1
|
Zyubanova IV, Falkovckaya AY, Manukyan MA, Solonskaya EI, Vtorushina AA, Khunkhinova SA, Gusakova AM, Pekarskiy SE, Mordovin VF. Features of The Dynamics of Profibrotic Markers and Regression of Left Ventricular Hypertrophy After Renal Denervation in Patients With Resistant Hypertension and Stenosing Atherosclerosis of the Coronary Arteries. KARDIOLOGIIA 2024; 64:45-53. [PMID: 38742515 DOI: 10.18087/cardio.2024.4.n2411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/15/2023] [Accepted: 03/17/2023] [Indexed: 05/16/2024]
Abstract
AIM To compare the changes in serum concentrations of matrix metalloproteinases (MMPs) and their tissue inhibitor (TIMP) to the dynamics of blood pressure (BP) and parameters of left ventricular hypertrophy (LVH) 6 months after renal denervation (RD) in patients with resistant arterial hypertension (RAH) and complicated coronary atherosclerosis. MATERIAL AND METHODS In 22 RAH patients with complicated coronary atherosclerosis (revascularization and/or history of myocardial infarction (MI)), 24-hour BP monitoring, echocardiography, and measurement of blood MMPs and TIMP were performed at baseline and six months after RD. The comparison group consisted of 48 RAH patients without a history of coronary revascularization or MI. RESULTS In 6 months after RD, BP was decreased comparably in both groups. In the group of complicated atherosclerosis, there were no significant changes in profibrotic markers or LVH parameters. Thus, at baseline and after 6 months, the values of the studied indicators were the following: left ventricular myocardial mass (LVMM) 233.1±48.1 and 243.0±52.0 g, LVMM index 60.6±14.5 and 62.8±10 .9 g/m2.7, proMMP-1 4.9 [2.1; 7.7] and 3.6 [2.0; 9.4] ng/ml, MMP-2 290.4 [233.1; 352.5] and 352.2 [277.4; 402.9] ng/ml, MMP-9 220.6 [126.9; 476.7] and 263.5 [82.9; 726.2] ng/ml, TIMP-1 395.7 [124.7; 591.4] and 424.2 [118.2; 572.0] ng/ml, respectively. In the comparison group, on the contrary, there was a significant decrease in LVMM from 273.6±83.3 g to 254.1±70.4 g, LVMM index from 67.1±12.3 to 64.0±14.4 g/m2.7, proMMP-1 from 7.2 [3.6; 11.7] to 5.9 [3.5; 10.9] ng/ml, MMP-2 from 328.9 [257.1; 378.1] to 272.8 [230.2; 343.2] ng/ml, MMP-9 from 277.9 [137.0; 524.0] to 85.5 [34.2; 225.9] ng/ml, and the MMP-9/TIMP-1 ratio from 0.80 [0.31; 1.30] to 0.24 [0.07; 0.76]. The BP dynamics in this group was inversely correlated with MMP-2 at 6 months (r=-0.38), and the MMP-9/TIMP-1 ratio was correlated with LVMM and the LVMM index at baseline (r=0.39 and r=0.39) and at 6 months (r=0.37 and r=0.32). The change in TIMP-1 from 543.9 [277.5; 674.1] to 469.8 [289.7; 643.6] ng/ml was not significant (p=0.060). CONCLUSION In RAH patients with complicated coronary atherosclerosis, the dynamics of profibrotic biomarkers and LVH parameters after RD was absent despite the pronounced antihypertensive effect, probably due to the low reversibility of cardiovascular remodeling processes or more complex regulatory mechanisms of the MMP system.
Collapse
Affiliation(s)
- I V Zyubanova
- Research Institute of Cardiology, Tomsk National Research Medical Center
| | - A Yu Falkovckaya
- Research Institute of Cardiology, Tomsk National Research Medical Center
| | - M A Manukyan
- Research Institute of Cardiology, Tomsk National Research Medical Center
| | - E I Solonskaya
- Research Institute of Cardiology, Tomsk National Research Medical Center
| | - A A Vtorushina
- Research Institute of Cardiology, Tomsk National Research Medical Center
| | - S A Khunkhinova
- Research Institute of Cardiology, Tomsk National Research Medical Center
| | - A M Gusakova
- Research Institute of Cardiology, Tomsk National Research Medical Center
| | - S E Pekarskiy
- Research Institute of Cardiology, Tomsk National Research Medical Center
| | - V F Mordovin
- Research Institute of Cardiology, Tomsk National Research Medical Center
| |
Collapse
|
2
|
Wang Y, Anesi J, Maier MC, Myers MA, Oqueli E, Sobey CG, Drummond GR, Denton KM. Sympathetic Nervous System and Atherosclerosis. Int J Mol Sci 2023; 24:13132. [PMID: 37685939 PMCID: PMC10487841 DOI: 10.3390/ijms241713132] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Atherosclerosis is characterized by the narrowing of the arterial lumen due to subendothelial lipid accumulation, with hypercholesterolemia being a major risk factor. Despite the recent advances in effective lipid-lowering therapies, atherosclerosis remains the leading cause of mortality globally, highlighting the need for additional therapeutic strategies. Accumulating evidence suggests that the sympathetic nervous system plays an important role in atherosclerosis. In this article, we reviewed the sympathetic innervation in the vasculature, norepinephrine synthesis and metabolism, sympathetic activity measurement, and common signaling pathways of sympathetic activation. The focus of this paper was to review the effectiveness of pharmacological antagonists or agonists of adrenoceptors (α1, α2, β1, β2, and β3) and renal denervation on atherosclerosis. All five types of adrenoceptors are present in arterial blood vessels. α1 blockers inhibit atherosclerosis but increase the risk of heart failure while α2 agonism may protect against atherosclerosis and newer generations of β blockers and β3 agonists are promising therapies against atherosclerosis; however, new randomized controlled trials are warranted to investigate the effectiveness of these therapies in atherosclerosis inhibition and cardiovascular risk reduction in the future. The role of renal denervation in atherosclerosis inhibition in humans is yet to be established.
Collapse
Affiliation(s)
- Yutang Wang
- Discipline of Life Science, Institute of Innovation, Science and Sustainability, Federation University Australia, Ballarat, VIC 3350, Australia
| | - Jack Anesi
- Discipline of Life Science, Institute of Innovation, Science and Sustainability, Federation University Australia, Ballarat, VIC 3350, Australia
| | - Michelle C. Maier
- Discipline of Life Science, Institute of Innovation, Science and Sustainability, Federation University Australia, Ballarat, VIC 3350, Australia
| | - Mark A. Myers
- Discipline of Life Science, Institute of Innovation, Science and Sustainability, Federation University Australia, Ballarat, VIC 3350, Australia
| | - Ernesto Oqueli
- Cardiology Department, Grampians Health Ballarat, Ballarat, VIC 3350, Australia
- School of Medicine, Faculty of Health, Deakin University, Geelong, VIC 3216, Australia
| | - Christopher G. Sobey
- Centre for Cardiovascular Biology and Disease Research, Department of Microbiology, Anatomy, Physiology & Pharmacology, School of Agriculture, Biomedicine & Environment, La Trobe University, Melbourne, VIC 3086, Australia
| | - Grant R. Drummond
- Centre for Cardiovascular Biology and Disease Research, Department of Microbiology, Anatomy, Physiology & Pharmacology, School of Agriculture, Biomedicine & Environment, La Trobe University, Melbourne, VIC 3086, Australia
| | - Kate M. Denton
- Department of Physiology, Monash University, Melbourne, VIC 3800, Australia
- Cardiovascular Disease Program, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia
| |
Collapse
|
3
|
Wang J, Venugopal J, Silaghi P, Su EJ, Guo C, Lawrence DA, Eitzman DT. Beta1-receptor blockade attenuates atherosclerosis progression following traumatic brain injury in apolipoprotein E deficient mice. PLoS One 2023; 18:e0285499. [PMID: 37235594 DOI: 10.1371/journal.pone.0285499] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
Traumatic brain injury (TBI) is associated with cardiovascular mortality in humans. Enhanced sympathetic activity following TBI may contribute to accelerated atherosclerosis. The effect of beta1-adrenergic receptor blockade on atherosclerosis progression induced by TBI was studied in apolipoprotein E deficient mice. Mice were treated with metoprolol or vehicle following TBI or sham operation. Mice treated with metoprolol experienced a reduced heart rate with no difference in blood pressure. Six weeks following TBI, mice were sacrificed for analysis of atherosclerosis. Total surface area and lesion thickness, analyzed at the level of the aortic valve, was found to be increased in mice receiving TBI with vehicle treatment but this effect was ameliorated in TBI mice receiving metoprolol. No effect of metoprolol on atherosclerosis was observed in mice receiving only sham operation. In conclusion, accelerated atherosclerosis following TBI is reduced with beta-adrenergic receptor antagonism. Beta blockers may be useful to reduce vascular risk associated with TBI.
Collapse
Affiliation(s)
- Jintao Wang
- Department of Internal Medicine, Cardiovascular Research Center, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Jessica Venugopal
- Department of Internal Medicine, Cardiovascular Research Center, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Paul Silaghi
- Department of Internal Medicine, Cardiovascular Research Center, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Enming J Su
- Department of Internal Medicine, Cardiovascular Research Center, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Chiao Guo
- Department of Internal Medicine, Cardiovascular Research Center, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Daniel A Lawrence
- Department of Internal Medicine, Cardiovascular Research Center, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Daniel T Eitzman
- Department of Internal Medicine, Cardiovascular Research Center, University of Michigan, Ann Arbor, Michigan, United States of America
| |
Collapse
|
4
|
Wang Y, Nguyen DT, Anesi J, Alramahi A, Witting PK, Chai Z, Khan AW, Kelly J, Denton KM, Golledge J. Moxonidine Increases Uptake of Oxidised Low-Density Lipoprotein in Cultured Vascular Smooth Muscle Cells and Inhibits Atherosclerosis in Apolipoprotein E-Deficient Mice. Int J Mol Sci 2023; 24:ijms24043857. [PMID: 36835270 PMCID: PMC9960795 DOI: 10.3390/ijms24043857] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/07/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
This study aimed to investigate the effect of the sympatholytic drug moxonidine on atherosclerosis. The effects of moxonidine on oxidised low-density lipoprotein (LDL) uptake, inflammatory gene expression and cellular migration were investigated in vitro in cultured vascular smooth muscle cells (VSMCs). The effect of moxonidine on atherosclerosis was measured by examining aortic arch Sudan IV staining and quantifying the intima-to-media ratio of the left common carotid artery in apolipoprotein E-deficient (ApoE-/-) mice infused with angiotensin II. The levels of circulating lipid hydroperoxides in mouse plasma were measured by ferrous oxidation-xylenol orange assay. Moxonidine administration increased oxidised LDL uptake by VSMCs via activation of α2 adrenoceptors. Moxonidine increased the expression of LDL receptors and the lipid efflux transporter ABCG1. Moxonidine inhibited mRNA expression of inflammatory genes and increased VSMC migration. Moxonidine administration to ApoE-/- mice (18 mg/kg/day) decreased atherosclerosis formation in the aortic arch and left common carotid artery, associated with increased plasma lipid hydroperoxide levels. In conclusion, moxonidine inhibited atherosclerosis in ApoE-/- mice, which was accompanied by an increase in oxidised LDL uptake by VSMCs, VSMC migration, ABCG1 expression in VSMCs and lipid hydroperoxide levels in the plasma.
Collapse
Affiliation(s)
- Yutang Wang
- Discipline of Life Science, Institute of Innovation, Science and Sustainability, Federation University Australia, Ballarat, VIC 3350, Australia
- Correspondence:
| | - Dinh Tam Nguyen
- Discipline of Life Science, Institute of Innovation, Science and Sustainability, Federation University Australia, Ballarat, VIC 3350, Australia
| | - Jack Anesi
- Discipline of Life Science, Institute of Innovation, Science and Sustainability, Federation University Australia, Ballarat, VIC 3350, Australia
| | - Ahmed Alramahi
- Discipline of Life Science, Institute of Innovation, Science and Sustainability, Federation University Australia, Ballarat, VIC 3350, Australia
| | - Paul K. Witting
- Molecular Biomedicine Theme, School of Medical Sciences, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Zhonglin Chai
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC 3004, Australia
| | - Abdul Waheed Khan
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC 3004, Australia
| | - Jason Kelly
- Fiona Elsey Cancer Research Institute, Ballarat, VIC 3350, Australia
| | - Kate M. Denton
- Department of Physiology, Monash University, Melbourne, VIC 3800, Australia
- Cardiovascular Disease Program, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
- Department of Vascular and Endovascular Surgery, The Townsville University Hospital, Townsville, QLD 4814, Australia
| |
Collapse
|
5
|
Transcriptional responses of skeletal stem/progenitor cells to hindlimb unloading and recovery correlate with localized but not systemic multi-systems impacts. NPJ Microgravity 2021; 7:49. [PMID: 34836964 PMCID: PMC8626488 DOI: 10.1038/s41526-021-00178-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 10/27/2021] [Indexed: 12/12/2022] Open
Abstract
Disuse osteoporosis (DO) results from mechanical unloading of weight-bearing bones and causes structural changes that compromise skeletal integrity, leading to increased fracture risk. Although bone loss in DO results from imbalances in osteoblast vs. osteoclast activity, its effects on skeletal stem/progenitor cells (SSCs) is indeterminate. We modeled DO in mice by 8 and 14 weeks of hindlimb unloading (HU) or 8 weeks of unloading followed by 8 weeks of recovery (HUR) and monitored impacts on animal physiology and behavior, metabolism, marrow adipose tissue (MAT) volume, bone density and micro-architecture, and bone marrow (BM) leptin and tyrosine hydroxylase (TH) protein expression, and correlated multi-systems impacts of HU and HUR with the transcript profiles of Lin-LEPR+ SSCs and mesenchymal stem cells (MSCs) purified from BM. Using this integrative approach, we demonstrate that prolonged HU induces muscle atrophy, progressive bone loss, and MAT accumulation that paralleled increases in BM but not systemic leptin levels, which remained low in lipodystrophic HU mice. HU also induced SSC quiescence and downregulated bone anabolic and neurogenic pathways, which paralleled increases in BM TH expression, but had minimal impacts on MSCs, indicating a lack of HU memory in culture-expanded populations. Although most impacts of HU were reversed by HUR, trabecular micro-architecture remained compromised and time-resolved changes in the SSC transcriptome identified various signaling pathways implicated in bone formation that were unresponsive to HUR. These findings indicate that HU-induced alterations to the SSC transcriptome that persist after reloading may contribute to poor bone recovery.
Collapse
|
6
|
Li Z, Li Q, Wang L, Li C, Xu M, Duan Y, Ma L, Li T, Chen Q, Wang Y, Wang Y, Feng J, Yin X, Wang X, Han J, Lu C. Targeting mitochondria-inflammation circle by renal denervation reduces atheroprone endothelial phenotypes and atherosclerosis. Redox Biol 2021; 47:102156. [PMID: 34607159 PMCID: PMC8498003 DOI: 10.1016/j.redox.2021.102156] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/20/2021] [Accepted: 09/28/2021] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE The disruption of mitochondrial redox homeostasis in endothelial cells (ECs) can cause chronic inflammation, a substantial contributor to the development of atherosclerosis. Chronic sympathetic hyperactivity can enhance oxidative stress to induce endothelial dysfunction. We determined if renal denervation (RDN), the strategy reducing sympathetic tone, can protect ECs by ameliorating mitochondrial reactive oxygen species (ROS)-induced inflammation to reduce atherosclerosis. METHODS AND RESULTS ApoE deficient (ApoE-/-) mice were conducted RDN or sham operation before 20-week high-fat diet feeding. Atherosclerosis, EC phenotype and mitochondrial morphology were determined. In vitro, human arterial ECs were treated with norepinephrine to determine the mechanisms for RDN-inhibited endothelial inflammation. RDN reduced atherosclerosis, EC mitochondrial oxidative stress and inflammation. Mechanistically, the chronic sympathetic hyperactivity increased circulating norepinephrine and mitochondrial monoamine oxidase A (MAO-A) activity. MAO-A activation-impaired mitochondrial homeostasis resulted in ROS accumulation and NF-κB activation, thereby enhancing expression of atherogenic and proinflammatory molecules in ECs. It also suppressed mitochondrial function regulator PGC-1α, with involvement of NF-κB and oxidative stress. Inactivation of MAO-A by RDN disrupted the positive-feedback regulation between mitochondrial dysfunction and inflammation, thereby inhibiting EC atheroprone phenotypic alterations and atherosclerosis. CONCLUSIONS The interplay between MAO-A-induced mitochondrial oxidative stress and inflammation in ECs is a key driver in atherogenesis, and it can be reduced by RDN.
Collapse
Affiliation(s)
- Zhuqing Li
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Qi Li
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Li Wang
- Department of Cardiology, Tianjin First Center Hospital, Tianjin, 300192, China
| | - Chao Li
- Department of Cardiology, Tianjin First Center Hospital, Tianjin, 300192, China
| | - Mengping Xu
- Department of Cardiology, Tianjin First Center Hospital, Tianjin, 300192, China
| | - Yajun Duan
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, Hefei University of Technology, Hefei, 230009, China; Department of Cardiology, The First Affiliated Hospital of the University of Science and Technology of China, Hefei, 230036, China
| | - Likun Ma
- Department of Cardiology, The First Affiliated Hospital of the University of Science and Technology of China, Hefei, 230036, China
| | - Tingting Li
- Department of Cardiology, The First Center Clinical College of Tianjin Medical University, Tianjin, 300070, China
| | - Qiao Chen
- Department of Cardiology, The First Center Clinical College of Tianjin Medical University, Tianjin, 300070, China
| | - Yilin Wang
- Department of Cardiology, The First Center Clinical College of Tianjin Medical University, Tianjin, 300070, China
| | - Yanxin Wang
- Department of Cardiology, The First Center Clinical College of Tianjin Medical University, Tianjin, 300070, China
| | - Jiaxin Feng
- Department of Cardiology, The First Center Clinical College of Tianjin Medical University, Tianjin, 300070, China
| | - Xuemei Yin
- Department of Cardiology, The First Center Clinical College of Tianjin Medical University, Tianjin, 300070, China
| | - Xiaolin Wang
- College of Life Sciences, State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Bioactive Materials of Ministry of Education, Nankai University, Tianjin, 300071, China
| | - Jihong Han
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, Hefei University of Technology, Hefei, 230009, China; College of Life Sciences, State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Bioactive Materials of Ministry of Education, Nankai University, Tianjin, 300071, China.
| | - Chengzhi Lu
- School of Medicine, Nankai University, Tianjin, 300071, China; Department of Cardiology, Tianjin First Center Hospital, Tianjin, 300192, China.
| |
Collapse
|
7
|
Chen H, Wang R, Xu F, Zang T, Ji M, Yin J, Chen J, Shen L, Ge J. Renal denervation mitigates atherosclerosis in ApoE-/- mice via the suppression of inflammation. Am J Transl Res 2020; 12:5362-5380. [PMID: 33042425 PMCID: PMC7540133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/07/2020] [Indexed: 06/11/2023]
Abstract
Atherosclerosis is a chronic pathological process characterized by the accumulation of inflammation. Overactivation of the sympathetic nervous system accelerates the progression of atherosclerosis. Renal denervation (RDN) reduces the activity of the sympathetic nerve system (SNS) by disrupting sympathetic nerves surrounding renal arteries. We sought to determine whether RDN could mitigate atherosclerosis through the suppression of inflammation. First, we investigated the correlation between plasma norepinephrine concentrations and circulatory inflammation in the progression of atherosclerosis. Then, forty ApoE-/- mice underwent renal denervation or a sham operation after 6 weeks or 12 weeks of feeding with a high-fat diet. The effects of RDN on atherosclerosis in mice were explored. In the development of atherosclerosis, positive correlations were found between SNS activation and the accumulation of circulatory myeloid cells and inflammatory cytokines. In the second part of the study, inhibition of the increase in plaque size was found in both RDN groups compared with that in the sham operation (SO) groups (P<0.05), and RDN also ameliorated inflammation in plaques. Furthermore, RDN attenuated the accumulation of circulating neutrophils and monocytes (P<0.05), which is associated with a significant reduction in levels of several circulating inflammatory cytokines related to hemopoiesis (P<0.05). Flow cytometry analysis revealed comparable levels of neutrophils and monocytes in the bone marrow between all four groups. However, RDN decreased the production and proportions of neutrophils and monocytes in the spleen and reduced splenic sympathetic activity (P<0.05). In summary, our study reveals a novel link between SNS activity and inflammation in atherosclerosis and identifies RDN as a potential anti-inflammatory therapeutic strategy for the treatment of atherosclerosis by restricting the production of splenic immune cells.
Collapse
Affiliation(s)
- Han Chen
- Department of Cardiology, Zhongshan Hospital, Fudan UniversityShanghai, China
- Shanghai Institute of Cardiovascular DiseasesShanghai, China
| | - Rui Wang
- Department of Cardiology, Zhongshan Hospital, Fudan UniversityShanghai, China
- Shanghai Institute of Cardiovascular DiseasesShanghai, China
| | - Fei Xu
- Department of Cardiology, Zhongshan Hospital, Fudan UniversityShanghai, China
- Shanghai Institute of Cardiovascular DiseasesShanghai, China
| | - Tongtong Zang
- Department of Cardiology, Zhongshan Hospital, Fudan UniversityShanghai, China
- Shanghai Institute of Cardiovascular DiseasesShanghai, China
| | - Meng Ji
- Department of Cardiology, Zhongshan Hospital, Fudan UniversityShanghai, China
- Shanghai Institute of Cardiovascular DiseasesShanghai, China
| | - Jiasheng Yin
- Department of Cardiology, Zhongshan Hospital, Fudan UniversityShanghai, China
- Shanghai Institute of Cardiovascular DiseasesShanghai, China
| | - Jiahui Chen
- Department of Cardiology, Zhongshan Hospital, Fudan UniversityShanghai, China
- Shanghai Institute of Cardiovascular DiseasesShanghai, China
| | - Li Shen
- Department of Cardiology, Zhongshan Hospital, Fudan UniversityShanghai, China
- Shanghai Institute of Cardiovascular DiseasesShanghai, China
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan UniversityShanghai, China
- Shanghai Institute of Cardiovascular DiseasesShanghai, China
| |
Collapse
|
8
|
Huo J, Jiang W, Geng J, Chen C, Zhu L, Chen R, Ge T, Chang Q, Jiang Z, Shan Q. Renal denervation attenuates pressure overload-induced cardiac remodelling in rats with biphasic regulation of autophagy. Acta Physiol (Oxf) 2019; 226:e13272. [PMID: 30830723 DOI: 10.1111/apha.13272] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 02/21/2019] [Accepted: 03/01/2019] [Indexed: 12/19/2022]
Abstract
AIM This study aimed to investigate effects of renal denervation (RDN) on pressure overload-induced cardiac remodelling in rats and the related mechanisms. METHODS Adult male Sprague-Dawley rats underwent transverse aortic constriction (TAC) to generate cardiac remodelling. RDN was performed 1 week after TAC. The animals were divided into four groups: control group, TAC group, TAC+RDN group and control+RDN group. Rats in all groups were studied at 3 and 10 weeks after TAC respectively. Echocardiography and histology were used to evaluate cardiac function and pathological changes. TUNEL staining and western blotting were used to assess apoptosis. Western blotting and transmission electron microscopy (TEM) were used to evaluate autophagy. RESULTS Three weeks after TAC, the TAC rats exhibited cardiac hypertrophy with normal cardiac function and no myocardial interstitial fibrosis or apoptosis, accompanied by a lower LC3 II level and fewer autophagic vacuoles in the left ventricles, both in the presence and absence of chloroquine (CQ), indicating suppressed autophagy at this stage. RDN ameliorated these pathological changes and attenuated the decrease in autophagy. Ten weeks after TAC, the TAC rats had decreased cardiac function, obvious cardiac interstitial fibrosis and apoptosis, with increased autophagy. RDN prevented these pathological changes, coincident with attenuation of increased autophagy. CONCLUSION Autophagy was suppressed at the early stage but activated at the late stage of TAC-induced cardiac remodelling. RDN attenuated the pathological changes of TAC rats, accompanied by attenuation of the changes in autophagy. Thus, RDN ameliorated TAC-induced cardiac remodelling partially associated with biphasic modulation of autophagy.
Collapse
Affiliation(s)
- Jun‐Yu Huo
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Wan‐Ying Jiang
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Jie Geng
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Chu Chen
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Lin Zhu
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Ran Chen
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Tian‐Tian Ge
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Qing Chang
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Zhi‐Xin Jiang
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Qi‐Jun Shan
- Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| |
Collapse
|
9
|
Moss ME, DuPont JJ, Iyer SL, McGraw AP, Jaffe IZ. No Significant Role for Smooth Muscle Cell Mineralocorticoid Receptors in Atherosclerosis in the Apolipoprotein-E Knockout Mouse Model. Front Cardiovasc Med 2018; 5:81. [PMID: 30038907 PMCID: PMC6046374 DOI: 10.3389/fcvm.2018.00081] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 06/11/2018] [Indexed: 12/12/2022] Open
Abstract
Objective: Elevated levels of the hormone aldosterone are associated with increased risk of myocardial infarction and stroke in humans and increased progression and inflammation of atherosclerotic plaques in animal models. Aldosterone acts through the mineralocorticoid receptor (MR) which is expressed in vascular smooth muscle cells (SMCs) where it promotes SMC calcification and chemokine secretion in vitro. The objective of this study is to explore the role of the MR specifically in SMCs in the progression of atherosclerosis and the associated vascular inflammation in vivo in the apolipoprotein E knockout (ApoE−/−) mouse model. Methods and Results: Male ApoE−/− mice were bred with mice in which MR could be deleted specifically from SMCs by tamoxifen injection. The resulting atheroprone SMC-MR-KO mice were compared to their MR-Intact littermates after high fat diet (HFD) feeding for 8 or 16 weeks or normal diet for 12 months. Body weight, tail cuff blood pressure, heart and spleen weight, and serum levels of glucose, cholesterol, and aldosterone were measured for all mice at the end of the treatment period. Serial histologic sections of the aortic root were stained with Oil Red O to assess plaque size, lipid content, and necrotic core area; with PicroSirius Red for quantification of collagen content; by immunofluorescent staining with anti-Mac2/Galectin-3 and anti-smooth muscle α-actin antibodies to assess inflammation and SMC marker expression; and with Von Kossa stain to detect plaque calcification. In the 16-week HFD study, these analyses were also performed in sections from the brachiocephalic artery. Flow cytometry of cell suspensions derived from the aortic arch was also performed to quantify vascular inflammation after 8 and 16 weeks of HFD. Deletion of the MR specifically from SMCs did not significantly change plaque size, lipid content, necrotic core, collagen content, inflammatory staining, actin staining, or calcification, nor were there differences in the extent of vascular inflammation between MR-Intact and SMC-MR-KO mice in the three experiments. Conclusion: SMC-MR does not directly contribute to the formation, progression, or inflammation of atherosclerotic plaques in the ApoE−/− mouse model of atherosclerosis. This indicates that the MR in non-SMCs mediates the pro-atherogenic effects of MR activation.
Collapse
Affiliation(s)
- M Elizabeth Moss
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA, United States.,Department of Developmental, Molecular, and Chemical Biology, Sackler School of Graduate Biomedical Sciences, Tufts University School of Medicine, Boston, MA, United States
| | - Jennifer J DuPont
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA, United States
| | - Surabhi L Iyer
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA, United States
| | - Adam P McGraw
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA, United States
| | - Iris Z Jaffe
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA, United States.,Department of Developmental, Molecular, and Chemical Biology, Sackler School of Graduate Biomedical Sciences, Tufts University School of Medicine, Boston, MA, United States
| |
Collapse
|
10
|
Wang J, Su E, Wang H, Guo C, Lawrence DA, Eitzman DT. Traumatic Brain Injury Leads to Accelerated Atherosclerosis in Apolipoprotein E Deficient Mice. Sci Rep 2018; 8:5639. [PMID: 29618740 PMCID: PMC5884790 DOI: 10.1038/s41598-018-23959-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 03/21/2018] [Indexed: 01/04/2023] Open
Abstract
Traumatic brain injury (TBI) has been associated with atherosclerosis and cardiovascular mortality in humans. However the causal relationship between TBI and vascular disease is unclear. This study investigated the direct role of TBI on vascular disease using a murine model of atherosclerosis. Apolipoprotein E deficient mice were placed on a western diet beginning at 10 weeks of age. Induction of TBI or a sham operation was performed at 14 weeks of age and mice were sacrificed 6 weeks later at 20 weeks of age. MRI revealed evidence of uniform brain injury in all mice subjected to TBI. There were no differences in total cholesterol levels or blood pressure between the groups. Complete blood counts and flow cytometry analysis performed on peripheral blood 6 weeks following TBI revealed a higher percentage of Ly6C-high monocytes in mice subjected to TBI compared to sham-treated mice. Mice with TBI also showed elevated levels of plasma soluble E-selectin and bone marrow tyrosine hydroxylase. Analysis of atherosclerosis at the time of sacrifice revealed increased atherosclerosis with increased Ly6C/G immunostaining in TBI mice compared to sham-treated mice. In conclusion, progression of atherosclerosis is accelerated following TBI. Targeting inflammatory pathways in patients with TBI may reduce subsequent vascular complications.
Collapse
Affiliation(s)
- Jintao Wang
- University of Michigan, Department of Internal Medicine, Cardiovascular Research Center, Ann Arbor, Michigan, USA
| | - Enming Su
- University of Michigan, Department of Internal Medicine, Cardiovascular Research Center, Ann Arbor, Michigan, USA
| | - Hui Wang
- University of Michigan, Department of Internal Medicine, Cardiovascular Research Center, Ann Arbor, Michigan, USA
| | - Chiao Guo
- University of Michigan, Department of Internal Medicine, Cardiovascular Research Center, Ann Arbor, Michigan, USA
| | - Daniel A Lawrence
- University of Michigan, Department of Internal Medicine, Cardiovascular Research Center, Ann Arbor, Michigan, USA
| | - Daniel T Eitzman
- University of Michigan, Department of Internal Medicine, Cardiovascular Research Center, Ann Arbor, Michigan, USA.
| |
Collapse
|
11
|
Wang Q, Wang H, Wang J, Venugopal J, Kleiman K, Guo C, Sun Y, Eitzman DT. Angiotensin II-induced Hypertension is Reduced by Deficiency of P-selectin Glycoprotein Ligand-1. Sci Rep 2018; 8:3223. [PMID: 29459637 PMCID: PMC5818646 DOI: 10.1038/s41598-018-21588-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 02/07/2018] [Indexed: 12/31/2022] Open
Abstract
Identification of inflammatory mediators that regulate the vascular response to vasopressor molecules may aid in the development of novel therapeutic agents to treat or prevent hypertensive vascular diseases. Leukocytes have recently been shown to be capable of modifying blood pressure responses to vasopressor molecules. The purpose of this study was to test the hypothesis that deficiency of the leukocyte ligand, Psgl-1, would reduce the pressor response to angiotensin II (Ang II). Mice deficient in Psgl-1 (Psgl-1−/−) along with wild-type (WT) controls were treated for 2 weeks with a continuous infusion of Ang II. No differences in blood pressure between the groups were noted at baseline, however after 5 days of Ang II infusion, systolic blood pressures were higher in WT compared to Psgl-1−/− mice. The pressor response to acute administration of high dose Ang II was also attenuated in Psgl-1−/− compared to WT mice. Chimeric mice with hematopoietic deficiency of Psgl-1 similarly showed a reduced pressor response to Ang II. This effect was associated with reduced plasma interleukin-17 (IL-17) levels in Psgl-1−/− mice and the reduced pressor response was restored by administration of recombinant IL-17. In conclusion, hematopoietic deficiency of Psgl-1 attenuates Ang II-induced hypertension, an effect that may be mediated by reduced IL-17.
Collapse
Affiliation(s)
- Qian Wang
- Department of Cardiology, the First Hospital of China Medical University, Shenyang, China
| | - Hui Wang
- Department of Internal Medicine, Cardiovascular Research Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Jintao Wang
- Department of Internal Medicine, Cardiovascular Research Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Jessica Venugopal
- Department of Internal Medicine, Cardiovascular Research Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Kyle Kleiman
- Department of Internal Medicine, Cardiovascular Research Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Chiao Guo
- Department of Internal Medicine, Cardiovascular Research Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Yingxian Sun
- Department of Cardiology, the First Hospital of China Medical University, Shenyang, China
| | - Daniel T Eitzman
- Department of Internal Medicine, Cardiovascular Research Center, University of Michigan, Ann Arbor, Michigan, USA.
| |
Collapse
|
12
|
Hong MN, Li XD, Chen DR, Ruan CC, Xu JZ, Chen J, Wu YJ, Ma Y, Zhu DL, Gao PJ. Renal denervation attenuates aldosterone expression and associated cardiovascular pathophysiology in angiotensin II-induced hypertension. Oncotarget 2018; 7:67828-67840. [PMID: 27661131 PMCID: PMC5356522 DOI: 10.18632/oncotarget.12182] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/14/2016] [Indexed: 12/20/2022] Open
Abstract
The sympathetic nervous system interacts with the renin-angiotensin-aldosterone system (RAAS) contributing to cardiovascular diseases. In this study, we sought to determine if renal denervation (RDN) inhibits aldosterone expression and associated cardiovascular pathophysiological changes in angiotensin II (Ang II)-induced hypertension. Bilateral RDN or SHAM operation was performed before chronic 14-day Ang II subcutaneous infusion (200ng/kg/min) in male Sprague-Dawley rats. Bilateral RDN blunted Ang II-induced hypertension and ameliorated the mesenteric vascular dysfunction. Cardiovascular hypertrophy in response to Ang II was significantly attenuated by RDN as shown by histopathology and transthoracic echocardiography. Moreover, Ang II-induced vascular and myocardial inflammation and fibrosis were suppressed by RDN with concurrent decrease in fibronectin and collagen deposition, macrophage infiltration, and MCP-1 expression. Interestingly, RDN also inhibited Ang II-induced aldosterone expression in the plasma, kidney and heart. This was associated with the reduction of calcitonin gene-related peptide (CGRP) in the adrenal gland. Ang II promoted aldosterone secretion which was partly attenuated by CGRP in the adrenocortical cell line, suggesting a protective role of CGRP in this model. Activation of transforming growth factor-β (TGF-β)/Smad and mitogen-activated protein kinases (MAPKs) signaling pathway was both inhibited by RDN especially in the heart. These results suggest that the regulation of the renal sympathetic nerve in Ang II-induced hypertension and associated cardiovascular pathophysiological changes is likely mediated by aldosterone, with CGRP involvement.
Collapse
Affiliation(s)
- Mo-Na Hong
- Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Hypertension, Shanghai, China
| | - Xiao-Dong Li
- Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Hypertension, Shanghai, China.,Laboratory of Vascular Biology and Key Laboratory of Stem Cell Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong-Rui Chen
- Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Hypertension, Shanghai, China
| | - Cheng-Chao Ruan
- Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Hypertension, Shanghai, China.,Laboratory of Vascular Biology and Key Laboratory of Stem Cell Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian-Zhong Xu
- Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Hypertension, Shanghai, China
| | - Jing Chen
- Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Hypertension, Shanghai, China
| | - Yong-Jie Wu
- Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Hypertension, Shanghai, China
| | - Yu Ma
- Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Hypertension, Shanghai, China
| | - Ding-Liang Zhu
- Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Hypertension, Shanghai, China
| | - Ping-Jin Gao
- Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Hypertension, Shanghai, China.,Laboratory of Vascular Biology and Key Laboratory of Stem Cell Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
13
|
Yang Y, Chen C, Fu C, Xu Z, Lan C, Zeng Y, Chen Z, Jose PA, Zhang Y, Zeng C. Angiotensin II type 2 receptor inhibits expression and function of insulin receptor in rat renal proximal tubule cells. ACTA ACUST UNITED AC 2017; 12:135-145. [PMID: 29289466 DOI: 10.1016/j.jash.2017.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 11/08/2017] [Accepted: 11/25/2017] [Indexed: 11/28/2022]
Abstract
Both renin-angiotensin systems and insulin participate in kidney-involved blood pressure regulation. Activation of angiotensin II type 2 receptor (AT2R) decreases sodium reabsorption in renal proximal tubule (RPT) cells, whereas insulin produces the opposite effect. We presume that AT2R has an inhibitory effect on insulin receptor expression in RPT cells, which may affect renal sodium transport and therefore be of physiological or pathological significance. Our present study found that activation of AT2R inhibited insulin receptor expression in a concentration and time-dependent manner in RPT cells from Wistar-Kyoto (WKY) rats. In the presence of a protein kinase C (PKC) inhibitor (PKC inhibitor peptide 19-31, 10-6 mol/L) or a phosphatidylinositol 3 kinase inhibitor (wortmannin, 10-6 mol/L), the inhibitory effect of AT2R on insulin receptor was blocked, indicating that both PKC and phosphatidylinositol 3 kinase were involved in the signaling pathway. There was a linkage between AT2R and insulin receptor which was determined by both laser confocal microscopy and coimmunoprecipitation. However, the effect of AT2R activation on insulin receptor expression was different in RPT cells from spontaneously hypertensive rats (SHRs). Being contrary to the effect in WKY RPT cells, AT2R stimulation increased insulin receptor in SHR RPT cells. Insulin (10-7 mol/L, 15 minutes) enhanced Na+-K+-ATPase activity in both WKY and SHR RPT cells. Pretreatment with CGP42112 decreased the stimulatory effect of insulin on Na+-K+-ATPase activity in WKY RPT cells, whereas pretreatment with CGP42112 increased it in SHR RPT cells. It is suggested that activation of AT2R inhibits insulin receptor expression and function in RPT cells. The lost inhibitory effect of AT2R on insulin receptor expression may contribute to the pathophysiology of hypertension.
Collapse
Affiliation(s)
- Yang Yang
- Department of Cardiology, Chongqing Institute of Cardiology, Chongqing Cardiovascular Disease Clinical Research Center, Daping Hospital, The Third Military Medical University, Chongqing, P.R. China
| | - Caiyu Chen
- Department of Cardiology, Chongqing Institute of Cardiology, Chongqing Cardiovascular Disease Clinical Research Center, Daping Hospital, The Third Military Medical University, Chongqing, P.R. China
| | - Chunjiang Fu
- Department of Cardiology, Chongqing Institute of Cardiology, Chongqing Cardiovascular Disease Clinical Research Center, Daping Hospital, The Third Military Medical University, Chongqing, P.R. China
| | - Zaicheng Xu
- Department of Cardiology, Chongqing Institute of Cardiology, Chongqing Cardiovascular Disease Clinical Research Center, Daping Hospital, The Third Military Medical University, Chongqing, P.R. China
| | - Cong Lan
- Department of Cardiology, Chongqing Institute of Cardiology, Chongqing Cardiovascular Disease Clinical Research Center, Daping Hospital, The Third Military Medical University, Chongqing, P.R. China
| | - Yongchun Zeng
- Department of Cardiology, Chongqing Institute of Cardiology, Chongqing Cardiovascular Disease Clinical Research Center, Daping Hospital, The Third Military Medical University, Chongqing, P.R. China
| | - Zhi Chen
- Department of Cardiology, Chongqing Institute of Cardiology, Chongqing Cardiovascular Disease Clinical Research Center, Daping Hospital, The Third Military Medical University, Chongqing, P.R. China
| | - Pedro A Jose
- Division of Renal Disease & Hypertension, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Ye Zhang
- Department of Cardiology, Chongqing Institute of Cardiology, Chongqing Cardiovascular Disease Clinical Research Center, Daping Hospital, The Third Military Medical University, Chongqing, P.R. China.
| | - Chunyu Zeng
- Department of Cardiology, Chongqing Institute of Cardiology, Chongqing Cardiovascular Disease Clinical Research Center, Daping Hospital, The Third Military Medical University, Chongqing, P.R. China.
| |
Collapse
|
14
|
Wang Y, Lim K, Denton KM. Editorial: Function of Renal Sympathetic Nerves. Front Physiol 2017; 8:642. [PMID: 28894424 PMCID: PMC5581391 DOI: 10.3389/fphys.2017.00642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 08/15/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Yutang Wang
- School of Applied and Biomedical Science, Federation University AustraliaBallarat, VIC, Australia
| | - Kyungjoon Lim
- Neurophysiology, Department of Physiology, Anatomy and Microbiology, La Trobe UniversityMelbourne, VIC, Australia
| | - Kate M Denton
- Cardiovascular Disease Program, Department of Physiology, School of Biomedical Sciences, Monash Biomedicine Discovery Institute, Monash UniversityClayton, VIC, Australia
| |
Collapse
|
15
|
Wang Y, Dinh TN, Nield A, Krishna SM, Denton K, Golledge J. Renal Denervation Promotes Atherosclerosis in Hypertensive Apolipoprotein E-Deficient Mice Infused with Angiotensin II. Front Physiol 2017; 8:215. [PMID: 28450836 PMCID: PMC5390019 DOI: 10.3389/fphys.2017.00215] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 03/24/2017] [Indexed: 11/13/2022] Open
Abstract
Objective: To determine the effect of renal denervation (RDN) on the severity of atherosclerosis and aortic aneurysm in hypertensive mice. Methods: Hypertension, atherosclerosis and aortic aneurysm were induced by subcutaneous infusion of angiotensin II (1 μg/kg/min) for 28 days in apolipoprotein E-deficient mice. RDN was conducted using combined surgical and local chemical denervation. The norepinephrine concentration in the kidney was measured by high-performance liquid chromatography. Blood pressure was measured by the tail-cuff method. Atherosclerosis was assessed by Sudan IV staining of the aortic arch. The aortic diameter was measured by the morphometric method. The mRNA expression of genes associated with atherosclerosis and aortic aneurysm were analyzed by quantitative PCR. Results: RDN decreased the median norepinephrine content in the kidney by 93.4% (n = 5-7, P = 0.003) 5 days after the procedure, indicating that the RDN procedure was successful. RDN decreased systolic blood pressure in apolipoprotein E-deficient mice. Mice that had RDN had more severe aortic arch atherosclerosis (median percentage of Sudan IV positive area: 13.2% in control mice, n = 12, and 25.4% in mice having RDN, n = 12, P = 0.028). The severity of the atherosclerosis was negatively correlated with the renal norepinephrine content (spearman r = -0.6557, P = 0.005). RDN did not affect the size of aortic aneurysms formed or the incidence of aortic rupture in mice receiving angiotensin II. RDN significantly increased the aortic mRNA expression of matrix metalloproteinase-2 (MMP-2). Conclusion: RDN promoted atherosclerosis in apolipoprotein E-deficient mice infused with angiotensin II associated with upregulation of MMP-2. The higher MMP-2 expression could be the results of the greater amount of atheroma in the RDN mice. The findings suggest further research is needed to assess potentially deleterious effects of RDN in patients.
Collapse
Affiliation(s)
- Yutang Wang
- School of Applied and Biomedical Science, Federation University AustraliaBallarat, VIC, Australia.,The Vascular Biology Unit, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook UniversityTownsville, QLD, Australia
| | - Tam N Dinh
- School of Applied and Biomedical Science, Federation University AustraliaBallarat, VIC, Australia.,The Vascular Biology Unit, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook UniversityTownsville, QLD, Australia
| | - Alexander Nield
- School of Applied and Biomedical Science, Federation University AustraliaBallarat, VIC, Australia
| | - Smriti M Krishna
- The Vascular Biology Unit, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook UniversityTownsville, QLD, Australia
| | - Kate Denton
- Cardiovascular and Renal Physiology, Department of Physiology, Monash UniversityClayton, VIC, Australia
| | - Jonathan Golledge
- The Vascular Biology Unit, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook UniversityTownsville, QLD, Australia.,Department of Vascular and Endovascular Surgery, The Townsville HospitalTownsville, QLD, Australia
| |
Collapse
|
16
|
Hohl M, Linz D, Fries P, Müller A, Stroeder J, Urban D, Speer T, Geisel J, Hummel B, Laufs U, Schirmer SH, Böhm M, Mahfoud F. Modulation of the sympathetic nervous system by renal denervation prevents reduction of aortic distensibility in atherosclerosis prone ApoE-deficient rats. J Transl Med 2016; 14:167. [PMID: 27277003 PMCID: PMC4898354 DOI: 10.1186/s12967-016-0914-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 05/18/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Apolipoprotein E-deficient (ApoE(-/-)) rodents spontaneously develop severe hypercholesterolemia and increased aortic stiffness, both accepted risk factors for cardiovascular morbidity and mortality in humans. In patients with resistant hypertension renal denervation (RDN) may improve arterial stiffness, however the underlying mechanisms are incompletely understood. This study investigates the impact of RDN on aortic compliance in a novel atherosclerosis prone ApoE(-/-)-rat model. METHODS Normotensive, 8 weeks old ApoE(-/-) and Sprague-Dawley (SD) rats were subjected to bilateral surgical RDN (n = 6 per group) or sham operation (n = 5 per group) and fed with normal chow for 8 weeks. Compliance of the ascending aorta was assessed by magnetic resonance imaging. Vasomotor function was measured by aortic ring tension recordings. Aortic collagen content was quantified histologically and plasma aldosterone levels were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS After 8 weeks, ApoE(-/-)-sham demonstrated a 58 % decrease in aortic distensibility when compared with SD-sham (0.0051 ± 0.0011 vs. 0.0126 ± 0.0023 1/mmHg; p = 0.02). This was accompanied by an impaired endothelium-dependent relaxation of aortic rings and an increase in aortic medial fibrosis (17.87 ± 1.4 vs. 12.27 ± 1.1 %; p = 0.006). In ApoE(-/-)-rats, RDN prevented the reduction of aortic distensibility (0.0128 ± 0.002 vs. 0.0051 ± 0.0011 1/mmHg; p = 0.01), attenuated endothelial dysfunction, and decreased aortic medial collagen content (12.71 ± 1.3 vs. 17.87 ± 1.4 %; p = 0.01) as well as plasma aldosterone levels (136.33 ± 6.6 vs. 75.52 ± 8.4 pg/ml; p = 0.0003). Cardiac function and metabolic parameters such as hypercholesterolemia were not influenced by RDN. CONCLUSION ApoE(-/-)-rats spontaneously develop impaired vascular compliance. RDN improves aortic distensibility and attenuated endothelial dysfunction in ApoE(-/-)-rats. This was associated with a reduction in aortic fibrosis formation, and plasma aldosterone levels.
Collapse
Affiliation(s)
- Mathias Hohl
- />Klinik für Innere Medizin III, Universität des Saarlandes, 66421 Homburg/Saar, Germany
| | - Dominik Linz
- />Klinik für Innere Medizin III, Universität des Saarlandes, 66421 Homburg/Saar, Germany
| | - Peter Fries
- />Klinik für Diagnostische und Interventionelle Radiologie, Universität des Saarlandes, Homburg/Saar, Germany
| | - Andreas Müller
- />Klinik für Diagnostische und Interventionelle Radiologie, Universität des Saarlandes, Homburg/Saar, Germany
| | - Jonas Stroeder
- />Klinik für Diagnostische und Interventionelle Radiologie, Universität des Saarlandes, Homburg/Saar, Germany
| | - Daniel Urban
- />Klinik für Innere Medizin III, Universität des Saarlandes, 66421 Homburg/Saar, Germany
| | - Thimoteus Speer
- />Klinik für Innere Medizin IV, Universität des Saarlandes, Homburg/Saar, Germany
| | - Jürgen Geisel
- />Zentrallabor, Klinische Chemie und Laboratorium Medizin, Universität des Saarlandes, Homburg/Saar, Germany
| | - Björn Hummel
- />Institut für Klinische Hämostaseologie und Transfusionsmedizin, Universität des Saarlandes, Homburg/Saar, Germany
| | - Ulrich Laufs
- />Klinik für Innere Medizin III, Universität des Saarlandes, 66421 Homburg/Saar, Germany
| | - Stephan H. Schirmer
- />Klinik für Innere Medizin III, Universität des Saarlandes, 66421 Homburg/Saar, Germany
| | - Michael Böhm
- />Klinik für Innere Medizin III, Universität des Saarlandes, 66421 Homburg/Saar, Germany
| | - Felix Mahfoud
- />Klinik für Innere Medizin III, Universität des Saarlandes, 66421 Homburg/Saar, Germany
| |
Collapse
|
17
|
Affiliation(s)
- Rhian M Touyz
- From the Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom.
| |
Collapse
|
18
|
Rimoldi SF, Messerli FH, Bangalore S, Scherrer U. Resistant hypertension: what the cardiologist needs to know. Eur Heart J 2015; 36:2686-95. [PMID: 26261296 DOI: 10.1093/eurheartj/ehv392] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 07/27/2015] [Indexed: 12/23/2022] Open
Abstract
Treatment-resistant hypertension (TRH) affects between 3 and 30% of hypertensive patients, and its presence is associated with increased cardiovascular morbidity and mortality. Until recently, the interest on these patients has been limited, because providing care for them is difficult and often frustrating. However, the arrival of new treatment options [i.e. catheter-based renal denervation (RDN) and baroreceptor stimulation] has revitalized the interest in this topic. The very promising results of the initial uncontrolled studies on the blood pressure (BP)-lowering effect of RDN in TRH seemed to suggest that this intervention might represent an easy solution for a complex problem. However, subsequently, data from controlled studies have tempered the enthusiasm of the medical community (and the industry). Conversely, these new studies emphasized some seminal aspects on this topic: (i) the key role of 24 h ambulatory BP and arterial stiffness measurement to identify 'true' resistant patients; (ii) the high prevalence of secondary hypertension among this population; and (iii) the difficulty to identify those patients who may profit from device-based interventions. Accordingly, for those patients with documented TRH, the guidelines suggest to refer them to a hypertension specialist/centre in order to perform adequate work-up and treatment strategies. The aim of this review is to provide guidance for the cardiologist on how to identify patients with TRH and elucidate the prevailing underlying pathophysiological mechanism(s), to define a strategy for the identification of patients with TRH who may benefit from device-based interventions and discuss results and limitations of these interventions, and finally to briefly summarize the different drug-based treatment strategies.
Collapse
Affiliation(s)
- Stefano F Rimoldi
- Department of Cardiology and Clinical Research, University Hospital, Bern, Switzerland
| | - Franz H Messerli
- Department of Cardiology and Clinical Research, University Hospital, Bern, Switzerland Division of Cardiology, St Luke's-Roosevelt Hospital Center, New York, NY, USA
| | - Sripal Bangalore
- Division of Cardiology, St Luke's-Roosevelt Hospital Center, New York, NY, USA
| | - Urs Scherrer
- Department of Cardiology and Clinical Research, University Hospital, Bern, Switzerland Facultad de Ciencias, Departamento de Biología, Universidad de Tarapacá, Arica, Chile
| |
Collapse
|
19
|
Xiao L, Kirabo A, Wu J, Saleh MA, Zhu L, Wang F, Takahashi T, Loperena R, Foss JD, Mernaugh RL, Chen W, Roberts J, Osborn JW, Itani HA, Harrison DG. Renal Denervation Prevents Immune Cell Activation and Renal Inflammation in Angiotensin II-Induced Hypertension. Circ Res 2015; 117:547-57. [PMID: 26156232 DOI: 10.1161/circresaha.115.306010] [Citation(s) in RCA: 164] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Accepted: 07/08/2015] [Indexed: 02/06/2023]
Abstract
RATIONALE Inflammation and adaptive immunity play a crucial role in the development of hypertension. Angiotensin II and probably other hypertensive stimuli activate the central nervous system and promote T-cell activation and end-organ damage in peripheral tissues. OBJECTIVE To determine if renal sympathetic nerves mediate renal inflammation and T-cell activation in hypertension. METHODS AND RESULTS Bilateral renal denervation using phenol application to the renal arteries reduced renal norepinephrine levels and blunted angiotensin II-induced hypertension. Bilateral renal denervation also reduced inflammation, as reflected by decreased accumulation of total leukocytes, T cells, and both CD4+ and CD8+ T cells in the kidney. This was associated with a marked reduction in renal fibrosis, albuminuria, and nephrinuria. Unilateral renal denervation, which partly attenuated blood pressure, only reduced inflammation in the denervated kidney, suggesting that this effect is pressure independent. Angiotensin II also increased immunogenic isoketal-protein adducts in renal dendritic cells (DCs) and increased surface expression of costimulation markers and production of interleukin (IL)-1α, IL-1β, and IL-6 from splenic DCs. Norepinephrine also dose dependently stimulated isoketal formation in cultured DCs. Adoptive transfer of splenic DCs from angiotensin II-treated mice primed T-cell activation and hypertension in recipient mice. Renal denervation prevented these effects of hypertension on DCs. In contrast to these beneficial effects of ablating all renal nerves, renal afferent disruption with capsaicin had no effect on blood pressure or renal inflammation. CONCLUSIONS Renal sympathetic nerves contribute to DC activation, subsequent T-cell infiltration and end-organ damage in the kidney in the development of hypertension.
Collapse
Affiliation(s)
- Liang Xiao
- From the Department of Medicine, Divisions of Clinical Pharmacology (L.X., A.K., J.W., M.A.S., L.Z., W.C., J.R., H.A.I., D.G.H.) and Nephrology and Hypertension (T.T.), Departments of Radiology and Radiological Sciences (F.W.), Molecular Physiology and Biophysics (R.L.), and Biochemistry (R.L.M.), Vanderbilt University, Nashville, TN; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Dakahlia Governorate, Egypt (M.A.S.); and Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis (J.D.F., J.W.O.)
| | - Annet Kirabo
- From the Department of Medicine, Divisions of Clinical Pharmacology (L.X., A.K., J.W., M.A.S., L.Z., W.C., J.R., H.A.I., D.G.H.) and Nephrology and Hypertension (T.T.), Departments of Radiology and Radiological Sciences (F.W.), Molecular Physiology and Biophysics (R.L.), and Biochemistry (R.L.M.), Vanderbilt University, Nashville, TN; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Dakahlia Governorate, Egypt (M.A.S.); and Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis (J.D.F., J.W.O.)
| | - Jing Wu
- From the Department of Medicine, Divisions of Clinical Pharmacology (L.X., A.K., J.W., M.A.S., L.Z., W.C., J.R., H.A.I., D.G.H.) and Nephrology and Hypertension (T.T.), Departments of Radiology and Radiological Sciences (F.W.), Molecular Physiology and Biophysics (R.L.), and Biochemistry (R.L.M.), Vanderbilt University, Nashville, TN; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Dakahlia Governorate, Egypt (M.A.S.); and Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis (J.D.F., J.W.O.)
| | - Mohamed A Saleh
- From the Department of Medicine, Divisions of Clinical Pharmacology (L.X., A.K., J.W., M.A.S., L.Z., W.C., J.R., H.A.I., D.G.H.) and Nephrology and Hypertension (T.T.), Departments of Radiology and Radiological Sciences (F.W.), Molecular Physiology and Biophysics (R.L.), and Biochemistry (R.L.M.), Vanderbilt University, Nashville, TN; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Dakahlia Governorate, Egypt (M.A.S.); and Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis (J.D.F., J.W.O.)
| | - Linjue Zhu
- From the Department of Medicine, Divisions of Clinical Pharmacology (L.X., A.K., J.W., M.A.S., L.Z., W.C., J.R., H.A.I., D.G.H.) and Nephrology and Hypertension (T.T.), Departments of Radiology and Radiological Sciences (F.W.), Molecular Physiology and Biophysics (R.L.), and Biochemistry (R.L.M.), Vanderbilt University, Nashville, TN; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Dakahlia Governorate, Egypt (M.A.S.); and Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis (J.D.F., J.W.O.)
| | - Feng Wang
- From the Department of Medicine, Divisions of Clinical Pharmacology (L.X., A.K., J.W., M.A.S., L.Z., W.C., J.R., H.A.I., D.G.H.) and Nephrology and Hypertension (T.T.), Departments of Radiology and Radiological Sciences (F.W.), Molecular Physiology and Biophysics (R.L.), and Biochemistry (R.L.M.), Vanderbilt University, Nashville, TN; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Dakahlia Governorate, Egypt (M.A.S.); and Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis (J.D.F., J.W.O.)
| | - Takamune Takahashi
- From the Department of Medicine, Divisions of Clinical Pharmacology (L.X., A.K., J.W., M.A.S., L.Z., W.C., J.R., H.A.I., D.G.H.) and Nephrology and Hypertension (T.T.), Departments of Radiology and Radiological Sciences (F.W.), Molecular Physiology and Biophysics (R.L.), and Biochemistry (R.L.M.), Vanderbilt University, Nashville, TN; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Dakahlia Governorate, Egypt (M.A.S.); and Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis (J.D.F., J.W.O.)
| | - Roxana Loperena
- From the Department of Medicine, Divisions of Clinical Pharmacology (L.X., A.K., J.W., M.A.S., L.Z., W.C., J.R., H.A.I., D.G.H.) and Nephrology and Hypertension (T.T.), Departments of Radiology and Radiological Sciences (F.W.), Molecular Physiology and Biophysics (R.L.), and Biochemistry (R.L.M.), Vanderbilt University, Nashville, TN; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Dakahlia Governorate, Egypt (M.A.S.); and Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis (J.D.F., J.W.O.)
| | - Jason D Foss
- From the Department of Medicine, Divisions of Clinical Pharmacology (L.X., A.K., J.W., M.A.S., L.Z., W.C., J.R., H.A.I., D.G.H.) and Nephrology and Hypertension (T.T.), Departments of Radiology and Radiological Sciences (F.W.), Molecular Physiology and Biophysics (R.L.), and Biochemistry (R.L.M.), Vanderbilt University, Nashville, TN; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Dakahlia Governorate, Egypt (M.A.S.); and Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis (J.D.F., J.W.O.)
| | - Raymond L Mernaugh
- From the Department of Medicine, Divisions of Clinical Pharmacology (L.X., A.K., J.W., M.A.S., L.Z., W.C., J.R., H.A.I., D.G.H.) and Nephrology and Hypertension (T.T.), Departments of Radiology and Radiological Sciences (F.W.), Molecular Physiology and Biophysics (R.L.), and Biochemistry (R.L.M.), Vanderbilt University, Nashville, TN; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Dakahlia Governorate, Egypt (M.A.S.); and Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis (J.D.F., J.W.O.)
| | - Wei Chen
- From the Department of Medicine, Divisions of Clinical Pharmacology (L.X., A.K., J.W., M.A.S., L.Z., W.C., J.R., H.A.I., D.G.H.) and Nephrology and Hypertension (T.T.), Departments of Radiology and Radiological Sciences (F.W.), Molecular Physiology and Biophysics (R.L.), and Biochemistry (R.L.M.), Vanderbilt University, Nashville, TN; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Dakahlia Governorate, Egypt (M.A.S.); and Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis (J.D.F., J.W.O.)
| | - Jackson Roberts
- From the Department of Medicine, Divisions of Clinical Pharmacology (L.X., A.K., J.W., M.A.S., L.Z., W.C., J.R., H.A.I., D.G.H.) and Nephrology and Hypertension (T.T.), Departments of Radiology and Radiological Sciences (F.W.), Molecular Physiology and Biophysics (R.L.), and Biochemistry (R.L.M.), Vanderbilt University, Nashville, TN; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Dakahlia Governorate, Egypt (M.A.S.); and Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis (J.D.F., J.W.O.)
| | - John W Osborn
- From the Department of Medicine, Divisions of Clinical Pharmacology (L.X., A.K., J.W., M.A.S., L.Z., W.C., J.R., H.A.I., D.G.H.) and Nephrology and Hypertension (T.T.), Departments of Radiology and Radiological Sciences (F.W.), Molecular Physiology and Biophysics (R.L.), and Biochemistry (R.L.M.), Vanderbilt University, Nashville, TN; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Dakahlia Governorate, Egypt (M.A.S.); and Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis (J.D.F., J.W.O.)
| | - Hana A Itani
- From the Department of Medicine, Divisions of Clinical Pharmacology (L.X., A.K., J.W., M.A.S., L.Z., W.C., J.R., H.A.I., D.G.H.) and Nephrology and Hypertension (T.T.), Departments of Radiology and Radiological Sciences (F.W.), Molecular Physiology and Biophysics (R.L.), and Biochemistry (R.L.M.), Vanderbilt University, Nashville, TN; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Dakahlia Governorate, Egypt (M.A.S.); and Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis (J.D.F., J.W.O.)
| | - David G Harrison
- From the Department of Medicine, Divisions of Clinical Pharmacology (L.X., A.K., J.W., M.A.S., L.Z., W.C., J.R., H.A.I., D.G.H.) and Nephrology and Hypertension (T.T.), Departments of Radiology and Radiological Sciences (F.W.), Molecular Physiology and Biophysics (R.L.), and Biochemistry (R.L.M.), Vanderbilt University, Nashville, TN; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Dakahlia Governorate, Egypt (M.A.S.); and Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis (J.D.F., J.W.O.).
| |
Collapse
|