V, Ouvrard-Pascaud A, Delcayre C, Samuel J, Launay JM, Sierra-Ramos C, de la Rosa DA, Clément K, Farman N, Jaisser F. Aldosterone-Specific Activation of Cardiomyocyte Mineralocorticoid Receptor In Vivo. Hypertension 2013; 61:361-7. [DOI: 10.1161/hypertensionaha.112.198986] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Smail Messaoudi
- From Inserm U872, Team 1, Pierre and Marie Curie University, Paris, France (S.M., B.G., A.T., N.F., F.J.); Inserm U872, Team 7, Pierre and Marie Curie University, Paris, France (V.P., K.C.); UMR 644 Inserm-Université de Rouen, Rouen, France (A.O.-P.); Inserm U942, Paris, France (C.D., J.S., J.-M.L.); University of La Laguna, Tenerife, Spain (C.S.-R, D.A.d.l.R.)
| | - Basile Gravez
- From Inserm U872, Team 1, Pierre and Marie Curie University, Paris, France (S.M., B.G., A.T., N.F., F.J.); Inserm U872, Team 7, Pierre and Marie Curie University, Paris, France (V.P., K.C.); UMR 644 Inserm-Université de Rouen, Rouen, France (A.O.-P.); Inserm U942, Paris, France (C.D., J.S., J.-M.L.); University of La Laguna, Tenerife, Spain (C.S.-R, D.A.d.l.R.)
| | - Antoine Tarjus
- From Inserm U872, Team 1, Pierre and Marie Curie University, Paris, France (S.M., B.G., A.T., N.F., F.J.); Inserm U872, Team 7, Pierre and Marie Curie University, Paris, France (V.P., K.C.); UMR 644 Inserm-Université de Rouen, Rouen, France (A.O.-P.); Inserm U942, Paris, France (C.D., J.S., J.-M.L.); University of La Laguna, Tenerife, Spain (C.S.-R, D.A.d.l.R.)
| | - Véronique Pelloux
- From Inserm U872, Team 1, Pierre and Marie Curie University, Paris, France (S.M., B.G., A.T., N.F., F.J.); Inserm U872, Team 7, Pierre and Marie Curie University, Paris, France (V.P., K.C.); UMR 644 Inserm-Université de Rouen, Rouen, France (A.O.-P.); Inserm U942, Paris, France (C.D., J.S., J.-M.L.); University of La Laguna, Tenerife, Spain (C.S.-R, D.A.d.l.R.)
| | - Antoine Ouvrard-Pascaud
- From Inserm U872, Team 1, Pierre and Marie Curie University, Paris, France (S.M., B.G., A.T., N.F., F.J.); Inserm U872, Team 7, Pierre and Marie Curie University, Paris, France (V.P., K.C.); UMR 644 Inserm-Université de Rouen, Rouen, France (A.O.-P.); Inserm U942, Paris, France (C.D., J.S., J.-M.L.); University of La Laguna, Tenerife, Spain (C.S.-R, D.A.d.l.R.)
| | - Claude Delcayre
- From Inserm U872, Team 1, Pierre and Marie Curie University, Paris, France (S.M., B.G., A.T., N.F., F.J.); Inserm U872, Team 7, Pierre and Marie Curie University, Paris, France (V.P., K.C.); UMR 644 Inserm-Université de Rouen, Rouen, France (A.O.-P.); Inserm U942, Paris, France (C.D., J.S., J.-M.L.); University of La Laguna, Tenerife, Spain (C.S.-R, D.A.d.l.R.)
| | - Janelise Samuel
- From Inserm U872, Team 1, Pierre and Marie Curie University, Paris, France (S.M., B.G., A.T., N.F., F.J.); Inserm U872, Team 7, Pierre and Marie Curie University, Paris, France (V.P., K.C.); UMR 644 Inserm-Université de Rouen, Rouen, France (A.O.-P.); Inserm U942, Paris, France (C.D., J.S., J.-M.L.); University of La Laguna, Tenerife, Spain (C.S.-R, D.A.d.l.R.)
| | - Jean-Marie Launay
- From Inserm U872, Team 1, Pierre and Marie Curie University, Paris, France (S.M., B.G., A.T., N.F., F.J.); Inserm U872, Team 7, Pierre and Marie Curie University, Paris, France (V.P., K.C.); UMR 644 Inserm-Université de Rouen, Rouen, France (A.O.-P.); Inserm U942, Paris, France (C.D., J.S., J.-M.L.); University of La Laguna, Tenerife, Spain (C.S.-R, D.A.d.l.R.)
| | - Catalina Sierra-Ramos
- From Inserm U872, Team 1, Pierre and Marie Curie University, Paris, France (S.M., B.G., A.T., N.F., F.J.); Inserm U872, Team 7, Pierre and Marie Curie University, Paris, France (V.P., K.C.); UMR 644 Inserm-Université de Rouen, Rouen, France (A.O.-P.); Inserm U942, Paris, France (C.D., J.S., J.-M.L.); University of La Laguna, Tenerife, Spain (C.S.-R, D.A.d.l.R.)
| | - Diego Alvarez de la Rosa
- From Inserm U872, Team 1, Pierre and Marie Curie University, Paris, France (S.M., B.G., A.T., N.F., F.J.); Inserm U872, Team 7, Pierre and Marie Curie University, Paris, France (V.P., K.C.); UMR 644 Inserm-Université de Rouen, Rouen, France (A.O.-P.); Inserm U942, Paris, France (C.D., J.S., J.-M.L.); University of La Laguna, Tenerife, Spain (C.S.-R, D.A.d.l.R.)
| | - Karine Clément
- From Inserm U872, Team 1, Pierre and Marie Curie University, Paris, France (S.M., B.G., A.T., N.F., F.J.); Inserm U872, Team 7, Pierre and Marie Curie University, Paris, France (V.P., K.C.); UMR 644 Inserm-Université de Rouen, Rouen, France (A.O.-P.); Inserm U942, Paris, France (C.D., J.S., J.-M.L.); University of La Laguna, Tenerife, Spain (C.S.-R, D.A.d.l.R.)
| | - Nicolette Farman
- From Inserm U872, Team 1, Pierre and Marie Curie University, Paris, France (S.M., B.G., A.T., N.F., F.J.); Inserm U872, Team 7, Pierre and Marie Curie University, Paris, France (V.P., K.C.); UMR 644 Inserm-Université de Rouen, Rouen, France (A.O.-P.); Inserm U942, Paris, France (C.D., J.S., J.-M.L.); University of La Laguna, Tenerife, Spain (C.S.-R, D.A.d.l.R.)
| | - Fréderic Jaisser
- From Inserm U872, Team 1, Pierre and Marie Curie University, Paris, France (S.M., B.G., A.T., N.F., F.J.); Inserm U872, Team 7, Pierre and Marie Curie University, Paris, France (V.P., K.C.); UMR 644 Inserm-Université de Rouen, Rouen, France (A.O.-P.); Inserm U942, Paris, France (C.D., J.S., J.-M.L.); University of La Laguna, Tenerife, Spain (C.S.-R, D.A.d.l.R.)
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He BJ, Anderson ME. Aldosterone and cardiovascular disease: the heart of the matter. Trends Endocrinol Metab 2013; 24:21-30. [PMID: 23040074 PMCID: PMC3532553 DOI: 10.1016/j.tem.2012.09.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2012] [Revised: 09/01/2012] [Accepted: 09/06/2012] [Indexed: 02/07/2023]
Abstract
Aldosterone contributes to the endocrine basis of heart failure, and studies on cardiac aldosterone signaling have reinforced its value as a therapeutic target. Recent focus has shifted to new roles of aldosterone that appear to depend on coexisting pathologic stimuli, cell type, and disease etiology. This review evaluates recent advances in mechanisms underlying aldosterone-induced cardiac disease and highlights the interplay between aldosterone and Ca(2+)/calmodulin dependent protein kinase II, whose hyperactivity during heart failure contributes to disease progression. Increasing evidence implicates aldosterone in diastolic dysfunction, and there is a need to develop more targeted therapeutics such as aldosterone synthase inhibitors and molecularly specific antioxidants. Despite accumulating knowledge, many questions still persist and will likely dictate areas of future research.
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Affiliation(s)
- B Julie He
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
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Bernstein KE, Ong FS, Blackwell WLB, Shah KH, Giani JF, Gonzalez-Villalobos RA, Shen XZ, Fuchs S, Touyz RM. A modern understanding of the traditional and nontraditional biological functions of angiotensin-converting enzyme. Pharmacol Rev 2012; 65:1-46. [PMID: 23257181 DOI: 10.1124/pr.112.006809] [Citation(s) in RCA: 201] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Angiotensin-converting enzyme (ACE) is a zinc-dependent peptidase responsible for converting angiotensin I into the vasoconstrictor angiotensin II. However, ACE is a relatively nonspecific peptidase that is capable of cleaving a wide range of substrates. Because of this, ACE and its peptide substrates and products affect many physiologic processes, including blood pressure control, hematopoiesis, reproduction, renal development, renal function, and the immune response. The defining feature of ACE is that it is composed of two homologous and independently catalytic domains, the result of an ancient gene duplication, and ACE-like genes are widely distributed in nature. The two ACE catalytic domains contribute to the wide substrate diversity of ACE and, by extension, the physiologic impact of the enzyme. Several studies suggest that the two catalytic domains have different biologic functions. Recently, the X-ray crystal structure of ACE has elucidated some of the structural differences between the two ACE domains. This is important now that ACE domain-specific inhibitors have been synthesized and characterized. Once widely available, these reagents will undoubtedly be powerful tools for probing the physiologic actions of each ACE domain. In turn, this knowledge should allow clinicians to envision new therapies for diseases not currently treated with ACE inhibitors.
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Affiliation(s)
- Kenneth E Bernstein
- Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Davis 2021, Los Angeles, CA 90048, USA.
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Vardeny O, Wu DH, Desai A, Rossignol P, Zannad F, Pitt B, Solomon SD. Influence of Baseline and Worsening Renal Function on Efficacy of Spironolactone in Patients With Severe Heart Failure. J Am Coll Cardiol 2012; 60:2082-9. [DOI: 10.1016/j.jacc.2012.07.048] [Citation(s) in RCA: 179] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 06/30/2012] [Accepted: 07/24/2012] [Indexed: 01/09/2023]
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López Andrés N, Tesse A, Regnault V, Louis H, Cattan V, Thornton SN, Labat C, Kakou A, Tual-Chalot S, Faure S, Challande P, Osborne-Pellegrin M, Martínez MC, Lacolley P, Andriantsitohaina R. Increased microparticle production and impaired microvascular endothelial function in aldosterone-salt-treated rats: protective effects of polyphenols. PLoS One 2012; 7:e39235. [PMID: 22808030 PMCID: PMC3393732 DOI: 10.1371/journal.pone.0039235] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 05/17/2012] [Indexed: 12/19/2022] Open
Abstract
We aimed to characterize circulating microparticles in association with arterial stiffness, inflammation and endothelial dysfunction in aldosterone-salt-induced hypertension in rats and to investigate the preventive effects of red wine polyphenols. Uninephrectomized male Sprague-Dawley rats were treated with aldosterone-salt (1 µg.h−1), with or without administration of either red wine polyphenols, Provinols™ (20 mg.kg−1.day−1), or spironolactone (30 mg.kg−1.day−1) for 4 weeks. Microparticles, arterial stiffness, nitric oxide (NO) spin trapping, and mesenteric arterial function were measured. Aldosterone-salt rats showed increased microparticle levels, including those originating from platelets, endothelium and erythrocytes. Hypertension resulted in enhanced aortic stiffness accompanied by increased circulating and aortic NO levels and an upregulation of aortic inducible NO-synthase, NFκB, superoxide anions and nitrotyrosine. Flow-induced dilatation was reduced in mesenteric arteries. These effects were prevented by spironolactone. Provinols™ did not reduce arterial stiffness or systolic hypertension but had effects similar to those of spironolactone on endothelial function assessed by flow-mediated vasodilatation, microparticle generation, aortic NO levels and oxidative stress and apoptosis in the vessel wall. Neither the contractile response nor endothelium-dependent relaxation in mesenteric arteries differed between groups. The in vivo effects of Provinols™ were not mediated by mineralocorticoid receptors or changes in shear stress. In conclusion, vascular remodelling and endothelial dysfunction in aldosterone-salt-mediated hypertension are associated with increased circulating microparticles. Polyphenols prevent the enhanced release of microparticles, macrovascular inflammation and oxidative stress, and microvascular endothelial dysfunction independently of blood pressure, shear stress and mineralocorticoid receptor activation in a model of hyperaldosteronism.
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Affiliation(s)
- Natalia López Andrés
- Institut National de la Santé et de la Recherche Médicale, U961, Nancy Université, Nancy, France
| | - Angela Tesse
- L’Université Nantes Angers Le Mans, Institut National de la Santé et de la Recherche Médicale, U1063, Angers, France
| | - Véronique Regnault
- Institut National de la Santé et de la Recherche Médicale, U961, Nancy Université, Nancy, France
| | - Huguette Louis
- Institut National de la Santé et de la Recherche Médicale, U961, Nancy Université, Nancy, France
| | - Valérie Cattan
- Institut National de la Santé et de la Recherche Médicale, U961, Nancy Université, Nancy, France
| | - Simon N. Thornton
- Institut National de la Santé et de la Recherche Médicale, U961, Nancy Université, Nancy, France
| | - Carlos Labat
- Institut National de la Santé et de la Recherche Médicale, U961, Nancy Université, Nancy, France
| | - Agustine Kakou
- Institut National de la Santé et de la Recherche Médicale, U961, Nancy Université, Nancy, France
| | - Simon Tual-Chalot
- L’Université Nantes Angers Le Mans, Institut National de la Santé et de la Recherche Médicale, U1063, Angers, France
| | - Sébastien Faure
- L’Université Nantes Angers Le Mans, Institut National de la Santé et de la Recherche Médicale, U1063, Angers, France
| | - Pascale Challande
- Université Pierre et Marie Curie Paris 06, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7190, Paris, France
| | - Mary Osborne-Pellegrin
- Institut National de la Santé et de la Recherche Médicale, U698, Paris Diderot University, Paris, France
| | - M. Carmen Martínez
- L’Université Nantes Angers Le Mans, Institut National de la Santé et de la Recherche Médicale, U1063, Angers, France
| | - Patrick Lacolley
- Institut National de la Santé et de la Recherche Médicale, U961, Nancy Université, Nancy, France
| | - Ramaroson Andriantsitohaina
- L’Université Nantes Angers Le Mans, Institut National de la Santé et de la Recherche Médicale, U1063, Angers, France
- * E-mail:
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Azibani F, Fazal L, Chatziantoniou C, Samuel JL, Delcayre C. [Hypertension-induced fibrosis: a balance story]. Ann Cardiol Angeiol (Paris) 2012; 61:150-5. [PMID: 22681982 DOI: 10.1016/j.ancard.2012.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 05/04/2012] [Indexed: 11/20/2022]
Abstract
Cardiac remodeling is a deleterious consequence of arterial hypertension. This remodeling results in cardiac transcriptomic changes induced by mechanical and hormonal factors (angiotensin II and aldosterone are the most important). The major features of cardiac remodeling are the hypertrophy of cardiomyocytes, interstitial and perivascular fibrosis, and microvascular rarefaction. Inappropriate stimulation of the renin-angiotensin-aldosterone system (RAAS) participates to the development of heart failure. The respective roles of angiotensin II and aldosterone in cardiac remodeling are poorly understood. The development of fibrosis in the heart depends of a balance between profibrotic (TGFβ, CTGF, inflammation) and antifibrotic (BNP, ANP, BMP4 and BMP7) factors. The profibrotic and proinflammatory effects of angiotensin II and aldosterone are very well demonstrated; however, their actions on antifibrotic factors expression are unknown. In order to explore this, we used RenTgKC mice overexpressing renin into the liver, leading to an increased plasma angiotensin II and thus induction of severe hypertension, and AS mice overexpressing aldosterone synthase (AS) in cardiomyocytes which have a doubled intracardiac aldosterone concentration. Male AS mice have a dysfunction of the coronary arteries relaxation without structural and functional changes of the myocardium. Mice derived from a crossing between the RenTgKC and AS strains were used in this work. It is shown that angiotensin II induces the expression of BNP and BMPs which ultimately slows the progression of myocardial fibrosis, and that aldosterone inhibits the expression of these factors and thus worsens the fibrosis.
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Affiliation(s)
- F Azibani
- Inserm U942, université Paris-Diderot, hôpital Lariboisière, 41, boulevard de la Chapelle, 75475 Paris cedex 10, France.
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Azibani F, Benard L, Schlossarek S, Merval R, Tournoux F, Fazal L, Polidano E, Launay JM, Carrier L, Chatziantoniou C, Samuel JL, Delcayre C. Aldosterone inhibits antifibrotic factors in mouse hypertensive heart. Hypertension 2012; 59:1179-87. [PMID: 22547442 DOI: 10.1161/hypertensionaha.111.190512] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The renin-angiotensin-aldosterone system is involved in the arterial hypertension-associated cardiovascular remodeling. In this context, the development of cardiac fibrosis results from an imbalance between profibrotic and antifibrotic pathways, in which the role of aldosterone is yet not established. To determine the role of intracardiac aldosterone in the development of myocardial fibrosis during hypertension, we used a double transgenic model (AS-Ren) of cardiac hyperaldosteronism (AS) and systemic hypertension (Ren). The 9-month-old hypertensive mice had cardiac fibrosis, and hyperaldosteronism enhanced the fibrotic level. The mRNA levels of connective tissue growth factor and transforming growth factor-β1 were similarly increased in Ren and AS-Ren mice compared with wild-type and AS mice, respectively. Hyperaldosteronism combined with hypertension favored the macrophage infiltration (CD68(+) cells) in heart, and enhanced the mRNA level of monocyte chemoattractant protein 1, osteopontin, and galectin 3. Interestingly, in AS-Ren mice the hypertension-induced increase in bone morphogenetic protein 4 mRNA and protein levels was significantly inhibited, and B-type natriuretic peptide expression was blunted. The mineralocorticoid receptor antagonist eplerenone restored B-type natriuretic peptide and bone morphogenetic protein 4 levels and decreased CD68 and galectin 3 levels in AS-Ren mice. Finally, when hypertension was induced by angiotensin II infusion in wild-type and AS mice, the mRNA profiles did not differ from those observed in Ren and AS-Ren mice, respectively. The aldosterone-induced inhibition of B-type natriuretic peptide and bone morphogenetic protein 4 expression was confirmed in vitro in neonatal mouse cardiomyocytes. Altogether, we demonstrate that, at the cardiac level, hyperaldosteronism worsens hypertension-induced fibrosis through 2 mineralocorticoid receptor-dependent mechanisms, activation of inflammation/galectin 3-induced fibrosis and inhibition of antifibrotic factors (B-type natriuretic peptide and bone morphogenetic protein 4).
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Affiliation(s)
- Feriel Azibani
- Institut National de la Santé et de la Recherche Médicale U942 and Université Paris-Diderot, Paris, France
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Speranza L, Franceschelli S, Riccioni G. The biological effects of ivabradine in cardiovascular disease. Molecules 2012; 17:4924-35. [PMID: 22547315 PMCID: PMC6268753 DOI: 10.3390/molecules17054924] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 03/27/2012] [Accepted: 04/16/2012] [Indexed: 12/31/2022] Open
Abstract
A large number of studies in healthy and asymptomatic subjects, as well as patients with already established cardiovascular disease (CAD) have demonstrated that heart rate (HR) is a very important and major independent cardiovascular risk factor for prognosis. Lowering heart rate reduces cardiac work, thereby diminishing myocardial oxygen demand. Several experimental studies in animals, including dogs and pigs, have clarified the beneficial effects of ivabradine associated with HR lowering. Ivabradine is a selective inhibitor of the hyperpolarisation activated cyclic-nucleotide-gated funny current (If) involved in pacemaker generation and responsiveness of the sino-atrial node (SAN), which result in HR reduction with no other apparent direct cardiovascular effects. Several studies show that ivabradine substantially and significantly reduces major risks associated with heart failure when added to guideline-based and evidence-based treatment. However the biological effect of ivabradine have yet to be studied. This effects can appear directly on myocardium or on a systemic level improving endothelial function and modulating immune cell migration. Indeed ivabradine is an 'open-channel' blocker of human hyperpolarization-activated cyclic nucleotide gated channels of type-4 (hHCN4), and a 'closed-channel' blocker of mouse HCN1 channels in a dose-dependent manner. At endothelial level ivabradine decreased monocyte chemotactin protein-1 mRNA expression and exerted a potent anti-oxidative effect through reduction of vascular NADPH oxidase activity. Finally, on an immune level, ivabradine inhibits the chemokine-induced migration of CD4-positive lymphocytes. In this review, we discuss the biological effects of ivabradine and highlight its effects on CAD.
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Affiliation(s)
- Lorenza Speranza
- Department of Medicine and Science of Aging, University G. d'Annunzio, 66123 Chieti, Italy.
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Messaoudi S, Azibani F, Delcayre C, Jaisser F. Aldosterone, mineralocorticoid receptor, and heart failure. Mol Cell Endocrinol 2012; 350:266-72. [PMID: 21784127 DOI: 10.1016/j.mce.2011.06.038] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 06/23/2011] [Accepted: 06/28/2011] [Indexed: 12/25/2022]
Abstract
Several large clinical studies have demonstrated the important benefit of mineralocorticoid receptor (MR) antagonists in patients with heart failure, left ventricular dysfunction after myocardial infarction, hypertension or diabetic nephropathy. Aldosterone adjusts the hydro-mineral balance in the body, and thus participates decisively to the control of blood pressure. This traditional view of the action of aldosterone restricted to sodium reabsorption in epithelial tissues must be revisited. Clinical and experimental studies indicated that chronic activation of the MR in target tissues induces structural and functional changes in the heart, kidneys and blood vessels. These deleterious effects include cardiac and renal fibrosis, inflammation and vascular remodeling. It is important to underscore that these effects are due to elevated MR activation that is inadequate for the body salt requirements. Aldosterone is generally considered as the main ligand of MR. However, this is a matter of debate especially in heart. Complexity arises from the glucocorticoids with circulating concentrations much higher than those of aldosterone, and the fact that the MR has a high affinity for 11β-hydroxyglucocorticoids. Nevertheless, the beneficial effects of MR inhibition in patients with heart failure emphasize the importance of this receptor in cardiovascular tissue. Diverse experimental models and strains of transgenic mice have allowed to dissect the effects of aldosterone and the MR in the heart. Taken together experimental and clinical data clearly highlight the deleterious cardiovascular effects of MR stimulation.
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Affiliation(s)
- Smail Messaoudi
- INSERM U872, Cordeliers Research Center, 15 rue de l’Ecole de Médecine, Paris Cedex 06, France
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Messaoudi S, Zhang AD, Griol-Charhbili V, Escoubet B, Sadoshima J, Farman N, Jaisser F. The epidermal growth factor receptor is involved in angiotensin II but not aldosterone/salt-induced cardiac remodelling. PLoS One 2012; 7:e30156. [PMID: 22291909 PMCID: PMC3264592 DOI: 10.1371/journal.pone.0030156] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Accepted: 12/11/2011] [Indexed: 01/10/2023] Open
Abstract
Experimental and clinical studies have shown that aldosterone/mineralocorticoid receptor (MR) activation has deleterious effects in the cardiovascular system; however, the signalling pathways involved in the pathophysiological effects of aldosterone/MR in vivo are not fully understood. Several in vitro studies suggest that Epidermal Growth Factor Receptor (EGFR) plays a role in the cardiovascular effects of aldosterone. This hypothesis remains to be demonstrated in vivo. To investigate this question, we analyzed the molecular and functional consequences of aldosterone exposure in a transgenic mouse model with constitutive cardiomyocyte-specific overexpression of a mutant EGFR acting as a dominant negative protein (DN-EGFR). As previously reported, Angiotensin II-mediated cardiac remodelling was prevented in DN-EGFR mice. However, when chronic MR activation was induced by aldosterone-salt-uninephrectomy, cardiac hypertrophy was similar between control littermates and DN-EGFR. In the same way, mRNA expression of markers of cardiac remodelling such as ANF, BNF or β-Myosin Heavy Chain as well as Collagen 1a and 3a was similarly induced in DN-EGFR mice and their CT littermates. Our findings confirm the role of EGFR in AngII mediated cardiac hypertrophy, and highlight that EGFR is not involved in vivo in the damaging effects of aldosterone on cardiac function and remodelling.
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Affiliation(s)
- Smail Messaoudi
- INSERM, U872, Centre de Recherche des Cordeliers, Paris, France
- Pierre et Marie Curie University, Paris VI, Paris, France
| | - An Di Zhang
- INSERM, U872, Centre de Recherche des Cordeliers, Paris, France
- Pierre et Marie Curie University, Paris VI, Paris, France
| | - Violaine Griol-Charhbili
- INSERM, U872, Centre de Recherche des Cordeliers, Paris, France
- Pierre et Marie Curie University, Paris VI, Paris, France
| | - Brigitte Escoubet
- INSERM, U872, Centre de Recherche des Cordeliers, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Paris, France
- University Denis Diderot, Paris 7, Paris, France
| | - Junichi Sadoshima
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey, United States of America
| | - Nicolette Farman
- INSERM, U872, Centre de Recherche des Cordeliers, Paris, France
- Pierre et Marie Curie University, Paris VI, Paris, France
| | - Frederic Jaisser
- INSERM, U872, Centre de Recherche des Cordeliers, Paris, France
- Pierre et Marie Curie University, Paris VI, Paris, France
- * E-mail:
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PKCβ inhibition with ruboxistaurin reduces oxidative stress and attenuates left ventricular hypertrophy and dysfunction in rats with streptozotocin-induced diabetes. Clin Sci (Lond) 2011; 122:161-73. [PMID: 21892921 DOI: 10.1042/cs20110176] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Oxidative stress plays critical roles in the development of diabetic cardiovascular complications, including myocardial hypertrophy. The β isoform of PKC (protein kinase C) is preferentially overexpressed in the myocardium of diabetic subjects accompanied with increased activation of the pro-oxidant enzyme NADPH oxidase, which may exacerbate oxidative stress. We hypothesized that myocardial PKCβ is a major upstream mediator of oxidative stress in diabetes and that PKCβ inhibition can attenuate myocardial hypertrophy and dysfunction. Control or streptozotocin-induced diabetic rats were treated with the selective PKCβ inhibitor RBX (ruboxistaurin; 1 mg/kg of body weight per day) or the antioxidant NAC (N-acetylcysteine) for 4 weeks. LV (left ventricular) dimensions and functions were detected by echocardiography. 15-F2t-isoprostane (a specific index of oxidative stress) and myocardial activities of superoxide dismutase as well as protein levels of NADPH oxidase were assessed by immunoassay or Western blotting. Echocardiography revealed that the LV mass/body weight ratio was significantly increased in diabetic rats (P<0.01 compared with the control group) in parallel with the impaired LV relaxation. A significant increase in cardiomyocyte cross-sectional area was observed in diabetic rats accompanied by an increased production of O2- (superoxide anion) and 15-F2t-isoprostane (all P<0.05 compared with the control group). RBX normalized these changes with concomitant inhibition of PKCβ2 activation and prevention of NADPH oxidase subunit p67phox membrane translocation and p22phox overexpression. The effects of RBX were comparable with that of NAC, except that NAC was inferior to RBX in attenuating cardiac dysfunction. It is concluded that RBX can ameliorate myocardial hypertrophy and dysfunction in diabetes, which may represent a novel therapy in the prevention of diabetic cardiovascular complications.
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Carll AP, Willis MS, Lust RM, Costa DL, Farraj AK. Merits of non-invasive rat models of left ventricular heart failure. Cardiovasc Toxicol 2011; 11:91-112. [PMID: 21279739 DOI: 10.1007/s12012-011-9103-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Heart failure (HF) is characterized as a limitation to cardiac output that prevents the heart from supplying tissues with adequate oxygen and predisposes individuals to pulmonary edema. Impaired cardiac function is secondary to either decreased contractility reducing ejection (systolic failure), diminished ventricular compliance preventing filling (diastolic failure), or both. To study HF etiology, many different techniques have been developed to elicit this condition in experimental animals, with varying degrees of success. Among rats, surgically induced HF models are the most prevalent, but they bear several shortcomings, including high mortality rates and limited recapitulation of the pathophysiology, etiology, and progression of human HF. Alternatively, a number of non-invasive HF induction methods avoid many of these pitfalls, and their merits in technical simplicity, reliability, survivability, and comparability to the pathophysiologic and pathogenic characteristics of HF are reviewed herein. In particular, this review focuses on the primary pathogenic mechanisms common to genetic strains (spontaneously hypertensive and spontaneously hypertensive heart failure), pharmacological models of toxic cardiomyopathy (doxorubicin and isoproterenol), and dietary salt models, all of which have been shown to induce left ventricular HF in the rat. Additional non-invasive techniques that may potentially enable the development of new HF models are also discussed.
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Affiliation(s)
- Alex P Carll
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, 27599 USA.
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Bertocchio JP, Warnock DG, Jaisser F. Mineralocorticoid receptor activation and blockade: an emerging paradigm in chronic kidney disease. Kidney Int 2011; 79:1051-60. [DOI: 10.1038/ki.2011.48] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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